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https://www.readbyqxmd.com/read/28219899/irrational-numbers-in-surgical-training
#1
Jonathan Glass
No abstract text is available yet for this article.
February 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28219677/nsqip-based-quality-improvement-curriculum-for-surgical-residents
#2
Mary M Mrdutt, Claire L Isbell, Justin L Regner, Bonnie R Hodges, Yolanda Munoz Maldonado, J Scott Thomas, Harry T Papaconstantinou
BACKGROUND: General surgery training has historically lacked a standardized approach to resident Quality Improvement (QI) education aside from traditional Morbidity and Mortality conference. In 2013, the Accreditation Council for Graduate Medical Education (ACGME) formalized QI as a component of residency training. Our residency chose the National Surgical Quality Improvement Program (NSQIP) Quality In-Training Initiative (QITI) as the foundation for our QI training. We hypothesized that a focused curriculum based on outcomes would produce change in culture and improve quality of patient care...
February 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28219086/first-report-of-awake-craniotomy-of-a-famous-musician-suprasellar-tumor-surgery-of-pianist-clara-haskil-in-1942
#3
Elena Romana Gasenzer, Ayhan Kanat, Edmund A M Neugebauer
Clara Haskil (January 7, 1895-December 7, 1960) was one of the most famous female pianists of the 20th century. In her life and work she set new standards in piano playing. However, her career was beset by poor health and the adversities of two world wars. In her lifetime Haskil had three major disorders: juvenile scoliosis requiring treatment in her adolescence, a tumor of the sellar region requiring surgery at age 47 years, and a traumatic brain injury causing her death at the age of 65. Her medical history illustrates the development of surgical methods and rehabilitation in medicine before and after World War II...
February 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28218561/scandcleft-randomised-trials-of-primary-surgery-for-unilateral-cleft-lip-and-palate-3-descriptive-study-of-postoperative-nursing-care-following-first-stage-cleft-closure
#4
Patricia Bannister, Nina Lindberg, Karin Jeppesen, Ulla Elfving-Little, Ann-Margritt Semmingsen, Anna Paganini, Annica Gustavsson, Emma Slevin, Gry Jacobsen, Phil Eyres, Gunvor Semb
BACKGROUND: Cleft lip and palate is one of the most common congenital anomalies requiring surgical treatment in children, normally commenced in the first year of life. Following the initiation of a group of multicentre surgical trials of primary surgery, variations in postoperative recovery and management became apparent. An agreement was made for a nurse-led survey in eight surgical centres to document postoperative care and recovery. MATERIALS AND METHODS: A postoperative recovery clinical report form was developed to capture relevant data for the children participating in the four arms of the trials...
February 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28216703/effects-of-avoiding-neuromuscular-blocking-agents-during-maintenance-of-anaesthesia-on-recovery-characteristics-in-patients-undergoing-craniotomy-for-supratentorial-lesions-a-randomised-controlled-study
#5
Ruchi A Jain, Anita N Shetty, Shrikanta P Oak, Anjana S Wajekar, Madhu B Garasia
BACKGROUND AND AIMS: Neuromuscular blocking agents have been one of the cornerstones of anaesthesia. With the advent of newer surgical, anaesthetic and neurological monitoring techniques, their utility in neuroanaesthesia practice seems dispensable. The aim of this prospective, comparative, randomised study was to determine whether neuromuscular blocking agents are required in patients undergoing supratentorial surgery when balanced anaesthesia with desflurane, dexmedetomidine and scalp block is used...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216519/study-of-preoperative-3d-ct-angiography-of-uterine-artery-in-patients-with-uterine-cervical-cancer
#6
Hitoshi Fujioka, Tomoyasu Kato, Miyuki Sone, Tatsuya Horita, Shunsuke Sugawara, Shinsuke Tsukagoshi
Depiction of the fine vessel can provide useful preoperative information for patients with uterine cervical cancer. Although angiography can visualize vessels in detail, it is invasive. MR-angiography is a minimally invasive method to depict vessels, but the resolution of images is insufficient for preoperative evaluation. In this study, we used less invasive three-dimensional CT angiography (3D-CTA) and reconstructed images of adaptive iterative dose resolution 3D (AIDR 3D) with display field of view (D-FOV), which are suitable for arteries with large and small diameters, and created the fusion images...
2017: Nihon Hoshasen Gijutsu Gakkai Zasshi
https://www.readbyqxmd.com/read/28215904/worldwide-survey-on-opinions-and-use-of-minimally-invasive-pancreatic-resection
#7
Jony van Hilst, Thijs de Rooij, Mohammed Abu Hilal, Horacio J Asbun, Jeffrey Barkun, Uggo Boggi, Olivier R Busch, Kevin C P Conlon, Marcel G Dijkgraaf, Ho-Seong Han, Paul D Hansen, Michael L Kendrick, Andre L Montagnini, Chinnusamy Palanivelu, Bård I Røsok, Shailesh V Shrikhande, Go Wakabayashi, Herbert J Zeh, Charles M Vollmer, David A Kooby, Marc G H Besselink
BACKGROUND: The introduction of minimally invasive pancreatic resection (MIPR) into surgical practice has been slow. The worldwide utilization of MIPR and attitude towards future perspectives of MIPR remains unknown. METHODS: An anonymous survey on MIPR was sent to the members of six international associations of Hepato-Pancreato-Biliary (HPB) surgery. RESULTS: The survey was completed by 435 surgeons from 50 countries, with each surgeon performing a median of 22 (IQR 12-40) pancreatic resections annually...
February 16, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28215494/2d-versus-3d-in-laparoscopic-surgery-by-beginners-and-experts-a-randomized-controlled-trial-on-a-pelvitrainer-in-objectively-graded-surgical-steps
#8
Johannes Spille, Antonia Wenners, Ulrike von Hehn, Nicolai Maass, Ulrich Pecks, Liselotte Mettler, Ibrahim Alkatout
BACKGROUND AND OBJECTIVE: Progress in endoscopic surgery in the past few decades has led to the application of 3-dimensional (3D) procedures in operating rooms. This permits patient- and surgeon-friendly operations and also maximizes the superiority of laparoscopy over laparotomy. In this study, we compare 2-dimensional (2D) and 3D endoscopy techniques with regard to time, efficiency, optics, and handling by users with different degrees of experience at 4 difficulty levels. DESIGN: A randomized controlled trial on a pelvitrainer in objectively graded surgical steps for students and postgraduates...
February 16, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28215039/impact-of-surgical-experience-on-management-and-outcome-of-pancreatic-surgery-performed-in-high-and-low-volume-centers
#9
Marco Stella, Massimiliano Bissolati, Daniele Gentile, Alessandro Arriciati
Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume...
February 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28211504/novel-preoperative-nomogram-for-prediction-of-futile-resection-in-patients-undergoing-exploration-for-potentially-resectable-intrahepatic-cholangiocarcinoma
#10
Kwangwoo Nam, Dae Wook Hwang, Ju Hyun Shim, Tae Jun Song, Sang Soo Lee, Dong-Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Ki-Hun Kim, Shin Hwang, Kwang-Min Park, Young-Joo Lee, Minkyu Han, Do Hyun Park
Surgical resection is the treatment of choice for intrahepatic cholangiocarcinoma (IHCC). However, discrepancies between preoperative workup and intraoperative findings can occur, resulting in unexpected and unfavorable surgical outcomes. The aim of this study was to develop a feasible preoperative nomogram to predict futile resection of IHCC. A total of 718 patients who underwent curative-intent surgery for IHCC between January 2005 and December 2014 were included. The patients were divided into a training cohort (2005-2010, n = 377) and validation cohort (2011-2014, n = 341)...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28210806/the-current-state-of-orthopaedic-residency-in-18-european-countries
#11
Rami Madanat, Tatu J Mäkinen, Daniel Ryan, Gazi Huri, Nikolaos Paschos, Joao Vide
PURPOSE: The aim of this study was to compare differences in current orthopaedic and trauma training programs across Europe. METHODS: A questionnaire was sent to the FORTE (Federation of Orthopaedic Trainees in Europe) representatives of 25 different European countries, of which 18 responded. The questionnaire included demographic information and information concerning the structure of the training programs, including duration, selection, and mandatory training requirements...
February 16, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28210793/a-national-population-based-cohort-study-of-urethral-injection-therapy-for-female-stress-and-mixed-urinary-incontinence-the-danish-urogynaecological-database-2007-2011
#12
Margrethe Foss Hansen, Gunnar Lose, Ulrik Schiøler Kesmodel, Kim Oren Gradel
INTRODUCTION AND HYPOTHESIS: Urethral injection therapy (UIT) has been performed since the early 20th century and a variety of agents have been launched. In 2006, polyacrylamide hydrogel (PAGH) was introduced and is now widely used as an agent. The objective was to evaluate the efficacy of PAGH based on a national population over a 5-year period (2007-2011) and the influence of patient-related factors, surgeon experience, and department volume. METHODS: A retrospective cohort study was carried out based on data from the Danish Urogynaecological Database (DugaBase)...
February 16, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28210649/predictive-surgical-reasons-for-failure-after-coracoid-process-transfers
#13
Gregory Gasbarro, Juan Marcelo Giugale, Gilles Walch, Albert Lin
BACKGROUND: Recurrent anterior shoulder instability after coracoid process transfers may be caused by trauma, sports injury, or technical failure of the index procedure. Surgical techniques vary with regard to graft orientation and positioning and number of screws utilized for fixation. PURPOSE: To identify surgical and patient-related factors associated with failure, defined as the need for revision surgery. We hypothesized that failures will occur more commonly with single-screw fixation and graft malposition...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28209451/assessment-of-operating-room-airflow-using-air-particle-counts-and-direct-observation-of-door-openings
#14
Jonathan Teter, Isabella Guajardo, Tamrah Al-Rammah, Gedge Rosson, Trish M Perl, Michele Manahan
BACKGROUND: The role of the operating room (OR) environment has been thought to contribute to surgical site infection rates. The quality of OR air, disruption of airflow, and other factors may increase contamination risks. We measured air particulate counts (APCs) to determine if they increased in relation to traffic, door opening, and other common activities. METHODS: During 1 week, we recorded APCs in 5-minute intervals and movement of health care workers. Trained observers recorded information about traffic, door openings, job title of the opener, and the reason for opening...
February 13, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28209417/influence-of-hospital-level-practice-patterns-on-variation-in-the-application-of-minimally-invasive-surgery-in-united-states-pediatric-patients
#15
Arianne T Train, Carroll M Harmon, David H Rothstein
BACKGROUND: Although disparities in access to minimally invasive surgery are thought to exist in pediatric surgical patients in the United States, hospital-level practice patterns have not been evaluated as a possible contributing factor. METHODS: Retrospective cohort study using the Kids' Inpatient Database, 2012. Odds ratios of undergoing a minimally invasive compared to open operation were calculated for six typical pediatric surgical operations after adjustment for multiple patient demographic and hospital-level variables...
February 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28207388/segmentation-of-pathological-structures-by-landmark-assisted-deformable-models
#16
Bulat Ibragimov, Robert Korez, Bostjan Likar, Franjo Pernus, Lei Xing, Tomaz Vrtovec
Computerized segmentation of pathological structures in medical images is challenging, as, in addition to unclear image boundaries, image artifacts and traces of surgical activities, the shape of pathological structures may be very different from the shape of normal structures. Even if a sufficient number of pathological training samples are collected, statistical shape modeling cannot always capture shape features of pathological samples as they may be suppressed by shape features of a considerably larger number of healthy samples...
February 13, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28206886/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#17
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28203537/robotic-cardiac-surgery-in-brazil
#18
Robinson Poffo, Alisson P Toschi, Renato B Pope, Paola K Montanhesi, Ricardo S Santos, Alexandre Teruya, Dina M Hatanaka, Gabriel F Rusca, Claudio H Fischer, Marcelo C Vieira, Marcia R Makdisse
BACKGROUND: Brazil, the largest country and economy in South America, is a major driving force behind the development of new medical technologies in the region. Robotic cardiac surgery (RCS) has been evolving rapidly since 2010, when the first surgery using the DaVinci(®) robotic system was performed in Latin America. The aim of this article is to evaluate short and mid-term results in patients undergoing robotic cardiac surgery in Brazil. METHODS: From March 2010 to December 2015, 39 consecutive patients underwent robotic cardiac surgery...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203253/the-use-of-laparoscopy-simulation-to-explore-gender-differences-in-resident-surgical-confidence
#19
Rebecca L Flyckt, Eliza E White, Linnea R Goodman, Catherine Mohr, Sanjeev Dutta, Kristine M Zanotti
Background. The objective of this study was to determine whether female surgical residents underestimate their surgical abilities relative to males on a standardized test of laparoscopic skill. Methods. Twenty-six male and female general surgery residents and 25 female obstetrics and gynecology residents at two academic centers were asked to predict their score prior to undergoing the Fundamentals of Laparoscopic Surgery standardized skills exam. Actual and predicted score as well as delta values (predicted score minus actual score) were compared between residents...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28203055/resident-surgeon-efficiency-in-femtosecond-laser-assisted-cataract-surgery
#20
Andrew C Pittner, Brian R Sullivan
PURPOSE: Comparison of resident surgeon performance efficiencies in femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification. PATIENTS AND METHODS: A retrospective cohort study was conducted on consecutive patients undergoing phacoemulsification cataract surgery performed by senior ophthalmology residents under the supervision of 1 attending physician during a 9-month period in a large Veterans Affairs medical center. Medical records were reviewed for demographic information, preoperative nucleus grade, femtosecond laser pretreatment, operative procedure times, total operating room times, and surgical complications...
2017: Clinical Ophthalmology
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