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https://www.readbyqxmd.com/read/28813585/association-of-general-surgery-resident-remediation-and-program-director-attitudes-with-resident-attrition
#1
Alexander C Schwed, Steven L Lee, Edgardo S Salcedo, Mark E Reeves, Kenji Inaba, Richard A Sidwell, Farin Amersi, Chandrakanth Are, Tracey D Arnell, Richard B Damewood, Daniel L Dent, Timothy Donahue, Jeffrey Gauvin, Thomas Hartranft, Garth R Jacobsen, Benjamin T Jarman, Marc L Melcher, John D Mellinger, Jon B Morris, Mark Nehler, Brian R Smith, Mary Wolfe, Amy H Kaji, Christian de Virgilio
Importance: Previous studies of resident attrition have variably included preliminary residents and likely overestimated categorical resident attrition. Whether program director attitudes affect attrition has been unclear. Objectives: To determine whether program director attitudes are associated with resident attrition and to measure the categorical resident attrition rate. Design, Setting, and Participants: This multicenter study surveyed 21 US program directors in general surgery about their opinions regarding resident education and attrition...
August 16, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28813172/rabbit-neutering-in-primary-care-education-insights-from-a-surgical-clinic
#2
Livia Benato, Jennifer Hammond
Involvement in canine and feline surgical neutering clinics is generally considered to be a key element of primary-care veterinary education, yet opportunities for veterinary students to develop their surgical skills with rabbit patients are uncommon. This is despite the fact that rabbits are currently estimated to be the third-most popular companion animal species and the fact that the British Small Animal Veterinary Association (BSAVA) recommends that all non-breeding rabbits be neutered soon after they attain sexual maturity...
August 16, 2017: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/28812196/convergent-validation-and-transfer-of-learning-studies-of-a-virtual-reality-based-pattern-cutting-simulator
#3
Arun Nemani, Woojin Ahn, Clairice Cooper, Steven Schwaitzberg, Suvranu De
INTRODUCTION: Research has clearly shown the benefits of surgical simulators to train laparoscopic motor skills required for positive patient outcomes. We have developed the Virtual Basic Laparoscopic Skill Trainer (VBLaST) that simulates tasks from the Fundamentals of Laparoscopic Surgery (FLS) curriculum. This study aims to show convergent validity of the VBLaST pattern cutting module via the CUSUM method to quantify learning curves along with motor skill transfer from simulation environments to ex vivo tissue samples...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28811593/prognostic-value-of-routine-laboratory-variables-in-prediction-of-breast-cancer-recurrence
#4
Zhu Zhu, Ling Li, Zhong Ye, Tong Fu, Ye Du, Aiping Shi, Di Wu, Ke Li, Yifan Zhu, Chun Wang, Zhimin Fan
The prognostic value of routine laboratory variables in breast cancer has been largely overlooked. Based on laboratory tests commonly performed in clinical practice, we aimed to develop a new model to predict disease free survival (DFS) after surgical removal of primary breast cancer. In a cohort of 1,596 breast cancer patients, we analyzed the associations of 33 laboratory variables with patient DFS. Based on 3 significant laboratory variables (hemoglobin, alkaline phosphatase, and international normalized ratio), together with important demographic and clinical variables, we developed a prognostic model, achieving the area under the curve of 0...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28810966/the-importance-of-medical-readiness-training-exercises-maintaining-medical-readiness-in-a-low-volume-combat-casualty-flow-era
#5
Kelly C Mead, David J Tennent, Daniel J Stinner
INTRODUCTION: Ringed external fixation has demonstrated promising results in the management of severe combat-related extremity injuries. The purpose of this study was to identify and compare rates of wartime-related surgical cases at times of high and low casualty time periods, and then compare these case numbers with those performed during a 2-week Medical Readiness Training Exercise (MEDRETE) in Honduras. MATERIALS AND METHODS: A retrospective review was performed of patients treated at a single Military Treatment Facility with definitive ringed external fixators during a 2-year period of high-volume combat casualty flow (January 2009-December 2010) and a subsequent 2-year period of low-volume combat casualty flow (January 2013-December 2014)...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810958/multispecialty-synchronous-telehealth-utilization-and-patient-satisfaction-within-regional-health-command-europe-a-readiness-and-recapture-system-for-health
#6
Kirk H Waibel, Steven M Cain, Todd E Hall, Ronald S Keen
BACKGROUND: Telehealth implementation within the Military Healthcare System continues to advance toward the goal of a mature regional health platform; however, specialty-specific usage or patient satisfaction regarding synchronous or "real-time" telehealth at the regional military hospital level has not been described. METHODS: A retrospective review of synchronous telehealth encounters and patient satisfaction surveys from Landstuhl Regional Medical Center (LRMC) specialty clinics engaging in synchronous telehealth to regional Army Health Clinics (AHCs) during 2015 was conducted...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28809594/evaluating-health-service-quality-using-importance-performance-analysis
#7
Azar Izadi, Younes Jahani, Sima Rafiei, Ali Masoud, Leila Vali
Purpose Measuring healthcare service quality provides an objective guide for managers and policy makers to improve their services and patient satisfaction. Consequently, the purpose of this paper is to measure service quality provided to surgical and medical inpatients at Kerman Medical Sciences University (KUMS) in 2015. Design/methodology/approach A descriptive-analytic study, using a cross-sectional method in the KUMS training hospitals, was implemented between October 2 and March 15, 2015. Using stratified random sampling, 268 patients were selected...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28809086/who-where-what-and-where-to-now-a-snapshot-of-publishing-patterns-in-australian-orthopaedic-surgery
#8
Nicholas Croker, Abhirup Lobo, Anne Croker, Zsolt J Balogh, David Dewar
BACKGROUND: Development of core research competency is a principle of orthopaedic surgical training in Australia. This paper aims to provide an objective snapshot of publications by Australian orthopaedic trainees and surgeons, to contribute to the discussion on how to identify and build on research capability in the Australian Orthopaedic Association (AOA). METHODS: By analysing journals with a journal impact factor >1 from 2009 to 2015, data were gathered to explore scientific journal publications by Australian orthopaedic surgeons and trainees in relation to who are the authors, what they are reporting and where they are publishing...
August 15, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28808622/radiation-exposure-and-reduction-in-the-operating-room-perspectives-and-future-directions-in-spine-surgery
#9
REVIEW
Ankur S Narain, Fady Y Hijji, Kelly H Yom, Krishna T Kudaravalli, Brittany E Haws, Kern Singh
Intraoperative imaging is vital for accurate placement of instrumentation in spine surgery. However, the use of biplanar fluoroscopy and other intraoperative imaging modalities is associated with the risk of significant radiation exposure in the patient, surgeon, and surgical staff. Radiation exposure in the form of ionizing radiation can lead to cellular damage via the induction of DNA lesions and the production of reactive oxygen species. These effects often result in cell death or genomic instability, leading to various radiation-associated pathologies including an increased risk of malignancy...
July 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28808603/aneurysm-treatment-practice-patterns-for-newly-appointed-dual-trained-cerebrovascular-endovascular-neurosurgeons-comparison-of-open-surgical-to-neuroendovascular-procedures-in-the-first-2-years-of-academic-practice
#10
Bowen Jiang, Matthew T Bender, Bima Hasjim, Frank P K Hsu, Rafael J Tamargo, Judy Huang, Geoffrey P Colby, Alexander L Coon, Li-Mei Lin
BACKGROUND: The practice patterns of a hybrid open cerebrovascular/neuroendovascular (CVNV) neurosurgeon in early academic practice is unknown. METHODS: We performed a multi-institutional retrospective cohort study of patients with cerebral aneurysms that were treated within the first 24 months of the neurosurgeon's practice. RESULTS: A total of 533 aneurysms were treated by the three senior authors within the first 24 months of their academic practice...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28807809/paraureteral-endometriosis-with-bilateral-gross-hydroureters-and-left-renal-compromise
#11
Arnaud Wattiez, Razan Nasir
Deep endometriosis is usually defined as endometriosis infiltrating the peritoneum by >5 mm. It sometimes involves the ureter causing hydronephrosis in 5% of cases. The latter is associated with 18% ureteral lesions. Ureteral endometriosis is one of the rare causes of silent Kidney failure. The ureter obstruction can lead to urinary tract obstruction, hydronephrosis and hydroureters. The ureters are usually compressed externally by the endometriotic lesions surrounding it causing extrinsic ureteral endometriosis, and sometimes by pressure from the bulky adenomyotic uterus with paraureteral fibrosis...
August 11, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28807248/tumor-model-for-surgical-simulation-to-assess-a-minimally-invasive-endoscopic-approach-for-midcheek-mass-removal
#12
Giovanni Dell' Aversana Orabona, Antonio Romano, Paola Bonavolontà, Vincenzo Abbate, Alfonso Manfuso, Giorgio Iaconetta, Bernhard Hirt, Luigi Califano
INTRODUCTION: The midcheek is considered one of the most important facial area due to its involvement in mimic expression and communication. Pathology of this district is complex due to the variety of soft tissue belonging to the face. We propose a surgical simulation, to assess the feasibility of a new minimally invasive endoscopic approach for midcheek mass removal. TECHNICAL REPORT: This study was performed on four cadavers, at the Anatomy Laboratory of the University of Tubingen...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28806982/software-guided-versus-nurse-directed-blood-glucose-control-in-critically-ill-patients-the-logic-2-multicenter-randomized-controlled-clinical-trial
#13
Dieter Mesotten, Jasperina Dubois, Tom Van Herpe, Roosmarijn T van Hooijdonk, Ruben Wouters, Domien Coart, Pieter Wouters, Aimé Van Assche, Guy Veraghtert, Bart De Moor, Joost Wauters, Alexander Wilmer, Marcus J Schultz, Greet Van den Berghe
BACKGROUND: Blood glucose control in the intensive care unit (ICU) has the potential to save lives. However, maintaining blood glucose concentrations within a chosen target range is difficult in clinical practice and holds risk of potentially harmful hypoglycemia. Clinically validated computer algorithms to guide insulin dosing by nurses have been advocated for better and safer blood glucose control. METHODS: We conducted an international, multicenter, randomized controlled trial involving 1550 adult, medical and surgical critically ill patients, requiring blood glucose control...
August 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28806538/surgical-safety-checklists-are-underutilized-in-ambulatory-oral-and-maxillofacial-surgery
#14
Archana Viswanath, Andras Balint, Robert E Johnson, Morton B Rosenberg, Daniel Oreadi
PURPOSE: The objective of this study was to determine attitudes toward and the prevalence of using a surgical safety checklist in ambulatory oral and maxillofacial surgery (OMS) practice. MATERIALS AND METHODS: The authors designed and implemented a cross-sectional study and enrolled a random sample of oral and maxillofacial surgeons. The predictor variable was years removed from residency. The primary outcome was the prevalence of surgical safety checklist usage in ambulatory OMS practice...
July 21, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28806470/efficacy-and-safety-of-sugammadex-versus-neostigmine-in-reversing-neuromuscular-blockade-in-adults
#15
REVIEW
Ana-Marija Hristovska, Patricia Duch, Mikkel Allingstrup, Arash Afshari
BACKGROUND: Acetylcholinesterase inhibitors, such as neostigmine, have traditionally been used for reversal of non-depolarizing neuromuscular blocking agents. However, these drugs have significant limitations, such as indirect mechanisms of reversal, limited and unpredictable efficacy, and undesirable autonomic responses. Sugammadex is a selective relaxant-binding agent specifically developed for rapid reversal of non-depolarizing neuromuscular blockade induced by rocuronium. Its potential clinical benefits include fast and predictable reversal of any degree of block, increased patient safety, reduced incidence of residual block on recovery, and more efficient use of healthcare resources...
August 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28806300/improving-benchmarks-for-global-surgery-nationwide-enumeration-of-operations-performed-in-ghana
#16
Adam Gyedu, Barclay Stewart, Cameron Gaskill, Godfred Boakye, Ebenezer Appiah-Denkyira, Peter Donkor, Ronald Maier, Robert Quansah, Charles Mock
OBJECTIVE: To evaluate the operation rate in Ghana and characterize it by types of procedures and hospital level. BACKGROUND: The Lancet Commission on Global Surgery recommended an annual rate of 5000 operations/100,000 people as a benchmark at which low- and middle-income countries could achieve most of the population-wide benefits of surgery, but did not define procedure-type benchmarks. METHODS: Data on operations performed from June 2014 to May 2015 were obtained from representative samples of 48 of 124 district-level (first-level) hospitals, 9 of 11 regional (referral) hospitals, and 3 of 5 tertiary hospitals, and scaled-up to nationwide estimates...
August 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28803176/an-easy-efficient-and-mobile-way-for-training-microsurgical-skills-during-busy-life-of-neurosurgical-residency-and-resource-challenged-environment
#17
Antti Huotarinen, Mika Niemelä, Behnam Rezai Jahromi
BACKGROUND: Residents life is more than hectic, it is hard to find place and time for training basic and advanced microsurgical skills. Surgical instruments, sutures can be purchased (or loaned from department) but the most expensive and space occupying device is microscope. In developing countries microscopes are used where the need is most; in operation rooms. Furthermore conventional microscope is not portable. For all mentioned reasons availability of microscope for training microsurgery is very limited...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28802786/transition-to-practice-a-global-surgery-approach
#18
Dustin K Donley, Cassandra K Graybill, Arega Fekadu, Tamara N Fitzgerald, Ryan A Hayton
OBJECTIVE: To determine the feasibility of a global surgery setting for a transition to practice experience. SETTING: A rural hospital in Malawi, Africa. PARTICIPANTS: A recent graduate of a U.S. general surgery residency program. RESULTS: Fellow performed 305 cases across the surgical disciplines with demonstrated improvements in operative ability. CONCLUSION: The global surgery approach to transition to practice offers a unique opportunity to complement domestic training while providing critical assistance to communities with few surgical providers...
August 9, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28802536/incidence-of-glove-perforation-during-hand-surgical-procedures
#19
Kevin F Lutsky, Christopher Jones, Jack Abboudi, William Kirkpatrick, Fred Liss, Charles Leinberry, Asif Ilyas, Dennis Martin, Pedro K Beredjiklian
PURPOSE: To determine the rate of glove perforation during hand surgery. METHODS: We prospectively examined the rate of glove perforations among 10 fellowship-trained hand surgeons at our institution during a 6 week period. Gloves were tested for perforation using a water-fill technique at the conclusion of each surgical procedure. Surgeons recorded the presence of any glove perforations. RESULTS: Eleven perforations were identified in 10 gloves among 600 surgical procedures during the study period...
August 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28802436/quantifying-the-cognitive-cost-of-laparo-endoscopic-single-site-surgeries-gaze-based-indices
#20
Leandro L Di Stasi, Carolina Díaz-Piedra, Juan Francisco Ruiz-Rabelo, Héctor Rieiro, Jose M Sanchez Carrion, Andrés Catena
BACKGROUND: Despite the growing interest concerning the laparo-endoscopic single-site surgery (LESS) procedure, LESS presents multiple difficulties and challenges that are likely to increase the surgeon's cognitive cost, in terms of both cognitive load and performance. Nevertheless, there is currently no objective index capable of assessing the surgeon cognitive cost while performing LESS. We assessed if gaze-based indices might offer unique and unbiased measures to quantify LESS complexity and its cognitive cost...
November 2017: Applied Ergonomics
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