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Surgery AND residency

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https://www.readbyqxmd.com/read/29777842/nationally-representative-readmission-factors-in-patients-with-claudication-and-critical-limb-ischemia
#1
Rennier A Martinez, Michelle Shnayder, Joshua Parreco, Lukas Gaffney, Marcus Eby, Nicholas Cortolillo, Michael Lopez, Jack Zeltzer
INTRODUCTION: Hospital readmissions are not only associated with increased mortality, morbidity and costs but also, with current healthcare reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide Readmission Database (NRD) is the most comprehensive national source of readmission data, gathering discharge information from 22 geographically dispersed states, accounting for 51...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777356/visuospatial-abilities-and-fine-motor-experiences-influence-acquisition-and-maintenance-of-fundamentals-of-laparoscopic-surgery-fls-task-performance
#2
Cuan M Harrington, Patrick Dicker, Oscar Traynor, Dara O Kavanagh
BACKGROUND: Minimally invasive surgery poses a unique learning curve due to the requirement for non-intuitive psychomotor skills. The fundamentals of laparoscopic surgery (FLS) program trains and certifies residents in such skills. However, innate predictors of FLS performance and maintenance remain to be described. This single-centre observational study aimed to assess for candidate factors influencing the acquisition and maintenance of FLS performance amongst a surgically naïve cohort...
May 18, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#3
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29776428/evidence-of-the-impact-of-systemic-inflammation-on-neuroinflammation-from-a-non-bacterial-endotoxin-animal-model
#4
Chunxia Huang, Michael Garnet Irwin, Gordon Tin Chun Wong, Raymond Chuen Chung Chang
BACKGROUND: Systemic inflammation induces neuroinflammation and cellular changes such as tau phosphorylation to impair cognitive function, including learning and memory. This study uses a single model, laparotomy without any pathogen, to characterize these changes and their responses to anti-inflammatory treatment in the intermediate term. METHODS: In a two-part experiment, wild-type C57BL/6N mice (male, 3 month old, 25 ± 2 g) were subjected to sevoflurane anesthesia alone or to a laparotomy...
May 17, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29776419/introduction-of-national-guidelines-for-restrictive-blood-transfusion-threshold-for-hip-fracture-patients-a-consecutive-cohort-study-based-on-complete-follow-up-in-national-databases
#5
Bjarke Viberg, Per Hviid Gundtoft, Jesper Schønnemann, Lasse Pedersen, Lis Røhl Andersen, Kjell Titlestad, Carsten Fladmose Madsen, Jens Lauritsen, Søren Overgaard
BACKGROUND: Randomized controlled trials have demonstrated that a restrictive red blood cell (RBC) transfusion strategy lowers transfusion frequency without affecting mortality. However, the external validity of these trials has not been tested in a large cohort. The purpose was to estimate the effect of introducing a National Clinical Guideline (NCG) for a restrictive hemoglobin transfusion threshold on transfusion frequency and mortality in hip fracture patients > 65 years old...
May 18, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29775972/the-effect-on-performance-time-and-quality-of-the-knots-after-mono-or-bimanual-training-of-laparoscopic-intracorporeal-knot-tying-according-to-the-gladiator-rule-technique
#6
Fernanda de Almeida Asencio, Helizabet Abdala Salomão Ayroza Ribeiro, Armando Romeo, Arnauld Wattiez, Paulo Augusto Galvão Ayroza Ribeiro
OBJECTIVE:  To assess whether the monomanual or bimanual training of laparoscopic suture following the same technique may interfere with the knots' performance time and/or quality. METHODS:  A prospective observational study involving 41 resident students of gynecology/obstetrics and general surgery who attended a laparoscopic suture training for 2 days. The participants were divided into two groups. Group A performed the training using exclusively their dominant hand, and group B performed the training using both hands to tie the intracorporeal knot...
May 18, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29773409/correlation-of-objective-assessment-data-with-general-surgery-resident-in-training-evaluation-reports-and-operative-volumes
#7
Jad M Abdelsattar, Yazan N AlJamal, Raaj K Ruparel, Phillip G Rowse, Stephanie F Heller, David R Farley
OBJECTIVE: Faculty evaluations, ABSITE scores, and operative case volumes often tell little about true resident performance. We developed an objective structured clinical examination called the Surgical X-Games (5 rooms, 15 minutes each, 12-15 tests total, different for each postgraduate [PGY] level). We hypothesized that performance in X-Games will prove more useful in identifying areas of strength or weakness among general surgery (GS) residents than faculty evaluations, ABSITE scores, or operative cases volumes...
May 14, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29772881/geographic-access-to-radiation-therapy-facilities-and-disparities-of-early-stage-breast-cancer-treatment
#8
Yan Lin, Michael C Wimberly, Patricia Da Rosa, Joseph Hoover, William F Athas
Few studies of breast cancer treatment have focused on the Northern Plains of the United States, an area with a high mastectomy rate. This study examined the association between geographic access to radiation therapy facilities and receipt of breast cancer treatments among early-stage breast cancer patients in South Dakota. Based on 4,209 early-stage breast cancer patients diagnosed between 2001 and 2012 in South Dakota, the study measured geographic proximity to radiation therapy facilities using the shortest travel time for patients to the closest radiation therapy facility...
May 7, 2018: Geospatial Health
https://www.readbyqxmd.com/read/29771846/educational-exposure-to-transgender-patient-care-in-otolaryngology-training
#9
Benjamin B Massenburg, Shane D Morrison, Vania Rashidi, Craig Miller, David W Grant, Christopher S Crowe, Nathalia Velasquez, Justin R Shinn, Jacob E Kuperstock, Deepa J Galaiya, Scott R Chaiet, Amit D Bhrany
OBJECTIVE: Gender dysphoria is estimated to occur in over 1 million people in the United States. With decreasing stigma regarding the transgender population, it is likely more patients will seek medical and surgical gender transition as parts of their treatment. However, otolaryngologists may lack training in gender-confirming surgery. This study aims to determine the current state of transgender-related education in the United States otolaryngology training programs and to evaluate trainee perceptions regarding the importance of such training...
May 15, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29771369/building-the-burn-physician-workforce-for-the-21st-century-report-from-february-2014-burns-workforce-conference
#10
Amalia Cochran, David G Greenhalgh
American Burn Association Past President Palmer Q. Bessey, MD, orchestrated a Burn Workforce Conference in Washington, DC in February, 2014, with the goal of evaluating the workforce needs for doctors, nurses and occupational/physical therapists. This report summarizes the issues related to the need for training future surgeons to manage burn patients. General surgery and plastic surgery residents currently have minimal requirements for burn experience during their training. The respective Boards, however, do require knowledge in the management of burn care...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29769058/efficacy-of-standardized-training-on-a-virtual-reality-simulator-to-advance-knee-and-shoulder-arthroscopic-motor-skills
#11
Stefan Rahm, Karl Wieser, David E Bauer, Felix Wa Waibel, Dominik C Meyer, Christian Gerber, Sandro F Fucentese
BACKGROUND: Most studies demonstrated, that training on a virtual reality based arthroscopy simulator leads to an improvement of technical skills in orthopaedic surgery. However, how long and what kind of training is optimal for young residents is unknown. In this study we tested the efficacy of a standardized, competency based training protocol on a validated virtual reality based knee- and shoulder arthroscopy simulator. METHODS: Twenty residents and five experts in arthroscopy were included...
May 16, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29768730/biofilm-in-voice-prosthesis-a-prospective-cohort-study-and-laboratory-tests-using-sonication-and-sem-analysis
#12
Jacopo Galli, Lea Calo', Duino Meucci, Monica Giuliani, Daniela Lucidi, Gaetano Paludetti, Riccardo Torelli, Maurizio Sanguinetti, Claudio Parrilla
OBJECTIVE: The objective of the study was to compare the biofilm growing pattern and its morphological extent on silicone and a teflon-like material using a sonication process and a Scanning Electron Microscope (SEM). DESIGN: A prospective cohort study and a laboratory study. SETTING: Otolaryngology -Head and Neck surgery Department and the Microbiology Institute. PARTICIPANTS: The participants included fifteen laryngectomized patients with phonatory prostheses, which were removed due to device failure, and two different kinds of phonatory prostheses from the laboratory (Provox 2 and ActiValve) that were artificially colonized by Candida albicans...
May 16, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29767689/commentary-on-plastic-surgery-resident-run-cosmetic-clinics-a-survey-of-current-practices
#13
Ali A Qureshi, Marissa M Tenenbaum
No abstract text is available yet for this article.
May 14, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29765827/a-cross-sectional-survey-of-the-north-american-skull-base-society-current-practice-patterns-of-vestibular-schwannoma-evaluation-and-management-in-north-america
#14
Matthew L Carlson, Jamie J Van Gompel, R Mark Wiet, Nicole M Tombers, Anand K Devaiah, Devyani Lal, Jacques J Morcos, Michael J Link
Background  Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America. Methods  This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Results  A total of 57 completed surveys were returned. Most respondents claimed to have over 20 years of experience and the majority reported working in an academic practice with an affiliated otolaryngology and/or neurosurgery residency program...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29762189/orthopaedic-resident-surgical-case-log-disparities-observed-in-the-next-accreditation-system
#15
Jonathan H Payne, Chad A Krueger, Jessica C Rivera, Patrick M Osborn
INTRODUCTION: With the institution of the Next Accreditation System (NAS), case log procedures fundamentally changed. Unless multiple entries are made, only one procedure per case is credited for procedure counts. We hypothesized that the NAS caused notable changes in national procedure data. METHODS: Accreditation Council for Graduate Medical Education Orthopaedic Surgery Case Logs National Data Reports from 2008 to 2016 were analyzed to calculate differences in case log data before and after NAS implementation...
May 14, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29759280/overlapping-surgery-a-case-study-in-operating-room-throughput-and-efficiency
#16
REVIEW
Amanda J Morris, Joseph A Sanford, Edward J Damrose, Samuel H Wald, Bassam Kadry, Alex Macario
A keystone of operating room (OR) management is proper OR allocation to optimize access, safety, efficiency, and throughput. Access is important to surgeons, and overlapping surgery may increase patient access to surgeons with specialized skill sets and facilitate the training of medical students, residents, and fellows. Overlapping surgery is commonly performed in academic medical centers, although recent public scrutiny has raised debate about its safety, necessitating monitoring. This article introduces a system to monitor overlapping surgery, providing a surgeon-specific Key Performance Indicator, and discusses overlapping surgery as an approach toward OR management goals of efficiency and throughput...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29759029/burnout-in-otolaryngology-head-and-neck-surgery-a-single-academic-center-experience
#17
Katie Geelan-Hansen, Samantha Anne, Michael S Benninger
Burnout in modern medicine is becoming more recognized and researched. The objective in this study is to evaluate burnout in a tertiary care academic institution and compare results among faculty, trainees, and advanced practice practitioners (APPs) in a cross-sectional survey using the Maslach Burnout Inventory. Fifty-two surveys were distributed; 44 participants completed the survey (85%): 25 staff physicians (57%), 14 resident physicians (32%), and 5 nurse practitioners (11%). Staff physicians had low emotional exhaustion, moderate depersonalization, and low result for reduced personal accomplishments; trainees reported low emotional exhaustion, high depersonalization, and moderate reduced personal accomplishment; and nurse practitioners reported moderate on all 3 dimensions...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29750933/regional-thoracic-surgery-quality-collaboration-formation-providence-thoracic-surgery-initiative
#18
John R Handy, Kimberly Costas, Robert McKenna, Steven Nisco, Raymond Schaerf, Kenton Stephens, Eric Vallières, Kasia Konieczny, Roshanthi Weerasinghe, Mansen Wang, Katherine Lothrop, Cathy Betzer
BACKGROUND: Surgery quality initiatives improve clinical outcomes in cardiac and general surgery. No mature thoracic surgery (TS) regional effort has been described. METHODS: An intramural grant funded the Thoracic Surgery Initiative (TSI). Using professional organization, site specific administrative and clinical databases, surgeons performing TS across a large western health system were identified. Participants were recruited through stakeholder surveys, personal contact and meetings...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29749428/accumulation-of-cd69-tissue%C3%A2-resident-memory-t-cells-in-the-nasal-polyps-of-patients-with-chronic-rhinosinusitis
#19
Pascal Ickrath, Norbert Kleinsasser, Xin Ding, Christian Ginzkey, Niklas Beyersdorf, Rudolf Hagen, Thomas Kerkau, Stephan Hackenberg
In patients with chronic rhinosinusitis with nasal polyps (CRSwNP), a relative accumulation of cluster of differentiation (CD)8+ T cells over CD4+ T cells occurs in nasal polyps compared with the peripheral blood. Nasal CD8+ T cells and CD4+ T cells predominantly present an effector memory phenotype. Immunological studies have reported that memory T cells recirculate from the tissues to the peripheral blood and a high percentage of these T cells persist within the tissue. The aim of the present study was to characterize CD69+ sphingosine‑1‑phosphate receptor 1 (S1PR1)‑ tissue resident memory T cells (Trm) in the polyps of patients with CRSwNP...
May 2, 2018: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29748045/radiology-education-in-medical-school-and-residency-the-views-and-needs-of-program-directors
#20
Patrick T Schiller, Andrew W Phillips, Christopher M Straus
RATIONALE AND OBJECTIVES: The authors of this study used the perspectives of residency program directors (PDs) nationally to explore whether trainees are adequately prepared to utilize and interpret medical imaging as interns, to identify the types of imaging skills most important for residency, and to begin to address current shortcomings in radiology education. MATERIALS AND METHODS: The authors created a survey using a modified version of Accreditation Council for Graduate Medical Education radiology milestones and sent it to 100 randomly selected PDs each in pediatrics, internal medicine, obstetrics and gynecology, and general surgery...
May 7, 2018: Academic Radiology
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