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https://www.readbyqxmd.com/read/27914844/the-july-effect-in-total-shoulder-arthroplasty
#1
Allison J Rao, Daniel D Bohl, Rachel M Frank, Gregory L Cvetanovich, Gregory P Nicholson, Anthony A Romeo
BACKGROUND: New medical doctors enter their residency fields in July, a time in the hospital in which patient morbidity and mortality rates are perceived to be higher. It remains controversial whether a "July effect" exists in different areas of medicine and surgery, including in orthopedic surgery. The purpose of this study is to test for the July effect in patients undergoing primary total shoulder arthroplasty (TSA). METHODS: Patients who underwent primary TSA from 2005-2012 were identified using the American College of Surgeons National Surgical Quality Improvement Program database...
November 30, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27913615/urban-rural-differences-in-cancer-directed-surgery-and-survival-of-patients-with-non-small-cell-lung-cancer
#2
Audrey Alforque Thomas, Alison Pearce, Ciaran O'Neill, Michal Molcho, Linda Sharp
BACKGROUND: Lung cancer is the leading cause of cancer death worldwide. Clinically appropriate cancer-directed surgery is an influential and significant prognostic factor. In a population-based study, we determined how urban/rural residence was related to surgery receipt for patients with non-small cell lung cancer. We assessed the relationship between relative survival and patients' area of residence, taking into account surgery receipt and area socioeconomic level. METHODS: We extracted data from the National Cancer Registry Ireland on patients with non-small cell lung cancer diagnosed during 1994-2011 and linked to area-level data on socioeconomic indicators and urban/rural categories...
December 2, 2016: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/27913069/otolaryngology-sleep-medicine-curriculum-objectives-as-determined-by-sleep-experts
#3
Nathan Cass, Alan Kominsky, Cristina Cabrera-Muffly
PURPOSE: (1) Ascertain the most important concepts and topics for otolaryngology resident education in sleep medicine and surgery, as determined by faculty who teach sleep medicine to otolaryngology residents. (2) Create learning objectives within the area of otolaryngologic sleep medicine in order to design a sleep medicine curriculum for otolaryngology residents. MATERIALS AND METHODS: Two web-based surveys were sent to 163 academic otolaryngologists who teach sleep medicine...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27911488/hepatocellular-carcinoma-as-an-emerging-morbidity-in-the-thalassemia-syndromes-a-comprehensive-review
#4
REVIEW
Hassan M Moukhadder, Racha Halawi, Maria Domenica Cappellini, Ali T Taher
The incidence of hepatocellular carcinoma (HCC) in patients with thalassemia is on the rise. The 2 well recognized HCC risk factors in thalassemia are iron overload and chronic viral infection with hepatitis C. The carcinogenicity of iron is related to its induction of oxidative damage, which results in genotoxicity, and to immunologic dysregulation, which attenuates cancer immune surveillance. Chronic hepatitis B and C infections lead to necroinflammation, which can prompt progression to HCC, but an independent role of hepatitis B virus in hepatic carcinogenesis among patients with thalassemia has not been demonstrated...
December 1, 2016: Cancer
https://www.readbyqxmd.com/read/27910052/a-needleless-liquid-jet-injection-delivery-approach-for-cardiac-gene-therapy
#5
Anthony S Fargnoli, Michael G Katz, Charles R Bridges
Fundamentally, cardiac gene therapy clinical trials have demonstrated that route efficiency is paramount in achieving maximum myocardial expression within safety limits. Gene transfer phenomena are largely influenced by physical transport principles (i.e., pressure, residence time, dispersion trafficking, mechanical resistance) that are independent of therapeutic characteristics. An alternative to intracoronary infusion methods, in an effort to improve efficiency in terms of cardiac specificity, is direct myocardial delivery via surgical injection...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27908638/using-the-acmge-milestones-as-a-handover-tool-from-medical-school-to-surgery-residency
#6
Lauren M Wancata, Helen Morgan, Gurjit Sandhu, Sally Santen, David T Hughes
OBJECTIVE: To map current medical school assessments for graduating students to the Accreditation Council for Graduate Medical Education (ACGME) milestones in general surgery, and to pass forward individual performance metrics on level 1 milestones to receiving residency programs. DESIGN: The study included 20 senior medical students who were accepted into surgery internship positions. Data from medical school performance assessments from the third-year surgery clerkship, fourth-year surgery rotations, fourth-year surgery boot camp, Clinical Competency Assessment Examination, and United States Medical Licensing Examination (USMLE) Step 1 and 2 examinations were used to map each student's competency assessments to the General Surgery Milestones based on a scoring system created and validated by independent assessors...
November 28, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27908501/prospective-evaluation-of-surgical-palliative-care-immersion-training-for-general-surgery-residents
#7
Mustafa Raoof, Lisa O'Neill, Leigh Neumayer, Mindy Fain, Robert Krouse
BACKGROUND: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. STUDY DESIGN: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework...
November 27, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27906805/predictors-of-positive-margins-at-time-of-loop-electrosurgical-excision-procedure
#8
Jill Liss, Meredith Alston, Mona B Krull, Sara E Mazzoni
OBJECTIVE: The aim of the study was to identify factors associated with the presence of high-grade squamous intraepithelial lesion (HSIL) at surgical margins of loop electrosurgical excision procedure (LEEP) pathology specimens. MATERIALS AND METHODS: All women evaluated for lower genital tract disease at a single academic institution were prospectively entered into a database. The database was queried for all women who had a LEEP performed for indications within contemporary American Society of Colposcopy and Cervical Pathology guidelines between April 1, 2013, and April 30, 2015...
November 30, 2016: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/27906761/surgical-education-and-health-care-reform-defining-the-role-and-value-of-trainees-in-an-evolving-medical-landscape
#9
Oluwadamilola M Fayanju, Reena Aggarwal, Rebeccah B Baucom, Cristina R Ferrone, David Massaro, Kyla P Terhune
OBJECTIVE: Health care reform and surgical education are often separated functionally. However, especially in surgery, where resident trainees often spend twice as much time in residency and fellowship than in undergraduate medical education, one must consider their contributions to health care. SUMMARY BACKGROUND DATA: In this short commentary, we briefly review the status of health care in the United States as well as some of the recent and current changes in graduate medical education that pertain to surgical trainees...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906760/improving-the-quality-of-ward-based-surgical-care-with-a-human-factors-intervention-bundle
#10
Maximilian J Johnston, Sonal Arora, Dominic King, Ara Darzi
OBJECTIVE: This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA: Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. METHODS: A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27905926/understanding-clinical-and-non-clinical-decisions-under-uncertainty-a-scenario-based-survey
#11
Vlad V Simianu, Margaret A Grounds, Susan L Joslyn, Jared E LeClerc, Anne P Ehlers, Nidhi Agrawal, Rafael Alfonso-Cristancho, Abraham D Flaxman, David R Flum
BACKGROUND: Prospect theory suggests that when faced with an uncertain outcome, people display loss aversion by preferring to risk a greater loss rather than incurring certain, lesser cost. Providing probability information improves decision making towards the economically optimal choice in these situations. Clinicians frequently make decisions when the outcome is uncertain, and loss aversion may influence choices. This study explores the extent to which prospect theory, loss aversion, and probability information in a non-clinical domain explains clinical decision making under uncertainty...
December 1, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27900775/pilot-testing-of-a-novel-surgical-simulator-for-endoscopic-zenker-s-diverticulotomy
#12
Nathan D Wiebracht, John P Giliberto, Charles Myer, Keith Casper, Kaalan E Johnson
OBJECTIVES/HYPOTHESIS: Restrictions on resident work hours and the increasing purview of otolaryngology reduce the efficacy of the traditional surgical training model. With limited case volumes at many institutions and the unique instrumentation of endoscopic Zenker's diverticulotomy (EZD), simulation may be useful to improve training. In this study, a novel surgical simulator for EZD is developed and validated. STUDY DESIGN: Simulation model development. METHODS: An EZD model was designed using an intubation trainer and disposable diverticulum inserts...
November 30, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27898160/haptic-feedback-improves-surgeons-user-experience-and-fracture-reduction-in-facial-trauma-simulation
#13
Sabine Girod, Sara C Schvartzman, Dyani Gaudilliere, Kenneth Salisbury, Rebeka Silva
Computer-assisted surgical (CAS) planning tools are available for craniofacial surgery, but are usually based on computer-aided design (CAD) tools that lack the ability to detect the collision of virtual objects (i.e., fractured bone segments). We developed a CAS system featuring a sense of touch (haptic) that enables surgeons to physically interact with individual, patient-specific anatomy and immerse in a three-dimensional virtual environment. In this study, we evaluated initial user experience with our novel system compared to an existing CAD system...
2016: Journal of Rehabilitation Research and Development
https://www.readbyqxmd.com/read/27897397/development-and-validation-of-a-septoplasty-training-model-using-3-dimensional-printing-technology
#14
Mahmoud A AlReefi, Lily H P Nguyen, Luc G Mongeau, Bassam Ul Haq, Siddharth Boyanapalli, Nauman Hafeez, Francois Cegarra-Escolano, Marc A Tewfik
BACKGROUND: Providing alternative training modalities may improve trainees' ability to perform septoplasty. Three-dimensional printing has been shown to be a powerful tool in surgical training. The objectives of this study were to explain the development of our 3-dimensional (3D) printed septoplasty training model, to assess its face and content validity, and to present evidence supporting its ability to distinguish between levels of surgical proficiency. METHODS: Imaging data of a patient with a nasal septal deviation was selected for printing...
November 29, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27896467/audit-of-geriatric-hip-fracture-care-a%C3%A2-slovenian-trauma-center-analysis
#15
Dejan Krušič, Drago Brilej, Colin Currie, Radko Komadina
BACKGROUND: The aim was to describe an audit of hip fracture patient care and outcomes in a Slovenian healthcare setting prior to the implementation of the Geriatric Fracture Center (GFC) model of care. METHODS: The Fragility Fracture Network (FFN) hip fracture audit database was used to collect data on hip fracture care in elderly patients. Epidemiological data were submitted as well as fracture type, prefracture residence and mobility prior to the fracture. The timeline of events and acute care data were also collected...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27894938/integrating-postoperative-feedback-into-workflow-perceived-practices-and-barriers
#16
Jay N Nathwani, Carly E Glarner, Katherine E Law, Robert J McDonald, Amy B Zelenski, Jacob A Greenberg, Eugene F Foley
OBJECTIVE: Previous studies have found that both resident and staff surgeons highly value postoperative feedback; and that such feedback has high educational value. However, little is known about how to consistently deliver this feedback. Our aim was to understand how often surgical residents should receive feedback and what barriers are preventing this from occurring. DESIGN: Surveys were distributed to resident and attending surgeons. Questions focused on the current frequency of postoperative feedback, desired frequency and methods of feedback, and perceived barriers...
November 25, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27893012/surgeons-and-trauma-care-physicians-perception-of-the-impact-of-the-globalization-of-medical-education-on-quality-of-care-in-lima-peru
#17
Lacey N LaGrone, Leah N Isquith-Dicker, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Alfredo Allagual, Fernando Revoredo, Charles N Mock
Importance: The globalization of medical education-the process by which trainees in any region gain access to international training (electronic or in-person)-is a growing trend. More data are needed to inform next steps in the responsible stewardship of this process, from the perspective of trainees and institutions at all income levels, and for use by national and international policymakers. Objective: To describe the impact of the globalization of medical education on surgical care in Peru from the perspective of Peruvian surgeons who received international training...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27890537/computational-fluid-dynamics-modeling-of-contrast-transport-in-basilar-aneurysms-following-flow-altering-surgeries
#18
Alireza Vali, Adib A Abla, Michael T Lawton, David Saloner, Vitaliy L Rayz
In vivo measurement of blood velocity fields and flow descriptors remains challenging due to image artifacts and limited resolution of current imaging methods; however, in vivo imaging data can be used to inform and validate patient-specific computational fluid dynamics (CFD) models. Image-based CFD can be particularly useful for planning surgical interventions in complicated cases such as fusiform aneurysms of the basilar artery, where it is crucial to alter pathological hemodynamics while preserving flow to the distal vasculature...
November 11, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27890330/assessing-surgical-residents-imaging-interpretation-skills
#19
Joseph J Eid, Francisco Igor B Macedo, Edsa Negussie, Vijay K Mittal
PURPOSE: During general surgery (GS) training, residents are expected to accurately interpret radiologic images. Objective evidence evaluating residents' ability to provide accurate interpretation of imaging studies is currently lacking. METHODS: A 30-item web-based test was developed using images from different radiologic modalities. Residents from 6 ACGME accredited GS programs participated. Residents from 1 radiology program served as a control group. RESULTS: 74 GS residents (GSR) enrolled in the online test...
November 19, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27889438/disparities-in-surgical-treatment-of-early-stage-breast-cancer-among-female-residents-of-texas-the-role-of-racial-residential-segregation
#20
Chinedum O Ojinnaka, Wen Luo, Marcia G Ory, Darcy McMaughan, Jane N Bolin
INTRODUCTION: Early-stage breast cancer can be surgically treated by using mastectomy or breast-conserving surgery and adjuvant radiotherapy, also known as breast-conserving therapy (BCT). Little is known about the association between racial residential segregation, year of diagnosis, and surgical treatment of early-stage breast cancer, and whether racial residential segregation influences the association between other demographic characteristics and disparities in surgical treatment...
October 19, 2016: Clinical Breast Cancer
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