A&A practice
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Traditional systems of anesthesia evaluation do not routinely incorporate cognitive screening into preoperative assessments of vital organ systems. Increasing recognition of the importance of preoperative cognitive assessment of the elderly surgical patient has resulted in a "call to action" from experts in this area. ⋯ We describe our preliminary experience with developing a training program and implementing routine cognitive screening in a preoperative evaluation clinic. We outline a process showing our successful clinical implementation of sustainable cognitive stratification and documentation of routine cognitive screening.
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Case Reports
Nutcracker Syndrome-An Unusual Case of Chronic Left Upper Abdominal Pain: A Case Report.
A 38-year-old woman presented with a chief complaint of sharp, achy left upper abdominal pain with radiation to the left flank. This pain started approximately one-and-a-half years before she consulted with a pain specialist. ⋯ The patient was evaluated by an urologist and underwent renal autotransplantation. The patient subsequently had complete relief of her pain.
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A 68-year-old man was scheduled for mediastinal tumor resection. Aortic invasion was unclear on preoperative computed tomography. ⋯ An endovascular stent graft was placed in the distal arch to protect the aorta, but excessive bleeding occurred from the aortic defect on tumor removal. This case shows that massive hemorrhage can occur during the resection of an aorta-invading tumor despite the use of an endovascular stent graft.
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As a step toward understanding whether learning preferences may benefit trainees and instructors, we studied the learning preferences, based on the VARK questionnaire, of anesthesiology residents during their orientation month to determine whether knowing their preferences influenced the educational resources they used. While resource utilization was similar for residents who knew their preferences and those who did not, residents overall used aural and read/write resources frequently. The learning preferences of 13 residents (72.2%) changed during the month. While further research is needed, this study provides insight into anesthesiology residents' learning styles.