Journal of surgical education
-
Review Case Reports
Conservative management of retained cardiac missiles: case report and literature review.
Intracardiac foreign bodies may be caused by direct penetrating trauma, embolization from injury to another area of the body, or iatrogenically from fragments of intravascular access devices. Penetrating cardiac trauma commonly presents with a hemodynamically unstable patient necessitating emergent life-saving procedures. Missile embolization to the heart can occur after injury to systemic and pulmonary veins. ⋯ Additional imaging revealed a metallic fragment localized to the interatrial septum. The patient suffered no adverse sequelae from nonoperative management. A review of the world literature regarding the subject of posttraumatic retained cardiac missiles (RCMs) is also included to help future surgeons in the management of this rare entity.
-
To evaluate the tensile strength and suture degradation of 5 commonly used absorbable suture materials in different pH and bacteria inoculated media. ⋯ The Maxon suture showed greater suture tensile strength when compared with other sutures. The presence of pH and bacteria caused variable rates of suture degradation, but the result was not significant.
-
Over the past 10 years, a dramatic shift has occurred toward web-based applications and information dissemination both for medical students applying to residency programs and for current housestaff seeking specialty-specific information. This shift has been witnessed in urology with adoption of the Internet-based Electronic Residency Application Service for residency application submission. Currently, most residency programs devote significant attention to developing and maintaining an attractive web page, as studies have suggested departmental websites may impact applicants' decisions regarding residency preference lists.(1,2) Recently, some third-party websites have been established to provide information to medical students and residents in a variety of specialties. ⋯ UrologyMatch.com in the AUA match process. During the 2007-2008 urology residency match, we evaluated whether information disseminated through the website influenced medical students' decisions to enter the field of urology and whether this information factored into the generation of residency preference lists. We hypothesized that information on this website played a significant role in decision making throughout the urology residency match experience.
-
Case Reports
Diagnosis and surgical management of spontaneous hepatic rupture associated with HELLP syndrome.
Spontaneous hepatic rupture with hemoperitoneum is an uncommon but devastating complication of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. Although the syndrome has been considered a variant of preeclampsia/eclampsia, its pathogenesis is not completely understood. ⋯ This report describes 3 cases of extensive spontaneous hepatic rupture in pregnant women with HELLP syndrome. Early diagnosis and adequate tertiary management of this rare but life-threatening condition reduce the high maternal and newborn mortality.
-
Despite the stabilization of match rates, negative perceptions toward general surgery are still rife among medical students. The aim of this study was to describe the attitudes of fourth-year medical students towards general surgery at a regional level. ⋯ The results of this study suggested regional variations in the level of interest toward general surgery and that interest in the field among medical students in Nebraska may be higher than what has been reported nationally. Students who chose general surgery did so for personal reasons, which were independent of external factors. Recruitment efforts into the field should be focused on those students who choose non-general surgery careers and on rectifying the negative influences that steered them away from the field.