American journal of surgery
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Randomized Controlled Trial Clinical Trial
The effectiveness of video feedback in the acquisition of orthopedic technical skills.
The addition of video feedback to bench model training offers residents the opportunity to see themselves perform a surgical task. Videotaped feedback therefore promotes self-evaluation, a critical learning skill, and also has the potential to influence how a resident executes a skill once they have had the opportunity to see themselves perform the task. ⋯ This study failed to demonstrate an improvement in technical skills based on utilization of video feedback.
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Comparative Study
The role of central venous pressure and type of vascular control in blood loss during major liver resections.
Blood loss during liver resection constitutes the primary determinant of the postoperative outcome. Various techniques of vascular control and maintenance of a low central vein pressure (CVP) have been used in order to prevent intraoperative blood loss and postoperative complications. Our study aims at assessing the effects of different levels of CVP in relation to type of vascular control on perioperative blood loss and patient outcome. ⋯ Elevated CVP during major liver resections results in greater blood loss and a longer hospital stay. The Pringle maneuver with CVP 5 mm Hg or less is associated with blood loss not significantly different from that with SHVE. The latter, though, has been shown not to be affected by CVP levels and should be used whenever CVP remains high despite adequate anesthetic management.
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Review Comparative Study
Pathophysiologic changes and effects of hypothermia on outcome in elective surgery and trauma patients.
Generally, hypothermia is defined as a core temperature <35 degrees C. In elective surgery, induced hypothermia has beneficial effects. It is recommended to diminish complications attributable to ischemia reperfusion injury. ⋯ This might have a beneficial effect on outcome. Nevertheless, posttraumatic infectious complications may be higher because of an immunosuppressive profile. Further studies are needed to investigate the impact of induced hypothermia on outcome in trauma patients.
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Comparative Study
Admission characteristics of trauma patients in whom delirium develops.
The purpose of this study was to describe the admission characteristics of trauma victims that are predictive of the development of delirium during hospitalization. ⋯ Older patients and alcoholics are at increased risk for delirum. Therapies directed at prevention have the potential to improve care and decrease lengths of stay.
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Comparative Study
Value of repeat cranial computed axial tomography scanning in patients with minimal head injury.
Patients with minimal head injury (MHI) and a cranial computed axial tomography (CAT) scan positive for the presence of intracranial injury routinely undergo a repeat CAT scan within 24 hours after injury. The value of this repeat cranial CAT scan is unclear in those patients who are neurologically normal or improving. ⋯ A persistently normal or improving neurological examination in a patient with MHI appears to exclude the need for neurosurgical intervention and thus a repeat cranial CAT scan.