American journal of surgery
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Comparative Study
Perioperative atrial arrhythmias in noncardiothoracic patients: a review of risk factors and treatment strategies in the veteran population.
Perioperative atrial arrhythmias (PAAs) in noncardiothoracic patients have poorly defined risk factors and management. ⋯ Coronary artery disease, cardiomegaly, hypokalemia, and premature atrial contractions were significantly associated with PAAs in noncardiothoracic patients. Prospective studies are needed to define treatment guidelines.
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Comparative Study
Briefing guide study: preoperative briefing and postoperative debriefing checklists in the Veterans Health Administration medical team training program.
The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. ⋯ Checklist-driven preoperative briefings and postoperative debriefings are associated with improvements in patient safety for surgical patients.
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As we change with health care reform we must be faithful to our core values: tell our own story, get involved in surgical performance measures, and let our trainees see what we do and who we are through our actions and words.
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Comparative Study Clinical Trial
Structured teaching versus experiential learning of palliative care for surgical residents.
Previous end-of-life and palliative care curricula for surgical residents have shown improved learner confidence, but have not measured cognitive knowledge or skill acquisition. ⋯ Junior surgical residents have similar palliative care knowledge to senior residents without a palliative care curriculum. After participating in a palliative care curriculum, they have simulated skills that are similar to chief residents. However, self-confidence is lower among junior residents despite undergoing a palliative care curriculum.
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The microbiology of war wounds has changed as medicine and warfare have evolved. This study was designed to determine the microbial flora and bacterial quantification of present-day war wounds in US troops from Iraq and Afghanistan upon arrival at the National Naval Medical Center (NNMC). ⋯ Most soft-tissue wounds from Iraq and Afghanistan do not have significant bacterial burden upon arrival to and during initial treatment at NNMC. Improved evaluation of combat wound microbiology at all levels of care is warranted to determine shifts in microbiology and to impact care practices.