Cir Cir
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Comparative Study
Self-estimation of surgical skills and competencies based on the learning curve theory in medical residents and fellows.
The aim was to explore how in-training junior physicians perceive their surgical performance compared with the one externally rated by their senior surgeon trainers, using a general learning curve model. ⋯ Nearly 51% of the residents/fellows included in some surgical specialty training program overestimated his/her actual performance as evaluated by classical learning curve categories. Underestimation of self-assessed performance was also observed in 17% of respondents. A better feedback from expert observers to in-training surgeons could result in a more accurate self-perception of their real surgical skills and competencies.
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Dog bite injuries represent an important public health problem, involving all levels of care. They can vary in severity, from superficial wounds (skin and subcutaneous tissue) to devitalization and tissue loss, with the presence of systemic infections, aestethic and functional sequels that require specialized treatment. ⋯ The right management of dog bite wounds in all the health care levels improve the patient prognosis. Complex dog bite wounds must be treated immediately by the plastic and reconstructive surgery department in second or third levels of healthcare. Most of the wounds can be managed by primary closure and other reconstructive techniques with confidence.
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Patients with bulky metastases of squamous cell carcinoma of the head and neck represent a challenge for the therapeutic decision; balance between oncological control and complications should be achieved. The therapeutic sequence has no impact on survival but sequelae. ⋯ The treatment of cervical metastasis depends on the possibility of resection. We should favor the initial surgery. The HPV is a factor of good prognosis.
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Review Case Reports
Case report of patient blood managment guided by rotational thromboelastometry in Mexico and literature review.
Thromboelastometry evaluates viscoelastic changes in the coagulation process. It offers a graphic representation of the formation of the coagulum, its stability and the presence of lysis. ⋯ The rotational thromboelastometry is a diagnostic tool that graphs the functionality of the clot, for a directed and individualized management of the coagulopathy associated with bleeding.
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Randomized Controlled Trial
Sonotherapy in the reduction of anxiety and postoperative pain in patients with regional anesthesia as a sole technique: randomized, controlled clinical trial.
To determine if sonotherapy reduces the anxiety level and postoperative pain in adults undergoing outpatient orthopedic surgery under regional anesthesia. ⋯ In adult patients undergoing outpatient orthopaedic surgery under regional anaesthesia, sound therapy is a novel strategy that significantly reduces systolic blood pressure, considered as an indicator of decreased anxiety. However, in our study, no difference could be demonstrated in terms of pain control or the need for additional sedation or analgesia.