The Journal of surgical research
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FTY720, a sphingosine-1-phosphate (S1P) receptor agonist, possesses potent anti-inflammation capacity. We evaluated the therapeutic potentials of FTY720 against testicular injury induced by testicular torsion and/or detorsion (T/D). ⋯ FTY720 significantly mitigated testicular injury induced by testicular T/D. The mechanisms may involve activating the S1P receptors.
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Assessment of interpersonal and psychosocial competencies during end-of-life care training is essential. This study reports the relationship between simulation-based end-of-life care Objective Structured Clinical Examination ratings and communication skills, trust, and self-assessed empathy along with the perceptions of students regarding their training experiences. ⋯ We found that simulation-based OSCE training in palliative and end-of-life care can be effectively conducted during a surgery clerkship. Moreover, the standardized patient encounters combined with the formal assessment of communication skills, physician trust, and empathy provide feedback to students at an early phase of their professional life. The positive and appreciative comments of students regarding the opportunity to practice difficult patient conversations suggest that attention to these professional characteristics and skills is a valued element of clinical training and conceivably a step toward better patient outcomes and satisfaction.
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Our purpose was to analyze modern major vascular injury (MVI) patterns in pediatric trauma, interventions performed, and outcomes at a level 1 trauma center. ⋯ MVI in children more commonly results from firearm-related injury. The mortality rate associated with MVI is profoundly higher than that of the overall pediatric trauma population. These findings underscore the major public health concern of firearm-related injury in children.
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Considerable debate exists regarding the definition, skill set, and training requirements for the new specialty of acute care surgery (ACS). We hypothesized that a patient subset could be identified that requires a level of care beyond general surgical training and justifies creation of this new specialty. ⋯ ACS and EGS patients represent distinct patient cohorts, as reflected by significant differences in critical care needs, likelihood of multiple operations, and need for postdischarge rehabilitation. The skills required to care for ACS patients, including ability to rescue from complications and provide critical care, differ from those required for EGS patients and supports development of ACS training and regionalization of care.
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Previous studies have demonstrated that ultrasonographic measurement of the inferior vena cava diameter is a useful tool for the evaluation of intravascular volume status in preoperative patients. However, ultrasonographic measurement of inferior vena cava diameter could be limited by factors including obesity, bowel gas, or complex abdominal wounds. Our study sought to determine whether subclavian vein (SCV) diameter measured by ultrasound correlate with central venous pressure (CVP), as another indicator of intravascular volume status in patients undergoing gastrointestinal surgery. ⋯ SCV diameter is consistently low in patients undergoing gastrointestinal surgery as compared with healthy subjects. Measuring the SCV diameter maybe an important addition to the ultrasonographic evaluation of hypovolemia and other potentially volume-depleted patients.