The Journal of surgical research
-
This study was conducted to assess the efficacy of preoperative chemoradiation followed by transanal excision among patients with locally advanced lower rectal cancer. ⋯ Transanal excision after preoperative chemoradiation in highly-selected patients with locally advanced lower rectal cancer could probably be an acceptable alternative to conventional radical surgery. However, this approach should be prospectively validated, and strict patient selection criteria should be used.
-
The need for leadership training has become recognized as being highly important to improving medical care, and should be included in surgical resident education curriculums. ⋯ Areas of resident leadership strengths and weaknesses were identified. The Multifactor Leadership Questionnaire was demonstrated to be a valuable tool for identifying specific areas where leadership training would be most beneficial in the educational curriculum. The future use of this instrument could prove valuable to surgical education training programs.
-
To evaluate the scientific impact of women in the surgical literature. ⋯ Although women comprise a small proportion of principal investigators on abstracts presented at these conferences, the quality of their presented work is equal to or better than those of their male counterparts.
-
Comparative Study
Extracorporeal membrane oxygenation for cardiopulmonary failure in pediatric patients: is a second course justified?
Extracorporeal membrane oxygenation (ECMO) is accepted therapy for cardiorespiratory failure. Even after a successful ECMO course, patient deterioration may occur and a second course of ECMO may be contemplated. Although data regarding second ECMO courses exist in neonates, there are no reports describing second ECMO courses in pediatric patients. We hypothesized that data from a national ECMO registry would be useful in identifying which pediatric patients would be optimal candidates for a second course of ECMO. ⋯ ECMO therapy achieves 49% survival in children 1-18 years of age. When a second ECMO course becomes necessary, survival rates comparable to the first ECMO course are possible. Patients developing renal complications during their first ECMO course have worse outcome with a second ECMO course. Patients are at greater risk for complications during a second ECMO course if they experience a high number of first-run complications, are >3 years old, or undergo a prolonged second ECMO course. These data are useful when deciding whether to offer a second ECMO course to an eligible pediatric patient.
-
The purpose of this study was to determine if anemia in isolated head trauma patients results in a higher mortality rate that would justify a more liberal use of blood transfusions. ⋯ This study supports the need to balance mild anemia with judicious blood product use in the head trauma patient. Given the risk with blood product use, each transfusion should be carefully considered and the patient re-evaluated regularly to determine the need for further intervention.