Isr Med Assoc J
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Nowadays more and more patients survive severe brain injury, whether due to traumatic or other causes, owing to the technological advances in medicine. Added to this is a better understanding of pathophysiologic processes, the quality and availability of emergency medicine, and increased medical knowledge in the field. ⋯ These changes in the levels of consciousness and function can also occur after very long periods of vegetative state. In our personal experience in the hospital, in 2004, 81% of patients in a post-traumatic vegetative state recovered some level of consciousness.
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Transport of hemodynamic unstable septic patients for diagnostic or therapeutic interventions outside the intensive care unit is complex but sometimes contributes to increasing the chance of survival. ⋯ Our data suggest that terlipressin is effective in septic shock. Because it is long-acting and necessitates less titration it might be indicated for patient transportation.
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The Israeli Board of Anesthesiology Examination Committee added a simulation-based Objective Structured Clinical Evaluation component to the board examination process. This addition was made in order to evaluate medical competence and considers certain domains that contribute to professionalism. This unique and new process needed to be validated. ⋯ The exam has gradually progressed from being an optional part of the oral board examination to a prerequisite component of this test. Other anesthesiology programs or medical professions can adopt the model described here.
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Recent data confirming the oncologic safety of laparoscopic colectomy for cancer as well as its potential benefits will likely motivate more surgeons to perform laparoscopic colorectal surgery. ⋯ There was a significant decrease in major complications after the first 50 laparoscopic colorectal procedures. Adequate oncologic resections may be achieved early in the learning curve. Right colectomies are less difficult to perform and are recommended as initial procedures.