Archives of surgery (Chicago, Ill. : 1960)
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Comparative Study
Decreased bile duct injury rate during laparoscopic cholecystectomy in the era of the 80-hour resident workweek.
Considerable concern has been raised about the effects of restricted duty hours on surgical training. However, to our knowledge, the effect of the 80-hour resident workweek on operative outcomes after laparoscopic cholecystectomy has not been well studied. ⋯ At a major public teaching hospital, the bile duct injury rate and the overall complication rate decreased after implementation of the 80-hour workweek.
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Surgical trainees in the United States have a growing interest in both clinical experiences and structured training opportunities in global health. Global health training and exposure can be integrated into a surgical residency program. ⋯ Global health training and exposure for residents can be effectively integrated into an academic surgical residency program through relationships with training programs in low-income countries. Legitimate academic experiences improve the success of these programs. Reciprocity with collaborative partners must be ensured, and sustained commitment and funding remain a great challenge to such programs. The long-term effect on the development of global health careers is yet to be determined.
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Multimedia delivery of cognitive content paired with faculty-supervised partial task simulation for both excision of a simulated skin lesion with subsequent wound closure and hand-sewn bowel anastomosis would be an effective method for developing appropriate procedural skills among junior residents. ⋯ Junior resident surgical performance improved substantially with 4 hours of laboratory-based, faculty-supervised practice. Both first- and second-year residents benefited from this training. These data show that curriculum-driven, faculty-supervised instruction in a laboratory setting is beneficial in the training of junior surgical residents.
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Meta Analysis
Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy.
To compare outcomes following abdominal surgery with or without the use of chewing gum in the early postoperative period. ⋯ Chewing gum may enhance intestinal recovery following colectomy and reduce the length of hospital stay. Owing to the potential for substantial cost savings, larger-scale, blinded, randomized controlled trials with placebo arms are warranted.
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To determine whether age bias is a factor in triage errors. ⋯ Even when trauma is recognized and acknowledged by EMS, providers are consistently less likely to consider transporting elderly patients to a trauma center. Unconscious age bias, in both EMS in the field and receiving trauma center personnel, was identified as a possible cause.