Surgery
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Randomized Controlled Trial Comparative Study
Comparison of expert instruction and computer-based video training in teaching fundamental surgical skills to medical students.
Practice using computer-based video instruction (CBVI) leads to improvements in surgical skills proficiency. This study investigated the benefits of the introduction of (a) learner-directed, interactive video training and (b) the addition of expert instruction on the learning and retention of the basic surgical skills of suturing and knot-tying in medical students. ⋯ This study shows that in surgical novices, neither the inclusion of expert instruction nor the addition of self-directed interaction with video leads to further improvements in skill development or retention. These findings further support the possible implementation of CBVI within surgical skills curricula.
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The physiologic response to surgical trauma promotes sodium and water retention AND weight gain owing to perioperative fluid loading increases morbidity SO perioperative fluid restriction should reduce postoperative complications after gastrointestinal surgery.
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A 35-year-old man attempted suicide by a shotgun discharge to his abdomen. Although the patient had been awake, oriented, and conversing about baseball during the emergency medical services ride to the hospital, he made no mention of his religious beliefs. He is bleeding profusely when he arrives at the emergency room (ER). ⋯ He has lost a critical amount of blood and is under anesthesia when a call to the OR comes from an ER nurse who has been approached by the patient's family and given a Jehovah's Witness card signed by the patient. The card states: "NO BLOOD TRANSFUSION. As a God-fearing Christian and a believer in Jehovah's word, the Bible, I hereby demand that blood, in any way, shape or form, is NOT to be fed into my body; however, blood substitutes may be used in case of extreme loss of blood."