Articles: surgery.
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Simulation is frequently cited as the ideal method to improve the training of health care professionals. Studies from specialties such as anesthesia and intensive care report that life-sized mannequins reliably measure acute care skills. Task trainers, such as laparoscopic simulators, effectively improve participants' ability to perform minimally invasive surgery. This review will chart the progress made in defining the role of simulation training in medical education. ⋯ Task trainers are recommended for training physicians for a number of minimally invasive procedures. Life-sized mannequins can be used to train residents to manage a range of critical events in a simulated setting. These exercises train residents to conduct a sequential, logical examination, perform various tasks, interpret clinical findings and use clinical reasoning to resolve the simulated crisis.
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Superior cluneal nerve (SCN) entrapment is one of the infrequent etiologies of low back pain (LBP), which is rarely diagnosed. Few clinical reports have been published in the literature. We present a case of severe LBP radiating to the ipsilateral buttock after decubitus surgery. ⋯ SCN entrapment should be considered in patients who suffer from LBP radiating to the iliac crest and buttock after other causes of LBP have been excluded.
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To evaluate the evidence regarding decisions made in the perioperative management of patients undergoing ambulatory surgery for the following: the elderly, hyper-reactive airways disease, coronary artery disease, diabetes, obesity, obstructive sleep apnea, the ex-premature infant and the child with an upper respiratory infection. ⋯ Evidence indicates that ambulatory anesthesia is currently very safe. Ambulatory surgery, however, is being offered to a population with increasing co-morbidity. As the population undergoing ambulatory surgery changes over time, the evidence regarding patient outcomes will need re-examination.
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Curr Opin Anaesthesiol · Dec 2005
Anesthetic management of the child with an upper respiratory tract infection.
The decision to proceed with anesthesia for the child with an upper respiratory tract infection is often difficult. Whereas most studies suggest that children who present for elective procedures with an upper respiratory tract infection are at increased risk of perioperative adverse events, these events are typically easy to recognize and treat. This review will discuss the current literature regarding outcome in children who present for elective surgery with an upper respiratory tract infection and suggests approaches to optimize their perioperative management. ⋯ An understanding of the risk factors associated with administering anesthesia to the child with an upper respiratory tract infection is important in identifying elements of the preoperative assessment that merit attention and in optimizing the anesthetic plan as a means to limit any perioperative complications.
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Journal of neurosurgery · Dec 2005
Prospective evaluation of surgical microscope-integrated intraoperative near-infrared indocyanine green videoangiography during aneurysm surgery.
The authors prospectively compared a new technique of surgical microscope-based indocyanine green (ICG) videoangiography with intraoperative or postoperative digital subtraction (DS) angiography. ⋯ Microscope-based ICG videoangiography is simple and provides real-time information about the patency of vessels of all sizes and about the aneurysm sac. This technique may be useful during routine aneurysm surgery as an independent form of angiography or as an adjunct to intra- or postoperative DS angiography.