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At least 253 records · Page 14Linked to original sources

PubMed1992

Learning objectives in training residents in general surgery in Kuwait.

An opinion survey of a five-year postgraduate training programme in general surgery was conducted using a questionnaire. The residents who responded indicated that the use of learning objectives needed to be given greater emphasis. They felt that learning objectives should be more clearly defined and be communicated with the learners and the instructors at an early stage in the programme. While the opportunity for learning theoretical concepts in surgery was rated as a strong feature of the programme, learning practical skills, it was pointed out, needed augmenting.

Curriculum↗

PubMed1984

[5 years' general drug prevention of thromboembolism in general surgery. Comparison of personal experiences with results from the literature].

Despite wide use of physical methods the number of fatal postoperative pulmonary embolisms in surgical patients increased in Kiel until 1976. Because of these results, additional general prophylaxis with 2-3 X 5000 i U of heparin-dihydroergotamine was introduced in 1978. The rate of fatal pulmonary embolism in general surgery proven by autopsy decreased to 0,3% between 1979 and 1983. It should be noted that six of the nine patients who died from pulmonary embolism had also suffered from an infaust disease. This is an excellent result since our study also includes high risk patients after emergency surgery, cases which Kakkar and Gruber did not include in their studies. Due to the extensive analysis of medical records and the pertinent post-mortem reports, the high effectivity of drug induced prophylaxis with 2-3 X 5000 i U of heparin-dihydroergotamine in order to reduce fatal pulmonary embolism in general surgery could be proven.

Adolescent↗

PubMed2001

Effects of surgical stress and nitrous oxide anaesthesia on peri-operative plasma levels of total homocysteine. A randomised, controlled study in general surgery.

Previous studies of patients have shown that anaesthesia with nitrous oxide (N2O) increases the plasma levels of total homocysteine. In a randomised, controlled trial we measured the plasma total homocysteine levels in patients undergoing general surgery before and after anaesthesia with and without N2O. Plasma total homocysteine levels were measured before anaesthesia and 1, 3-5 and 24 h after incision in 24 patients randomly allocated to anaesthesia with N2O (n = 12) and without N2O (n = 12). Total homocysteine levels significantly decreased from 10.4 +/- 2.7 to 8.2 +/- 2.9 micromol x l(-1) in the non-N2O group 24 h after incision (p < 0.02), while they tended to increase slightly in the N2O group from 10.5 +/- 4.5 to 10.9 +/- 4.3 micromol x l(-1) (p > 0.05). Our randomised controlled study indicates that total homocysteine decreases after general surgery in patients in whom anaesthesia is maintained without N2O, but not in patients in whom anaesthesia is maintained with N2O.

Adolescent↗

PubMed1996

Operative ultrasound in general surgery.

BACKGROUND: Since the introduction of real-time B-mode ultrasound during surgery almost 20 years ago, the use of operative ultrasound (OUS) has gradually expanded to a variety of surgical fields. METHODS: A review of the history, technology, and specific applications of OUS in general surgery is presented with our clinical results of over 2300 operations. RESULTS: The benefits provided by OUS are the acquisition of new information not otherwise available, complement to or replacement for operative radiography, confirmation of satisfactory completion of an operation, and guidance of surgical procedures. OUS possesses many advantages as an intraoperative tool, including safety, speed, unique imaging information, wide applicability, high accuracy and procedure guidance capability. CONCLUSION: OUS is gaining wider acceptance in hepatobiliary, pancreatic, endocrine, and vascular surgery. Newer OUS modalities-color Doppler imaging and laparoscopic ultrasound-potentially may widen the applications of OUS in general surgery.

Biliary Tract Diseases↗

PubMed2004

Trends in general surgery workforce data.

BACKGROUND: During the past 25 years, there has been much debate about general surgical workforce supply and demand. In the late 1970s and early 1980s, concern was raised by the Study on Surgical Services for the United States and the Graduate Medical Education National Advisory Council that there would be a gross oversupply of total physicians and surgeons by the years 1990 and 2000. DATA SOURCES: In a 1990 report sponsored by the Council on Graduate Medical Education, reevaluation of the workforce data showed no surplus at that time and instead predicted a deficit of surgeons by 2010. Studies by other investigators in the mid-1990s supported these conclusions. Furthermore, a new workforce model published in 2002 predicted a significant overall deficit of physicians by 2020. The discrepancies in the projected and the actual data have been explained by a variety of factors including an aging population with increased surgical needs, an increasing number of outpatient surgical procedures, subspecialization within the field of general surgery, and decreasing interest in the field by United States medical students. CONCLUSIONS: Although it is difficult to compare data among studies, and there are many confounding factors in the data, review of the workforce data does support a future deficit of surgeons, a prediction that warrants further investigation.

Career Choice↗

PubMedDate not supplied

Prophylaxis of fatal pulmonary embolism in general surgery using low-molecular weight heparin Cy 216: a multicentre, double-blind, randomized, controlled, clinical trial versus placebo (STEP). STEP-Study Group.

The effectiveness of low-molecular weight heparin CY 216 in the prophylaxis of fatal pulmonary embolism in patients undergoing general surgery was assessed in a multicentre, double-blind, randomized, clinical trial against placebo. A total of 4,498 patients aged over 40 undergoing general surgery were enrolled in the 18 centres which took part in the trial. Patients received a single daily subcutaneous injection of 7,500 anti-Xa units I.C. of CY 216 or placebo two hours before surgery, 12 hours after the initial injection and then daily for at least seven days. A post-mortem examination had to be carried out in every patient who died. The two groups of patients were well-matched for age, sex, type of disease, site and duration of operation as well as for incidence of risk factors which could predispose to the development of thromboembolism. Twenty-six deaths were recorded and validated: eight (0.36%) in the CY 216 group and 18 (0.80%) in the placebo group (p less than 0.05). At the post-mortem examination, carried out in 23 patients (88.5%), two deaths were found to be directly due to pulmonary embolism (0.09%) in the CY 216 group and four (0.18%) in the placebo group. Pulmonary embolism contributed to death in four other placebo-treated patients. Pulmonary or extrapulmonary thromboembolism was a significantly less frequent direct cause of death (p less than 0.05) in the CY 216 group (two pulmonary embolisms) than in the placebo group (four pulmonary embolisms, one acute myocardial infarction, one disseminated intravascular coagulation, two ischemic cerebral strokes).(ABSTRACT TRUNCATED AT 250 WORDS)

Double-Blind Method↗

PubMed1991