The journal of trauma and acute care surgery
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This study was designed to define the gaps in essential and desirable (E/D) case volumes that may prompt reevaluation of the acute care surgery (ACS) curriculum or restructuring of the training provided. ⋯ The current ACS trainees lack adequate head/neck and pediatric experience as defined by the ACS curriculum. Restructuring rotations at individual institutions and a focus on novel educational modalities may be needed to augment the individual institutional exposure. Reevaluation of the curriculum may be warranted.
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Other than the Advanced Trauma Life Support course, usually run for postgraduate trainees, there are few trauma courses available for medical students. It has been shown that trauma teaching for medical students is sadly lacking within the undergraduate curriculum. We stated that students following formal teaching, even just theory and some practice in basic skills significantly improved their management of trauma patients. ⋯ We believe that students benefit substantially from the course and gain lasting skills and confidence in trauma management, decision making, and organizational skills. The course provides students with the opportunity to learn and ingrain trauma principles along Advanced Trauma Life Support guidelines and prepares them for practice as safe doctors. We advocate the global implementation of a student trauma training course as a mandatory educational initiative and propose our course format as a model for similar courses.
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J Trauma Acute Care Surg · Feb 2015
The impact of preexisting comorbidities on failure to rescue outcomes in nonelderly trauma patients.
Death after complication or "failure to rescue" (FTR) contributes to differences in risk-adjusted mortality rates among trauma centers and is considered an indicator of quality of care. Successful management of trauma patients requires not only appropriately responding to complications but also timely recognition of adverse events. Identifying associations between patient characteristics, such as the presence of comorbidities, and FTR outcomes can potentially improve early detection of complications and can reduce the risk of in-hospital mortality. ⋯ Prognostic study, level IV.
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J Trauma Acute Care Surg · Feb 2015
Inhibition of histone deacetylase 6 improves long-term survival in a lethal septic model.
We recently demonstrated that suberoylanilide hydroxamic acid, a broad-spectrum histone deacetylase (HDAC) inhibitor that inhibits HDACs 1, 2, 3, and 6, improves survival in a mouse model of cecal ligation and puncture (CLP)-induced lethal sepsis. The current study was undertaken to determine the effect of selective inhibition of HDAC isoform on survival, key cytokine production, organ injury, bacteria clearance, and cell apoptosis. ⋯ HDAC6 inhibition significantly improves survival, reduces "cytokine storm," attenuates acute livery injury, increases bacteria clearance and immune cell phagocytosis, and inhibits macrophage apoptosis in a lethal mouse CLP model.