Arch Surg Chicago
-
Patient-based outcomes, such as impaired quality of life (QOL) and depression, may adversely affect the clinical course of patients with peripheral arterial disease (PAD). Disease severity indices, including the ankle brachial index, are only partially associated with these outcomes. ⋯ Type-D personality independently predicted individual differences in impaired QOL and depressive symptoms in patients with PAD above and beyond ankle brachial index. It is important to account for personality when evaluating patient-based outcomes in the context of PAD.
-
Thrombolytic therapy will decrease the incidence of amputation when administered within 24 hours of exposure. ⋯ Tissue plasminogen activator improved tissue perfusion and reduced amputations when administered within 24 hours of injury. This modality represents the first clinically significant advancement in the treatment of frostbite in more than 25 years.
-
Comparative Study
Long-term outcomes in laparoscopic vs open ventral hernia repair.
To investigate whether there was a difference in morbidity, recurrence rate, and length of hospital stay between patients undergoing open or laparoscopic incisional hernia repair. ⋯ Outcomes did not differ with respect to recurrence rates after long-term follow-up; however, the lower rate of major morbidity and increased outpatient-based procedure rates favor laparoscopic repair in this study.
-
Surgery residents can learn continuous quality improvement (CQI) principles within a structured curriculum and propose quality improvement projects. ⋯ A structured CQI curriculum can be successfully integrated into a general surgery residency program. Residents can learn the skill of constructing CQI project ideas within the framework of the plan-do-study-act cycle. Residents are eager to make improvements in their local system of residency. By giving them the tools to critically investigate systems improvement and a much needed ear to hear their concerns and suggestions for improvement, we found ways to potentially enhance patient care and developed ideas to improve the education of future surgeons. In doing so, we provided the residents with "buy-in" into their residency program, while addressing the competency of practice-based learning and improvement required by the Accreditation Council for Graduate Medical Education for resident education.