Current surgery
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PURPOSE:To determine the role, organization, and importance of journal clubs in surgical education. Program directors of all general surgical residencies were asked to respond by mail to a structured survey containing questions about their journal club in the following general categories: Setting, Format, Content, and Purpose. With over 80% of the 278 program directors responding, the typical journal club was found to be one that meets once per month to discuss 3 to 6 articles. ⋯ Although journal clubs are active in over 65% of general surgery residency programs, little data exist on the purposes served by this aspect of resident training. The data provided by program directors in response to this survey will ideally serve as a starting point for discussion of how to maximize the benefits that residents receive from this part of their curriculum. Adoption of more formalized approaches to evaluating outcomes would assist in this process.
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PURPOSE:Patients admitted with the diagnosis of gastrointestinal bleeding at our institution typically undergo diagnostic/therapeutic endoscopy. Surgery is consulted and operative intervention considered when the patient has reached a 6-unit transfusion requirement for resuscitation. The purpose of this study is to examine the association between number of units transfused and clinical outcome in patients admitted for gastrointestinal hemorrhage. ⋯ Seven deaths (20%) occurred among the 35 patients, 3 of whom had received more than 6 units of blood. Patients admitted with gastrointestinal hemorrhage who require less than 6 units of blood may have a lower chance of dying (15%) than do patients requiring more than 6 units of blood (38%). Emergent surgical intervention, even in high-risk patients, can be safely performed.
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Description of a black widow spider (Latrodectus mactans) envenomation in a term pregnancy. Case report conducted at an Air Force tertiary care hospital of a 27-year-old primigravida at 38 1/7 weeks pregnancy. Latrodectus mactans antivenin can be given to treat symptoms of black widow envenomation. ⋯ If latrodectism is considered to be the underlying origin for these symptoms, appropriate treatment should be administered. In cases of pregnancy, treatment should include L. mactans antivenin if believed to be clinically indicated. There is no current evidence that this antivenin is contraindicated in pregnancy. (Curr Surg 57:346-348)