Evaluating the Impact of Surgical Residents on Hospital Quality and Operational Metrics.

Objective: The purpose of this study is to conduct a follow up analysis comparing operational and quality measures of the pre-residency period with those of a mature program comprised of a full cohort of 15 residents, with 3 residents in each post graduate year (PGY) 1-5.

Design: A retrospective review of 25,900 surgeries performed by the general, breast, plastics, thoracic, and vascular services at a single regional medical center was performed and surgeries were classified as pre-residency period and residency period. Independent variables included patient demographics, comorbidity burden, emergency department arrivals, and outcomes of interest included daily elective case volume, the percent of cases performed during 'off-hours' (defined as 7p-7a), operating room (OR) and procedure minutes, average length of stay (LOS), average total hospital charges, rates of 30-day return to OR (ROR), ED visits, and readmissions, and patient satisfaction.

Gallbladder cancer presenting as hemobilia on capsule endoscopy.

Gallbladder adenocarcinoma is a rare gastrointestinal malignancy and is associated with a poor prognosis. These malignancies are most often discovered incidentally in [Formula: see text]1% of all cholecystectomy procedures. We report an 80-year-old male patient with iron deficiency anemia, who underwent an unremarkable endoscopy and colonoscopy, and was subsequently found to have hemobilia discovered on capsule endoscopy.

Environmental enrichment modulates inflammation during development in long-evans rats (Rattus norvegicus).

It is unknown whether increased production of pro-inflammatory mediators during the life span is caused by aging per se or via the combination of a cumulative allostatic load due to life challenges. This study aimed to investigate the long-term effects of stress and environmental enrichment on the inflammatory status associated with aging in rats. Animals were assigned to the following five treatment groups: chronic stress with and without environmental enrichment; acute stress with and without environmental enrichment; control animals.

Postpartum environmental challenges alter maternal responsiveness and offspring development.

Because many threats exist in an animal's natural habitat, it is important to understand the impact of environmental challenges on maternal-offspring interactions and outcomes. In the current study, a rodent model incorporating the presence of restricted resources and an environmental threat (e.g.

Immunomodulatory Effects of Stress and Environmental Enrichment in Long-Evans Rats ().

Stress can influence the secretion of neuroendocrine mediators, thereby exposing immune cells to altered signaling and interactions. Here we investigated the synergetic effect of stress and environmental enrichment on the immune response of Long-Evans rats. Subjects ( = 46) were assigned to 5 treatment groups: acute compared with chronic stress with or without environmental enrichment, plus an unmanipulated control group.