Background: Access to surgical training is challenging for undergraduate and early postgraduate trainees due to a greater focus on developing generic knowledge and skills, and a drive to recruit greater numbers into internal medicine and primary care. COVID-19 accelerated the declining access to surgical training environments. Our aims were to: 1) establish the feasibility of an online, specialty-specific, case-based surgical training series, and 2) evaluate its suitability for meeting the needs of trainees.
Methods: A nationwide audience of undergraduate and early postgraduate trainees were invited to a series of bespoke online case-based educational meetings in Trauma & Orthopaedics (T&O) over a six month period. The six sessions, which simulated real-world clinical meetings, were constructed by Consultant sub-specialists and involved the presentation of cases by registrars, followed by structured discussion of basic principles, radiological interpretation, and management strategies. Mixed qualitative and quantitative analyses were conducted.
Results: There were 131 participants (59.5% male), consisting mostly of doctors in training (58%) and medical students (37.4%). The mean quality rating was 9.0/10 (SD 1.06), further supported by qualitative analysis. 98% enjoyed the sessions, 97% reported improved knowledge of T&O, and 94% reported a direct benefit to clinical practice. There was a significant improvement in knowledge of T&O conditions, management plans, and radiological interpretation (p = <0.05).
Conclusion: Structured virtual meetings, underpinned by bespoke clinical cases, may widen access to T&O training, increase flexibility and robustness of learning opportunities, and mitigate the effects of reduced exposure on preparation for surgical careers and recruitment.
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http://dx.doi.org/10.1016/j.surge.2023.02.005 | DOI Listing |
Nat Commun
December 2024
Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Glioblastoma is immunologically "cold" and resistant to single-agent immune-checkpoint inhibitors (ICI). Our previous study of neoadjuvant pembrolizumab in surgically-accessible recurrent glioblastoma identified a molecular signature of response to ICI and suggested that neoadjuvant pembrolizumab may improve survival. To increase the power of this observation, we enrolled an additional 25 patients with a primary endpoint of evaluating the cell cycle gene signature associated with neoadjuvant pembrolizumab and performed bulk-RNA seq on resected tumor tissue (NCT02852655).
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, United States.
Background: Despite advancements in valve implantation devices, vascular access complications (VAC) remain a significant cause of morbidity and mortality for those undergoing transcatheter aortic valve replacement (TAVR). We describe pre-operative imaging analysis of the aortoiliac and femoral arterial beds using the TransAtlantic intersociety consensus (TASC) score, ilio-femoral tortuosity, and procedural characteristics to identify anatomic risk factors predictive of VAC in TAVR.
Methods: Consecutive patients undergoing TAVR from 2012 to 2022 at a single North Dakota hospital were retrospectively reviewed.
Cureus
November 2024
Radiodiagnosis, MNR Medical College and Hospital, Sangareddy, IND.
Lymphangiomas are localized multi-cystic malformations of the lymphatic and vascular system, primarily affecting the head and neck regions in children. Orbital lymphangiomas are not considered hamartomas because the orbit does not commonly display lymphatic vessels. In this case report, we describe a male patient who was 15 years old and presented to our medical facility with the primary complaints of having a bulging left eye, sudden chemosis of the lower conjunctiva, and pain in the left eye.
View Article and Find Full Text PDFCureus
November 2024
Cardiology, Mount Sinai West Hospital, New York, USA.
The mechanism and severity of mitral valve (MV) regurgitation (MR) play a critical role in guiding treatment decisions. Transthoracic echocardiography (TTE) is the primary diagnostic modality for evaluating MV disease. Discordant findings on TTE can be further quantified through transesophageal echocardiography (TEE).
View Article and Find Full Text PDFCureus
November 2024
Accident and Emergency, Pilgrim Hospital, United Lincolnshire Hospitals Trust, Boston, GBR.
Epigastric pain and vomiting are common presentations associated with various causes of acute abdomen. Acute abdomen encompasses a range of different pathologies, with epigastric pain narrowing the differential diagnosis to conditions such as pancreatitis, bowel obstruction, acute cholecystitis, gastritis, acute coronary syndrome (ACS), and peptic ulcer disease, such as gastric ulcers and duodenal ulcers with/without perforation. This is a case of a male patient in his 80s who came to the emergency department with symptoms of generalized abdominal pain, vomiting, and constipation.
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