SESC Practice Committee survey: surgical practice in the duty-hour restriction era.

Debate continues as to the relevance of Accreditation Council for Graduate Medical Education (ACGME) duty-hour restrictions in actual practice and the adequacy of resident training in surgery. A survey of the membership of the Southeastern Surgical Congress using an Internet-based questionnaire was conducted: adherence to duty-hour restrictions, evidence of sleepiness and fatigue, opinions regarding the training, and clinical performance of surgeons who had trained after the institution of duty-hour restrictions in 2003 (termed "recently trained surgeons"). One hundred seventy-seven members respondents out of 1008 (18%).

The first pediatric operation performed under anesthesia.

A number of articles and chapters in the pediatric anesthesia credit the first use of ether anesthesia to Crawford Long in an operation performed on an 8-year-old male slave. However, Long never gave the ages of any of his patients in any of his letters, articles, or communications. The 1840 and 1850 federal censuses give ages but no names for male slaves, two of whom are candidate patients.

Developing culturally congruent weight maintenance programs for African American church members.

Objectives: Developing community-based and culturally congruent weight loss maintenance programs is an important component of weight reduction interventions in high-risk populations. This qualitative investigation was conducted to guide development of faith-based weight maintenance programs for African American church members.

Design: Twenty African American church members who previously participated in a church-based group weight loss program were recruited to participate in focus groups.

Translation of the National Institutes of Health Diabetes Prevention Program in African American churches.

Objective: To translate the Diabetes Prevention Program (DPP) for delivery in African American churches.

Methods: Two churches participated in a 6-week church-based DPP and 3 churches participated in a 16-week church-based DPP, with follow-up at 6 and 12 months. The primary outcomes were changes in fasting glucose and weight.

Diabetes prevention in a faith-based setting: results of translational research.

Aim: The purpose of this study was to translate the National Institutes of Health (NIH)-Diabetes Prevention Program (DPP) into a church-based setting.

Methods: The lifestyle arm of the NIH-DPP was implemented in an African American Baptist church. Church members 18 years or older completed a risk screen during Sunday service followed by fasting glucose (FG) testing at the church during the week.

The effects of a patient-based risk assessment prompt on diabetes screening.

Objective: Previous research has determined that nurse-based diabetes risk assessment increases screening and preventive services for patients at risk for type 2 diabetes. This pilot study tested the impact of a diabetes risk assessment completed by patients without nursing assistance.

Research Design And Methods: Patients from a family medicine residency clinic completed an American Diabetes Association Risk Assessment questionnaire.

Placement of nasoenteral feeding tubes using external magnetic guidance.

Background: Enteral feeding is preferred over parenteral methods, and feeding into the duodenum is preferred over gastric feeding in certain groups of critically ill patients. However, with current techniques, feeding tubes often coil in the stomach, exposing patients to the risk of aspiration. This study investigated whether a nasoenteral feeding tube can be guided beyond the pyloric sphincter, using external magnetic guidance.

Accurate deployment of vena cava filters: comparison of intravascular ultrasound and contrast venography.

Background: The increasing use of vena cava filters by trauma surgeons has led to reports of filter placement using intravascular ultrasound (IVUS). Although attractive because of its ease of use and elimination of contrast and radiation, no studies have examined the accuracy of filter placement by IVUS as compared with contrast venography (CV). The purpose of this study was to compare the anatomic information obtained by both techniques during filter placement.

The successful surgical treatment of a paradoxical embolus to the carotid bifurcation.

Paradoxical embolism is a rare cause of ischemic stroke. We report the case of a 67-year-old man who had a saddle embolus to the carotid bifurcation successfully treated with emergency embolectomy. Transesophageal echocardiogram revealed a large patent foramen ovale and an easily demonstrable right-to-left shunt.

Medical consultation for the elderly patient with hip fracture.

Background: This article describes a family physician geriatrician's perspective on the comprehensive management of hip fracture in frail elderly patients. Primary care physicians might be called upon to provide medical consultation for these patients.

Methods: Guidelines were developed by a combination of personal experience in consulting for several hundred elderly patients with hip fracture at a large community hospital, literature review using the key words "hip fractures," "aged," and "aged, 80 and over," and educational presentations for family practice residents.

The effect of a physician assistant on the hospitalization of nursing home residents.

Objectives: To describe the impact of regular visits to a nursing home by a gerontologist physician assistant (PA) on the hospitalization and medical costs of patients.

Design: A 6-year case series (1992-1997) incorporating events before and after introduction of a PA in May 1994. The PA visited the nursing home 3 to 4 times per week, provided nearly all of the acute medical care, and alternated routine visits with supervising physicians.

Adhesion formation after intraperitoneal and extraperitoneal implantation of polypropylene mesh.

Polypropylene mesh is commonly used in open and laparoscopic hernia repairs. We tested the hypothesis that intra-abdominal adhesion formation secondary to polypropylene mesh is greater when mesh is placed in an intraperitoneal versus an extraperitoneal position. Fifty adult male rats underwent midline laparotomy with or without implantation of a nonabsorbable mesh.