Trauma bay virtual reality-A game changer for ATLS instruction and assessment.

Background: Medical educational research highlights the need for high-fidelity, multidisciplinary simulation training to teach complex decision-making skills, such as those taught in Advanced Trauma Life Support (ATLS). This approach is, however, expensive and time-intensive. Virtual reality (VR) education simulation may improve skill acquisition in a cost-effective and time-sensitive manner.

Preoperative Advance Care Planning for Older Adults Undergoing Major Abdominal Surgery.

Background: Advance care planning (ACP) is recommended for older patients undergoing surgery. ACP consists of creating advance directives (ADs), identifying surrogate decision makers (SDMs), and documenting goals of care. We identified factors associated with documentation of preoperative ACP to identify opportunities to optimize ACP for older surgical patients.

Perioperative Support in the Rural Surgery World.

Perioperative support in a rural surgical environment encompasses unique challenges but ultimately should not substantially differ from those in resource-rich, urban hospitals. Perioperative support can be divided into 5 different phases of care, each with their own resource needs and challenges. These phases include (1) preoperative phase, (2) immediate preoperative phase, (3) intraoperative phase, (4) postoperative phase, and (5) postdischarge phase.

Metabolic Syndrome in Commercial Truck Drivers: Prevalence, Associated Factors, and Comparison With the General Population.

Introduction: Commercial motor vehicle drivers, such as truck drivers, experience unique health, lifestyle, and occupational challenges directly associated with their profession.

Methods: All participants in this multistate cross-sectional study completed questionnaire measurements. Participants were categorized with metabolic syndrome (MetS) if they had at least three of the five modified criteria used in the joint scientific statement on metabolic syndrome.

Currarino syndrome presenting as a cerebrospinal fluid leak from the dermal sinus tract: case report.

Currarino syndrome is an autosomal dominant condition with variable expressivity and penetrance that is associated with several classic features: sacral dysgenesis, presacral mass, and/or anorectal anomalies. The authors present a unique case in which the patient's initial presentation was a CSF leak from a sinus tract. The sinus tract was identified and disconnected from the thecal sac, obliterating the anterior sacral meningocele.

Implementation of an academic half day in a vascular surgery residency program improves trainee and faculty satisfaction with surgical indications conference.

Background: The Accreditation Council for Graduate Medical Education mandates scheduled didactics for residency programs but allows flexibility in implementation. Work-hour restrictions, patient care duties, and operative schedules create barriers to attendance for surgical trainees. We explored vascular surgery trainees and faculty perceptions on trainees operative preparation and participation, and overall fund of knowledge after implementing an academic half day conference (AHD) schedule.

Misuse of statistics in surgical literature.

Statistical analyses are a key part of biomedical research. Traditionally surgical research has relied upon a few statistical methods for evaluation and interpretation of data to improve clinical practice. As research methods have increased in both rigor and complexity, statistical analyses and interpretation have fallen behind.

The Effects of Maternal Obesity on Neonates, Infants, Children, Adolescents, and Adults.

With the increasing prevalence of obesity, including among women of childbearing age, there is increasing concern regarding the short-term and long-term effects on the offspring of women who are overweight and obese. In this paper we report the results of our review of the recent literature suggesting important adverse short-term and long-term consequences of maternal obesity on their children.

Factors Associated With Truck Crashes in a Large Cross Section of Commercial Motor Vehicle Drivers.

Objective: This large, cross-sectional study calculated prevalence of disorders and assessed factors associated with self-reported lifetime crashes.

Methods: Truck drivers (n = 797) completed computerized questionnaires reporting crashes, demographics, psychosocial factors, and other elements, as well as had taken measurements (eg, height, weight, serum, and blood pressure).

Results: Most drivers were male (n = 685, 85.

ACOEM practice guidelines: elbow disorders.

Objective: The American College of Occupational and Environmental Medicine has updated the treatment guidelines in its Elbow Disorders chapter through revision processes begun in 2006. This abbreviated version of that chapter highlights some of the evidence and recommendations developed.

Methods: Comprehensive systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance.

Prospective evaluation of the use of the thrombolysis in myocardial infarction score as a risk stratification tool for chest pain patients admitted to an ED observation unit.

Background: The Thrombolysis in Myocardial Infarction (TIMI) score has shown use in predicting 30-day and 1-year outcomes in emergency department (ED) patients with potential acute coronary syndrome. Few studies have evaluated the TIMI score in risk stratifying patients selected for the ED observation Unit (EDOU). Risk stratification of patients in this group could identify those at risk for significant cardiac events.

Prospective evaluation of an ED observation unit protocol for trauma activation patients.

Background: The University of Utah emergency department (ED) observation unit (EDOU) cares for over 2500 patients each year, with a significant portion of these patients being trauma activation patients. We evaluated the safety and efficacy of our EDOU trauma protocol and described patient characteristics and outcomes of trauma patients managed in an EDOU.

Methods: We performed a prospective observational study of all trauma patients admitted to the EDOU over a 1-year period.