Monahanmalik1175

PURPOSE We attempted to adopt quantitative methods to precisely evaluate the surgical effect of sagittal fractures of mandibular condyle (SFMCs) and aimed to determine differences in postoperative results between different groups of patients. MATERIALS AND METHODS Postoperative data of patients with SFMC were collected and quantitative evaluations of subjective, clinical and imaging results were performed. SPSS software was used to analyze the data, and certain factors (gender, age, unilateral or bilateral SFMCs, injury time) were analyzed by univariate analysis. RESULTS Forty-four postoperative patients were included with an average follow-up of 15.7 months. Averages of resting pain, moving pain, and chewing pain were all 2 weeks). Patients with unilateral SFMC showed greater protrusive movement and higher condylar index than those with bilateral SFMCs. CONCLUSION Most patients with SFMCs could obtain good subjective, clinical and imaging results by appropriate surgical treatment. Early surgery could improve postoperative outcomes. Post-transplant lymphoproliferative disease (PTLD) is a clinicopathologic entity characterized by an abnormal lymphocytic proliferation that occurs in immunosuppressed patients following organ transplantation. Several sites in the head and neck may be affected by PTLD with rare involvement of the larynx. Affected patients often present with symptoms and signs suggestive of a malignant lesion. Early diagnosis using histopathologic examination is paramount to prevent life-threatening airway compromise. The authors of this manuscript report a 52-year-old women, diagnosed case of renal failure for which she had undergone kidney transplant, who presented with symptoms of laryngeal PTLD. The clinical work-up and management of these cases is reviewed. BACKGROUND Feedback (FB) regarding perioperative care is essential in general surgery residents' (GSRs) training. We hypothesized that FB would be distributed unevenly across preoperative (PrO), intraoperative (IO), and postoperative (PO) continuum of the perioperative period. We aimed to compare results between university- and community-hospital settings planning to institute structured, formalized FB in a large health care system operating multiple surgery residency programs in departments that are linked strategically. METHODS Quantitative, cross-sectional, Likert scale anonymous surveys were distributed to all GSRs (categorical and preliminary; university community 12). Twenty-five questions considered frequency and perceived quality of FB in PrO, IO, and PO settings. Ro 20-1724 clinical trial Data were tabulated using REDCap and analyzed in Microsoft Excel using the Mann-Whitney U test, with α = 0.05. Comparisons were made between university- and community-hospital settings, between junior (Post-Graduate Year (PGY) 1-3) and seniod format and designated times for debriefing and evaluation of performance. Subanalyses of gender and GSR level of training showed no differences. CONCLUSIONS FB during GSR training varies across the perioperative continuum of care. Community programs seem to do better than University Programs. More work need to be done to elucidate why differences exist between the frequency of FB at University and Community programs. Further, data show particularly low FB outside of the operating room. Ideally, according to respondents, FB would be provided in a structured format and at designated times for debriefing and evaluation of performance, which poses a challenge considering the temporal dynamism of general surgery services. OBJECTIVES Self-regulated learning has been proposed as a resource saving alternative for learning knot tying. However, this may be hindered by the Dunning-Kruger effect. A potential alternative is guided video reflection. The objectives of this study are to compare the performance and self-assessment abilities amongst medical students learning knot tying using either a traditional self-regulated approach versus guided video reflection. DESIGN This randomized, single-blinded, controlled trial used a pre-post-retention test design. All knot tying performances were video recorded and assessed nonsequentially by blinded evaluators using a modified Objective Structured Assessment of Technical Skills tool. PARTICIPANTS This study recruited 31 first- and second-year medical students and 6 senior urology residents from Western University in Canada. RESULTS At baseline, the performances of the experts were significantly higher than the experimental groups (F3,85 = 9.080, p less then 0.001). After the intervention, there was a significant increase in the performance for both experimental groups compared to the pretest period (p less then 0.001). The scores between the experimental groups were not significantly different (p = 0.338). The improved performances of both groups were sustained on retention testing (p less then 0.001). The self-assessment abilities were accurate for both experimental groups at baseline. However, at the post-test period the accuracy was poor (interclass correlation 0.361) for the self-regulated group, while remaining moderately (interclass correlation 0.685) accurate for the reflection group. CONCLUSIONS Students using guided video reflection were able to achieve competency and maintained their knot tying skills to the same degree as those who used the self-regulated approach. These results may be due to the positive effects of reflection on self-assessment abilities and subsequent improvement in goal setting for further practice. OBJECTIVES Adequate pain management is crucial for pediatric patients undergoing open cardiac surgery. The aim of the present study was to investigate the effect of a bilateral transversus thoracis muscle plane (TTP) block on open cardiac surgery outcomes. SETTING First Affiliated Hospital of Nanchang University. PARTICIPANTS Patients ages 6 to 60 months undergoing cardiac surgical procedures were included. INTERVENTIONS A group of 100 children were randomly allocated to receive either bilateral TTP block (TTP group) or no nerve block. MEASUREMENTS AND MAIN RESULTS The primary endpoint was postoperative pain, which was measured with the Modified Objective Pain Score. The secondary outcome measures included intraoperative and postoperative fentanyl consumption; time to extubation; time to first feces; length of stay in the intensive care unit; length of hospital stay; and possible complications such as ropivacaine allergy, pneumothorax, hematomas, infections, and injuries to the internal mammary artery and vein.