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  1. Article ; Online: Working Through the Pain: A Cross-Sectional Survey on Musculoskeletal Pain Among Surgeons and Residents.

    Shah, Meghal / Gross, Karlie / Wang, Chunhui / Kurlansky, Paul / Krishnamoorthy, Subhash

    The Journal of surgical research

    2023  Volume 293, Page(s) 335–340

    Abstract: Introduction: While prior studies have reported that over 80% of surgeons report musculoskeletal pain, to our knowledge, the degree of care required to manage these symptoms has not been discussed. Here, we present granular data on musculoskeletal ... ...

    Abstract Introduction: While prior studies have reported that over 80% of surgeons report musculoskeletal pain, to our knowledge, the degree of care required to manage these symptoms has not been discussed. Here, we present granular data on musculoskeletal treatment modalities used by surgeons and residents at a single institution.
    Methods: We distributed a survey to assess the prevalence of musculoskeletal pain and treatment utilization to surgery attending and residents at a single institution.
    Results: Fifty-five out of 115 residents and attending (47.8%) responded to our survey. Among the respondents, 87.3% reported pain within the past week and 76.4% (42/55) of respondents required treatment for musculoskeletal pain and injuries: 63.6% had taken over the counter pain medication, 10.9% had taken prescription pain medication, 25.5% required physical therapy, 14.5% required orthopedic surgery, 23.6% made an appointment with a specialist, and 21.8% required additional testing (i.e., imaging, labs). Interestingly, treatment utilization overall and by modality was similar between residents and attending surgeons.
    Conclusions: Our study mirrors the high prevalence of musculoskeletal pain in surgeons that has been previously reported in the literature. Among survey respondents, 76.5% of surgeons and 76.2% of residents required some form of treatment. These findings suggest a significant burden of musculoskeletal disorders of likely multifactorial etiologies including operating room ergonomics. Therefore, comprehensive ergonomics programs to measure, prevent, and treat musculoskeletal injury may help to fulfill a compelling need to ensure health and career longevity of the surgical workforce.
    MeSH term(s) Humans ; Musculoskeletal Pain/epidemiology ; Musculoskeletal Pain/etiology ; Musculoskeletal Pain/therapy ; Cross-Sectional Studies ; Occupational Diseases/epidemiology ; Surgeons ; Surveys and Questionnaires ; Ergonomics ; Prevalence
    Language English
    Publishing date 2023-10-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2023.08.021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  2. Article ; Online: An Open Operative Readiness Standard for Surgical Trainees.

    Sathe, Tejas S / Shah, Meghal / Pokrzywa, Courtney J / Crum, Robert W / Krishnamoorthy, Subhash / McManus, Catherine

    The Journal of surgical research

    2023  Volume 293, Page(s) 281–290

    Abstract: Introduction: The American Board of Surgery is transitioning from a volume-based to a competency-based assessment of residents using Entrustable Professional Activities. This form of feedback and evaluation should also apply to operative procedures to ... ...

    Abstract Introduction: The American Board of Surgery is transitioning from a volume-based to a competency-based assessment of residents using Entrustable Professional Activities. This form of feedback and evaluation should also apply to operative procedures to help residents track their own progress. We describe an operative readiness tool that measures perceived competency in trainees across several operative, procedural, and clinical activities.
    Methods: We distributed a survey to General Surgery trainees at our institution. Participants were asked to rate their level of comfort in 28 operative, procedural, or clinical activities using the standard Entrustable Professional Activity scale: (1) Observation Only, (2) Direct Supervision, (3) Indirect Supervision, (4) Unsupervised Practice, or (5) Supervising Others.
    Results: 43 of 46 residents (93%) responded to the survey. Median perceived comfort level generally increased with post graduate year level across all competencies. Residents reached a median perceived level of "Unsupervised Practice" by post graduate year 5 in 17 of 28 competencies of various complexity levels.
    Conclusions: While residents are not expected to achieve an "Unsupervised Practice" comfort level in all competencies, creating a transparent platform for reporting this information provides programs a tool to guide educational quality improvement efforts. In addition, it allows for program directors to have greater resolution into the operative advancement of residents outside of their own specialty. In the future, this tool may be instrumental in the development of national competency standards.
    MeSH term(s) Humans ; United States ; Internship and Residency ; Clinical Competence ; Education, Medical, Graduate/methods ; Competency-Based Education/methods ; Surveys and Questionnaires
    Language English
    Publishing date 2023-10-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2023.09.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 178: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
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    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Prognostic markers in acute liver failure - Alpha feto protein

    P Gayathri / Smitha Krishnamoorthy / Subhash Chandra / M G K Pillai / Raviraj Menon / Mahesh Subramania Iyer

    Archives of Medicine and Health Sciences, Vol 9, Iss 1, Pp 55-

    2021  Volume 61

    Abstract: Background and Aim: Acute liver failure is associated with high mortality and only about 40% patients survive without liver transplantation. The available prognostic models failed to predict the outcome correctly. Here, we aimed to determine if alpha- ... ...

    Abstract Background and Aim: Acute liver failure is associated with high mortality and only about 40% patients survive without liver transplantation. The available prognostic models failed to predict the outcome correctly. Here, we aimed to determine if alpha-fetoprotein (AFP) can be used as a prognostic marker in acute liver failure. Materials and Methods: For this prospective observational study, sixty patients with the diagnosis of acute liver failure were allocated and serum AFP ratio was measured on days 1 and 3 of admission. AFP ratio was calculated as day 3 AFP/day 1 AFP value. Other laboratory parameters and various etiological factors of acute liver failure were also studied. Results: The average AFP ratio among survivors was 1.77 ± 0.94 and among patients who died, the average ratio was 0.68 ± 0.58. Hence, AFP ratio is an important prognostic tool in predicting mortality with a P < 0.001. Majority of patients (80.6%) of patients whose AFP ratio was <0.7 died while majority of patients whose AFP ratio was >0.7 survived (70.4%). Hence, we concluded that AFP values change dynamically during the course of acute liver failure and AFP ratio can be used as a prognostic marker in acute liver failure. AFP ratio showed statistically significant negative correlation with prothrombin time and international normalized ratio, serum globulin, and the levels of indirect bilirubin, especially on the third day after admission and the variables were significantly elevated in the patients who died. Conclusions: AFP ratio can be used as a predictor of mortality in acute liver failure patients. Higher the ratio more are the chances of survival.
    Keywords acute liver failure ; alpha-fetoprotein ; prognostic marker ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: The Safety and Efficacy of Tracheostomy in Patients Diagnosed With COVID-19: An Analysis of 143 Patients at a Major NYC Medical Center.

    Krishnamoorthy, Subhash / Polanco, Antonio / Coleman, Natasha / Prigoff, Jake / Sturm, Joshua / Blitzer, David / Erwin, Clinton / D'Ovidio, Frank / Lemaitre, Philippe / Troob, Scott / Hills, Susannah / Stanifer, Bryan Payne

    Annals of surgery

    2020  Volume 276, Issue 5, Page(s) e342–e346

    Abstract: Objective: To determine the optimal surgical strategy for performing tracheostomy in COVID-19 patients.: Background: Many ventilated COVID-19 patients require prolonged ventilation. We do not know if tracheostomy will improve their care. Given the ... ...

    Abstract Objective: To determine the optimal surgical strategy for performing tracheostomy in COVID-19 patients.
    Background: Many ventilated COVID-19 patients require prolonged ventilation. We do not know if tracheostomy will improve their care. Given the paucity of data on this topic, the optimal surgical approach has yet to be elucidated.
    Methods: This is a cohort study of 143 ventilator dependent COVID-19 patients undergoing tracheostomy at an academic medical center from April 15th to May 15th, 2020, with follow up until June 1, 2020. We included adult patients admitted to a NYC medical center with COVID-19 who required invasive mechanical ventilation for greater than 2 weeks who were unable to be extubated and determined to have reasonable chance of recovery and fit defined tracheostomy candidate criteria. Patients underwent either a percutaneous tracheostomy (PT) or open surgical tracheostomy (ST) performed by 1 of 3 surgical services.
    Results: One hundred forty-three patients underwent tracheostomy, 58 (41%) via a ST, and 85 (59%) via a PT. There were no significant differences in patient characteristics between the 2 groups, except that more patients who had a history of extracorporeal membrane oxygenation underwent PT (11% vs 2%, P = 0.049). There were no statistical differences observed between the PT and ST groups with regard to bleeding complications (3.5%vs 10.3%, P = 0.099), tracheostomy related complications (5.9% vs 8.6%, P = 0.528), inpatient death (12% vs 5%, P = 0.178), discharge from hospital (39% vs 36%, P = 0.751) or surgeon illness (0% vs 0%, P = 1).
    Conclusion and relevance: The rapid formation of a multi-disciplinary team allows for the efficient evaluation and performance of a large volume of tracheostomies in a resource-limited setting. Bedside tracheostomy in COVID-19 does not cause additional harm to patients if performed after 2 weeks from intubation. It also seems to be safe for proceduralists to perform in this timeframe. The manner of tracheostomy does not change outcomes significantly if it is performed safely and efficiently.
    MeSH term(s) Adult ; COVID-19/epidemiology ; Cohort Studies ; Hospitals ; Humans ; Postoperative Complications/epidemiology ; Respiration, Artificial ; Tracheostomy
    Keywords covid19
    Language English
    Publishing date 2020-11-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000004612
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.35/1: Show issues Location:
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