Medical Specialties Commons^™

Development Of Takotsubo Cardiomyopathy In 46-Year-Old With Refractory Crohn's Disease, Margarita Pipinos, Andrea Klooz, Maria E. Tecos, Andrew Kamien

Graduate Medical Education Research Journal

Rampant autoimmune disease has the potential to ravage the entirety of the body in a systemic fashion. Rarely, it has been reported for Takotsubo cardiomyopathy develop as a result of refractory inflammatory bowel disease. Balancing the comprehensive cares required to support both the cardiovascular system and treat the underlying autoimmune condition care present unique challenges. Here, we describe a patient who developed late-onset Takotsubo cardiomyopathy after prolonged systemic stress as a result of uncontrolled Crohn’s disease. While this patient unfortunately did succumb to the disease process, it is our hope that highlighting these rare cases may progress care for future …

Hemoadsorption With Cytosorb As Part Of A Strategy To Improve Outcomes In Patients On Extracorporeal Membrane Oxygenation, Ruzica Mrkonjic

The VAD Journal

The exposure of a patient’s blood to the non-endothelialized surface of the extracorporeal membrane oxygenation (ECMO) system results in the production of pro-inflammatory and anti-inflammatory cytokines. This imbalance in pro- and anti-inflammatory cytokines leads to inflammatory response syndrome, which contributes to edema, vasoplegia, and multiple organ failure among other complications. Hemoadsorption therapy, with the use of CytoSorb^® (CytoSorbents) has emerged as a well-accepted treatment option that helps control pro-inflammatory response and improve outcomes for patients on ECMO. However, studies have shown that the potential of hemoadsorption is controversial and that it is crucial for clinicians to weigh the pros …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Synchronous Cervical Sympathetic Chain Schwannoma, Parathyroid Adenoma And Hypofunctional Nodular Goiter - A Case Report And Literature Review, Flaviu Muresan, Alexandrina Manuela Muresan, Gabriel Emil Petre, Iacob Domsa, Vasile Ovidiu Fabian, Olga Hilda Orasan

Journal of Mind and Medical Sciences

Simultaneously diagnosing cervical sympathetic chain schwannoma, nodular goiter and parathyroid adenoma is a very rare event during clinical practice. We had the opportunity to find this unusual association on a female patient. While nodular goiter and parathyroid adenoma are more common diseases and easier to diagnose, identifying the etiology of a parapharyngeal space tumor remains a challenge and requires multiple imaging studies such as computed tomography scan, magnetic resonance imaging or angiography. A cervical sympathetic chain schwannoma, a carotid body tumor, a paraganglioma or a vagal schwannoma must be taken into account as possible diagnostic variants. Complaints such as Horner`s …

Ercp Extraction Of Stones In Situs Inversus Patients; State-Of-The-Art Techniques, Deniz Gunsahin, Madalina Ilie, Oana Plotogea, Dan Nicolae Paduraru, Alexandra Bolocan, Octavian Andronic, Florentina Musat, Vlad Baleanu, Dragos Davitoiu, Mihai Pahomeanu, Bogdan Dumbrava, Vlad Enciu, Alexandru Constantinescu

Journal of Mind and Medical Sciences

Situs inversus totalis (SIT) is a rare congenital disease that causes mirror transposition of the abdomino-thoracic structures. When such patients develop pathologies related to the bile duct, most commonly choledocholithiasis, the optimal diagnostic process can be hampered by the rarity of such a pathology and the lack of medical information on this topic. Once the diagnosis is established, through endoscopic ultrasound and MRCP, the patient is sent to perform ERCP, which requires tailored approaches for each case. We present the case of a 33-year-old patient who was previously documented with SIT. On admission she presented with abdominal pain and fever …

Surgical Management Of Retroperitoneal Hydatid Cysts - Results On A Group Of Six Patients, Dragos George Popa, Cosmin Vasile Obleaga, Ana Maria Rukie Ahmet, Cristin Constantin Vere, Vlad Ionuț Ducu, Cecil Sorin Mirea, Dan Nicolae Florescu, Mihai Călin Ciorbagiu, Dragoş Marian Popescu, Costin Teodor Streba, Lucian Florescu, Teodor Sas, Lorena Sas

Journal of Mind and Medical Sciences

Objectives. Hydatid disease is a potentially lethal parasitic condition caused by the larvae of Echinococcus Granulosus; it is found in humans and more commonly in domestic and wild animals in endemic areas. This pathology is frequently encountered in the liver, the hydatid cyst with retroperitoneal location representing a rarely encountered form of evolution. Materials and Methods. In the present paper, we present a study carried out on 6 patients hospitalized in the Surgery Department of the Craiova County Emergency Clinical Hospital. These patients were diagnosed between 2002-2022 with retroperitoneal hydatid cyst or with multiple cysts (including retroperitoneal), being operated and …

Systematic Surgical Approach To Juvenile Angiofibroma, Raluca Oana Pulpă, Viorel Zainea, Cătălina Voiosu, Ruxandra Oana Aliuș, Andreea Rusescu, Irina Gabriela Ioniță, Veronica Epure, Dragoș Octavian Palade, Răzvan Hainăroșie

Journal of Mind and Medical Sciences

Introduction. Juvenile nasopharyngeal angiofibroma is a rare type of benign vascular tumour that affects only young males, especially those between the ages of 9 and 19. Therapeutic management depends on the extent of the lesion, being conditioned by the complexity of the anatomy of the skull base and the risk of massive bleeding due to the abundant vascular supply. The purpose of this article is to describe the modern approach to juvenile nasopharyngeal angiofibroma, starting from the general knowledge on this topic and presenting the experience of our clinic. Materials and Methods. A retrospective study was conducted on 10 male …

Advantages Of Mechanical Anastomosis In Rectal Cancer Surgery, Paul Șiancu, Adrian Boicean, Denisa Tănăsescu, Dan Bratu, Ciprian Tănăsescu

Journal of Mind and Medical Sciences

Rectal oncological pathology represents an increased degree of difficulty in terms of surgical approach. Along with the development of minimally invasive surgery, technology has also increased the options for performing digestive anastomoses. A significant increase has been observed among mechanical anastomoses. The evolution of mechanical sutures through the use of the stapler has become a true symbol of technological advancement, as they have led to improvements and effective gains in quality and productivity in suture making. The aim of this paper is to highlight the advantages of the use of staplers in rectal surgery, with their help achieving a lower …

Arterial Vascularization Of The Colon; A Guide To Surgical Resection, Iulian Slavu, Florin Filipoiu, Raluca Tulin, Ileana Dima, Alexandru Dogaru, Bogdan Socea, Luminita Tomescu, Theodor Badea, Anca Oprescu Macovei, Adrian Tulin

Journal of Mind and Medical Sciences

Background. Colorectal cancer is a commonly diagnosed neoplasia in men and women worldwide. This study aims to rigorously map the arterial distribution of the colon in order to assess the implications of vascular patterns in surgical resection. Methods. Cadaveric dissections were performed to explore the arterial distribution (including collateral blood flow) of the colon. The study used standard dissection tools and photographic documentation to detail the vascular architecture supporting the large intestine. Results. The dissection revealed important arterial branches and anastomoses in the area of the superior and inferior mesenteric arteries, which are able to ensure continuous local blood supply …

Correlation Between Molecular Prognostic Factors And Bevacizumab Therapeutic Resistance In Patients With Metastatic Colorectal Cancer; The Avamet Study, Adrian Paul Suceveanu, Dragos Serban, Andreea Daniela Caloian, Georgeta Camelia Cozaru, Anca Chisoi, Anca Antonela Nicolau, Ioan Sergiu Micu, Andra Iulia Suceveanu

Journal of Mind and Medical Sciences

Objectives. Colorectal cancer is responsible for more than two million cases diagnosed annually. Despite early diagnosis through screening programs and adequate treatment, 25% of cases are diagnosed with metastatic disease while up to 50% of patients diagnosed early progress to metastatic disease. Materials and Methods. The study of 40 patients aims to identify the role of placental growth factor and heparin-binding growth factor as prognostic tools for current treatments involving resistance to bevacizumab in metastatic colorectal cancer. Results. Our results suggested that overall survival was influenced by serum fibroblast growth factor 1 levels. A cut-off value of 260.71 pg/ml was …

Medical And Psychological Management Of Patients With A History Of Surgical Treatment For Pancreatic Diseases, Magdalena Țone, Daniel Cochior, Oana Denisa Balalau, Tomescu Dana Rodica, Cristian Balalau, Teodora Mocan, Aurelian Udristoiu, Gabriel Petre Gorecki

Journal of Mind and Medical Sciences

Background. Pancreatic cancer, known for its high mortality rate and late diagnosis, remains a significant health concern. Surgery offers a potential therapeutic remedy, but it is only valid in the early stage of detection. Increasing risk factors and an aging population are expected to raise the incidence of pancreatic cancer, further challenging healthcare systems. Methods. The general objective of this study was to analyze doctors' experiences regarding the health status of patients with benign pancreatic pathology who underwent surgery and were admitted to CF2 Clinical Hospital in Bucharest. The research involved a specialized questionnaire addressing various aspects of patient health, …

Surgery Of The Colon; The Impact Of Colostomy And Postoperative Complications On Patients' Quality Of Life, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Daniela Gabriela Bălan, Florin Silviu Groseanu, Denisa Mihaela Nedelcu, Ioana Paunica

Journal of Mind and Medical Sciences

Introduction. This study aims to evaluate the impact of stoma formation on the quality of life of patients undergoing colonic surgery, considering both emergency and elective procedures. Several factors (demographic data, Charlson comorbidity score, type of surgical intervention, duration of hospitalization, postoperative outcomes and complications, etc.) were analyzed to understand their influence on patients' well-being. Materials and Methods. A retrospective analysis was performed on patients who underwent colorectal surgery that required stoma formation. A total of 270 patients were included in the study, with 69.25% undergoing emergency surgery and 30.74% undergoing elective procedures. Results. The Charlson comorbidity score was significantly …

Preoperative Risk Factors In Hernia Recurrence: A Single-Center Study, Anca Tigora, Vlad Paic, Dragos Nicolae Garofil, Mircea Nicolae Bratucu, Mihai Zurzu, Daniela Nuta, Florian Popa, Valeriu Surlin, Stefan Patrascu, Victor Dan Eugen Strambu, Petru Adrian Radu

Journal of Mind and Medical Sciences

Background and Objectives. Hernia recurrence is still a great challenge for surgeons regarding the optimal surgical technique, the best alloplastic material and the management of risk factors (advanced age, female sex, body mass index, smoking, diabetes, the presence of connective tissue disorders, chronic cough, etc.). The present study attempts to assess the impact of these factors in hernia recurrence, as well as the integration of the prosthetic material at the tissue level, in order to reduce possible postoperative complications. Material and Methods. A retrospective study was performed on 108 patients operated (between January 2012 and December 2022) for recurrence of …

Low Anterior Rectal Resection; The Impact Of Anastomotic Fistula On Incidence And Severity Of Low Anterior Resection Syndrome, Georgiana Cotofana-Graure, Cecil Mirea, Silviu Daniel Preda, Stefan Patrascu, Tiberiu Stefanita Tenea-Cojan, Adina Turcu-Stiolica, Alexandru Munteanu, Vlad Padureanu, Dragos Margaritescu, Sandu Ramboiu, Dan Cartu, Valeriu Surlin, Petru Radu

Journal of Mind and Medical Sciences

Objectives. Low anterior resection is a common surgical procedure for rectal cancer, but it is associated with a distressing complication known as Low Anterior Resection Syndrome (LARS). The incidence of LARS varies, with severe symptoms persisting in some patients even years after surgery. This study aimed to investigate the association between anastomotic leak and LARS severity in rectal cancer patients. Methods. A retrospective analysis was conducted on 100 rectal cancer patients who underwent LAR between 2017 and 2021. Patients were categorized based on LARS questionnaire responses into groups with anastomotic leakage and LARS, LARS alone, or no LARS. Various factors, …

Assessing Mid To Long Term Amputation-Free Survival Rates In Chronic Limb-Threatening Ischemia; A Study Of Hybrid Vascular Techniques, Cristian Traian Paius, Vlad Denis Constantin, Alexandru Carap, Andrei Tarus, Grigore Tinica

Journal of Mind and Medical Sciences

Introduction. Chronic limb-threatening ischemia (CLTI) is a debilitating condition characterized by inadequate blood supply to the lower extremities, often leading to tissue damage, ulcers, and limb loss. Amputation-free survival (AFS) serves as a crucial measure in evaluating interventions and managing CLTI, emphasizing limb preservation, functional restoration, and prevention of recurrent ischemic events. Objectives. This study aimed to assess mid to long term AFS in CLTI patients treated with hybrid vascular techniques. Materials and Methods. Conducted over 24 months at the Emergency Hospital of Saint Pantelimon in Bucharest, Romania, the study enrolled 62 adult CLTI patients, tracking them postoperatively. Kaplan Meyer …

Genetic And Serological Markers In Colorectal Cancer Surgery, Adrian Silaghi, Vlad Denis Constantin, Dragos Serban, Dragos Epistatu, Ioana Paunica, Daniela Gabriela Bălan, Laura Florentina Rebegea

Journal of Mind and Medical Sciences

Colon cancer is relatively asymptomatic in the early stages, the manifestations appearing and intensifying with the evolution of the disease, especially when associated with local and/or systemic complications. In such cases, surgical interventions are often emergency and involve more extensive operations (on metabolically and immune-stressed organisms), so that an early diagnosis (endoscopy, tumor markers, etc.) remains not only desirable but even a priority, especially in predisposed patients (genetic factors, lifestyle, etc.). As a consequence, the involvement of tumor markers in colon neoplasms has become more and more investigated in recent times. This review investigates the roles of serological and genetic …

Diabetic Patients And Postoperative Complications In Colorectal Surgery, Ioana Paunica, Adrian Silaghi, Daniela Gabriela Bălan, Bogdan Socea, Cristian Balalau, Florin Silviu Groseanu, George Alexandru Popescu, Dragos Epistatu, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Diabetes mellitus is one of the most common comorbidities of patients undergoing surgery. Colorectal surgery is frequently associated with postoperative complications, and diabetic patients represent a population that presents a high risk of developing such complications. Understanding the interrelationships between neoplastic disease and diabetes, as well as the pathophysiological mechanisms underlying postoperative complications, are essential for effective therapeutic management. Genetic predispositions, alterations in the gut microbiota, inflammatory response, ischemic, thrombotic and infectious processes contribute significantly to the development of severe surgical complications, such as anastomotic fistulas. Postoperative ileus, characterized by gastrointestinal dysmotility, is common in diabetic patients due to neuropathic …

Open Versus Laparoscopic Appendectomy: A Literature Review, Nicole Kiril Nikolov, Hannah Theresa Reimer, Alvin Sun, Benjamin David Bunnell, Zachary Isaac Merhavy

Journal of Mind and Medical Sciences

Appendectomy is the most common emergency abdominal surgery in the United States. Open appendectomy has been the standard procedure for decades, whereas laparoscopic appendectomy is a newer, less-invasive method of removing the appendix. This review intends to elucidate the similarities and differences between these two procedures as well as explore the advantages and disadvantages of each approach. Socioeconomic factors, associated costs, preoperative imaging, operative time and methods, length of hospital stay, recovery time, and complications associated with open and laparoscopic appendectomy are discussed. Overall, laparoscopic appendectomy has shorter hospital stays and recovery times, requires less analgesics, and results in better …

The Case For Using Composition Tomography To Evaluate Perirectal Necrotizing Fasciitis: Is It Really Necessary?, Tyler Bayliss, David Denning

Marshall Journal of Medicine

Clinical reviews of Fournier’s Gangrene state that diagnostic protocol includes interpreting CT, MRI, or Ultrasound imaging along with clinical symptoms and lab findings. We think that the use of imaging techniques as a diagnostic tool is no longer needed as Fournier’s Gangrene is specific enough of a disease that clinicians can diagnose using labs and physical examination alone.

Cases of perirectal necrotizing soft tissue infection recorded at St. Marys Medical Center were reviewed. Results of physical exams and imaging were compared along with measurements of severity upon admittance and length of stay. Due to the COVID-19 pandemic, we investigated if …

Colon Cancer Metastasis To Spermatic Cord Presenting As An Inguinal Hernia, Jessica G. Laenger, Eamon Ff Rooney, Patrick F. Dial, Candie T. Le, Sanda A. Tan

HCA Healthcare Journal of Medicine

Introduction

Inguinal hernias are very common. Their pathology and treatment are typically strait forward. Metastatic cancer can sometimes present as an inguinal hernia, but this presentation is often local metastasis.

Case Presentation

Herein we describe the case of a 68-year-old man who presented with a 2-month history of an inguinal hernia. Intraoperatively, the hernia sac was found to contain a mass attached to the spermatic cord, which was later determined to be a metastatic lesion from a locally advanced proximal transverse colon adenocarcinoma.

Conclusion

A spermatic cord mass can be a rare presentation of colon cancer metastasis. Colon cancer should …

Prophylactic Mesh Reinforcement For Non-Midline Incisions: A Systematic Review, Rainna Coelho, Oluwatunmininu Anwoju, Ali Siddiqui, Andrew Youssef, Oscar A. Olavarria, Nalia H. Dhanani, Karla Bernardi, Zuhair Ali, Mike Liang

HCA Healthcare Journal of Medicine

Background

Many abdominal-pelvic surgeries utilize incisions not along the linea alba, such as transverse, laparoscopic, ostomy reversal, or ostomy formation incisions. The prevalence of ventral incisional hernias (VIH) at these sites and the efficacy of prophylactic mesh in preventing VIH remains unclear.

Methods

PubMed, Embase, Scopus, and Cochrane databases were systematically reviewed from inception to September 2022. We included published randomized controlled trials (RCTs) that compared prophylactic mesh reinforcement versus no mesh. The primary outcome was the incidence of VIH at postoperative follow-up equal to or greater than 24 months. Secondary outcomes included surgical site infection (SSI) and surgical site …

Gibbon Surgical Review, Volume 7, Issue 1, 2024

Gibbon Surgical Review

Table of Contents

6 - Socially Responsible Surgery: Better Practices for Better Outcomes

8 - Interview with Dr. Talar Tatarian - Assistant Professor

10 - Global Surgery : Current State and Involvement as a Trainee

12 - Interview with Dr. Ibnouf Sulieman - Transplant Surgery Fellow

14 - Resident Spotlight - Dr. Sam Nasser - PGY3

16 - A Review of the FIRST and SECOND Trials

18 - Residency Signaling in General Surgery

20 - Navigating Competency: Entrustable Professional Activities (EPAs)

22 - The Effect of Language Barriers on Surgical Outcomes

24 - Research Spotlight: The First Complete Human Eye …

Highlights Of The 2023 Brano Heart Failure Forum, Bela Merkely, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric

The VAD Journal

Since 2007, the Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) has been held annually to provide a venue for experts to present and discuss “Innovations and New Treatment Strategies in Heart Failure.” Clinicians and researchers gather yearly in a different Eastern European city to discuss the latest in heart failure diagnostics and therapeutics. The 2023 BHHF forum was held on the 13^th thru 15^th of September 2023 in Budapest, Hungary. It was attended by over 100 faculty from 16 countries. In addition, participation through online streaming was available. Throughout the forum, 16 sessions focused on challenges and solutions …

Barriers To And Facilitators Of Using Cognitive Aids In Perioperative Emergencies: An Integrative Review, Simon Almoite, Paula Foran

Journal of Perioperative Nursing

Problem identification: Perioperative emergencies, although infrequent, may lead to significant morbidity and mortality associated with anaesthesia and/or surgery. Human factor errors account for between 43 to 65 per cent of sentinel events in the perioperative environment. Cognitive aids were introduced to reduce a user’s cognitive workload and assist in adherence to key interventions during emergencies. Despite the availability of these aids, implementation of their use remains low. This integrative literature review will identify the barriers to and facilitators of the implementation of cognitive aids during perioperative emergencies.

Literature search: An electronic database search of EBSCO databases (CINAHL Complete, Health Source: …

Assessment Of General Surgery Resident Wellness From The Perspectives Of Family, Friends, And Loved Ones, Dana Unninayar, Benjamin Sc Fung, Gordon Best, Isabelle Raiche

Journal of Wellness

Introduction: Surgical trainees have high rates of burnout compared to residents from other specialties. However, burnout is underreported by trainees, limiting potential interventions to improve wellness. Loved ones are an underused resource for assessing wellness and detecting burnout among residents. The purpose of this study is to assess the perceptions and concerns regarding resident wellness and burnout, as well as strategies to improve wellness, from the perspective of loved ones.

Methods: This cross-sectional survey study was conducted in 2022 at an urban academic center after ethics board approval. An anonymous 18-question survey to assess resident burnout, wellness, and …

Operative Versus Nonoperative Management For Diverticulitis Complicated By Abscess, Alix Bernholtz, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

You K, Bendl R, Taut C, et al. Randomized clinical trial of elective resection versus observation in diverticulitis with extraluminal air or abscess initially managed conservatively. Br J Surg. 2018;105(8):971-979. https://doi.org/10.1002/bjs.10868

for a patient with a recurrent diverticulitis complicated by abscess formation.

Efficacy Of Observational Care Versus Antibiotic Therapy For Treatment Of Acute Uncomplicated Diverticulitis, Morgan Mooty, Abbie R. Bauer

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

van Dijk ST, Daniels L, Ünlü Ç, et al. Long-Term Effects of Omitting Antibiotics in Uncomplicated Acute Diverticulitis. Am J Gastroenterol. 2018;113(7):1045-1052. https://doi.org/10.1038/s41395-018-0030-y

for a patient with acute uncomplicated diverticulitis.

Pediatric Appendicitis Or Not? A Retrospective Cohort Study From A Single Institution - Our Management And Factors Determining The Disease, Nimmita Srisan, Teerasak Phewplung, Katawaetee Decharun, Prapapan Rajatapiti, Paisarn Vejchapipat

Chulalongkorn Medical Journal

Purpose: The aims were to assess our treatment guidelines and to determine factors in differentiating children with acute appendicitis from other diseases.

Methods: Pediatric surgery consultations for suspected appendicitis from October 2019 to October 2021 was retrospectively studied. The treatment guidelines of children with suspected appendicitis were elucidated. Moreover, factors identifying the diagnosis of appendicitis were analyzed using multi-variate logistic regression.

Results: Ninety-one children were consulted for suspected appendicitis. Forty-one children (45.1%) were promptly successfully treated without observation or ultrasonography, except one negative appendectomy (2.4%). The other 50 children (54.9%), showed equivocal clinical symptoms and signs, requiring further management either …

Endoscopic Management Of Boerhaave Syndrome: Are Outcomes Better Than Surgery? A Case Report And Review Of Literature, Ammar Qureshi, Uvesh Mansuri, Mona Roknsharifi, Youssef Ghobrial, Artin Asgeri, Mehrdad Asgeri

Journal of Community Hospital Internal Medicine Perspectives

Boerhaave syndrome (BS) is a rare clinical diagnosis associated with a high morbidity and mortality rate. Diagnosis of this condition is usually delayed which can lead to a very poor outcome. The timing of presentation and time to management plays a very important role in the prognosis and selection of the management method. With the advances seen in therapeutic endoscopy, many authors have been exploring the possibility of shifting the focus of management from surgery to interventional endoscopy. We present a case report of a patient presenting with BS that was successfully managed endoscopically. We also reviewed the literature on …

Structured Textbook Review And Individualized Learning Plans Successfully Remediate Underperforming Residents And Improve General Surgery Program Performance On The Absite, Aaron Pinnola, Christoph Kaufmann

HCA Healthcare Journal of Medicine

Background

We endeavored to create an evidence-based curriculum to improve general surgery resident fund of knowledge. Global and resident-specific interventions were employed to this end. These interventions were monitored via multiple choice question results on a weekly basis and American Board of Surgery In-Training Examination (ABSITE) performance.

Methods

This study was performed in a prospective manner over a 2-year period. A structured textbook review with testing was implemented for all residents. A focused textbook question-writing assignment and a Surgical Council on Resident Education (SCORE)-based individualized learning plan (ILP) were implemented for residents scoring below the 35th percentile on the ABSITE. …