RESUMEN
OBJECTIVE: To evaluate whether the rate of surgical complications is higher during the first semester of the General Surgery residency in the largest hospital complex in Latin America. During this period, students are expected to have less experience in carrying out procedures. METHODS: During a period of two years, all General Surgery resident doctors at the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo, made a notification of all the procedures they performed (n = 14.063), containing information such as name of the procedure, date, who participated, complications, among others. These data were analyzed with the purpose of evaluating the variation in the rate of complications throughout the year. RESULTS: There was a 52 % increase in the rate of complications in the first academic semester when compared to the second semester. This phenomenon was observed in resident doctors in the first and second years of residency. Furthermore, it was observed that second-year residents remain with high rates of complications, in some procedures, for a longer time than first-year residents. Furthermore, the first three months (March, April and May) seem to have the highest complication rates of the entire year. CONCLUSION: The impact of these complications can affect several health services and the increase in surgical complications in the first half of the year must be monitored by institutions, in order to control this phenomenon.
Asunto(s)
Internado y Residencia , Medicina , Humanos , Competencia ClínicaRESUMEN
The American College of Surgeons Committee on Trauma's Advanced Trauma Life Support Course is currently taught in 50 countries. The 8th edition has been revised following broad input by the International ATLS subcommittee. Graded levels of evidence were used to evaluate and approve changes to the course content. New materials related to principles of disaster management have been added. ATLS is a common language teaching one safe way of initial trauma assessment and management.
Asunto(s)
Curriculum/normas , Educación Médica Continua , Cuidados para Prolongación de la Vida/normas , Traumatología/educación , Heridas y Lesiones/terapia , Competencia Clínica , Curriculum/tendencias , Medicina de Emergencia/educación , Tratamiento de Urgencia/normas , Tratamiento de Urgencia/tendencias , Femenino , Predicción , Humanos , Cuidados para Prolongación de la Vida/tendencias , Masculino , Resucitación/educación , Sensibilidad y Especificidad , Traumatología/tendencias , Estados UnidosRESUMEN
O volvo de colo direito é uma rara causa de obstruçäo intestinal em nosso meio e apresenta uma mortalidade elevada. Apresentam-se dois casos de volvo de colo direito associado ao megacolo adquirido, que apresentaram boa evoluçäo. Discute-se a etiologia, o tratamento e as complicaçöes
Asunto(s)
Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Megacolon/complicaciones , Enfermedades del Colon/complicaciones , Obstrucción Intestinal/complicaciones , Megacolon/etiología , Megacolon/patología , Enfermedad de Chagas/complicaciones , Obstrucción Intestinal/etiologíaRESUMEN
A necrose isquêmica do colo associada à tromboangeíte obliterante é rara e grave, com uma mortalidade elevada. A tromboangeíte abliterante ocorre em pacientes jovens e as manifestaçöes digestivas, raras nesta moléstia, ocorrem posteriormente aos acometimentos dos membros. Relata-se caso de um paciente com necrose segmentar isquêmica de colo com tromboangeite obliterante