Abstract:
:Individuals in clinical training programs concerned with critical medical care must learn to manage clinical cases effectively as a member of a team. However, practice on live patients is often unpredictable and frequently repetitive. The widely substituted alternative for real patients-high-fidelity, manikin-based simulators (human patient simulator)-are expensive and require trainees to be in the same place at the same time, whereas online computer-based simulations, or virtual worlds, allow simultaneous participation from different locations. Here we present three virtual world studies for team training and assessment in acute-care medicine: (1) training emergency department (ED) teams to manage individual trauma cases; (2) prehospital and in-hospital disaster preparedness training; (3) training ED and hospital staff to manage mass casualties after chemical, biological, radiological, nuclear, or explosive incidents. The research team created realistic virtual victims of trauma (6 cases), nerve toxin exposure (10 cases), and blast trauma (10 cases); the latter two groups were supported by rules-based, pathophysiologic models of asphyxia and hypovolemia. Evaluation of these virtual world simulation exercises shows that trainees find them to be adequately realistic to "suspend disbelief," and they quickly learn to use Internet voice communication and user interface to navigate their online character/avatar to work effectively in a critical care team. Our findings demonstrate that these virtual ED environments fulfill their promise of providing repeated practice opportunities in dispersed locations with uncommon, life-threatening trauma cases in a safe, reproducible, flexible setting.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
LeRoy Heinrichs W,Youngblood P,Harter PM,Dev Pdoi
10.1007/s00268-007-9354-2subject
Has Abstractpub_date
2008-02-01 00:00:00pages
161-70issue
2eissn
0364-2313issn
1432-2323journal_volume
32pub_type
杂志文章abstract:BACKGROUND:Acute colonic diverticulitis is a common clinical condition. Severity of the disease is based on clinical, laboratory, and radiological investigations and dictates the need for medical or surgical intervention. Recent clinical trials have improved the understanding of the natural history of the disease resul...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-016-3560-8
更新日期:2016-10-01 00:00:00
abstract::In 141 patients with chronic pancreatitis and an inflammatory enlargement of the head of the pancreas, a duodenum-preserving resection of the head of the pancreas was performed within a 16-year period. The hospital mortality was 0.7%; the late mortality was 5%. Seventy-seven percent of the patients were completely fre...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01670550
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Barriers to female surgeons entering the field are well documented in Australia, the USA and the UK, but how generalizable these problems are to other regions remains unknown. METHODS:A cross-sectional survey was developed by the International Federation of Medical Students' Associations (IFMSA)'s Global Su...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05199-1
更新日期:2020-01-01 00:00:00
abstract::To illustrate how the high incidence of arrow wounds provided a major stimulus for the development of surgery until a century ago, we conducted a literature search. Our research shows that archaic peoples developed considerable surgical skill for extraction of arrows, including thoracotomy and trephination. A classica...
journal_title:World journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1007/s00268-001-0168-3
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:The present study is designed to determine the feasibility and impact of the introduction of laparoscopic wedge resection as a surgical option for the treatment of suspected small/medium-sized (<7 cm) gastric gastrointestinal stromal tumors (GISTs). METHODS:The study involved a retrospective review of 53 co...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0590-5
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:When needle core biopsies (NCBs) of the breast reveal fibroepithelial lesions (FELs), excision is often performed to rule out a phyllodes tumor (PT), despite low malignancy rates. Consequently, the natural history of observed FELs is not well described. We analyzed the malignancy risk in excised FELs and the...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05385-6
更新日期:2020-05-01 00:00:00
abstract:OBJECT:The massive typhoon Haiyan (Yolanda) ripped across the central Philippines on November 8, 2013, and damaged infrastructure including hospitals. The Israeli Defense Forces field hospital was directed by the Philippine authorities to Bogo City in the northern part of the island of Cebu, to assist the damaged local...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3692-x
更新日期:2017-02-01 00:00:00
abstract::The role of nitric oxide in mediating smooth muscle relaxation is well established. Less is known about the downstream signaling events inside the smooth muscle cell that produce relaxation of the contractile machinery. One possible effector molecule is the small heat shock protein HSP20. Increased phosphorylation of ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-002-4052-6
更新日期:2002-07-01 00:00:00
abstract:INTRODUCTION:Response rates to systemic chemotherapy for patients who have failed irinotecan-based chemotherapy for liver-dominant metastatic colorectal cancer range between 10 and 18 % with overall survival between 7 and 9 months. The aim of this study was to assess the efficacy and safety of hepatic arterial irinotec...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-015-3386-9
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:A precise understanding of anastomotic recurrence (AR) permits efficient surveillance and treatment strategies. This study aimed to evaluate the clinicopathologic characteristics of patients with AR undergoing curative resection for colorectal cancer (CRC), compare colonic with rectal tumors and investigate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3663-2
更新日期:2017-01-01 00:00:00
abstract:INTRODUCTION:Difficulties with liver transplantation (LT)-related surgical techniques are great challenges for young surgeons. Thus, young surgeons need to undergo systematic preclinical training. However, an optimal training system for LT is still lacking. This study aims to evaluate the safety and educational value o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05300-8
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Midgut malrotation most commonly presents in young children. This diagnosis is not often entertained in the adolescent or adult with abdominal complaints. We reviewed our experience with this subset of malrotation patients. METHODS:A retrospective review of medical records from adolescent or adult patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9490-3
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Video-assisted thoracoscopic surgery (VATS) is a new area of exploration and evolution in thoracic minimal invasive surgery. The uniportal VATS approach has become popular during lung resection for small nodules and ground glass lesions. Our objective is to investigate the efficacy, availability and safety o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05781-y
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The open surgical wound is exposed to cold dry ambient air, resulting in substantial heat loss through radiation, evaporation, and convection. At the same time, anesthesia decreases the patient's core temperature. Despite preventive measures, mild intraoperative hypothermia has been associated with postopera...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1735-5
更新日期:2012-11-01 00:00:00
abstract::In 1947, a patient with metastatic islet cell tumor was treated for intractable ulcer disease at the University of Chicago Medical Center. Eight years later, in retrospect, it was recognized that he and another patient had the Zollinger-Ellison syndrome (ZE). From 1947 until the present, 30 patients with the ZE syndro...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658530
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Owing to an aging society, both the number of operations for patients aged >85 years and the average age of patients admitted to the intensive care unit (ICU) are rapidly increasing. However, mortality is not an appropriate outcome measurement in patients aged >85 years; a more important outcome is home retu...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3830-5
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:There are scant studies that have analyzed the prognostic factors for malignant nonfunctioning endocrine tumors of the pancreas. We identified the predictive factors associated with long-term survival after surgical resection for malignant nonfunctioning endocrine tumors. METHODS:Among the 25 patients seen ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0585-4
更新日期:2007-03-01 00:00:00
abstract::Persistent pain after hernia repair is common, although it is usually mild. In 3% of patients it is severe, however, and has significant effects on work and social activities. The purpose of this review was to examine factors that affect pain after hernia repair. Although the type of anaesthetic used, local or general...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7903-0
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Peritoneal adhesions are recognized as an important cause for patient morbidity, but complications related to adhesions occur relatively late after the original operation. Therefore preoperative consent may not adequately reflect the proportions of the problem. METHODS:A total of 200 patients admitted for i...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-008-9917-x
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Flow disruptions (FDs) are deviations from the progression of care that compromise safety or efficiency. The frequency and specific causes of FDs remain poorly documented in trauma care. We undertook this study to identify and quantify the rate of FDs during various phases of trauma care. METHODS:Seven trai...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2306-0
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Sometimes, it seems to be difficult to preserve the aberrant hepatic artery (HA) during pancreaticoduodenectomy (PD), with respect to en bloc lymph node dissection, especially in the case of aberrant right hepatic artery (RHA). Therefore, we evaluated the influence of incomplete en bloc lymph node (LN) disse...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0063-x
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Superficial soft tissue sarcomas (sSTS) are an important and frequent subtype of soft tissue sarcoma (STS). A wider knowledge of this tumor type may lead to better strategies in tumor therapy. METHODS:An institutional review was performed on all patients with primary sSTS of the extremities and trunk operat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0051-1
更新日期:2009-08-01 00:00:00
abstract:INTRODUCTION:The role for diverting ostomy as a method to help reduce morbidity and mortality has been well established in the combat trauma population. However, factors that influence the type of ostomy used and which ostomies become permanent are poorly studied. We examine patterns of ostomy usage and reversal in a l...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4759-7
更新日期:2019-01-01 00:00:00
abstract::Radiation-induced proctitis with hemorrhage is not a common complication of radiotherapy to the pelvis for carcinoma. In the most severe forms, massive hemorrhage may necessitate repeated transfusions and inpatient treatment. In severe cases medical treatment has not been proved effective. Surgery may lead to serious ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900166
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemotherapy (NC) is standard therapy for patients with locally advanced breast cancer and is increasingly used for early-stage operable disease. Clinical and pathological responses are important prognostic parameters for NC, which aims to achieve a pathological complete response or tumor reducti...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9800-9
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:We describe a new technique of segment-based liver resection by inserting a 6 French balloon catheter into the portal vein via a branch of the superior mesenteric vein. MATERIALS AND METHODS:The catheter was guided into the relevant portal branch supplying the liver segment that contained the tumor. Injecti...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9043-1
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Laparoscopic incisional and ventral hernia repair (LIVHR) is an alternative approach to conventional open incisional and ventral hernia repair (OIVHR). A consensus on outcomes of LIVHR when compared with OIVHR has not been reached. METHODS:As the basis for the present study, we performed a systematic review...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-014-2578-z
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Trauma continues to be a major health problem worldwide, particularly in the developing world, with high mortality and morbidity. Yet most developing countries lack an organized trauma system. Furthermore, developing countries do not have in place any accreditation process for trauma centers; thus, no accept...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2538-7
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Concurrent vitamin D(3) deficiency is common in primary hyperparathyroidism (pHPT). We aimed to examine the clinicopathologic features and short-term outcomes of vitamin D(3)-deficient patients after minimally invasive parathyroidectomy (MIP). METHODS:Over 2-year period, 80 consecutive MIP patients had preo...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0377-8
更新日期:2010-06-01 00:00:00
abstract::There are now excellent data that patients with stage III colon cancer or stage II and III rectal cancer live longer if they receive, respectively, systemic or regional and systemic therapy after surgery. In addition, disease-free survival, particularly freedom from the symptoms of regional recurrence, in the high ris...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00308633
更新日期:1995-03-01 00:00:00