Abstract:
OBJECTIVE:To isolate heat exposure as a cause of cognitive impairment and increased subjective workload in burns surgical teams. SUMMARY BACKGROUND DATA:Raising ambient temperature of the operating room can improve burns patient outcomes, but risks increased cognitive impairment and workload of surgical team members. Prior research indicates ambient heat exposure depletes physiological and cognitive resources, but these findings have not been studied in the context of burns surgical teams. METHODS:Seventeen surgical team members completed two surgery simulations of similar complexities in a hot and in a normothermic operating room. During each simulation, participants completed multiple cognitive tests to assess cognitive functioning and the SURG-TLX to self-assess workload. Order effects, core body temperature changes due to menstruation, and circadian rhythms were controlled for in the experimental design. Descriptive statistics, correlations, and mixed ANOVAs were performed to assess relationships between ambient heat exposure with cognitive functioning and perceived workload. RESULTS:Heat had a main effect on executive functioning and verbal reasoning. Duration of heat exposure (heat*time) increased response times and negatively impacted executive functioning, spatial planning and mental rotation. Perceived workload was higher in the hot condition. CONCLUSIONS:We provide causal evidence that over time, heat exposure impairs cognitive speed and accuracy, and increases subjective workload. We recommend building on this study to drive best-practices for acute burns surgery and design work to enable burns teams to maintain their cognitive stamina, lower their workload, and improve outcomes for patients and surgeons.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Ward MK,Yam CMH,Palejwala Z,Wallman K,Taggart SM,Wood FM,Parker SKdoi
10.1097/SLA.0000000000004598subject
Has Abstractpub_date
2020-11-13 00:00:00eissn
0003-4932issn
1528-1140pub_type
杂志文章abstract:OBJECTIVES:Immediate breast reconstruction (IBR) after mastectomy for cancer has increased in recent years, yet long-term, modality-specific comparative data are lacking. We performed this study to compare short- and long-term outcomes after expander, autologous (AT), and direct-to-implant (DI) breast reconstruction. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001457
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:We examined the influence of surgeon age and other factors on proficiency in laparoscopic or open hernia repair. SUMMARY BACKGROUND DATA:In a multicenter, randomized trial comparing open and laparoscopic herniorrhaphies, conducted in Veterans Administration hospitals (CSP 456), we reported significant diffe...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.sla.0000179644.02187.ea
更新日期:2005-09-01 00:00:00
abstract::MINI: In cases of true short esophagus diagnosed intraoperatively with an endoscopic-laparoscopic method, Collis-Nissen and stomach around stomach fundoplication procedures achieved similar results. The notion that the gastric fundus must be wrapped around a conveniently long segment of the tubular esophagus to obtain...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003582
更新日期:2019-09-03 00:00:00
abstract::This study sought to minimize juxta-anastomotic neointimal hyperplasia (JNIH) following the use of polytetrafluorethylene (PTFE) conduits. PTFE anastomoses to canine carotid arteries (noncuff grafts) were compared with grafts with vein cuffs interposed proximally and distally between the graft and native artery. This ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198806000-00011
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to determine the rate, predictors, and impact of complete pathologic response (cPR) to pretransplant locoregional therapy (LRT) in a large, multicenter cohort of hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT). BACKGROUND:LRT is used to mitigate waitlist...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003253
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to use a comprehensive whole-mount pathologic analysis to characterize microscopic patterns of residual disease, as well as circumferential and distal resection margins, in rectal cancer treated with preoperative CMT; and to identify clinicopathologic factors associated with residu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000232540.82364.43
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To determine whether the acute anti-inflammatory influence of epinephrine (EPI) extends to changes in heart rate variability (HRV) induced by the prototypical inflammatory stimulus, endotoxin (lipopolysaccharide [LPS]). SUMMARY BACKGROUND DATA:HRV reflects fluctuating cardiac autonomic inputs and is acutely ...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181a40193
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To determine the proportion of registered trials published in the surgical literature, to compare, in registered trials, the primary outcomes registered with those published and to determine whether outcome-reporting bias favored significant primary outcomes. BACKGROUND:Trial protocol registration before pat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318299d00b
更新日期:2014-01-01 00:00:00
abstract::CLINICAL AND LABORATORY STUDIES OF AFP PRODUCING HEPATOMAS DEMONSTRATED THAT: 1) serum AFP levels correlated directly with tumor growth; 2) circulating AFP could be cleared by passive administration of an. excess of anti-AFP; and 3) highly specific anti-AFP functioned as a carrier to localize diagnostic and possibly t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00025
更新日期:1974-10-01 00:00:00
abstract:OBJECTIVE:To analyze the long-term results of distal pancreatectomy with en bloc celiac axis resection (DP-CAR), a newly designed extended surgical procedure for locally advanced cancer of the pancreatic body. SUMMARY BACKGROUND DATA:Pancreatic body cancer often involves the common hepatic artery and/or the celiac axi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000258608.52615.5a
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:The authors determine the reliability, validity, and usefulness of the Objective Structured Clinical Examination (OSCE) in the evaluation of surgical residents. SUMMARY BACKGROUND DATA:Interest is increasing in using the OSCE as a measurement of clinical competence and as a certification tool. However, conce...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199512000-00007
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the potential of postischemic intravenous infusion of the endogenous antioxidant glutathione (GSH) to protect the liver from reperfusion injury following prolonged warm ischemia. BACKGROUND DATA:The release of reactive oxygen species (ROS) by activated Kupffer cells (KC) and leukocytes causes rep...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000110321.64275.95
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000520
更新日期:2015-02-01 00:00:00
abstract::Forty-nine patients with chronic ulcerative colitis refractory to medical therapy and four with multiple polyposis have undergone total colectomy, mucosal protectomy, and endorectal ileal pull-through with ileoanal anastomosis at the UCLA Medical Center during the past 12 years (mean age, 19.4 years). Thirty-eight pat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198402000-00003
更新日期:1984-02-01 00:00:00
abstract:OBJECTIVE:To estimate long-term mortality following major burn injury compared with matched controls. SUMMARY BACKGROUND DATA:The effect of sustaining a major burn injury on long-term life expectancy is poorly understood. METHODS:Using health administrative data, all adults who survived to discharge after major burn ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002722
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To investigate whether the accuracy of magnetic resonance imaging (MRI) after neoadjuvant systemic therapy (NST) is affected by molecular features of primary breast cancer and the use of human epidermal growth factor receptor 2 (HER2)-targeted agents. BACKGROUND:Improved understanding of factors affecting th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182686bd9
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze the health care costs and savings associated with quality improvement (QI) interventions initiated and implemented utilizing NSQIP. BACKGROUND:Five acute care facilities of Alberta Health Services (AHS) adopted NSQIP in 2015 for a pilot project. METHODS:The cost-savings ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002708
更新日期:2019-05-01 00:00:00
abstract::This study addresses the use of decision analysis and Markov models to make contemplated decisions for surgical problems. Decision analysis and decision modeling in surgical research are increasing, but many surgeons are unfamiliar with the techniques and are skeptical of the results. The goal of this review is to fam...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000001569
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:This study aimed to identify risk factors for recurrence after pancreatic resection for intraductal papillary mucinous neoplasm (IPMN). SUMMARY BACKGROUND DATA:Long-term follow-up data on recurrence after surgical resection for IPMN are currently lacking. Previous studies have presented mixed results on the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004427
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:The authors analyzed the frequency and character of postoperative complications after splenectomy in patients with hematologic malignancies, and correlated these findings with preoperative conditions that could have predicted their outcome. SUMMARY BACKGROUND DATA:Splenectomy is performed for hematologic mal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199603000-00010
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To determine the survival curves for laparoscopic resection (LR) of colorectal cancer. SUMMARY BACKGROUND DATA:Laparoscopic resection for cure of colorectal cancer is controversial, and survival curves have not been determined. METHODS:A prospective database of 177 consecutive LRs of colorectal cancers perf...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199904000-00006
更新日期:1999-04-01 00:00:00
abstract::Eighty-nine grafts of expanded microporous polytetrafluoroethylene (PTFE) with a diameter of 4 mm, were placed in the carotid and femoral arteries of dogs. The animals were sacrificed at varying intervals beginning three days after operation. Four animals remain alive with patent grafts 10 months post-operatively. Twe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197508000-00010
更新日期:1975-08-01 00:00:00
abstract:OBJECTIVE:To examine the financial impact of quality improvement using Medicare payment data. BACKGROUND:Demonstrating a business case for quality improvement--that is, that fewer complications translates into lower costs--is essential to justify investment in quality improvement. Prior research is limited to cross-se...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001069
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility and safety of laparoscopic liver resections. SUMMARY BACKGROUND DATA:The use of the laparoscopic approach for liver resections has remained limited for technical reasons. Progress in laparoscopic procedures and the development of dedicated technology have made it possible to conside...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200012000-00004
更新日期:2000-12-01 00:00:00
abstract:OF BACKGROUND DATA AND OBJECTIVES:Operating theatres are typically the most resource-intensive area of a hospital, 3-6 times more energy-intensive than the rest of the hospital and a major contributor of waste. The primary objective of this systematic review was to evaluate existing literature calculating the carbon fo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003951
更新日期:2020-12-01 00:00:00
abstract::1016 Women were placed on estrogen support following hysterectomy and have been followed for a total of 14,318 patient/years. Support was principally conjugated estrogen with the customary dose 1.5 mg/day. The follow-up studies in this group of women shows a marked drop in deaths from all causes over those which might...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197705000-00010
更新日期:1977-05-01 00:00:00
abstract::Thin melanomas can metastasize and be lethal. The purpose of this review was to identify negative risk factors in patients with melanomas less than 0.76 mm thick. Six hundred and eighty-one (681) such patients are reviewed in this study. Of those referred without metastatic disease (583 patients), metastases developed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198808000-00004
更新日期:1988-08-01 00:00:00
abstract::Two-plane angiography and direct segmental pressure measurements in the femoral and popliteal arteries and indirectly on the arm and ankle were performed in 101 limbs seeking to establish a relationship between angiographic assessment of the patency of the popliteal artery and the trifurcation vessels and the poplitea...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198312000-00017
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:The aim of this prospective study was to determine incidence, duration, and risk factors for postoperative delirium (PD) in elderly patients undergoing major abdominal surgery. SUMMARY BACKGROUND DATA:The incidence and risk factors of PD after major abdominal surgery in elderly patients are not well document...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181c1cfc9
更新日期:2010-04-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:The extent of hepatectomies is limited by the functional reserve of the remnant liver. The introduction of preoperative portal vein occlusion techniques to induce a preoperative hyperplasia of the future liver remnant has reduced the risk of postoperative liver failure. However, it has remained ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31816a9d7c
更新日期:2008-05-01 00:00:00