Discover and read the best of Twitter Threads about #some4surgery
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#Communication is a vital skill for any professional, but especially for surgeons. In this thread, I will share some reasons why surgeons should master communication and some tips on how to improve it.
#GPT4 #SoMe4Surgery
#GPT4 #SoMe4Surgery
#Communication can improve patient outcomes. Effective communication between surgeons and patients can reduce anxiety, increase satisfaction, and enhance adherence to treatment plans. It can also help prevent medical errors and malpractice claims. #GPT4 #SoMe4Surgery
The following thread about surgeons and social media has been written by #GPT4 to answer the following prompt:
"Can you write a text on why social media is important for surgeons, how they can use it and, what actions should be taken?
#SoMe4Surgery
"Can you write a text on why social media is important for surgeons, how they can use it and, what actions should be taken?
#SoMe4Surgery
#SoMe is important for surgeons because it allows them to:
1. Share their expertise and knowledge with other professionals and the public
2. Build their reputation and credibility as leaders in their field
#SoMe4Surgery
1. Share their expertise and knowledge with other professionals and the public
2. Build their reputation and credibility as leaders in their field
#SoMe4Surgery
3. Engage with their patients and potential patients in a more personal and interactive way
4. Learn from the feedback and experiences of other surgeons and patients
5. Stay updated on the latest developments and innovations in surgery
#SoMe4Surgery
4. Learn from the feedback and experiences of other surgeons and patients
5. Stay updated on the latest developments and innovations in surgery
#SoMe4Surgery
Banning Noncompete Clauses by the Federal Trade Commission would dramatically change the structure of medical health networks and greatly increase competition-It may destroy vulnerable medical systems who stand to lose physicians to higher paying neighbors ftc.gov/news-events/ne…
#Noncompete clauses in contracts prevent employees from leaving a business, practice, or company and opening up their own establishment or joining a competitor in a location adjacent to their previous employer. They prevent competition locally. 2/
These clauses protect the company that is losing the individual and prevent employees from leaving unless they choose to move their location. 3/
January began the re-release of our COSECSA MCS (PGY1/2) curriculum. This massive undertaking is revolutionizing surgical curriculum and education through the use of e-learning with 60 weeks of content and 300+ trainees annually throughout Africa.
🧵 1/6
🧵 1/6
#globalsurgery #surgicaleducation #SoMe4Surgery @cosecsa @rcsi_cosecsa @RCSI_GlobalSurg @PAACS_ @bobparkermd @MichaelMwachiro @abebesurg @Ndagetare
2/6
2/6
I thought that for the next few weeks, it would be fun to highlight some of the aspects of this curriculum that make it so exciting and novel.
3/6
3/6
Recall of gut anatomy wanes and waxes,
So let’s quickly recap the coeliac axis,
The first of three vessels to supply the intestine,
The content of these vessels normally fluid and sanguine;
#SurgEd @roux_group #SoMe4Surgery @ASiTofficial
So let’s quickly recap the coeliac axis,
The first of three vessels to supply the intestine,
The content of these vessels normally fluid and sanguine;
#SurgEd @roux_group #SoMe4Surgery @ASiTofficial
Arising from the aorta, at the level of T12,
From beneath the arcuate, into the abdomen it does delve,
Enters lesser sac, then divides into three,
At the upper border of ‘The Queen’, like an inverted tree;
From beneath the arcuate, into the abdomen it does delve,
Enters lesser sac, then divides into three,
At the upper border of ‘The Queen’, like an inverted tree;
COMMON HEPATIC is first, and heads off to the Right,
Gives off GDA and RIGHT GASTRIC, when liver’s in sight,
‘PROPER HEPATICS’ to the liver blood do serve,
The RIGHT GASTRIC does the same, to the stomachs lesser curve;
Gives off GDA and RIGHT GASTRIC, when liver’s in sight,
‘PROPER HEPATICS’ to the liver blood do serve,
The RIGHT GASTRIC does the same, to the stomachs lesser curve;
So why pediatric surgery? Pediatric Surgery in India is a last choice super-speciality for surgeons. Low money. Long hours. Complex cases. Seeing kids die. All are often cited reasons. Thread. 1/n
I worked in a minimal access surgery unit and a GI Surgery unit post general surgery. GI surgery was something I liked. But more I read about child surgery - felt an irresistible pull. 2/n
Ended up starting a reasonably successful surgical education platform @Surgtest_NEETSS with @Gopi31676594 . We did pretty well. Scored a decent rank in GI Surgery in 2020. 3/n
How to do a pro search in Pubmed?
This special #TheAmylaseSchool infographics (or mini-course) is a guide to navigate the deep waters of Pubmed (and not get drown). I provide a pdf at the end of the Twitter Thread
1/5
Author Journal Date Title Abstract Language Affiliation
👇
This special #TheAmylaseSchool infographics (or mini-course) is a guide to navigate the deep waters of Pubmed (and not get drown). I provide a pdf at the end of the Twitter Thread
1/5
Author Journal Date Title Abstract Language Affiliation
👇
How to search in Pubmed 2/5
Mesh terms, Boolean operators, My NCBI filters
👇
Mesh terms, Boolean operators, My NCBI filters
👇
How to search in Pubmed 3/5
How to save your search
👇
How to save your search
👇
One year ago today @CovidSurg started.
It's been a tough year for everyone, both professionally and personally. @CovidSurg's priority has been to support surgeons & anaesthetists by providing these best possible evidence to inform surgical care during the pandemic.
It's been a tough year for everyone, both professionally and personally. @CovidSurg's priority has been to support surgeons & anaesthetists by providing these best possible evidence to inform surgical care during the pandemic.
As the pandemic has progressed, we constantly re-prioritised
Our early work included
▶️Natural history of perioperative SARS-CoV-2: thelancet.com/journals/lance…
▶️Burden of pandemic on surgical services: bjssjournals.onlinelibrary.wiley.com/doi/full/10.10…
▶️Early consensus guidance: academic.oup.com/bjs/article/10…
Our early work included
▶️Natural history of perioperative SARS-CoV-2: thelancet.com/journals/lance…
▶️Burden of pandemic on surgical services: bjssjournals.onlinelibrary.wiley.com/doi/full/10.10…
▶️Early consensus guidance: academic.oup.com/bjs/article/10…
We then pivoted to exploring how to mitigate SARS-CoV-2 risks for surgical patients
▶️COVID-free surgical pathways: ascopubs.org/doi/full/10.12…
▶️Preoperative swab screening: academic.oup.com/bjs/article/10…
▶️Timing of surgery in patients with previous SARS-Cov-2: …-publications.onlinelibrary.wiley.com/doi/full/10.11…
▶️COVID-free surgical pathways: ascopubs.org/doi/full/10.12…
▶️Preoperative swab screening: academic.oup.com/bjs/article/10…
▶️Timing of surgery in patients with previous SARS-Cov-2: …-publications.onlinelibrary.wiley.com/doi/full/10.11…
The global survey investigating the psychological health of surgeons in the time of COVID-19 was finally published @AnnalsofSurgery! It is a combined effort from the whole #SoMe4Surgery community. @CUHKMedicine @NUSMedicine (1/n) journals.lww.com/annalsofsurger…
This is an international cross-surgical specialty survey. A total of 4283 participants from 101 countries responded within 15 DAYS. This will NEVER be successful without the strong support from the surgical community aka #SoMe4Surgery established by @juliomayol! (2/n)
The survey was developed using a modified Delphi method. There were 66 questions in total, including the DASS-21 (Depression, Anxiety and Stress Scale) and IES-R (For post-traumatic stress disorder) scores. (3/n)
The toxic culture of surgery...
The story of two attendings. One we’ll call Toxic and the other Nice.
Toxic is your typical surgery bro with a god complex.
Nice is a good surgeon and a patient teacher.
The story of two attendings. One we’ll call Toxic and the other Nice.
Toxic is your typical surgery bro with a god complex.
Nice is a good surgeon and a patient teacher.
I was on call with Nice when Toxic came to sign out to us on the patient he just operated on. He shared his plans and some labs to follow up on.
I asked if the labs had already been ordered or if I needed to order them.
Things went off the rails quickly. This was routine for him to go off for random reasons. And it didn’t help that he and I never got along for some reason.
Things went off the rails quickly. This was routine for him to go off for random reasons. And it didn’t help that he and I never got along for some reason.
🟠17 de septiembre es el día internacional de la #SeguridadDelPaciente. La seguridad de pacientes y #PersonalSanitario están íntimamente relacionadas y hay innumerables ejemplos históricos que lo ilustran. Las infecciones quirúrgicas es uno de ellos: 🧶 1/13
🟠 Alrededor de 1846, en Londres, Joseph Lister era apenas un estudiante de cirugía. La cirugía era una disciplina aún con más potencial que logros -aunque ya los había. El último recurso. Las infecciones = causa de que hubiera una tasa de mortalidad de cerca del 70%... 2/13
🟠Gangrena, Pyemia, Erisipela, Septicemia. Mataban a pacientes y cirujanos por igual. Los cirujanos operaban sin guantes y un rasguño del cuchillo de amputación equivalía a una sentencia de muerte. En una década habrían de morir más de 45 cirujanos tan solo en el RU. 3/13
Association of Surgeons of the Netherlands Practice Guidelines of acute abdomen (some points of review)
💎10% of presentations at the Emergency Department are because of acute abdominal pain
💎Urgent causes require immediate treatment (within 24 h) to prevent complications
💎10% of presentations at the Emergency Department are because of acute abdominal pain
💎Urgent causes require immediate treatment (within 24 h) to prevent complications
💎Most common urgent causes are acute appendicitis, acute diverticulitis, and bowel obstruction
💎Sensitivity of medical history, physical examination, and laboratory values are higher for differentiating urgent from non-urgent conditions than for a specific diagnosis
💎Sensitivity of medical history, physical examination, and laboratory values are higher for differentiating urgent from non-urgent conditions than for a specific diagnosis
💎The inter-observer agreement between residents and staff is moderate for several aspects of medical history and physical examination (κ = 0.29–0.74)
💎The agreement between residents and emergency physicians for additional diagnostic imaging is sufficient (κ = 0.6)
💎The agreement between residents and emergency physicians for additional diagnostic imaging is sufficient (κ = 0.6)
Some thoughts on PPE as our case numbers go up.
My practice has been to wear N95 with every patient. N95, face shield, gown with every trauma patient. My initial instinct was that we’re in the middle of a pandemic and almost everyone is an unknown.
My practice has been to wear N95 with every patient. N95, face shield, gown with every trauma patient. My initial instinct was that we’re in the middle of a pandemic and almost everyone is an unknown.
I now think we need to standardize complete PPE for all patients.
We’ve had multiple patients not suspected to have Covid admitted through the ED, taken to the operating room, cared for in the ICU and then the floor, only to find out they’re COVID positive upon discharge.
We’ve had multiple patients not suspected to have Covid admitted through the ED, taken to the operating room, cared for in the ICU and then the floor, only to find out they’re COVID positive upon discharge.
There’s no way of knowing whether they came in with it or were infected while in the hospital.
Another trend we’ve seen in the last few weeks is hip fractures and patients “not feeling well for a few days.” We picked up the Covid after our assessment.
Another trend we’ve seen in the last few weeks is hip fractures and patients “not feeling well for a few days.” We picked up the Covid after our assessment.
#Lymphatics of the Abdomen!!!➡️🤔/?👨🏻⚕️👩🏻⚕️
The lymphatic vessels and nodes of the abdomen drain the abdominal and pelvic organs as well as the pelvic walls and the lower part of the abdominal wall....⤵️👇🏻👨🏻⚕️
#SoMe4IQLatAm #SoMe4Surgery
The lymphatic vessels and nodes of the abdomen drain the abdominal and pelvic organs as well as the pelvic walls and the lower part of the abdominal wall....⤵️👇🏻👨🏻⚕️
#SoMe4IQLatAm #SoMe4Surgery
(The upper part of the abdominal wall is drained by the internal thoracic and axillary nodes In addition, the abdominal lymphatics receive lymph from the lower limb, the gonads and the perineum...⤵️👇🏻
Polycystic liver disease (PLD)....⤵️📚
⚜️A heriditary autosomal dominant (AD) disease.
⚜️Arises from biliary epithelium, but does not communicate with biliary system....⤵️
#SoMe4IQLatAm #SoMe4Surgery
⚜️A heriditary autosomal dominant (AD) disease.
⚜️Arises from biliary epithelium, but does not communicate with biliary system....⤵️
#SoMe4IQLatAm #SoMe4Surgery
⚜️Types:) 1ry PLD or an extrarenal manifestation of AD polycystic kidney disease (ADPKD).
⚜️Presentation: usually asymptomatic, hepatomegally, abd pain, jaundice, portal HTN.⤵️
⚜️Presentation: usually asymptomatic, hepatomegally, abd pain, jaundice, portal HTN.⤵️
⚜️Complications:) hemorrhage, biliary obstruction, Budd-Chiari syndrome, rarely malignant transformation.
LFTs are well preserved and so liver failure will not occur.⤵️
LFTs are well preserved and so liver failure will not occur.⤵️
10 ➡️ rules:) for TAPP for inguinal hernia.📚👨🏻⚕️👩🏻⚕️👇🏻↘️⤵️
#SoMe4IQLatAm #SoMe4Surgery
#SoMe4IQLatAm #SoMe4Surgery
Rule 1:) Beginning of Surgery↘️⤵️
💠TAPP: Start Flap 4 cm above Deep Ring, Continue from ASIS to Medial Umbilical Ligament
💠TEP: Blunt Telescopic Dissection or Balloon Dissection
💠TAPP: Start Flap 4 cm above Deep Ring, Continue from ASIS to Medial Umbilical Ligament
💠TEP: Blunt Telescopic Dissection or Balloon Dissection
Rule 2:) Dissection Should Follow the Peritoneal Plane
💠Keep Fatty Tissue with the Muscle of the Inguinal Floor
💠Avoid Exposing Muscle to Preserve Nerves in Zone 1 and Inferior Epigastric Vessels in Zone 3
💠Don't Overdissect Nerves
💠Zone 3 Dissection is Left for Last⤴️⤴️
💠Keep Fatty Tissue with the Muscle of the Inguinal Floor
💠Avoid Exposing Muscle to Preserve Nerves in Zone 1 and Inferior Epigastric Vessels in Zone 3
💠Don't Overdissect Nerves
💠Zone 3 Dissection is Left for Last⤴️⤴️
Surgeons have experienced enormous stress during this pandemic of COVID-19. I'd like to ask #SoMe4Surgery and its social networks to help disseminate this important survey investigating the psychological impact of COVID-19. Pls RT & spread the survey link! surveymonkey.com/r/COVIDPsych001
Los #trasplantes son una expresión bellísima de la #ciencia quirugica, y mejor aún, la expresión más grande del altruismo humano! Son místicos, transforman la muerte ☠ en vida.
#WorldTransplantDay #SoMe4Surgery
#WorldTransplantDay #SoMe4Surgery
Hilito con los últimos hitos en materia de #trasplante 👇🏻
Trasplante renal asistido con #robot 🤖 por puerto único 🤯🤯🤯 en la @ClevelandClinic 2019
Both #EricGarner and #GeorgeFloyd died from the use of approved neck/carotid restraints.
Would you consider death from being restrained a never event as defined by @CMSGov?
#MedTwitter #BlackMedTwitter #MedEd #SoMe4Surgery @Me4Trauma @ACSTrauma
cms.gov/newsroom/fact-…
Would you consider death from being restrained a never event as defined by @CMSGov?
#MedTwitter #BlackMedTwitter #MedEd #SoMe4Surgery @Me4Trauma @ACSTrauma
cms.gov/newsroom/fact-…
Should deadly force be an option if your intent is to restrain?
“Never events,” like surgery on the wrong body part or mismatched blood transfusion, cause serious injury or death to beneficiaries,” -CMS
Neck restraints and carotid restraints have caused the deaths of unarmed Black men.
Where’s the oversight?
Neck restraints and carotid restraints have caused the deaths of unarmed Black men.
Where’s the oversight?
A:)➡️ Mucinous cystadenoma➡️↙️📚👇🏻
💠F>M {50 -_- 60 yrs}
💠M/c site ↔️ body & tail
💠Septate microcyst ➕ solid component
💠CECT ↔️ egg shell calcification
💠No communication with duct
💠Low s.amylase, high CEA level
💠Positive mucin stain⤵️⤵️
💠F>M {50 -_- 60 yrs}
💠M/c site ↔️ body & tail
💠Septate microcyst ➕ solid component
💠CECT ↔️ egg shell calcification
💠No communication with duct
💠Low s.amylase, high CEA level
💠Positive mucin stain⤵️⤵️
B:)➡️ IPMN(Intraductal Papillary Mucinous Neoplasm)➡️↙️📚
💠F=M {60 -_- 70 yrs}
💠M/c site ↔️ Head
💠Lobulated polycystic mass ➕ dilated main pancreatic duct
💠Endoscopy ↔️ mucin protruding from fish mouth.....👇🏻👇🏻
💠F=M {60 -_- 70 yrs}
💠M/c site ↔️ Head
💠Lobulated polycystic mass ➕ dilated main pancreatic duct
💠Endoscopy ↔️ mucin protruding from fish mouth.....👇🏻👇🏻
1/
Hello @Me4Trauma and @me4_so. Welcome to my tweetorial on Palliative Care for the trauma patient.
To start, palliative care as defined by @WHO. Palliative care is often delivered along side disease modifying treatment.
@Surgpallcare #SoMe4Trauma #SoMe4Surgery
Hello @Me4Trauma and @me4_so. Welcome to my tweetorial on Palliative Care for the trauma patient.
To start, palliative care as defined by @WHO. Palliative care is often delivered along side disease modifying treatment.
@Surgpallcare #SoMe4Trauma #SoMe4Surgery
2/
What is Surgical Palliative Care? As defined by Dr. Geoffrey Dunn, it is "interdisciplinary care whose goal is to relieve suffering and improve quality of life of the surgical patient and their family." More info here:
ncbi.nlm.nih.gov/pubmed/21419251
#SoMe4Trauma #SoMe4Surgery
What is Surgical Palliative Care? As defined by Dr. Geoffrey Dunn, it is "interdisciplinary care whose goal is to relieve suffering and improve quality of life of the surgical patient and their family." More info here:
ncbi.nlm.nih.gov/pubmed/21419251
#SoMe4Trauma #SoMe4Surgery
3/
While the practice of Surgical Palliative Care may include palliative procedures (venting G tubes, intestinal bypass, etc) it definitely includes family meetings, goals of care & code status discussions, prognostication & skilled symptom management. #SoMe4Trauma #SoMe4Surgery
While the practice of Surgical Palliative Care may include palliative procedures (venting G tubes, intestinal bypass, etc) it definitely includes family meetings, goals of care & code status discussions, prognostication & skilled symptom management. #SoMe4Trauma #SoMe4Surgery
Welcome to the first tweetorial in our Critical Care Corner. Stay tuned for this spooky Halloween thread, hosted by none other than the Addams Family.
We have kept it simple here. Links provided for further reading.
No sensitive images in this thread
#SoMe4Trauma
#SoMe4Surgery
We have kept it simple here. Links provided for further reading.
No sensitive images in this thread
#SoMe4Trauma
#SoMe4Surgery
Our topic for today is the “festering” problem of necrotizing fasciitis (NF) otherwise known as “flesh eating bacteria syndrome”. It is a life threatening soft tissue infection,with a mortality rate ranging from 8.6-76% in the literature(median 32.2%)
#SoMe4Trauma
#SoMe4Surgery
#SoMe4Trauma
#SoMe4Surgery
It commonly affects the perineum and scrotum (Fournier’s gangrene), the abdominal wall & extremities. Trauma pts, & pts with surgical wounds, are particularly susceptible as the site of trauma can act as a portal of entry for bacteria.
#SoMe4Trauma
#SoMe4Surgery
#SoMe4Trauma
#SoMe4Surgery
@Me4Trauma Another great question. Starts with a mindset. For surgeons in uniform, no matter how subspecialized you are, you will be called upon to deploy and be a facile trauma surgeon #Q5 #SoMe4Trauma #SoMe4Surgery
@Me4Trauma First step was alluded to in #Q4. Training must be high quality but brief. To that end, the Emergency War Surgery course has undergone significant revision in recent years. Still work to do there though #Q5 #SoMe4Trauma #SoMe4Surgery
@Me4Trauma EWS has partnered with @AmCollSurgeons @ACSTrauma and incorporated the ASSET course into the curriculum. Vascular exposure is possibly the most important refresher prior to deployment #Q5 #SoMe4Trauma #SoMe4Surgery
@Me4Trauma Absolutely! My predeployment training pipeline was 5 months, I was deployed for 7, and had a month after returning before I resumed practice. Skill atrophy is a real phemonenon. #Q4 #SoMe4Trauma #SoMe4Surgery
@Me4Trauma Several of us have a grant to look at this as it applies to robotics for military surgeons (who are already lower volume than private sector). Proud to be working with Rob Lim, @Averywalker21 @Doc_Brown44 and others on this project #Q4 #SoMe4Trauma #SoMe4Surgery
@Me4Trauma @Averywalker21 @Doc_Brown44 We address this in a twofold manner:
1) military predeployment training must be high quality, but also done quickly. 5 months to train and not operate, followed by a low volume deployment is not the way forward #Q4 #SoMe4Trauma #SoMe4Surgery
1) military predeployment training must be high quality, but also done quickly. 5 months to train and not operate, followed by a low volume deployment is not the way forward #Q4 #SoMe4Trauma #SoMe4Surgery
