Saturday, April 28, 2007

Update from the Medical Journals

This should be welcome news for all those parents who have been saying "Stop playing those video'll never amount to anything...."

Impact of Video Games on Training Surgeons

Surgeons in the 21st century need to have different skills than in the past. Laparoscopic surgery requires a different hand/eye coordination that is similar to the equipment maneuvers and screens that kids use in playing video games. Researchers looked at the link between playing video games and surgical skill and suturing. They did an analysis of the performance of surgical residents and attending physicians with past experience with video games and current level of play. They controlled for the number of laparoscopic cases performed , their level of surgical training and the number of years in medical practice.
Guess what? They found that video game skill and experience are significant predictors of laparoscopic skills. Past video game play in excess of 3 hours/week correlated with 37% fewer errors, and 27% faster completion of surgery. They concluded that video games may be a practical teaching tool to help train surgeons.
Note to kids: You still need organic chemistry, physiology and anatomy to be a surgeon so listen to your mom when she says turn off the Xbox and get back to studying!
Archives of Surgery

I have sent a number of patients to the neurosurgeon for epidural steroid injections in the hopes their severe back pain and sciatica would be relieved. So much of what we do is not backed up with evidence.

Epidural Injections Benefit for Back Pain Questioned

Giving epidural corticosteroid injections to treat back pain has been an increasingly common practice over the past 50 years. There have not been rigorous studies that prove the effectiveness and safety of this expensive procedure. An analysis of studies that covered 300 patients found that there was no benefit at 24 hours postinjection, at 3-6 months or 1 year later.
The epidural steroid injections had no impact on patient's day-to-day functioning, need for surgery, or long-term pain.
The authors recommend future studies of epidural injections compared with other therapies to more accurately determine the degree and duration of pain relief.

I love these maggot reports. Once you get past the "eeew" factor, it makes sense.

Return of the Maggots
Staphylococccus aureus is a common skin bacteria that is becoming more resistant to antibiotics. When a diabetic patient gets a resistant Staph foot ulcer, they are difficult to treat and often require surgery and long treatment with IV antibiotics.
Researchers applied larvae (maggots) of the green bottle fly to ulcers on 13 patients (aged 19-80 years) for four days. The infection was completely cleared after two to eight maggot applications in all but one patient. No adverse events were reported by any of the patients.
Maggot treatment is the first non-invasive and risk-free treatment of this increasing problem.
Diabetes Care


Paul Levy said...
This comment has been removed by the author.
Paul Levy said...

Hi Toni,

Good news on your first point, for sure. We built an extensive skills training lab based on that premise -- that practice, practice, practice is better than "see one, do one, teach one", the old mantra for surgeons.

On the maggots - I believe it, but it still seems like it would be creepy!

K said...

Thanks for posting that bit about the epidural injections - I mentioned it to one of the attorneys at work and he had me print it out and put it in one of our casefiles! said...

It won't work in actual fact, that is exactly what I suppose.