Acute care surgery: what's in a name? A new specialty comes of age.

A quiet revolution in American surgery has occurred over the past 10-15 years, with the emergence of acute care surgery as a true specialty, and apparently the heir to general surgery. This new paradigm traces its beginning to certain core safety net hospitals in the U.S., such as Denver Health Medical Center, San Fancisco General Hospital, Detroit Receiving Hospital, and Grady Memorial Hospital in Atlanta, and has now extended its foothold to most U.S. academic institutions as well. The discipline of acute care surgery represents a fusion of trauma surgery, surgical critical care, and emergency surgery. although the actual surgical responsibilities of the ACS surgeon may vary, depending on local institutional needs, the core principles remain the same. The new specialty appears to have broad appeal not only to the departments in which they serve, but to resident trainees and hospital administration as well. While a number of challenges need to be addressed before adaption of this system to Israel, the new paradigm appears to have potential for serving Israeli surgery in the future. In summary, there is much to a name. Just as the guardian angel of Aisov gave the new name "Israel" to the biblical patriarch Jacob to signify that he had been evaluated to a new level--"a prince in the eye of G-d and man", "Acute Care Surgery" appears poised to transform General Surgery to a new level for the next generation of surgeons.

Surgical emergencies confounded by H1N1 influenza infection - a plea for concern.

The outbreak of the H1N1 influenza pandemic resulted in unprecedented, overwhelming exposure in the medical and lay media, with the obvious focus of healthcare providers being on patients in internal medicine or intensive care settings.Recently, we treated 3 patients with various surgical emergencies who were also diagnosed with active H1N1 influenza. The purpose of this report is to bring the issue of H1N1 flu in association with surgical emergencies to the forefront of the literature, and suggest that surgical diseases might be significantly accentuated in patients with H1N1 influenza.