RESUMO
Traditional training in pediatric surgery has focused on knowledge acquisition and technical skills. Although recognized as important, the skills relating to communication, collaboration, leadership, management, health advocacy and professionalism have received less formal attention. Recognition of the importance of these softer skills in combination with the greater use of simulation in education prompted us to develop a national simulation-based curriculum in pediatric surgery. This paper describes the development, implementation and three-year follow-up of the mandatory, simulation-based curriculum for pediatric surgery residents in France. We review the available literature on the topic and present our results.
Assuntos
Currículo , Internato e Residência/métodos , Pediatria/educação , Treinamento por Simulação/métodos , Especialidades Cirúrgicas/educação , Competência Clínica , França , Humanos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de SaúdeRESUMO
Anorectal leiomyomatosis is exceedingly rare in children. Its association with the more common diffuse oesophageal leiomyomatosis has been documented in only two previous cases. This report describes the presentation, diagnosis and treatment of two further cases of diffuse oesophageal combined with anorectal leiomyomatosis.
Assuntos
Neoplasias Esofágicas/cirurgia , Leiomiomatose/cirurgia , Neoplasias Retais/cirurgia , Criança , Neoplasias Esofágicas/diagnóstico , Feminino , Humanos , Leiomiomatose/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Neoplasias Retais/diagnóstico , Tomografia Computadorizada por Raios XAssuntos
Colo/anormalidades , Colo/diagnóstico por imagem , Colo/cirurgia , Humanos , Recém-Nascido , Masculino , RadiografiaRESUMO
OBJECTIVE: To assess the effectiveness of preoperative manual detorsion in acute testicular torsion. MATERIALS AND METHODS: Between June 1998 and March 1999, seven patients presenting with testicular torsion underwent manual manipulation under US monitoring in order to restore the flow to the testis prior to surgery (orchidopexy). All detorsions were lateral in direction. The success of the manoeuvre was assessed both clinically and sonographically and confirmed at surgery. RESULTS: Six manoeuvres were successful in restoring flow to the testis. The failed attempt in the seventh patient was due to failure to manipulate beyond an initial 1 1/2 rotations (540 degrees). CONCLUSIONS: Preoperative detorsion is the fastest way to relieve testicular ischaemia. However, manual detorsion of the spermatic cord is not a substitute for surgical exploration and bilateral orchidopexy is still necessary.
