Mucormycosis in patients with inflammatory bowel disease: case series and review of the literature.

Mucormycosis is a rare and often fatal invasive fungal infection mostly seen in immune-compromised individuals. A high index of clinical suspicion is necessary, so that effective preemptive therapy can be started, as timely intervention is crucial. In this series we present three cases of invasive mucormycosis in patients with underlying inflammatory bowel disease that had received therapy with immunomodulators prior to the infection. All three had varied clinical manifestations. We also review the literature of invasive mucormycosis in patients with inflammatory bowel disease.

Effect of alcohol on surgical dexterity after a night of moderate alcohol intake.

BACKGROUND: Alcohol misuse is commonplace among health professionals. The effects of alcohol on cognition and dexterity have been shown up to 14 hours after alcohol intake. The aerospace industry has restrictions on alcohol intake, and there is pressure for the health care industry to do the same. Few studies have addressed the lingering impact alcohol has on surgical performance, and none have measured surgical dexterity using well-established Fundamentals of Laparoscopic Surgery benchmarks. METHODS: Twenty-seven surgeons participated in this study: 11 attending surgeons, 2 fellows, and 14 resident surgeons. Three Fundamentals of Laparoscopic Surgery tasks measured surgical dexterity: peg transfer, pattern cutting, and intracorporeal suturing. Performance on these tasks was measured before alcohol intake and the morning after a night of social drinking. Alcohol levels were measured via breathalyzer 20 minutes after completion of drinking and the following morning before testing. Time and accuracy were compared. RESULTS: The mean blood alcohol level was .076 mg/100 mL blood. Times for peg transfer, pattern cutting, and intracorporeal suturing showed no differences. Accuracy in pattern cutting was not different, but accuracy for intracorporeal suturing was significantly worse the morning after alcohol intake. CONCLUSIONS: The morning after moderate alcohol intake, the time to complete Fundamentals of Laparoscopic Surgery tasks was unchanged, but accuracy was worse.