BACKGROUND: During the current global crisis unleashed by the severe acute respiratory syndrome coronavirus 2 outbreak, surgical departments have considerably reduced the amount of elective surgeries. This decrease leads to less time in the surgical room to develop and improve the surgical skills of residents. In this study, we developed a training program to obtain and maintain microsurgical skills at home, using a smartphone camera and low-cost materials, affordable for everyone.-METHODS: Using a smartphone camera as a magnification device, 6 participants performed 5 exercises (coloring grids, grouping colors, unraveling of a gauze, knots with suture threads, and tower of Hanoi), both with the dominant and with the nondominant hand, for 4 weeks. We compared performance at the beginning and at the end of the training process. Each participant filled out an anonymous survey.-RESULTS: When we compared the performance at the beginning and at the end of the training process, we found significant improvements (P [ 0.05) with the dominant as well as the nondominant hand in all the exercises. All participants were satisfied or very satisfied with the definition of the objectives of the training process, material availability, the exercises performed, the choice of the time to train, and general satisfaction with the training program.-CONCLUSIONS: We developed a microsurgical skills training program to be performed at home, which can be easily reproduced. It allows residents to improve manual coordination skills and is regarded as a feasible adjunct for ongoing training for surgical residents.
To mitigate the burden of COVID-19 on healthcare systems and to reduce infections and associated deaths, public health measures including physical distancing and mask-wearing have been recommended. We know little regarding important predictors of adherence and motivation to engage in public guidelines among at-risk populations, such as adolescents. Objectives. The purpose of the present study was to examine differences in adherence to public health measures across provinces, and to examine developmental differences in both adherence and motivations to engage in public health among adolescents and adults across Canada during the COVID-19 pandemic. Methods. Participants from two samples, including adolescents (N=788, 56.7% female, M=15.68, SD=1.36) and adults (N=578, 94.6% female; M=45.12, SD=5.83) completed online quesionnaires during the summer 2020. Results. Both adolescents and adults in provinces mandating masks were more likely to wear a mask. There were no provincial differences in adherence to social distancing. Adolescents were more likely to be motivated by social reasons, while adults were motivated by social responsibility. For both adults and adoeslcents, social responsibility was associated with more adherence to public health measures, while social concerns(e.g., maintaining social ties, social judgment) was associated with less adherence. Conclusion. Adherence to public health measures was mixed, with most participants reporting socializing in-person with people outside of their home. At the time of the survey, provincial mask mandates were associated with more mask-wearing. Results also suggest social responsibility was the main predictor of increased adherence to public health measures.
Introducción: los quistes epidermoides son tumores benignos de origen ectodérmico que constituyen el 1% de los tumores intracraneales. Su localización más frecuente es el Ángulo Pontocerebeloso (APC), constituyendo el 3er tumor en frecuencia en dicho sitio.Objetivos: presentar nuestra serie de casos de tumores epidermoides del APC intervenidos por vía endoscópica en nuestra instituciónMateriales y métodos: se realizó un estudio descriptivo retrospectivo de los pacientes con quistes epidermoides del APC intervenidos por vía endoscópica en nuestra institución en el periodo 2017-2022. Se analizaron datos demográficos, evaluación prequirúrgica, imágenes intraoperatorias y evolución postquirúrgica.Resultados: fueron intervenidos 5 pacientes utilizando la modalidad endoscópica. Se empleo la posición de banco de plaza, abordaje retrosigmoideo y monitoreo neurofisiológico en todos los casos. La edad promedio fue de 46 años (30-51); todos de sexo masculino. El síntoma más frecuente fue la ataxia, seguido del compromiso del V, VI y VII par. No se registraron casos de meningitis aséptica. Un paciente presentó paresia leve del VII par (H&B II) postquirúrgica. La resección fue subtotal en 4 pacientes, en el caso restante se logró resección total; 3 pacientes mejoraron la paresia facial prequirúrgica y dos de ellos la ataxia.Conclusiones: la consistencia blanda y aspirable de los quistes epidermoides, asociado a su escasa vascularización resultan favorables para su resolución quirúrgica endoscópica. El endoscopio permite una vista panorámica del APC, con la fuente de luz cercana al campo de trabajo y gran maniobrabilidad. La retracción dinámica, sin espátula, disminuye la injuria al parénquima cerebeloso. Como limitantes del método podemos citar la curva de aprendizaje del endoscopio, así como la falta de percepción 3D.
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