journal
https://read.qxmd.com/read/38844859/trauma-program-value-assessment-at-an-academic-health-network-system-over-12-years
#41
JOURNAL ARTICLE
Michael Abdelmasseh, Araceli Cuaranta, Errington Thompson, Robert K Finley, Barbara Payne, Jing Tian, Alexei Gorka, Jonathan Willis, Vineela Kadiyala, Juan R Sanabria
BACKGROUND: Trauma is a leading cause of global death, with 200 000 deaths and over 3 million non-fatal injuries/year in the United States. We aim to assess trauma care value for patients who underwent urgent laparotomies (LAP) and thoracotomies (THO) in our Health Network System. METHODS: Clinical variables (v = 84) from trauma patients (>18 yo) were retrieved retrospectively (Jan-2010 to July-2016) and prospectively (Aug-2016 to Sept-2021) from a Health System warehouse under IRB-approved protocols...
June 6, 2024: American Surgeon
https://read.qxmd.com/read/38840297/initial-experience-with-robotic-liver-resection-in-the-united-states
#42
JOURNAL ARTICLE
Daisuke Imai, Masaya Yokoyama, Yuzuru Sambommatsu, Aamir A Khan, Vinay Kumaran, Muhammad I Saeed, Hannah Lee, Scott Matherly, Adrian H Cotterell, Marlon F Levy, David A Bruno, Seung D Lee, Amit Sharma
BACKGROUND: This study's aim was to show the feasibility and safety of robotic liver resection (RLR) even without extensive experience in major laparoscopic liver resection (LLR). METHODS: A single center, retrospective analysis was performed for consecutive liver resections for solid liver tumors from 2014 to 2022. RESULTS: The analysis included 226 liver resections, comprising 127 (56.2%) open surgeries, 28 (12.4%) LLR, and 71 (31.4%) RLR...
June 5, 2024: American Surgeon
https://read.qxmd.com/read/38839096/an-age-stratified-analysis-of-early-postoperative-mortality-among-medicare-eligible-patients-with-common-gastrointestinal-and-hepato-pancreato-biliary-malignancies
#43
JOURNAL ARTICLE
Alexander W Loftus, Jonathan J Hue, Mohamedraed Elshami, Jennifer L Miller-Ocuin, Emily Steinhagen, Richard S Hoehn, Luke D Rothermel, John B Ammori, Jeffrey M Hardacre, Lee M Ocuin
Background: The frequency of major cancer surgery in the elderly (≥80 years) has increased concomitantly with the rise in average age of the population. We assessed early postoperative mortality following hepato-pancreato-biliary (HPB) and gastrointestinal (GI) procedures for common malignancies stratified by age. Methods: The National Cancer Database (2004-2017) was queried for patients who underwent resection for GI (gastroesophageal and colorectal) or HPB (pancreatic adenocarcinoma, biliary tract, and primary liver) cancers...
June 5, 2024: American Surgeon
https://read.qxmd.com/read/38836432/outcomes-of-combined-opioids-and-benzodiazepines-consumption-in-elderly-trauma-a-retrospective-cohort-study
#44
JOURNAL ARTICLE
Osaid Alser, Ander Dorken Gallastegi, Mohamad El Moheb, Toby Raybould, Christopher DePesa, Alice Gervasini, Michael Flaherty, Peter T Masiakos, George C Velmahos, Haytham Kaafarani, Jonathan Parks
BACKGROUND: Acute substance intoxication is associated with traumatic injury and worse hospital outcomes. The objective of this study was to evaluate the association between simultaneous opioids and benzodiazepines (OB) use and hospital outcomes in elderly trauma patients. METHODS: We performed a retrospective analysis using the American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) 2017 database. We included trauma patients (age ≥ 65 years) examined by urine toxicology within 24 hours of presentation...
June 5, 2024: American Surgeon
https://read.qxmd.com/read/38835213/comparison-of-therapeutic-effects-between-conventional-2d-laparoscopy-and-3d-laparoscopy-in-the-treatment-of-colorectal-cancer-a-systematic-review-and-meta-analysis
#45
REVIEW
Shixiong Zhan, Zhicheng Zhu, Haitao Yu, Yu Xia, Yuangui Zhu, Feixiang Wu, Hui Liao, Zhenda Wan
BACKGROUND: This study aimed to evaluate the effectiveness and safety of 2D laparoscopy vs 3D laparoscopy for the treatment of colorectal cancer. METHODS: A literature search was conducted through PubMed, Web of Science, and Embase from their inception to January 2024. Studies investigating different outcomes of colorectal surgery were included. Results are presented as odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42024504902)...
June 4, 2024: American Surgeon
https://read.qxmd.com/read/38834358/be-efficient-to-be-fast-in-the-operating-room
#46
JOURNAL ARTICLE
Eric Knauer
No abstract text is available yet for this article.
June 4, 2024: American Surgeon
https://read.qxmd.com/read/38831679/a-comparison-of-clinical-outcomes-of-colectomies-for-pediatric-and-adult-patients-with-inflammatory-bowel-disease
#47
JOURNAL ARTICLE
Satyam K Ghodasara, Kristine M Hauser, Kaitlyn M Oldewurtel, Rolando H Rolandelli, Zoltan H Nemeth
Background: Crohn's disease (CD) and ulcerative colitis (UC) are prevalent in adult and pediatric populations, but their differences are not well studied using national data. We compared the clinical outcomes of these patients using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) databases. Methods: Colectomy cases for CD and UC, the 2 major forms of inflammatory bowel disease (IBD), were compared between adult and pediatric patients using the 2017-2019 ACS NSQIP databases...
June 3, 2024: American Surgeon
https://read.qxmd.com/read/38830580/optimizing-nutritional-needs-of-burn-patients-an-evaluation-of-nutritional-assessment-tools-feeding-strategies-and-their-impact-on-patient-outcomes
#48
REVIEW
Ruth Zagales, Emelia Watts, Muhammad Usman Awan, Nickolas Hernandez, Minna Haddadi, Howard G Smith, Adel Elkbuli
BACKGROUND: Optimal nutritional support is essential to the recovery and improved outcomes of burn patients. This review aims to explore existing literature to evaluate nutrition assessment tools, feeding formulations' caloric predictive ability, timing of initiation of feeding, optimal nutritional composition, and caloric intake in burn patients. METHODS: Three databases were searched to glean studies investigating nutrition in acute severe adult burn patient populations in four areas: outcomes based on feeding type and timing, the caloric predictability of nutritional assessment tools, outcomes associated with the composition of feeding formulas, and considerations related to caloric intake...
June 3, 2024: American Surgeon
https://read.qxmd.com/read/38830241/medicine-s-glass-slipper-the-pavaex-boot-and-20th-century-negative-pressure-therapy
#49
JOURNAL ARTICLE
Alexandria L Soto, Todd M Olszewski, Justin Barr
Before the 20th century, peripheral artery disease (PAD) manifested as extreme pain, chronic wounds, and, eventually, gangrene requiring amputation. Despite this, it was rarely diagnosed. However, at the turn of the century, Western medicine shifted focus from infectious to chronic illnesses, and with this change, physicians' engagement with PAD transformed. Aiming to mitigate long-term injury, physicians now worked to identify and treat vessel disease to restore meaningful blood circulation. This article explores the development and deployment of a new device resulting from this refocus, the PAssive VAscular EXerciser (PAVAEX) Boot, and its role as a creative response to a previously intractable clinical problem...
June 3, 2024: American Surgeon
https://read.qxmd.com/read/38828777/thyrotoxicosis-presenting-as-an-acute-abdomen
#50
JOURNAL ARTICLE
Samantha Woolery, Mari Freedberg, Jason D Sciarretta, Christine Castater, Jonathan Nguyen
Abdominal pain continues to be a common chief complaint in the emergency setting. While this presentation can be non-specific, there are certain findings that warrant immediate surgical intervention. Portal venous gas on imaging in the setting of peritonitis and sepsis is one such finding. Thyrotoxicosis on the other hand is an uncommon diagnosis that is associated with non-specific symptoms resulting in delayed diagnosis, a clinical scenario that can lead to significant morbidity and mortality. Here, we present a rare case of a patient who presented with signs and symptoms of peritonitis and portal venous gas on CT scan that was taken emergently to the operating room...
June 3, 2024: American Surgeon
https://read.qxmd.com/read/38825791/association-of-burnout-and-other-factors-within-physicians-and-advanced-practice-providers-in-an-academic-surgery-department
#51
JOURNAL ARTICLE
Sally A Santen, Kelly S Lockeman, Amelia Grover, Dana Burns, Kwame Asante Akuamoah-Boateng, Cynthia Siner, Lisa Ellis, Brian K Sparkman, Sarah Miller, Carla Nye
BACKGROUND: Provider burnout is a work-related syndrome that is under-recognized, under-reported, and has negative repercussions on the individual, system, and patients. This study investigated burnout incidence and its association with wellness characteristics such as resilience, psychological safety, and perceptions of the workplace to inform future work in improving well-being. METHODS: Electronic surveys were sent to 153 physicians and advanced practice providers (APPs) in the department of surgery at a single institution...
June 2, 2024: American Surgeon
https://read.qxmd.com/read/38822765/impact-of-the-affordable-care-act-on-revascularization-versus-amputation-in-patients-presenting-with-chronic-limb-threatening-ischemia-in-maryland
#52
JOURNAL ARTICLE
Oluwasegun Akinyemi, Terhas Weldeslase, Mojisola Fasokun, Eunice Odusanya, Andine Tsion, Edward Cornwell, Kakra Hughes
INTRODUCTION: The Affordable Care Act (ACA) aimed to expand Medicaid, enhance health care quality and efficiency, and address health disparities. These goals have potentially influenced medical care, notably revascularization rates in patients presenting with chronic limb-threatening ischemia (CLTI). This study examines the effect of the ACA on revascularization vs amputation rates in patients presenting with CTLI in Maryland. METHODS: This was a retrospective analysis of the Maryland State Inpatient Database comparing the rate of revascularization to rate of major amputation in patients presenting with CLTI over 2 periods: pre-ACA (2007-2009) and post-ACA (2018-2020)...
June 1, 2024: American Surgeon
https://read.qxmd.com/read/38822562/gender-disparity-in-academic-trauma-surgery-the-current-state-of-affairs
#53
JOURNAL ARTICLE
Syed Ali Farhan, Nimra Hasnain, Manpreet Moorpani, Emad-Ud-Din Sajid, Izza Shahid, Tanya Anand, Faisal Khosa
INTRODUCTION: Despite the increasing number of female surgeons in general surgery programs, women are still inadequately represented in leadership positions. This study aims to investigate the magnitude of gender bias in university-based trauma surgery fellowship programs and leadership positions in the United States of America. MATERIAL AND METHODS: FRIEDA was used to identify trauma surgery programs. A thorough website review of each program obtained further information on faculty members, including their name, age, gender, and faculty rank...
May 31, 2024: American Surgeon
https://read.qxmd.com/read/38821531/predictors-of-clinical-outcomes-and-the-need-for-massive-transfusion-protocols-in-geriatric-trauma-patients-with-hemorrhagic-shock-a-systematic-review
#54
REVIEW
Hazem Nasef, Caitlin Tweedie, Nikita Bundschu, Quratulain Amin, Nickolas Hernandez, Francis Cruz, Chadwick P Smith, Adel Elkbuli
INTRODUCTION: The current literature lacks a clear consensus on the predictors of mortality and outcomes of geriatric trauma patients in hemorrhagic shock. This systematic review aims to investigate predictors of clinical outcomes and the need for massive transfusion protocol in the geriatric trauma population with hemorrhagic shock. METHODS: PubMed, EMBASE, Cochrane, ProQuest, and Google Scholar were searched for studies evaluating geriatric trauma patients in hemorrhagic shock or receiving MTP...
May 31, 2024: American Surgeon
https://read.qxmd.com/read/38820594/persistent-racial-disparities-in-morbidity-following-major-elective-operations
#55
JOURNAL ARTICLE
Sara Sakowitz, Syed Shahyan Bakhtiyar, Saad Mallick, Giselle Porter, Konmal Ali, Amulya Vadlakonda, Joanna Curry, Peyman Benharash
Introduction: Despite considerable national attention, racial disparities in surgical outcomes persist. We sought to consider whether race-based inequities in outcomes following major elective surgery have improved in the contemporary era. Methods: All adult hospitalization records for elective coronary artery bypass grafting, abdominal aortic aneurysm repair, colectomy, and hip replacement were tabulated from the 2016-2020 National Inpatient Sample. Patients were stratified by Black or White race. To consider the evolution in outcomes, we included an interaction term between race and year...
May 31, 2024: American Surgeon
https://read.qxmd.com/read/38820223/does-the-surgical-approach-affect-the-incidence-of-post-hepatectomy-liver-failure-in-cirrhotic-patients-an-analysis-of-the-nsqip-database
#56
JOURNAL ARTICLE
Faisal S Jehan, Sangrag Ganguli, Niklas E Hase, Abhinav Seth, Yong Kwon, Alan W Hemming, Hassan Aziz
Background: The association between surgical approach and post-hepatectomy liver failure (PHLF) in cirrhotic patients is poorly understood. We hypothesize that patients will have similar rates of liver failure regardless of whether they undergo minimally invasive liver resection (MILR) or open liver resection (OLR) in major liver resections. In contrast, there will be lower rates of PHLF in patients undergoing minor hepatectomy via the MILR approach. Methods: Propensity score matching was used to analyze regression by matching the MILR to the OLR cohort...
May 31, 2024: American Surgeon
https://read.qxmd.com/read/38819076/an-analysis-on-the-effect-of-income-changes-in-the-resection-of-early-stage-pancreatic-adenocarcinoma
#57
JOURNAL ARTICLE
Ahmer Irfan, J Bart Rose, Vikas Dudeja, Daniel I Chu, Sushanth Reddy
INTRODUCTION: The impact of socioeconomic inequalities on cancer care and outcomes has been well recognized and the underlying causes are likely multifactorial. Income is regarded as a cornerstone of socioeconomic status and has been assumed to correlate with access to care. We therefore sought to investigate whether income and changes in income would affect the rate of patients undergoing surgical resection for early-stage pancreatic cancer. METHODS: Inflation-adjusted income data were obtained from the United States Census Bureau from 2010 to 2019...
May 31, 2024: American Surgeon
https://read.qxmd.com/read/38817103/reframing-surgery-using-the-concepts-of-diversity-equity-and-inclusion
#58
JOURNAL ARTICLE
Vishal Kumar
No abstract text is available yet for this article.
May 30, 2024: American Surgeon
https://read.qxmd.com/read/38816937/screening-for-breast-cancer-risk-an-analysis-of-under-recognized-risk-factors-and-comparison-of-interventions
#59
JOURNAL ARTICLE
Mary Wolf, Rebecca L Vanderveken, Gabriela Rodriguez, Amanda Kasumu, Katie Frank, Matthew Billy, Jacqueline C Oxenberg
Recognition of patients at high risk (HR) for breast cancer allows earlier screening and opportunities for risk reduction. We compare patients referred to our breast clinic as HR vs referrals for other reason (ROR) and found to be HR. We evaluate under-recognized factors and treatment differences. A retrospective chart review of patients found to be HR but referred for any reason to our breast clinic from July 2012 to December 2022 was performed. Referral reason, demographics, hormonal history, family history, and other risk factors were evaluated and compared (HR vs ROR)...
May 30, 2024: American Surgeon
https://read.qxmd.com/read/38816892/comparing-chest-tube-thoracostomy-in-east-tennessee-trauma-centers-a-prospective-study-highlighting-differences-in-urban-vs-rural-locations
#60
JOURNAL ARTICLE
Vinila Baljepally, Tyler Lock, Chase Hayman, Ethan Ward, Sarah A King, Alva Bethurum, Lou M Smith
Chest tube thoracostomy (CTT) is essential for lung expansion, but protocol discrepancies exist across trauma centers. This prospective study compared CTT protocols between an urban (center 1) and rural (center 2) level 1 trauma center in East Tennessee from June to August 2023. 66 trauma patients required CTT (51 from center 1 and 15 from center 2). Diagnostic practices and post-pull chest X-rays (CXR) differed significantly. Center 1 favored CXR for diagnosis ( P = 0.012), while center 2 relied more on clinical presentation ( P = 0...
May 30, 2024: American Surgeon
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