0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
In This Issue of JAMA Surgery |

Highlights FREE

JAMA Surg. 2016;151(7):597. doi:10.1001/jamasurg.2015.2928.
Text Size: A A A
Published online

RESEARCH

In this nationwide retrospective cohort study evaluating inpatient, outpatient, and antibiotic prescription claims of 87 461 patients, Simianu et al found that 56.3% of elective resections for uncomplicated diverticulitis occurred after fewer than 3 episodes of diverticulitis. Earlier surgery was not explained by younger patient age, laparoscopy, time between the last 2 episodes preceding surgery, or financial risk-bearing for patients.

Despite the lack of efficacy data, robotic-assisted surgery has diffused rapidly into practice. Marketing to physicians, hospitals, and patients has been widespread, but how this marketing has contributed to the diffusion of the technology remains unknown. Wright and colleagues examined the effect of regional hospital competition and hospital financial status on the use of robotic-assisted surgery for 5 commonly performed procedures. They found that patients undergoing surgery in a hospital in a competitive regional market were more likely to undergo a robotic-assisted procedure.

The appropriately coached implementation of surgical safety checklists (SSCs) reduces the incidence of perioperative complications and 30-day mortality of patients undergoing surgery. However, the association of the introduction of SSCs with 90-day mortality remains unclear. Bock et al assessed the association between the implementation of SSCs and all-cause 90- and 30-day mortality rates among 10 741 patients. They found that the implementation of SSCs was associated with a 27% reduction of the adjusted risk for all-cause death within 90 days but not within 30 days.

CLINICAL REVIEW & EDUCATION

Because surgical procedures require clinicians to develop and maintain procedural expertise and because blinding in randomized clinical trials of such therapies is often challenging, their critical appraisal raises unique issues. To address these issues, this Users’ Guide to the Medical Literature reviews the use of remote randomization systems, blinding, sham-controlled trials, split-body trials, expertise-based trials, and mechanistic vs practical trials.

CME

The diagnosis and surgical treatment of thyroid cancer is challenging when preoperative biopsy results are cytologically indeterminate. In a review by Yip and Sosa, molecular marker tests, such as gene expression classifier analysis and evaluation for somatic mutations or rearrangements, can be used to differentiate benign from malignant nodules. Preoperative genotyping may also correlate with tumor phenotype and may be used to tailor the extent of the initial surgery.

CME

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

309 Views
0 Citations
×

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs