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 Showing 1-20 of 54 Articles
Arghavan Salles, MD, PhD; Cara A. Liebert, MD; Ralph S. Greco, MD

This Viewpoints report on a program to help residents cope with daily stress, provide tools to manage challenges after completing residency, and reduce the risk of burnout, depression, and suicide.

Original Investigation  FREE
Junun Bae, MHS; Jaime Shade; Amanda Abraham; Brianna Abraham; Leigh Peterson, MHS; Eric B. Schneider, PhD; Thomas H. Magnuson, MD; Michael A. Schweitzer, MD; Kimberly E. Steele, MD, PhD

Importance  From February 21, 2006, through September 24, 2013, the Centers for Medicare & Medicaid Services (CMS) required, via the National Coverage Determination manual, that bariatric surgery be performed only in hospitals that had been designated as a Center of Excellence (COE). The effect of this certification ...

Invited Commentary: Evaluating Changes in Health Care Policy; Lauren Hersch Nicholas, PhD, MPP; Justin B. Dimick, MD, MPH
Original Investigation 
Christina L. Jacovides, MD; Gregory Nadolski, MD; Steven R. Allen, MD; Niels D. Martin, MD; Daniel N. Holena, MD; Patrick M. Reilly, MD; Scott Trerotola, MD; Benjamin M. Braslow, MD; Lewis J. Kaplan, MD; Jose L. Pascual, MD, PhD, FRCPS(C)
Includes: Supplemental Content

Importance  Optimizing the nature and sequence of diagnostic imaging when managing lower gastrointestinal hemorrhage may reduce subsequent morbidity and mortality.

Objectives  To determine if preceding visceral arteriography with computed tomographic angiography (CTA) in acute lower gastrointestinal hemorrhage increases hemorrhage identification and localization and to determine if ...

Invited Commentary: Computed Tomographic Angiography for Lower Gastrointestinal Hemorrhage; Amy L. Lightner, MD; Marcia M. Russell, MD
Invited Commentary 
Amy L. Lightner, MD; Marcia M. Russell, MD

This Invited Commentary discusses the increasing use of computed tomographic angiography prior to visceral angiography for lower gastrointestinal hemorrhage and raises questions about clinical outcomes and costs to be considered before it is used routinely.

Invited Commentary 
Lauren Hersch Nicholas, PhD, MPP; Justin B. Dimick, MD, MPH

The cost-benefit trade-offs of regionalizing elective surgery remain an important policy issue.1,2 In this issue, Bae and colleagues3 examine patient demographics following a 2006 Medicare National Coverage Decision (NCD) regarding bariatric surgery. The NCD simultaneously extended bariatric surgery coverage to all Medicare patients (previously ...

JAMA Surgery Clinical Challenge 
Matthew M. Boelig, MD; Pablo Laje, MD; William H. Peranteau, MD
Comment & Response 
Neeraja Nagarajan, MD, MPH; Varshini Varadaraj, MBBS, MS

To the Editor We commend the timely article by Kotagal and Horvath1 that discusses the challenges of providing surgical care in under-resourced settings, and we look forward to more articles that address this important issue. As the authors point out, low- and middle-income countries have complex health ...

Comment & Response 
Richard Vander Burg, RN, BSN; Charles Kabetu, MD; Ruben Ayala, MD

To the Editor We commend Ginwalla and Rickard on their recent publication “Surgical Missions: The View From the Other Side”1 in JAMA Surgery. At Operation Smile, we wholeheartedly support and agree with the comments put forward by the authors regarding the duty of mission-based organizations to ...

Original Investigation  FREE
Caitlin W. Hicks, MD, MS; Elizabeth C. Wick, MD; Joseph K. Canner, MHS; James H. Black III, MD; Isibor Arhuidese, MD, MPH; Umair Qazi, MD, MPH; Tammam Obeid, MD; Julie A. Freischlag, MD; Mahmoud B. Malas, MD, MHS

Importance  Endovascular technology has become ubiquitous in the modern care of abdominal aortic aneurysm (AAA), yet broad estimates of its efficacy among variable hospital and regional settings is not known.

Objective  To perform a preliminary analysis of hospital effects on mortality following open AAA repair (OAR) ...

Invited Commentary: Improving the Quality of Data in Surgical Registries; Philip P. Goodney, MD, MS
Original Investigation 
Hunter B. Moore, MD; Elizabeth Juarez-Colunga, PhD; Michael Bronsert, PhD, MS; Karl E. Hammermeister, MD; William G. Henderson, MPH, PhD; Ernest E. Moore, MD; Robert A. Meguid, MD, MPH
Includes: Supplemental Content

Importance  The literature regarding the occurrence of adverse outcomes following nonobstetric surgery in pregnant compared with nonpregnant women has conflicting findings. Those differing conclusions may be the result of inadequate adjustment for differences between pregnant and nonpregnant women. It remains unclear whether pregnancy is a risk factor ...

Invited Commentary 
Philip P. Goodney, MD, MS

This Invited Commentary discusses the need for better data to assess mortality in abdominal aortic aneurysm repair and improve practice patterns in vascular surgery.

Surgical Innovation 
Audrey E. Ertel, MD; Tiffany Kaiser, PharmD; Shimul A. Shah, MD, MHCM

A telehealth intervention is described in patients following liver transplantation.

Research Letter 
Judson B. Williams, MD, MHS; Ralf E. Harskamp, MD; Saideep Bose, MD, MPH; Jeffrey H. Lawson, MD, PhD; John H. Alexander, MD, MHS; Peter K. Smith, MD; Renato D. Lopes, MD, PhD

This anonymous, voluntary, electronic survey sought to characterize the techniques of vein graft preservation and handling among a large cohort of high-performing US cardiovascular hospitals.

William P. Schecter, MD

This Viewpoint discusses global surgery initiatives in low- and middle-income countries.

Original Investigation  FREE
Turner Osler, MD, MSc; Laurent G. Glance, MD; Wenjun Li, PhD; Jeffery S. Buzas, PhD; David W. Hosmer, PhD
Includes: Supplemental Content

Importance  Massachusetts introduced health care reform (HCR) in 2006, expecting to expand health insurance coverage and improve outcomes. Because traumatic injury is a common acute condition with important health, disability, and economic consequences, examination of the effect of HCR on patients hospitalized following injury may help inform ...

Invited Commentary: Trauma Patients and Health Insurance Reform; Jarone Lee, MD, MPH
Original Investigation 
Aslam Ejaz, MD, MPH; Steven M. Frank, MD; Gaya Spolverato, MD; Yuhree Kim, MD, MPH; Timothy M. Pawlik, MD, MPH, PhD

Importance  Transfusion practice among surgeons varies despite several evidence-based recommendations supporting the restrictive use of blood products.

Objective  To define the economic impact of liberal blood transfusions as assessed through an analysis of hemoglobin (Hb) triggers.

Design, Setting, and Participants  Using a prospective database, data ...

Invited Commentary: Use of Restrictive Transfusion in Abdominal Surgery; Danny Chu, MD
Invited Commentary 
Jarone Lee, MD, MPH

With the passing of the Affordable Care Act and the need for policymakers to focus on implementing the individual mandate, the article by Osler et al1 comes at a most needed time. This article adds to the national debate by finding a surprising and interesting result: excessive ...

Ejaz et al1 elegantly demonstrated in a single-institution study that significant monetary savings may be realized if surgeons were to adhere to a restrictive transfusion policy based on concrete intraoperative and postoperative hemoglobin values. There is little doubt that blood transfusion exposes patients to potential risks of ...

JAMA Surgery Clinical Challenge 
Mersadies Martin, MD, MS; Hiromichi Ito, MD
Comment & Response 
Fady Saleh, MD, MPH; Allan Okrainec, MD, MHPE

To the Editor We read with interest the article by Hakkarainen et al1 and wish to commend the authors on their attempt to shed light on the challenging question of nonsteroidal anti-inflammatory drugs (NSAIDs) and the risk for anastomotic leakage after colorectal surgery. A growing body of ...

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