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Editor's Audio Summary

February 25, 2014

JAMA Surgery, 2014-02-19 Online First articles, Editor's Audio Summary

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 Showing 1-20 of 35 Articles
Invited Commentary 
Robert G. Sawyer, MD
The article by Bulger et al1 represents an advance in the world of surgical infections as the first interventional trial using an immunomodulatory agent to treat necrotizing soft-tissue infections. Any prospective interventional study is difficult to execute, and one in such a complicated disease state with such severe morbid effects ...
Original Investigation 
Eileen M. Bulger, MD; Ronald V. Maier, MD; Jason Sperry, MD; Manjari Joshi, MD; Sharon Henry, MD; Frederick A. Moore, MD; Lyle L. Moldawer, PhD; Demetrios Demetriades, MD; Peep Talving, MD; Martin Schreiber, MD; Bruce Ham, MD; Mitchell Cohen, MD; Steven Opal, MD; Irit Segalovich, BS; Greg Maislin, MSc; Raymond Kaempfer, PhD; Anat Shirvan, PhD
Includes: Supplemental Content

Importance  Necrotizing soft-tissue infections (NSTI) have high morbidity and mortality rates despite aggressive surgical debridement and antibiotic therapy. AB103 is a peptide mimetic of the T-lymphocyte receptor, CD28. We hypothesized that AB103 will limit inflammatory responses to bacterial toxins and decrease the incidence of organ failure.

Objectives...

Original Investigation 
Jonathan K. Aboagye, MD, MPH; Heather E. Kaiser, MD, MPH; Awori J. Hayanga, MD, MPH

Importance  Although early detection and treatment of colorectal cancer has been shown to improve outcomes, geographic proximity may influence access to these services.

Objective  To examine the disparities that may exist in colorectal cancer screening and treatment by comparing the distribution of providers of these services ...

JAMA Surgery Clinical Challenge 
Trisha L. Marshall, BS; Kristin C. Turza, MD; Stephen L. Cook, MD; Philip W. Smith, MD
Original Investigation  FREE
Mehraneh D. Jafari, MD; Fariba Jafari, BS; Wissam J. Halabi, MD; Vinh Q. Nguyen, PhD; Alessio Pigazzi, MD, PhD; Joseph C. Carmichael, MD; Steven D. Mills, MD; Michael J. Stamos, MD

Importance  The incidence of colorectal cancer in elderly patients is likely to increase, but there is a lack of large nationwide data regarding the mortality and morbidity of colorectal cancer resections in the aging population.

Objective  To examine the surgical trends and outcomes of colorectal cancer ...

Original Investigation 
Michael N. Mavros, MD; Konstantinos P. Economopoulos, MD; Vangelis G. Alexiou, MD, PhD; Timothy M. Pawlik, MD, MPH, PhD

Importance  Data on outcomes following surgical management of intrahepatic cholangiocarcinoma (ICC) are limited. The incidence of ICC is increasing and it has a poor prognosis. No consensus has been reached regarding the optimal treatment modalities.

Objective  To systematically review and synthesize the available evidence regarding treatment ...

Original Investigation 
Nicole M. Tapia, MD; Allen Milewicz, MD, MBA; Stephen E. Whitney, MD, MBA; Michael K. Liang, MD; Carla C. Braxton, MD, MBA

Importance  Although the Accreditation Council for Graduate Medical Education has defined 6 core competencies required of resident education, no consensus exists on best practices for reaching resident proficiency. Surgery programs must develop resourceful methods to incorporate learning. While patient care and medical knowledge are approached with formal ...

Original Investigation 
Gang Huang, MD; Wan Yee Lau, MD, FRCS; Wei-ping Zhou, MD, PhD; Feng Shen, MD, PhD; Ze-ya Pan, MD; Sheng-xian Yuan, MD; Meng-chao Wu, MD

Importance  In patients with low viral loads, high levels of hepatitis B surface antigen (HBsAg) have been shown to predict development of hepatocellular carcinoma (HCC). Whether high levels of HBsAg increase the risk for HCC recurrence after hepatic resection remains unknown.

Objective  To investigate the association ...

Viewpoint 
Stefano Giuliani, MD, PhD; Dean M. Anselmo, MD
Includes: Supplemental Content
Over the past 50 years, there has been a significant improvement in the outcomes for children with many complex congenital or acquired surgical conditions such as heart disease, gastroschisis, diaphragmatic hernia, anorectal malformations, spina bifida, and intestinal failure. As a result, the adult health care system is receiving a growing ...
Viewpoint 
Diana Farmer, MD; Nicole Sitkin, BA
The 20th century marked a turning point in the development of pediatric surgery. At one time considered the younger stepchild of adult surgery, the field has matured into a distinct entity that encompasses surgical diseases and interventions unique to the pediatric patient. Congenital anomalies once considered fatal, such as esophageal ...
JAMA Surgery Clinical Challenge 
Remealle How, MD; Krzysztof J. Wikiel, MD; Giselle G. Hamad, MD
Invited Commentary 
David H. Berger, MD, MHCM
Dendritic cell (DC)–based cancer vaccines can be prepared with relative ease and have been shown to induce therapeutic antitumor immune responses both in experimental models and, more recently, in the clinic for treatment of hormone-resistant prostate cancer and other malignant neoplasms.1 However, DC vaccination protocols are clearly not yet optimized2 ...
Invited Commentary 
Jason MacTaggart, MD
Like the first reported abdominal aortic stent grafts, most commercially sold devices, such as the one modified by Pisimisis et al,1 are tediously assembled by human hands. In reality, stent graft modification and implantation are analogous to the simpler tailoring and implantation of traditional synthetic surgical grafts. While years of ...
Original Investigation 
Ramesh B. Batchu, PhD; Oksana Gruzdyn, BS; Ravindra B. Potti, PhD; Donald W. Weaver, MD; Scott A. Gruber, MD, PhD, MBA

Importance  In conjunction with chemotherapy, immunotherapy with dendritic cells (DCs) may eliminate minimal disease burden by generating cytotoxic T lymphocytes. Enhanced cytosolic bioavailability of tumor-specific antigens improves access to human leukocyte antigen (HLA) class I molecules for more efficient cytotoxic T lymphocyte generation. Various cell-penetrating domains (CPDs) ...

Original Investigation 
George T. Pisimisis, MD; Panagiotis Kougias, MD; Neal R. Barshes, MD; Carlos F. Bechara, MD

Importance  No endovascular devices are commercially available in the United States to treat high–surgical risk patients with aneurysms extending to visceral arteries. Treatment options are even further limited for symptomatic patients in need of urgent treatment.

Objective  To describe a successful urgent endovascular repair of a ...

Invited Commentary 
George W. Machiedo, MD
The multicenter prospective randomized clinical trial (RCT) is the keystone of clinical research. It is the research format that has the greatest possibility of causing a widespread change in clinical practice, with the change based on scientifically valid data. These studies attempt to avoid the biases of an individual site ...
Invited Commentary 
Eric K. Nakakura, MD, PhD
Good outcomes after surgery require scrupulous attention to detail: careful patient selection, thorough preoperative evaluation, meticulous surgery and intraoperative anesthesia management, and comprehensive postoperative care. However, numerous perioperative practices based on few or no data—surgical dogma—may do little to help and may even harm patients. For example, routine use of ...
Original Investigation 
Faisal G. Bakaeen, MD; Domenic J. Reda, PhD; Annetine C. Gelijns, PhD; Lorraine Cornwell, MD; Shuab Omer, MD; Rayan Al Jurdi, MD; Panos Kougias, MD; Daniel Anaya, MD; David H. Berger, MD; Grant D. Huang, MPH, PhD

Importance  Surgical clinical trials have played a critical role in shaping clinical practice, yet their launch and conduct remain challenging. Innovative approaches to carrying out such studies can not only help transform how trials produce definitive evidence but also move the field toward increased participation in trials....

Original Investigation 
Raymond F. Lamore III, PharmD; Elizabeth M. Hechenbleikner, MD; Christina Ha, MD; Roberto Salvatori, MD; Lindsay H. Harris, PharmD; Michael R. Marohn, DO; Susan L. Gearhart, MD; Jonathan E. Efron, MD; Elizabeth C. Wick, MD

Importance  High-dose glucocorticoids (GCs) are routinely given to surgical patients with a history of GC exposure to prevent perioperative acute adrenal insufficiency, but this practice is not well supported.

Objective  To evaluate the variability of perioperative GC dosing among patients with inflammatory bowel disease (IBD) undergoing ...

Viewpoint 
Andrew A. Gonzalez, MD, JD, MPH; Amir A. Ghaferi, MD
Since the 1999 Institute of Medicine report “To Err is Human: Building a Safer Health System,” hospital safety has emerged as a central issue for patients, payers, and policy makers. Based on estimates from that report, medical errors result in 44 000 to 98 000 deaths every year in the ...
Topics: safety

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