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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 32 Articles
Viewpoint 
Clark D. Kensinger, MD; Walter H. Merrill, MD; Sunil K. Geevarghese, MD, MSCI
This Viewpoint offers a historical perspective on the significance of mentorship in surgical education and training.
Original Investigation 
Abigail S. Caudle, MD, MS; Wei T. Yang, MD; Elizabeth A. Mittendorf, MD, PhD; Daliah M. Black, MD; Rosa Hwang, MD; Brian Hobbs, PhD; Kelly K. Hunt, MD; Savitri Krishnamurthy, MD; Henry M. Kuerer, MD, PhD

Importance  Nodal ultrasonography with needle biopsy of abnormal lymph nodes helps to define the extent of breast cancer before neoadjuvant chemotherapy. A clip can be placed to designate lymph nodes with documented metastases. Targeted axillary dissection or selective removal of lymph nodes known to contain metastases (clip-containing ...

Original Investigation  FREE
Syed Nabeel Zafar, MBBS, MPH; Augustine Obirize, MBBS, MPH; Babawande Adesibikan, BSc; Edward E. Cornwell III, MD; Terrence M. Fullum, MD; Daniel D. Tran, MD

Importance  There is growing evidence in support of performing early laparoscopic cholecystectomy (LC) for acute cholecystitis. However, the definition of early LC varies from 0 through 10 days depending on the research protocol. The optimum time to perform early LC is still unclear.

Objectives  To determine ...

Research Letter 
Andrew Curtiss Eppstein, MD; Imtiaz A. Munshi, MD, MBA; Bryan Sakamoto, MD, PhD; Kenneth Gwirtz, MD
Chronic ilioinguinal pain is a common but morbid complication of inguinal herniorrhaphy for 12% to 62% of patients.1 Although pharmacologic options exist (such as nerve blocks), long-term pain relief is inferior to surgical neurectomy.2,3 We present our experience in ilioinguinal neurectomy with preoperative ultrasonography-guided identification and perineural injection of methylene ...
Research Letter 
Natale Vazzana, MD; Maria Teresa Guagnano, MD; Liberato Aceto, MD; Paolo Innocenti, MD; Giovanni Davì, MD
Laparoscopic adjustable gastric banding (LAGB) is associated with persistent weight reduction but variable health outcomes.1 The molecular heterogeneity of obesity may lead to substantial variability among its specific subtypes.2 In severe obesity, bariatric surgery is the only treatment that results in considerable, persistent weight loss. Compared with usual care, bariatric ...
Original Investigation 
Denise S. Tai, MD; Na Shen, MD; Gregory L. Szot, MS; Andrew Posselt, MD, PhD; Nicholas J. Feduska, MS; Andrew Habashy, BS; Barbara Clerkin, RN; Erin Core, RN; Ronald W. Busuttil, MD, PhD; O. Joe Hines, MD; Howard A. Reber, MD; Gerald S. Lipshutz, MD, MS

Importance  Autologous islet transplantation is an elegant and effective method for preserving euglycemia in patients undergoing near-total or total pancreatectomy for severe chronic pancreatitis. However, few centers worldwide perform this complex procedure, which requires interdisciplinary coordination and access to a sophisticated Food and Drug Administration–licensed islet-isolating facility....

Original Investigation 
Daniel E. Hall, MD, MDiv, MHSc; Barbara H. Hanusa, PhD; Roslyn A. Stone, PhD; Bruce S. Ling, MD; Robert M. Arnold, MD

Importance  Despite growing concern that institutional review boards (IRBs) impose burdensome delays on research, little is known about the time required for IRB review across different types of research.

Objective  To measure the overall and incremental process times for IRB review as a process of quality ...

Original Investigation 
Daniel Nassau, MD; Svetlana Avulova, MD; Fara M. Friedman, MD; Jeffrey P. Weiss, MD; Jerry G. Blaivas, MD

Importance  Nocturia is one of the most common and bothersome of lower urinary tract symptoms.

Objective  To examine the effect of race and metabolic risk factors on nocturia severity in men as measured by the number of nightly voids.

Design, Setting, and Participants  A retrospective ...

JAMA Surgery Clinical Challenge 
Alexandra Leon Guerrero, MD; Ioannis Hatzaras, MD, MPH
Viewpoint 
Joseph A. Hyder, MD, PhD; Ronald E. Hirschberg, MD; Louis L. Nguyen, MD, MBA, MPH
Physicians and surgeons face increasing pressure to demonstrate patient-centered care through performance metrics. Although surgeons have been providing patient-centered care for generations, the science of patient-centered outcomes research is nascent; the definition of patient-centered outcomes research is only a few years old.1 One common approach to increasing the patient-centeredness of ...
Original Investigation 
Elliot Wakeam, MD; Joseph A. Hyder, MD, PhD; Wei Jiang, MS; Stuart A. Lipsitz, ScD; Sam Finlayson, MD, MPH
Includes: Supplemental Content

Importance  Little empirical evidence exists on how a first (index) complication influences the risk of specific subsequent secondary complications. Understanding these risks is important to elucidate clinical pathways of failure to rescue or death after postoperative complication.

Objective  To understand patterns of secondary complications in the ...

Original Investigation  FREE
John Y. S. Kim, MD; Nima Khavanin, BS; Aksharananda Rambachan, BA; Robert J. McCarthy, DPharm; Alexei S. Mlodinow, BA; Gildasio S. De Oliveria Jr, MD; M. Christine Stock, MD; Madeleine J. Gust, MD; David M. Mahvi, MD
Includes: Supplemental Content

Importance  There is a paucity of data assessing the effect of increased surgical duration on the incidence of venous thromboembolism (VTE).

Objective  To examine the association between surgical duration and the incidence of VTE.

Design, Settings, and Participants  Retrospective cohort of 1 432 855 patients undergoing surgery ...

Original Investigation 
Thomas C. Tsai, MD, MPH; E. John Orav, PhD; Ashish K. Jha, MD, MPH

Importance  Despite policies aimed at incentivizing clinical integration, few data exist on whether fragmentation of care is associated with worse outcomes for elderly patients undergoing major surgery.

Objective  To determine whether postdischarge surgical care fragmentation is associated with worse outcomes and whether distances between hospitals explain ...

Original Investigation 
John W. Morgan, DrPH, CPH; Liang Ji, MBA; Garrett Friedman, MD; Maheswari Senthil, MD; Crickett Dyke, CTR; Sharon S. Lum, MD
Includes: Supplemental Content

Importance  Cancer center recognition, offered as accreditation by the American College of Surgeons Commission on Cancer or the National Cancer Institute, and quality measure reporting purport to improve the quality of cancer care. For surgically resectable gastric cancer, removal of 15 or more lymph nodes has been ...

Original Investigation 
Mila H. Ju, MD, MS; Clifford Y. Ko, MD, MS, MSHS; Bruce L. Hall, MD, PhD, MBA; Charles L. Bosk, PhD; Karl Y. Bilimoria, MD, MS; Elizabeth C. Wick, MD

Importance  Surgical site infection (SSI) has emerged as the leading publicly reported surgical outcome and is tied to payment determinations. Many hospitals monitor SSIs using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), in addition to mandatory participation (for most states) in the ...

Invited Commentary 
Mary T. Hawn, MD, MPH
Surgical site infection (SSI) prevention has been a national priority for more than a decade. Substantial resources and importance have been placed on the Surgical Care Improvement Project’s infection prevention measures. Unfortunately, little evidence exists that widespread adoption of these measures has resulted in reduced SSI rates.1 As such, the ...
JAMA Surgery Clinical Challenge 
Reshma Brahmbhatt, MD; Ravi Veeraswamy, MD; Shipra Arya, MD, SM
Research Letter 
Jennifer Tseng, MD; Susan L. Orloff, MD
Polycystic liver disease causes devastating symptoms owing to hepatomegaly. Aspiration or fenestration fails to definitively remove the cyst wall and results in the reaccumulation of cyst fluid. Preserved hepatic function generally precludes consideration of a liver transplant, leaving hepatic resection the best available treatment option for patients with impaired quality ...
Research Letter 
Tiffany Wu, MD; Fred Weaver, MD; Steven Katz, MD
With the aging of the adult population, a significant increase in the number of procedures required to alleviate symptoms of lower extremity ischemia has occurred. The ability to predict either a major adverse limb event or a major adverse cardiac event following open infrainguinal revascularization may help us to select ...
Viewpoint 
David C. Chang, PhD, MPH, MBA; Christopher Evans, BS; Joseph Parker, PhD
More than a decade has passed since the Institute of Medicine released the Crossing the Quality Chasm report, highlighting the challenges in health care–quality improvements.1 The proposals outlined by this report have extensive data needs. Given the ubiquitous nature of administrative databases that are already being generated from hospital billings, ...

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