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 Showing 1-20 of 116 Articles
Original Investigation 
Xinli Li, PhD; Mark Wilson, MD, PhD; William Nylander, MD, MBA; Tracy Smith, MS; Marilyn Lynn, NP, MSN, CPHQ; William Gunnar, MD, JD

Importance  This study analyzes and reports Clostridium difficile infection (CDI) rates, risk factors, and associations with postoperative outcomes in the Veterans Health Administration (VHA).

Objective  To report 30-day postoperative CDI rates and outcomes and identify associated risks by surgical procedures and preoperative patient demographics in a ...

Invited Commentary: The High Stakes of Postoperative Clostridium difficile Infection; Paul K. Waltz, MD; Brian S. Zuckerbraun, MD
Invited Commentary 
Paul K. Waltz, MD; Brian S. Zuckerbraun, MD

Clostridium difficile is a major cause of hospital-acquired infections. Attention has been focused over the past 2 decades to the increasing incidence of C difficile infection (CDI), the high recurrence rates, and the associated morbidity and mortality. Patients undergoing surgical procedures are at relatively high risk for ...

Review  FREE
Elizabeth J. Lilley, MD, MPH; Kashif T. Khan, MD; Fabian M. Johnston, MD, MHS; Ana Berlin, MD, MPH; Angela M. Bader, MD, MPH; Anne C. Mosenthal, MD; Zara Cooper, MD, MSc
Includes: Supplemental Content

Importance  Inpatient palliative care improves symptom management and patient satisfaction with care and reduces hospital costs in seriously ill patients. However, the role of palliative care in the treatment of patients undergoing surgery (surgical patients) remains poorly defined.

Objective  To characterize the content, design, and results ...

JAMA Surgery Clinical Challenge 
Sonia T. Orcutt, MD; Mark A. Sultenfuss, MD; Daniel A. Anaya, MD

A man in his 60s presents to the emergency department after collapsing with sudden-onset back and abdominal pain; computed tomography shows a large right hepatic mass with intrahepatic and intraperitoneal hemorrhage. What is your diagnosis?

Research Letter 
Katharine Yao, MD; Jeff Belkora, PhD; Mark Sisco, MD; Shoshana Rosenberg, ScD, MPH; Isabelle Bedrosian, MD; Erik Liederbach, BS; Chihsiung Wang, PhD

This survey examines surgeons’ knowledge of contralateral prophylactic mastectomy.

Comment & Response 
Dipesh P. Gopal, BMBS; Charlotte Lee, MBChB

To the Editor We commend Salles and colleagues1 on their comprehensive well-being program, which is laudable in its scope. The issue of physicians’ well-being is one shared across the Atlantic.2 Increasing strain on health care organizations increases the risk of physician burnout. We provide evidence for ...

Steven J. Hasday, BS; Karan R. Chhabra, AB; Justin B. Dimick, MD, MPH

This Viewpoint reviews the study results of and reactions to the Salminen et al acute appendicitis trial and provides recommendations for surgeons who will be confronted by patients questioning whether they need surgery.

Original Investigation 
Charles C. van Rossem, MD; Marc H. F. Schreinemacher, MD, PhD; Anna A. W. van Geloven, MD, PhD; Willem A. Bemelman, MD, PhD; for the Snapshot Appendicitis Collaborative Study Group

Importance  Optimal duration of antibiotic treatment to reduce infectious complications after an appendectomy for acute complicated appendicitis remains unclear.

Objective  To investigate the effect of antibiotic duration on infectious complications after laparoscopic appendectomy for acute complicated appendicitis.

Design, Setting, and Participants  National multicenter prospective, observational, ...

Original Investigation 
Mia Shapiro, MD; Qi Chen, MD, PhD; Qin Huang, MD, PhD; Valia A. Boosalis, MD; Charles H. Yoon, MD, PhD; Mandeep S. Saund, MD; Edward E. Whang, MD; Jason S. Gold, MD

Importance  Socioeconomic variables including sex, race, ethnicity, marital status, and insurance status are associated with survival in pancreatic cancer. It remains unknown exactly how these variables influence survival, including whether they affect stage at presentation or receipt of treatment or are independently associated with outcomes.

Objectives  ...

Invited Commentary: Outcome Disparities in Pancreatic Cancer; Daniel A. Anaya, MD; Mokenge Malafa, MD
Original Investigation 
Zhengqing Lei, MD; Jun Li, MD; Dong Wu, MD; Yong Xia, MD; Qing Wang, MD; Anfeng Si, MD; Kui Wang, MD; Xuying Wan, MD; Wan Yee Lau, MD, FRCS; Mengchao Wu, MD; Feng Shen, MD, PhD
Includes: Supplemental Content

Importance  The presence of microvascular invasion (MVI) decreases surgical outcomes of hepatocellular carcinoma (HCC). An accurate preoperative prediction of MVI can help surgeons to better choose surgical procedures, but accuracy is still difficult to achieve.

Objective  To develop a nomogram to predict MVI presence before liver ...

Invited Commentary: Evaluation of Microvascular Invasion in Hepatocellular Carcinoma; Ernesto Sparrelid, MD; Marco Del Chiaro, MD, PhD
Invited Commentary 
Daniel A. Anaya, MD; Mokenge Malafa, MD

The study published in this issue of JAMA Surgery by Shapiro et al1 sought to understand differences in outcomes observed in early-stage pancreatic cancer. The authors used a population-level cancer registry (Surveillance, Epidemiology, and End Results Program) and included patients with localized disease only, for whom surgery ...

Invited Commentary 
Ernesto Sparrelid, MD; Marco Del Chiaro, MD, PhD

The presence of microvascular invasion (MVI) is regarded as an important prognostic factor after resection for hepatocellular carcinoma.1,2 However, both the prognostic value and clinical relevance of MVI are being questioned.3,4 The main reason behind this disagreement lies in the fact that ...

Haut proposes that the findings from Salminen et al’s clinical trial are not enough to shift from the use of appendectomy to antibiotics in the treatment of appendicitis.

Research Letter 
William Toppen, BA; Sohail Sareh, MS; Daniel Johansen, BA; Bradley Genovese, MD; Nancy Satou, RN; Richard Shemin, MD; Peyman Benharash, MD

This study reports on whether treatment with β-blockers, statins, or both before cardiac surgery is associated with a reduction in the risk of adverse events after surgery.

Comment & Response 
Xiulu Ruan, MD; Alan D. Kaye, MD, PhD

To the Editor It is with interest that we read the article by Dawes and colleagues1 published in JAMA Surgery. The authors found that, while treating patients with severe traumatic brain injury, the guideline adherence rates ranged from 9.6% to 65.2% for intracranial pressure monitoring and ...

Comment & Response 
Yaseen Arabi, MD, FCCP; Sami Alsolamy, MD, MPH; Saad Al-Qahtani, MD, MMEd, MAHA, FRCPC

To the Editor Dawes et al1 found no association of hospital-level compliance with the Brain Trauma Foundation (BTF) guidelines for intracranial pressure (ICP) monitoring and craniotomy with mortality rates for patients with severe traumatic brain injury (TBI). They concluded that evidence-based guidelines have a minimal association with ...

Comment & Response 
Aaron J. Dawes, MD; H. Gill Cryer, MD, PhD

In Reply We thank both sets of authors for their comments on our article.1 Arabi and colleagues pose several important questions about our methods, namely our choice of Brain Trauma Foundation guidelines. Only 1 of 15 clinical areas listed in the current Brain Trauma Foundation guidelines is ...

Original Investigation 
Paul J. Matheson, PhD; Rafael Fernandez-Botran, PhD; Jason W. Smith, MD, PhD; Samuel A. Matheson, BS; Cynthia D. Downard, MD, MMSc; Craig J. McClain, MD; Richard N. Garrison, MD

Importance  Hemorrhagic shock (HS) due to trauma remains a major cause of morbidity and mortality in the United States, despite continuing progression of advanced life support and treatment. Trauma is the third most common cause of death worldwide and is the leading cause of death in the ...

Original Investigation 
Joaquim M. Havens, MD; Olubode A. Olufajo, MD, MPH; Zara R. Cooper, MD, MS; Adil H. Haider, MD, MPH; Adil A. Shah, MD; Ali Salim, MD
Includes: Supplemental Content

Importance  Hospital readmission rates following surgery are increasingly being used as a marker of quality of care and are used in pay-for-performance metrics. To our knowledge, comprehensive data on readmissions to the initial hospital or a different hospital after emergency general surgery (EGS) procedures do not exist....

Invited Commentary: Opportunities to Improve Care for Surgery Patients; O. Joe Hines, MD
Original Investigation 
Emmanuel Gabriel, MD, PhD; Kristopher Attwood, PhD; William Du, MD; Rebecca Tuttle, MD; Raed M. Alnaji, MD; Steven Nurkin, MD, MS; Usha Malhotra, MD; Steven N. Hochwald, MD; Moshim Kukar, MD
Includes: Supplemental Content

Importance  While neoadjuvant chemoradiation for esophageal cancer improves oncologic outcomes for a broad group of patients with locally advanced and/or node-positive tumors, it is less clear which specific subset of patients derives most benefit in terms of overall survival (OS).

Objective  To determine whether neoadjuvant chemoradiation ...

Invited Commentary: Preoperative Chemoradiation in an Era of Suboptimal Clinical Staging; Wayne L. Hofstetter, MD

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