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Basic View | Expanded View
 Showing 1-20 of 76 Articles
Rajesh N. Keswani, MD; Nathaniel J. Soper, MD

This Viewpoint reports on the transmission of carbapenem-resistant Enterobacteriaceae through duodenoscopes, the device used to perform endoscopic retrograde cholangiopancreatography.

Original Investigation 
Ramzi Amri, MD; Liliana G. Bordeianou, MD, MPH; Patricia Sylla, MD; David L. Berger, MD

Importance  In colon cancer, radial margin positivity (RMP) is defined as primary disease involvement at the cut edge of the mesentery or nonserosalized portions of the colon. Although extensively studied for rectal malignancies, RMP has unclear prognostic implications for tumors of the colon.

Objective  To determine ...

Invited Commentary: The Role of the Radial Margin; Jonathan Efron, MD
Original Investigation  FREE
Anita P. Courcoulas, MD, MPH; Steven H. Belle, PhD, MScHyg; Rebecca H. Neiberg, MS; Sheila K. Pierson, BS, BA; Jessie K Eagleton, MPH; Melissa A. Kalarchian, PhD; James P. DeLany, PhD; Wei Lang, PhD; John M. Jakicic, PhD
Includes: Supplemental Content

Importance  Questions remain about the role and durability of bariatric surgery for type 2 diabetes mellitus (T2DM).

Objective  To compare the remission of T2DM following surgical and nonsurgical treatments.

Design, Setting, and Participants  In this 3-arm randomized clinical trial conducted at the University of Pittsburgh ...

Invited Commentary: Bariatric Surgery vs Lifestyle Intervention for Type 2 Diabetes Mellitus; Michel Gagner, MD, FRCSC, FASMBS
Invited Commentary 
Michel Gagner, MD, FRCSC, FASMBS

I read with interest the article by Courcoulas et al1 in which outcomes were assessed 3 years after treating obese patients with type 2 diabetes mellitus (T2DM) who were randomized to an intensive lifestyle weight loss intervention for 1 year followed by a lower-level lifestyle weight loss ...

Invited Commentary 
Jonathan Efron, MD

This is an Invited Commentary on a retrospective review on the effect of margin positivity on survival among patients with colon cancer.

JAMA Surgery Clinical Challenge 
Reilly D. Hobbs, MD, MBS; Jessica A. Cintolo, MD; Robert E. Roses, MD

A 52-year-old woman with a history of diabetes mellitus and cigarette smoking who had a prior laparoscopic cholecystectomy was referred to our institution for severe postprandial epigastric abdominal pain that had been ongoing for several months and unintentional weight loss. What is your diagnosis?

Original Investigation 
Greg D. Sacks, MD, MPH; Elise H. Lawson, MD, MSHS; Aaron J. Dawes, MD; Marcia M. Russell, MD; Melinda Maggard-Gibbons, MD, MSHS; David S. Zingmond, MD, PhD; Clifford Y. Ko, MD, MS, MSHS

Importance  The Centers for Medicare and Medicaid Services include patient experience as a core component of its Value-Based Purchasing program, which ties financial incentives to hospital performance on a range of quality measures. However, it remains unclear whether patient satisfaction is an accurate marker of high-quality surgical ...

Invited Commentary: Public Reporting of Patient Satisfaction vs Objective Quality Measures; Elliott R. Haut, MD, PhD
Original Investigation 
Chethan Sathya, MD; Aziz S. Alali, MD, PhD; Paul W. Wales, MD; Damon C. Scales, MD, PhD; Paul J. Karanicolas, MD, PhD; Randall S. Burd, MD, PhD; Michael L. Nance, MD; Wei Xiong, MSc; Avery B. Nathens, MD, PhD, MPH

Importance  Trauma is the leading cause of death among US children. Whether pediatric trauma centers (PTCs), mixed trauma centers (MTCs), or adult trauma centers (ATCs) offer a survival benefit compared with one another when treating injured children is controversial. Ascertaining the optimal care environment will better inform ...

Original Investigation 
Devin S. Zarkowsky, MD; Caitlin W. Hicks, MD, MS; Isibor Arhuidese, MD, MPH; Joseph K. Canner, MHS; Tammam Obeid, MD; Umair Qazi, MD; Eric Schneider, PhD; Christopher J. Abularrage, MD; James H. Black III, MD; Julie A. Freischlag, MD; Mahmoud B. Malas, MD, MHS
Includes: Supplemental Content

Importance  Arteriovenous fistula (AVF) access improves survival in patients with end-stage renal disease (ESRD) compared with other modalities when used at first hemodialysis. Use varies between locations, but, to our knowledge, no study has related this finding to mortality on a national scale.

Objective  To quantify ...

Original Investigation 
Bellal Joseph, MD; Viraj Pandit, MD; Ansab A. Haider, MD; Narong Kulvatunyou, MD; Bardiya Zangbar, MD; Andrew Tang, MD; Hassan Aziz, MD; Gary Vercruysse, MD; Terence O’Keeffe, MD; Randall S. Freise, MD; Peter Rhee, MD

Importance  The role of acute care surgeons is evolving; however, no guidelines exist for the selective treatment of patients with traumatic brain injury (TBI) exclusively by acute care surgeons. We implemented the Brain Injury Guidelines (BIG) for managing TBI at our institution on March 1, 2012.


Invited Commentary: Brain Injury Guidelines for Small Head Injuries; George C. Velmahos, MD, PhD, MSEd
Original Investigation 
Wayne S. Lee, MD; Vincent E. Chong, MD, MS; Gregory P. Victorino, MD

Importance  The care of most patients with pneumomediastinum (PNM) due to trauma can be managed conservatively; however, owing to aerodigestive tract injury and other associated injuries, there is a subset of patients with PNM who are at higher risk of mortality but can be difficult to identify....

Invited Commentary: Pneumomediastinum Following Blunt Trauma; Christian de Virgilio, MD; Dennis Yong Kim, MD
Invited Commentary 
Christian de Virgilio, MD; Dennis Yong Kim, MD

The discovery of pneumomediastinum following blunt trauma is a source of great consternation for trauma surgeons because pneumomediastinum comes in 2 forms: the one that you do not have to worry about and the other that is really bad and that you do need to worry about. Fortunately, ...

Invited Commentary 
George C. Velmahos, MD, PhD, MSEd

In the Joseph et al article,1 the authors proposed locally produced Brain Injury Guidelines (BIG), which allowed the acute care surgery team to manage patients with mild head injuries without neurosurgical consultation. All moderate and severe head injuries were managed per routine. The decision to avoid calling ...

As physicians and surgeons, we believe patients are fully rational human beings who make the same health care decisions we would if they had optimal data. Unfortunately, this is not the case. We all know patients, colleagues, friends, family members, and even ourselves who continue to smoke tobacco, ...

JAMA Surgery Clinical Challenge 
Maham Rahimi, MD, PhD; Jonathan Bath, MD

This clinical review describes the use of an endovascular approach as a viable method for a pulsatile mass in the right upper side of the chest.

Research Letter 
Katherine A. Kelley, MD; Jeffrey D. Crawford, MD; Kari Thomas, MD; Stuart K. Gardiner, PhD; Nathalie G. Johnson, MD

This review reports on the use of breast-specific gamma imaging as an adjunct imaging method for detecting invasive lobular carcinomas.

Comment & Response 
Timothy J. Price, MBBS, FRACP, DHSc; Niall Tebbutt, MBBS, FRACP, PhD; Amanda R. Townsend, MBBS, FRACP

To the Editor Hu et al1 report improved survival for patients with metastatic colorectal cancer over time and note that this corresponds to a decrease in the rate of surgery for the primary lesion. Based on the data, they suggest that resections for synchronous primary lesions may ...

Comment & Response 
Chung-Yuan Hu, MPH, PhD; Christina E. Bailey, MD, MS; George J. Chang, MD, MS

In Reply In our recent study entitled “Time Trend Analysis of Primary Tumor Resection for Stage IV Colorectal Cancer: Less Surgery, Improved Survival,”1 we noted a trend toward improved survival despite decreasing primary tumor resection (PTR) rates for patients presenting with unresectable metastatic colorectal cancer (MCRC). We ...

Comment & Response 
Rachel Wong, MBBS(Hons), FRACP; Peter Gibbs, MBBS, FRACP, MD

To the Editor We were surprised at the conclusions reached by Hu et al1 in their analysis of rates of primary tumor resection (PTR) and of survival of patients with metastatic colorectal cancer (MCRC) over time. Specifically, they have concluded that decreasing rates of PTR have directly ...

Original Investigation 
Christoph Czarnetzki, MD, MBA; Nadia Elia, MD, MSc; Jean-Louis Frossard, MD; Emiliano Giostra, MD; Laurent Spahr, MD; Jean-Luc Waeber, MD; Gordana Pavlovic, MD; Christopher Lysakowski, MD; Martin R. Tramèr, MD, DPhil
Includes: Supplemental Content

Importance  Patients undergoing emergency procedures under general anesthesia have impaired gastric emptying and are at high risk for aspiration of gastric contents. Erythromycin has strong gastric prokinetic properties.

Objective  To evaluate the efficacy of erythromycin lactobionate in gastric emptying in patients undergoing emergency surgery.

Design, Setting, ...

Invited Commentary: Erythromycin Use and General Endotracheal Anesthesia; Marco G. Patti, MD

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