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Basic View | Expanded View
 Showing 21-40 of 99 Articles
Original Investigation 
Danny Chu, MD; Lara Schaheen, MD; Victor O. Morell, MD; Thomas G. Gleason, MD; Chris C. Cook, MD; Lawrence M. Wei, MD; Vinay Badhwar, MD

Importance  Aortic clamping technique has been implicated in stroke risk at the time of on-pump coronary artery bypass grafting (CABG) procedures. We hypothesized that partial aortic clamping (PAC) use in performing proximal coronary anastomosis does not increase risk of stroke.

Objective  To determine whether postoperative stroke ...

Invited Commentary: Partial vs Single Aortic Clamping; Michael D. Crittenden, MD
Invited Commentary 
Melissa Anne Mallory, MD; Stanley W. Ashley, MD

Ventral hernias (VHs) are common in the United States, with more than 350 000 repairs performed annually.1 Nevertheless, consensus regarding the optimal technique for VH repair is lacking and recurrence rates remain high (approaching 50% in some series), suggesting we are not quite ready to close the book ...

Invited Commentary 
Michael D. Crittenden, MD

Once cardiopulmonary bypass became a clinical reality, the application of a noncrushing clamp across the ascending aorta allowed pioneering surgeons to correct congenital and acquired heart disease under direct vision. Favaloro et al1 described using partial aortic clamping (PAC) for proximal anastomoses for coronary operations at the ...

JAMA Surgery Clinical Challenge 
Marcelo Garcia Toneto, MD, PhD; Angélica Maria Lucchese, MD, MSc; Tiago Cataldo Breitenbach, MD

A woman in her 40s was referred to our service because findings on routine abdominal ultrasonography showed a hepatic mass in the right lobe composing approximately 50% of the liver parenchyma. The patient was asymptomatic, and there were no significant findings on abdominal physical examination—the liver was not ...

Research Letter 
Michael A. Vella, MD; Kristy Kummerow Broman, MD; John L. Tarpley, MD; Robert S. Dittus, MD, MPH; Christianne L. Roumie, MD, MPH

This quality improvement project assesses the preferences of veterans with regard to telephone, video, and in-person postoperative visits.

Comment & Response 
Aneel Bhangu, MBChB, MRCS, PhD; J. Edward F. Fitzgerald, BA(Hons), BM, BCh, MRCS(Eng), FHEA; Ewen M. Harrison, MB, ChB, PhD, FRCS

To the Editor We read the Viewpoint by Schecter1 with interest. The training of surgical educators is paramount in addressing the wide global disparities in surgical care provision, and we commend the efforts of the Alliance for Global Clinical Training in developing academic surgical services at the ...

Vakhtang Tchantchaleishvili, MD; William Hallinan, RN, MS; H. Todd Massey, MD

This Viewpoint discusses the current state of acute cardiogenic shock management and proposes a 3-level statewide network model.

Original Investigation 
Tyler R. Grenda, MD, MS; Jason C. Pradarelli, BS; Jyothi R. Thumma, MPH; Justin B. Dimick, MD, MPH

Importance  Under bundled payment programs, hospitals receive a single payment for all services provided surrounding an episode of care. Because health care providers, such as hospitals and physicians, accept more financial risk under these programs, they will need a better understanding of episode costs to identify areas ...

Invited Commentary: Bundling Our Health Care Future; Kenric M. Murayama, MD
Original Investigation 
Chih-Cheng Hsu, MD; Abdullah Almulaifi, MD; Jung-Chien Chen, MD; Kong-Han Ser, MD; Shu-Chun Chen, RN; Kai-Ci Hsu, MS; Yi-Chih Lee, MHA; Wei-Jei Lee, MD

Importance  It has been well recognized that metabolic surgery has short-term benefits for mildly obese patients with type 2 diabetes mellitus (T2DM), but how long these effects can be sustained is uncertain.

Objective  To compare the 5-year efficacy between gastrointestinal metabolic surgery and medical treatment on ...

Invited Commentary: Metabolic and Bariatric Surgery for Obesity and Diabetes; Robin P. Blackstone, MD
Invited Commentary 
Kenric M. Murayama, MD

Proponents of a movement away from the traditional fee-for-service model of reimbursement for health care argue that it results in unnecessary use of services and interventions by rewarding volume and not value, increasing the cost of care. In 1984, Medicare instituted the diagnostic-related group model in an effort ...

Invited Commentary 
Robin P. Blackstone, MD

Metabolic and bariatric surgery (MBS) is shown to be more effective in the treatment of type 2 diabetes mellitus and obesity than medical weight loss in the retrospective study comparing surgical and medical cohorts with body mass index (BMI; calculated as weight in kilograms divided by height in ...

Research Letter 
Rachel M. Danforth, MD; M. Francesca Monn, MD; Leigh J. Spera, MD; Alyssa D. Fajardo, MD; Virgilio V. George, MD

This study hypothesizes that safe and reasonable outcomes can be achieved when single-port laparoscopy is used before a right hemicolectomy for obese patients.

Comment & Response 
Joseph A. Hyder, MD, PhD

To the Editor Mohanty and colleagues have published an excellent description of the updated American College of Surgeons (ACS) Risk Calculator, which now includes the outcome of “risk of discharge to postacute care.”1 In contrast to previous work,2 the updated ACS Risk Calculator provides estimates of ...

Comment & Response 
Sanjay Mohanty, MD; Mark Cohen, PhD; Karl Y. Bilimoria, MD, MS

In Reply In our study, we examined the risk of discharge to postacute care for several operations. We subsequently built the outcome into the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator (http://riskcalculator.facs.org/) for all operations captured by the National Surgical Quality ...

Original Investigation 
Bellal Joseph, MD; Mazhar Khalil, MD; Bardiya Zangbar, MD; Narong Kulvatunyou, MD; Tahereh Orouji, MD; Viraj Pandit, MD; Terence O’Keeffe, MB, ChB; Andrew Tang, MD; Lynn Gries, MD; Randall S. Friese, MD; Peter Rhee, MD, MPH; James W. Davis, MD
Includes: Supplemental Content

Importance  Domestic violence is an extremely underreported crime and a growing social problem in the United States. However, the true burden of the problem remains unknown.

Objective  To assess the reported prevalence of domestic violence among trauma patients.

Design, Setting, and Participants  A 6-year (2007-2012) ...

Original Investigation 
Blayne Welk, MD, MSc; Hana’a Al-Hothi, MD; Jennifer Winick-Ng, MSc
Includes: Supplemental Content

Importance  Synthetic mesh slings are the most common surgical treatment for female stress urinary incontinence (SUI). However, the US Food and Drug Administration has released warnings that question the safety of vaginal mesh.

Objectives  To measure the incidence of mesh removal or revision after SUI procedures ...

Invited Commentary: Untangling a Mesh of Uncertainties; Christian P. Meyer, MD; Quoc-Dien Trinh, MD
Original Investigation 
Lauren J. Gleason, MD; Eva M. Schmitt, PhD; Cyrus M. Kosar, MA; Patricia Tabloski, PhD; Jane S. Saczynski, PhD; Thomas Robinson, MD; Zara Cooper, MD; Selwyn O. Rogers Jr, MD, MPH; Richard N. Jones, ScD; Edward R. Marcantonio, MD, SM; Sharon K. Inouye, MD, MPH
Includes: Supplemental Content

Importance  Major postoperative complications and delirium contribute independently to adverse outcomes and high resource use in patients who undergo major surgery; however, their interrelationship is not well examined.

Objective  To evaluate the association of major postoperative complications and delirium, alone and combined, with adverse outcomes after ...

Invited Commentary 
Christian P. Meyer, MD; Quoc-Dien Trinh, MD

Recently, a Delaware jury awarded $100 million to a woman who sued a manufacturer of vaginal mesh devices on the basis of negligence, breach of warranty, and fraud.1 This case may represent the tip of the iceberg because many similar litigation cases are pending. Although the lay ...

JAMA Surgery Clinical Challenge 
Goran Šantak, MD, PhD; Damir Matoković, MD, PhD; Irena Gašparić, MD

A 65-year-old man had a painful anal mass and fecal incontinence. The anal lesion appeared 1 year earlier and grew slowly to the current size. The patient reported bleeding from the rectum after defecation and denied weight loss or fever. What is your diagnosis?

Research Letter 
Elizabeth R. Benjamin, MD, PhD; Stefano Siboni, MD; Tobias Haltmeier, MD; Alexander Lofthus, BA; Kenji Inaba, MD; Demetrios Demetriades, MD, PhD

This study investigates whether a negative computed tomographic finding following blunt trauma is sufficient for ruling out intra-abdominal injury.

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