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 Showing 21-40 of 90 Articles
JAMA Surgery Clinical Challenge 
Ryan A. Macke, MD; Thomas P. Templin, MD; Justin D. Blasberg, MD

A man in his early 40s was referred for surgical evaluation following abnormal imaging obtained during workup of recent left-sided chest discomfort and longstanding dyspnea on exertion. What is your diagnosis?

Research Letter 
Neilesh Soneji, MD; Hance A. Clarke, MD, PhD, FRCPC; Dennis T. Ko, MD, MSc; Duminda N. Wijeysundera, MD, PhD

This cohort study measures opioid use between 90 days and 1 year after major surgery..

Original Investigation 
Christopher R. Connelly, MD; Philbert Y. Van, MD; Kyle D. Hart, MS; Scott G. Louis, MD; Kelly A. Fair, MD; Anfin S. Erickson, BA; Elizabeth A. Rick, BS; Erika C. Simeon, BA; Eileen M. Bulger, MD; Saman Arbabi, MD; John B. Holcomb, MD; Laura J. Moore, MD; Martin A. Schreiber, MD
Includes: Supplemental Content

Importance  Prophylactic enoxaparin is used to prevent venous thromboembolism (VTE) in surgical and trauma patients. However, VTE remains an important source of morbidity and mortality, potentially exacerbated by antithrombin III or anti–Factor Xa deficiencies and missed enoxaparin doses. Recent data suggest that a difference in reaction time ...

Invited Commentary: Optimizing Venous Thromboembolic Prophylaxis; Matthew J. Martin, MD
Original Investigation 
Tadaki M. Tomita, MD; Heron E. Rodriguez, MD; Andrew W. Hoel, MD; Karen J. Ho, MD; William H. Pearce, MD; Mark K. Eskandari, MD

Importance  Vascular surgeons possess a skill set that allows them to assist nonvascular surgeons in the operating room. Existing studies on this topic are limited in their scope to specific procedures or clinical settings.

Objective  To describe the broad spectrum of cases that require intraoperative vascular ...

Invited Commentary: The Role of a Vascular Surgeon; Ying Wei Lum, MD; James H. Black, MD
Invited Commentary 
Matthew J. Martin, MD

Despite being one of the more common sources of morbidity and mortality among critically ill or injured patients, venous thromboembolic disease (VTE) remains poorly understood, inadequately characterized, and minimally responsive to both mechanical and pharmacologic prophylaxis. As a result, approaches to prevention and diagnosis of VTE can fairly ...

Invited Commentary 
Ying Wei Lum, MD; James H. Black, MD

Because of the number of surgical subspecialties, the role of a vascular surgeon in modern surgical practice has grown from arbiter of bleeding to a key assistant for safe surgical operations. However, the value of a vascular surgeon in a hospital system has always been difficult to measure. ...

Research Letter 
Jason B. Liu, MD; Sharon M. Weber, MD; Julia R. Berian, MD; Shenglin Chen, PhD; Mark E. Cohen, PhD; Clifford Y. Ko, MD, MS, MSHS; Karl Y. Bilimoria, MD, MS

This study reports on the Oncology NSQIP National Cancer Center Collaborative collecting 3 additional case characteristics representing greater operative complexity and risk with the aim to improve patient risk prediction and case-mix adjustment.

To the Editor Hussain et al1 investigated the efficacy of a risk-reduction program that promoted the use of medications, smoking cessation, and weight control for the prevention of cardiovascular and limb events in patients with peripheral arterial disease (PAD). The median follow-up for the cohort was 5.3 ...

Comment & Response 
Mohamad A. Hussain, MD; Mohammed Al-Omran, MD, MSc; Thomas F. Lindsay, MDCM, MSc

In Reply Dr Kawada correctly recognized that we did not observe an improvement in the overall mean body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of patients with peripheral arterial disease (PAD) enrolled in a risk-reduction program (mean [SD] BMI, 27.2 ...

Karan R. Chhabra, MD; Justin B. Dimick, MD, MPH

This Viewpoint considers 3 nuances of the policy debate regarding the regionalization of high-risk surgery by restricting care to high-volume centers of excellence.

Original Investigation 
Derek E. Go, MS; Daniel E. Abbott, MD; Koffi Wima, MS; Dennis J. Hanseman, PhD; Audrey E. Ertel, MD, MS; Alex L. Chang, MD; Shimul A. Shah, MD, MHCM; Richard S. Hoehn, MD
Includes: Supplemental Content

Importance  Safety-net hospitals care for vulnerable patients, providing complex surgery at increased costs. These hospitals are at risk due to changing health care reimbursement policies and demand for better value in surgical care.

Objective  To model different techniques for reducing the cost of complex surgery performed ...

Invited Commentary: Quality of Care and Cost at Safety-Net Hospitals; Taylor S. Riall, MD, PhD; Purvi Parikh, MD
Invited Commentary 
Taylor S. Riall, MD, PhD; Purvi Parikh, MD

In this issue of JAMA Surgery, Go et al1 use University HealthSystem Consortium data to demonstrate that high-burden hospitals (HBHs), while providing a safety net and caring for the most severely ill patients, had worse outcomes and higher costs after pancreaticoduodenectomy compared with low-burden hospitals (LBHs) ...

Surgical Innovation 
Paul D. DiMusto, MD; Herbert Chen, MD; K. Craig Kent, MD

This article discusses a hands-on training program that allows surgeons in practice to scrub alongside an expert, providing 1-on-1 exposure to new techniques and surgical skills.

Research Letter 
Joshua D. Brown, PharmD, MS; Jeffery C. Talbert, PhD

This study determines whether differences in the use of vena cava filters in hospitals in Kentucky can be explained by observable factors rather than potential reimbursement upcoding.

Original Investigation 
Michael L. Pezold, MD; Andrea L. Pusic, MD, MHS; Wess A. Cohen, MD; James P. Hollenberg, MD; Zeeshan Butt, PhD; David R. Flum, MD, MPH; Larissa K. Temple, MD

Importance  Identifying timely and important research questions using relevant patient-reported outcomes (PROs) in surgery remains paramount in the current medical climate. The inaugural Patient-Reported Outcomes in Surgery (PROS) Conference brought together stakeholders in PROs research in surgery with the aim of creating a research agenda to help ...

Invited Commentary: Defining a Valid Research Agenda; Lisa M. Kodadek, MD; Brandyn D. Lau, MPH, CPH; Elliott R. Haut, MD, PhD
Original Investigation 
Garth H. Utter, MD, MSc; Tejveer S. Dhillon, MD, MAS; Edgardo S. Salcedo, MD; Daniel J. Shouldice, BS; Cassandra L. Reynolds, MD; Misty D. Humphries, MD, MAS; Richard H. White, MD

Importance  Deep vein thrombosis (DVT) isolated to the calf veins (distal to the popliteal vein) is frequently detected with duplex ultrasonography and may result in proximal thrombosis or pulmonary embolism (PE).

Objective  To evaluate whether therapeutic anticoagulation is associated with a decreased risk for proximal DVT ...

Invited Commentary: Significance of Isolated Calf Vein Thrombosis; Xuan-Binh D. Pham, MD; Christian de Virgilio, MD
Original Investigation 
A. Rani Elwy, PhD; Kamal M. F. Itani, MD; Barbara G. Bokhour, PhD; Nora M. Mueller, MAA; Mark E. Glickman, PhD; Shibei Zhao, MPH; Amy K. Rosen, PhD; Dana Lynge, MD; Melissa Perkal, MD; Erica A. Brotschi, MD; Vivian M. Sanchez, MD; Thomas H. Gallagher, MD
Includes: Supplemental Content

Importance  Surgeons are frequently faced with clinical adverse events owing to the nature of their specialty, yet not all surgeons disclose these events to patients. To sustain open disclosure programs, it is essential to understand how surgeons are disclosing adverse events, factors that are associated with reporting ...

Invited Commentary 
Lisa M. Kodadek, MD; Brandyn D. Lau, MPH, CPH; Elliott R. Haut, MD, PhD
Invited Commentary 
Xuan-Binh D. Pham, MD; Christian de Virgilio, MD

Clotting or bleeding? Which is worse? Surgeons grapple with this age-old conundrum every day. When we err on the side of withholding anticoagulants, we face the former, whereas aggressive blood thinning inevitably risks the latter. With the growing body of evidence that calf deep vein thrombosis (DVT) can ...

JAMA Surgery Clinical Challenge 
Nitin Vashistha, MS; Rakesh Tandon, MD, PhD; Dinesh Singhal, MS

A young adult presented with a progressively growing abdominal lump that left him feeling a dull ache and heavy. Ten weeks previously he was hospitalized and conservatively managed for acute pancreatitis. What is your diagnosis?

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