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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 21-40 of 47 Articles
JAMA Surgery Clinical Challenge 
Mimmie Kwong, BA; Jacqueline Garonzik-Wang, MD, PhD; Timothy M. Pawlik, MD, MPH, PhD
Invited Commentary 
Martin A. Schreiber, MD
Resnick and colleagues1 have performed a prospective observational trial during a 17-month period assessing the accuracy of cervical spine computed tomography (CT) in the evaluation of patients with blunt trauma. The population included patients at a level I trauma center with persistent cervical tenderness or a focal neurologic deficit. They ...
Invited Commentary 
Karen E. Deveney, MD
The multi-institutional study by Gifford et al1 in this issue reports the results of a survey of 371 residents in 13 general surgery programs and explores how many residents consider leaving residency and why. The authors correlate their findings with data obtained from the program directors of these residencies. They ...
I commend Franken et al1 for an outstanding attempt to eliminate selection bias from this retrospective case series comparing laparoscopic with open hepatectomy for the management of mostly malignant disease of the liver. The authors performed 52 laparoscopic hepatic resections during a period of approximately 10 years. They then tried ...
Original Investigation 
Shelby Resnick, MD; Kenji Inaba, MD, FRCSC; Efstathios Karamanos, MD; Martin Pham, MD; Saskya Byerly, MD; Peep Talving, MD, PhD; Sravanthi Reddy, MD; Megan Linnebur, MD; Demetrios Demetriades, MD, PhD

Importance  A missed cervical spine (CS) injury can have devastating consequences. When CS injuries cannot be ruled out clinically using the National Emergency X-Radiography Utilization Study low-risk criteria because of either a neurologic deficit or pain, the optimal imaging modality for CS clearance remains controversial.

Objective  ...

Original Investigation 
Edward Gifford, MD; Joseph Galante, MD; Amy H. Kaji, MD, PhD; Virginia Nguyen, BS; M. Timothy Nelson, MD; Richard A. Sidwell, MD; Thomas Hartranft, MD; Benjamin Jarman, MD; Marc Melcher, MD, PhD; Mark Reeves, MD, PhD; Christopher Reid, MD; Garth R. Jacobsen, MD; Jonathan Thompson, MD; Chandrakanth Are, MD; Brian Smith, MD; Tracey Arnell, MD; Oscar J. Hines, MD; Christian de Virgilio, MD
Includes: Supplemental Content

Importance  General surgical residency continues to experience attrition. To date, work hour amendments have not changed the annual rate of attrition.

Objective  To determine how often categorical general surgery residents seriously consider leaving residency.

Design, Setting, and Participants  At 13 residency programs, an anonymous survey ...

Original Investigation 
Cara Franken, MD; Briana Lau, MD; Krishna Putchakayala, MD; L. Andrew DiFronzo, MD

Importance  Despite the increasing role of laparoscopy in partial hepatic resection, its short-term benefit compared with traditional open surgery remains unclear.

Objective  To compare short-term (30-day) outcomes between laparoscopic (LH) and open (OH) partial hepatectomies.

Design, Setting, and Participants  Retrospective matched case-control study from April ...

Original Investigation 
Michael M. Sigman, MD; Owen P. Palmer, MD; Sung W. Ham, MD; Mark Cunningham, MD; Fred A. Weaver, MD, MMM
Includes: Supplemental Content

Importance  Thoracic endovascular aortic repair (TEVAR) is used in the treatment of type B aortic dissections. Information related to aortic morphologic findings and the condition of the abdominal aorta after TEVAR is limited.

Objective  To analyze aortic morphologic findings after TEVAR for type B aortic dissections....

Invited Commentary 
Ali Salim, MD
Despite the growing success of organ transplantation as the primary treatment for end-stage organ failure, the gap between demand and supply for organs continues to widen. As a result, nearly 20 people die each day waiting for an organ transplant.1 Innovative methods to narrow this discrepancy are needed, and one ...
Topics: tissue donors
Invited Commentary 
Catherine E. Lewis, MD
While pneumonia is a common postoperative complication, there is a paucity of literature on pneumonia prevention outside of the intensive care unit. Wren and colleagues designed and implemented a ward-based pneumonia prevention program at the Veterans Affairs Palo Alto Health Care System in 2007. They previously reported an initial 81% ...
Original Investigation 
Cristina B. Geltzeiler, MD; Alizah Rotramel, MD; Charlyn Wilson, BSN; Lisha Deng, PhD; Mark H. Whiteford, MD; Joseph Frankhouse, MD

Importance  Enhanced recovery after surgery (ERAS) colorectal programs have shown to be successful at reducing length of stay in many international and academic centers; however, their efficacy in a community hospital setting remains unclear.

Objective  To determine if favorable results could be reproduced in a community ...

Original Investigation 
Madhukar S. Patel, MD, MBA, ScM; John Zatarain, MD; Salvador De La Cruz, MD; Mitchell B. Sally, MD; Tyler Ewing, BS; Megan Crutchfield, MPH; C. Kristian Enestvedt, MD; Darren J. Malinoski, MD

Importance  The shortage of organs available for transplant has led to the use of expanded criteria donors (ECDs) to extend the donor pool. These donors are older and have more comorbidities and efforts to optimize the quality of their organs are needed.

Objective  To determine the ...

Original Investigation 
Hadiza S. Kazaure, MD; Molinda Martin, BSN, RN; Jung K. Yoon, RN, MS; Sherry M. Wren, MD

Importance  Pneumonia is the third most common complication in postoperative patients and is associated with significant morbidity and high cost of care. Prevention has focused primarily on mechanically ventilated patients. This study outlines the results of the longest-running postoperative pneumonia prevention program for nonmechanically ventilated patients, to ...

Lenworth M. Jacobs, MD, MPH; Karyl J. Burns, RN, PhD
With mass shootings happening more frequently, the epidemic of gun violence in the United States continues to produce death and suffering.1,2 This is true even though considerable attention has been directed at mental health services and gun control. While gun violence and mass killings will continue to occur, steps can ...
JAMA Surgery Clinical Challenge 
Devin S. Zarkowsky, MD; Peter B. Cornell, NP; Frederic Eckhauser, MD
The study by Langan et al1 reviews the association between damage control resuscitation (DCR) and combat casualty outcomes over a 10-year period (2002-2011). Damage control resuscitation is a resuscitation guideline written and distributed in the Iraq war combat theater in 2005, and as Langan et al1 demonstrate in their study ...
Invited Commentary 
Jeffrey M. Gauvin, MD
Surgical training programs have long had the highest attrition rates of any medical specialty; approximately 20% of categorical general surgery residents do not complete their training.1 Understanding the changing demographics and priorities of our current residents is crucial if we are to address this issue. Women have been underrepresented in ...
Topics: pregnancy
Original Investigation 
Nicholas R. Langan, MD; Matthew Eckert, MD; Matthew J. Martin, MD

Importance  Analysis of combat deaths provides invaluable epidemiologic and quality-improvement data for trauma centers and is particularly important under rapidly evolving battlefield conditions.

Objective  To analyze the evolution of injury patterns, early care, and resuscitation among patients who subsequently died in the hospital, before and after ...

Original Investigation 
Erin G. Brown, MD; Joseph M. Galante, MD; Benjamin A. Keller, MD; Juanita Braxton, PhD; Diana L. Farmer, MD
Includes: Supplemental Content

Importance  Residency attrition rates remain a great challenge for general surgery training programs. Despite the increasing acceptance of pregnancy during training, 1 common perception is that women who become pregnant are at increased risk of leaving surgery programs.

Objective  To determine whether child rearing increases the ...

Emily K. Bergsland, MD; Eric K. Nakakura, MD, PhD
In approximately 13% of patients who are diagnosed as having neuroendocrine tumors (NETs), the primary site is not known.1 Commonly, biopsy of a liver mass reveals an NET metastasis; in other instances, a lymph node metastasis is found on biopsy of a mesenteric, retroperitoneal, or peripancreatic mass. However, a primary ...

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