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 Showing 61-80 of 101 Articles
Comment & Response 
Peter C. Minneci, MD, MHSc; Katherine J. Deans, MD, MHSc

In Reply We thank Dr Drake for his insightful comments. As pointed out, our intent was to study the effectiveness of nonoperative management in clinical practice because we believe that the safety and efficacy of antibiotics to treat acute appendicitis are now well established in recent trials and ...

Original Investigation 
Mohamad A. Hussain, MD; Mohammed Al-Omran, MD, MSc; Muhammad Mamdani, PharmD, MA, MPH; Naomi Eisenberg, MEd; Azra Premji, MD, MSc; Lisa Saldanha, MSc; Xuesong Wang, MSc; Subodh Verma, MD, PhD; Thomas F. Lindsay, MDCM, MSc
Includes: Supplemental Content

Importance  Patients with peripheral arterial disease (PAD) are at a high risk for cardiovascular events, yet, to our knowledge, no studies have examined the effect of a comprehensive risk-reduction program on long-term outcomes for patients with PAD.

Objective  To investigative whether a program that focuses on ...

Invited Commentary: A Risk-Reduction Program for Patients With Peripheral Arterial Disease; William P. Robinson, MD; Gilbert R. Upchurch Jr, MD
Invited Commentary 
William P. Robinson, MD; Gilbert R. Upchurch Jr, MD

In their observational cohort study, Hussain et al1 present a thoughtful case for the efficacy of a guideline-based risk-reduction program, the Systematic Assessment of Vascular Risk (SAVR) program, for patients with peripheral arterial disease (PAD). Based on comparison with a group of patients from other tertiary centers ...

Research Letter 
Christina A. Minami, MD; Allison R. Dahlke, MPH; Cynthia Barnard, MBA; Christine V. Kinnier, MD, MS; Ravi R. Rajaram, MD, MS; Gary A. Noskin, MD; Karl Y. Bilimoria, MD, MS

This study evaluates the association between hospital characteristics and surgical site infection measures.

Comment & Response 
Macaulay Amechi Chukwukadibia Onuigbo, MD, MSc, FWACP, MBA

To the Editor In a single-center cohort study of 3646 patients who underwent inpatient vascular surgery, 2000-2010, at a tertiary care teaching hospital, Huber et al1 had demonstrated that perioperative acute kidney injury (AKI) occurred in 1801 patients (49.4%). Furthermore, adjusted cardiovascular mortality estimates at 10 years ...

Comment & Response 
Charles Hobson, MD, MHA; Matthew Huber, BS; Azra Bihorac, MD, MS

In Reply We thank Dr Onuigbo for his comments on our study.1 We agree that identification—and thus prevention—of intraoperative hypotension is a crucial part of the equation in preventing acute kidney injury in surgical patients, especially for patients with known vascular disease. The risk for any postoperative ...

Original Investigation 
Fizan Abdullah, MD, PhD; Jose H. Salazar, MD; Colin D. Gause, MD; Samir Gadepalli, MD; Thomas W. Biester, MS; Kenneth S. Azarow, MD; Mary L. Brandt, MD; Dai H. Chung, MD; Dennis P. Lund, MD; Frederick J. Rescorla, MD; John H. T. Waldhausen, MD; Thomas F. Tracy, MD; Mary E. Fallat, MD; Michael D. Klein, MD; Frank R. Lewis, MD; Ronald B. Hirschl, MD

Importance  The number of practicing pediatric surgeons has increased rapidly in the past 4 decades, without a significant increase in the incidence of rare diseases specific to the field. Maintenance of competency in the index procedures for these rare diseases is essential to the future of the ...

Special Communication 
Nathan Evaniew, MD; Alonso Carrasco-Labra, DDS, MSc; P. J. Devereaux, MD, PhD, FRCPC; Kari A. O. Tikkinen, MD, PhD; Yutong Fei, MD, PhD; Mohit Bhandari, MD, PhD, FRCSC; Gordon Guyatt, MD, MSc, FRCPC
Includes: Supplemental Content

Because surgical procedures require clinicians to develop and maintain procedural expertise and because blinding in randomized clinical trials of such therapies is often challenging, their critical appraisal raises unique issues. Risk of bias of trials of surgical procedures increases if investigators fail to rigorously conceal allocation and, where ...

Research Letter 
Kunal Shetty, MRCS; Daniel Richard Leff, FRCS, MS, PhD; Felipe Orihuela-Espina, PhD; Guang-Zhong Yang, PhD, FREng; Ara Darzi, FRCS, FRS

This study examines prefrontal responses of surgeons of varying experience levels during a suturing drill to evaluate laparoscopic surgery skills.

Original Investigation 
Thomas G. Peters, MD; Jonathan S. Fisher, MD; Robert G. Gish, MD; Richard J. Howard, MD, PhD

Importance  Patients in the United States waiting for kidney transplantation die in increasing numbers owing to the severe kidney shortage, which might be alleviated by compensating living kidney donors.

Objective  To determine the willingness of voting US citizens to become living kidney donors and to ascertain ...

Invited Commentary: The Ethical Dilemma of Compensating Living Kidney Donation; Marco Del Chiaro, MD, PhD; Elena Rangelova, MD; Markus Maeurer, MD, PhD, FRCP(London)
Invited Commentary 
Marco Del Chiaro, MD, PhD; Elena Rangelova, MD; Markus Maeurer, MD, PhD, FRCP(London)

Since 1954, when the first kidney transplantation was performed, more than half a million living donor kidney transplants have been completed.1 A study2 on 3698 living kidney donors showed that the postoperative mortality rate of donation is 0.03% and that the risk of long-term end-stage renal ...

Comment & Response 
Yohnosuke Wada, MD; Hiroyuki Tsunemori, MD, PhD; Mamoru Kikuchi, MD, PhD

To the Editor We read the study by Li et al1 with great interest and have been inspired to consider new prophylactic strategies against Clostridium difficile infection because the surgical patients in our departments are similar to those in their study. However, we have 2 questions for ...

Comment & Response 
Xinli Li, PhD; Tracy Smith, MS; William Gunnar, MD, JD

In Reply We appreciate the thoughtful letter by Wada et al in response to our study.1 In Veterans Affairs Surgical Quality Improvement Program (VASQIP)–assessed cases, data for risk assessment and postoperative events are obtained via 1 of 2 methods. The majority of data are collected manually by ...

Correction  FREE

In the Original Investigaton titled “Analysis of Morbidity and Mortality Outcomes in Postoperative Clostridium difficile Infection in the Veterans Health Administration,”1 there was a typographical error in Table 1. The number (%) of patients in the age group of younger than 50 years should be 79 694 ...

Correction  FREE

In the Original Investigation entitled “Association of Breast Conservation Surgery for Cancer With 90-Day Reoperation Rates in New York State” published online February 17, 2016, and in the July print issue of JAMA Surgery,1 an error occurred in the key to Figure 1. The labels in ...

Alexander Langerman, MD, SM

This Viewpoint examines the practice of concurrent surgery and the need to discuss with patients when and why a surgeon may be absent during noncritical portions of a procedure.

Research Letter 
Gregory B. Auffenberg, MD; Khurshid R. Ghani, MBChB, MS; Zaojun Ye, MS; Apoorv Dhir, BBA; Yuqing Gao, MS; Brian Stork, MD; David C. Miller, MD, MPH

This study examines whether surgeon-specific complication rates reported in the Surgeon Scorecard correlate with several perioperative quality measures.

Original Investigation 
Brianna L. Siracuse, BS; Ronald S. Chamberlain, MD, MPA
Includes: Supplemental Content

Importance  Total hip replacement is a commonly performed orthopedic procedure for the treatment of painful arthritis, osteonecrosis, or fracture.

Objective  To develop and verify a scale for predicting readmission rates for total hip replacement patients and allow for the development and implementation of readmission risk-reduction strategies....

Research Letter 
Joseph A. Lin, MPH; Joseph K. Canner, MHS; Eric B. Schneider, PhD

This study examines the traumatic brain injury–related factors associated with accelerated change in health insurance coverage and the differences in time to coverage change among individuals with employer-provided private insurance.

Original Investigation 
Aslam Ejaz, MD, MPH; Andrew A. Gonzalez, MD, JD, MPH; Faiz Gani, MD; Timothy M. Pawlik, MD, MPH, PhD
Includes: Supplemental Content

Importance  Reduction of postoperative readmissions has been identified as an opportunity for containment of health care costs. To date, the effect of index hospitalization costs on subsequent readmissions, however, has not been examined.

Objectives  To identify the effect of index admission costs on readmission rates and ...

Invited Commentary: Targeting Future Health Care Expenditure Reductions; Alexander C. Schwed, MD; Christian de Virgilio, MD

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