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American Journal of Surgery

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https://www.readbyqxmd.com/read/28720216/the-effects-of-red-cell-transfusion-donor-age-on-nosocomial-infection-among-trauma-patients
#1
Tyler J Loftus, Ryan M Thomas, Travis W Murphy, Linda L Nguyen, Frederick A Moore, Scott C Brakenridge, Philip A Efron, Alicia M Mohr
BACKGROUND: We hypothesized that packed red blood cell (PRBC) transfusions from older donors would be associated with fewer nosocomial infections among trauma patients. METHODS: We performed a four-year retrospective analysis of 264 consecutive adult trauma patients who received ≥1 PRBC transfusion during admission. The capacity of donor age to predict nosocomial infection was assessed by logistic regression. RESULTS: Thirty-three percent of all patients developed a nosocomial infection...
July 12, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28716310/the-role-of-same-sex-mentorship-and-organizational-support-in-encouraging-women-to-pursue-surgery
#2
Erynne A Faucett, Hilary C McCrary, Tijana Milinic, Tania Hassanzadeh, Simin G Roward, Leigh A Neumayer
INTRODUCTION: While women represent approximately half of all medical students, only 38% of general surgery residents are women. The objective of this study is to explore how access to mentors and organizational support affects career choices. METHODS: In June of 2016, a survey was sent to medical students at a single institution (n = 472). Questions utilized a 5-point Likert scale. A two-sample t-test was used to evaluate data. RESULTS: A total of 160 students participated in the survey...
July 12, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28724500/a-20-year-review-of-pediatric-pregnant-trauma-from-a-level-i-trauma-center
#3
Tanya L Zakrison, Xiomara Ruiz, Nicholas Namias, Marie Crandall
BACKGROUND: Trauma in pregnancy remains an important but understudied public health issue. We aimed to determine the prevalence of interpersonal violence in our pregnant trauma population (including pediatric) over the last 20 years, from our Level I trauma center. METHODS: We conducted a descriptive, retrospective chart review to identify all pregnant trauma patients between Jan 1993 and Sept 2013. Pediatric was ≤18 years of age. We evaluated demographics, mechanism of injury, injury location, disposition, and outcome data...
July 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28709626/subtotal-colectomy-versus-left-hemicolectomy-for-the-elective-treatment-of-splenic-flexure-colonic-neoplasia
#4
Marc Beisani, Francesc Vallribera, Albert García, Laura Mora, Sebastiano Biondo, Jaime Lopez-Borao, Ramon Farrés, Júlia Gil, Eloy Espin
BACKGROUND: Optimal elective surgical treatment for splenic flexure neoplasm (SFN) is unclear. Subtotal colectomy (STC) and left hemicolectomy (LHC) are the two more common strategies used. METHODS: Observational multicentric study comparing postoperative morbidity, mortality and long-term survival on patients with SFN electively operated by STC versus LHC between 2003 and 2014. RESULTS: After revision of the databases, 144 patients were included (STC group, n = 68; LHC group, n = 76)...
July 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28709625/the-cost-of-intraoperative-adverse-events-in-abdominal-and-pelvic-surgery-a-systematic-review
#5
REVIEW
A Garbens, M Goldenberg, C J D Wallis, A Tricco, T P Grantcharov
BACKGROUND: The assessment of intra-operative adverse events (iAEs) is a vastly under researched area with the potential to provide new methods on how to improve patient outcomes and hospital costs. Our objective was to determine the relationship between iAEs and total hospital costs in abdominal and pelvic surgery. DATA SOURCES: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Embase, MEDLINE and EBM Reviews online databases were searched to identify all studies that reported iAE rates and total hospital costs...
July 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28693841/tattooing-improves-the-detection-of-small-lymph-nodes-and-increases-the-number-of-retrieved-lymph-nodes-in-patients-with-rectal-cancer-who-receive-preoperative-chemoradiotherapy-a-randomized-controlled-clinical-trial
#6
Kazutake Okada, Sotaro Sadahiro, Takashi Ogimi, Hiroshi Miyakita, Gota Saito, Akira Tanaka, Toshiyuki Suzuki
BACKGROUND: In rectal cancer who received chemoradiotherapy, the number of Lymph nodes (LNs) required remains unclear. We conducted a randomized controlled trial to determine whether preoperative tattooing increases the number of LNs and enhances the detection rate of metastatic LNs. METHODS: Eighty patients with rectal cancer who received chemoradiotherapy were randomly assigned to receive no tattooing (C group) or to receive tattooing (T group). RESULTS: The number of LNs was significantly higher in the T group (13...
July 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28701263/treatment-for-anal-fissure-is-there-a-safe-option
#7
Justin T Brady, Alison R Althans, Ruel Neupane, Eslam M G Dosokey, Murad A Jabir, Harry L Reynolds, Scott R Steele, Sharon L Stein
BACKGROUND: Surgeons often approach anal fissure with chemical denervation (Botulinum toxin, BT) instead of initial lateral internal sphincterotomy (LIS) due to concerns for long-term incontinence. We evaluated the characteristics and outcomes of patients who received BT or LIS. METHODS: We performed a retrospective chart review of patients undergoing LIS and BT for anal fissure between 2009 and 2015. In 2015, a telephone survey was performed to evaluate durability, long-term incontinence and patient satisfaction...
July 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28693840/long-term-outcomes-of-laparoscopic-adjustable-gastric-banding
#8
Jad Khoraki, Marilia G Moraes, Adriana P F Neto, Luke M Funk, Jacob A Greenberg, Guilherme M Campos
BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is an option for the treatment of severe obesity. Few US studies have reported long-term outcomes. We aimed to present long-term outcomes with LAGB. METHODS: Retrospective study of patients who underwent LAGB at an academic medical center in the US from 1/2005 to 2/2012. Outcomes included weight loss, complications, re-operations, and LAGB failure. RESULTS: 208 patients underwent LAGB...
July 3, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28712671/analysis-of-stereotactic-biopsies-performed-on-suspicious-calcifications-identified-within-24-months-after-completion-of-breast-conserving-surgery-and-radiation-therapy-for-early-breast-cancer-can-biopsy-be-obviated
#9
Rosalind P Candelaria, Palita Hansakul, Alastair M Thompson, Huong Le-Petross, Vicente Valero, Roland Bassett, Monica L Huang, Lumarie Santiago, Beatriz E Adrada
BACKGROUND: To determine the cancer yield of stereotactic biopsy of suspicious calcifications identified within 24 months after breast conservation therapy (BCT). METHODS: Retrospective review of stereotactic biopsies performed during 2009-2013 for suspicious calcifications in the ipsilateral breast of patients who completed BCT. RESULTS: 94/2773 (3.4%) had stereotactic biopsies for suspicious calcifications in the ipsilateral breast; 7/94 (7...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28711151/intelligent-cooperation-a-framework-of-pedagogic-practice-in-the-operating-room
#10
Gary Sutkin, Eliza B Littleton, Steven L Kanter
BACKGROUND: Surgeons who work with trainees must address their learning needs without compromising patient safety. METHODS: We used a constructivist grounded theory approach to examine videos of five teaching surgeries. Attending surgeons were interviewed afterward while watching cued videos of their cases. Codes were iteratively refined into major themes, and then constructed into a larger framework. RESULTS: We present a novel framework, Intelligent Cooperation, which accounts for the highly adaptive, iterative features of surgical teaching in the operating room...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28705420/is-it-necessary-to-perform-full-pathologic-review-of-all-gastric-remnants-following-sleeve-gastrectomy
#11
S K Hansen, B J Pottorf, H W Hollis, J L Rogers, F A Husain
BACKGROUND: This study attempts to determine if enough pathological abnormalities in gastric remnants from sleeve gastrectomy exist to warrant full pathologic evaluation in all remnants. METHODS: Data was collected on patients undergoing sleeve gastrectomy between 08/01/2011 and 06/30/2014. Significant abnormalities were classified as any pathology that might require follow-up or treatment beyond standard follow-up. Age, comorbidities, gender, and Helicobacter pylori titers were analyzed and compared with pathology specimens using 95% confidence intervals and Phi contingency coefficients...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28697844/preoperative-predictor-of-extensive-resection-for-acute-appendicitis
#12
Fumitaka Saida, Shokei Matsumoto, Mitsuhide Kitano
BACKGROUND: Appendectomy has been the preferred treatment of acute appendicitis. However, extensive resection (ER) such as an ileocecal resection is sometimes needed. We analyzed the predictive factors of ER. METHODS: This was a retrospective study of 927 patients with acute appendicitis in 7 years. The data collected, including demographic characteristics, laboratory tests, computed tomography (CT) findings and days from onset. RESULTS: ER was performed in 40 patients (4...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28693843/surgical-time-out-our-counts-are-still-short-on-racial-diversity-in-academic-surgery
#13
Jonathan S Abelson, Matthew M Symer, Heather L Yeo, Paris D Butler, Patrick T Dolan, Tracy A Moo, Anthony C Watkins
BACKGROUND: This study provides an updated description of diversity along the academic surgical pipeline to determine what progress has been made. METHODS: Data was extracted from a variety of publically available data sources to determine proportions of minorities in medical school, general surgery training, and academic surgery leadership. RESULTS: In 2014-2015, Blacks represented 12.4% of the U.S. population, but only 5.7% graduating medical students, 6...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28688514/pain-control-with-continuous-infusion-preperitoneal-wound-catheters-versus-continuous-epidural-analgesia-in-colon-and-rectal-surgery-a-randomized-controlled-trial
#14
Nicolas J Mouawad, Stefan W Leichtle, Christodoulos Kaoutzanis, Kathleen Welch, Suzanne Winter, Richard Lampman, Matt McCord, Kimberly A Hoskins, Robert K Cleary
OBJECTIVE: To compare continuous infusion preperitoneal wound catheters (CPA) versus continuous epidural analgesia (CEA) after elective colorectal surgery. METHODS: An open-label equivalence trial randomizing patients to CPA or CEA. Primary outcomes were postoperative pain as determined by numeric pain scores and supplemental narcotic analgesia requirements. Secondary outcomes included incidence of complications and patient health status measured with the SF-36 Health Survey (Acute Form)...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28687101/increased-pancreatic-cancer-survival-with-greater-lymph-node-retrieval-in-the-national-cancer-data-base
#15
Carlo M Contreras, Chee Paul Lin, Robert A Oster, Sushanth Reddy, Thomas Wang, Selwyn Vickers, Martin Heslin
BACKGROUND: We evaluated the role of lymph node (LN) retrieval in pancreatic adenocarcinoma (PA) patients undergoing pancreaticoduodenectomy (PD). METHODS: We utilized the National Cancer Data Base; Cox regression models and logistic regression models were used for statistical evaluation. RESULTS: We evaluated 26,792 patients with PA who underwent PD. The mean LN retrieved in LN(-) patients was 10.8 vs 14.4 for LN(+) patients (P < 0.0001)...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28683896/analysis-of-the-biliostatic-potential-of-two-sealants-in-a-standardized-porcine-model-of-liver-resection
#16
H Fonouni, A Kashfi, O Stahlheber, L Konstantinidis, T W Kraus, A Mehrabi, H Oweira
BACKGROUND: Improved resection techniques has decreased mortality rate following liver resections(LRx). Sealants are known as effective adjuncts for haemostasis after LRx. We compared biliostatic effectiveness of two sealants in a standardized porcine model of LRx. MATERIAL AND METHODS: We accomplished left hemihepatectomy on 27 pigs. The animals were randomized in control group(n = 9) with no sealant and treatment groups (each n = 9), in which resection surfaces were covered with TachoSil(®) and TissuFleece(®)/Tissucol Duo(®)...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28683894/alcohol-and-drug-toxicology-screens-at-time-of-hospitalization-do-not-predict-ptsd-or-depression-after-traumatic-injury
#17
Cory McLaughlin, Nathan T Kearns, Monica Bennett, Jacob W Roden-Foreman, Kenleigh Roden-Foreman, Evan Elizabeth Rainey, Geoffrey Funk, Mark B Powers, Ann Marie Warren
BACKGROUND: Identifying risk factors for the development of PTSD and depression is critical for intervention and recovery after injury. Given research linking toxicology screens and substance use and the evidenced relationship between substance misuse and distress, the current study aimed to gauge the predictive value of toxicology testing on PTSD and depression. METHODS: Patients admitted to a Level I Trauma Center (N = 379) completed the PC-PTSD, PCL-C, and PHQ-8 at baseline, 3, 6, and 12 months...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28683891/postoperative-serum-vascular-endothelial-growth-factor-is-an-independent-prognostic-factor-of-disease-free-survival-an-overall-survival-in-patients-with-non-metastatic-colon-cancer
#18
M Pascual, S Alonso, S Salvans, X Mayol, S Mojal, M J Gil, L Grande, M Pera
BACKGROUND: Angiogenesis is essential for tumor growth and formation of metastasis. VEGF is the most potent agiogenic citokine. The aim was to investigate the predictive value of postoperative VEGF serum concentration in patients undergoing surgery for colon cancer. METHODS: Consecutive patients with colon cancer undergoing surgery with curative intent were included. VEGF was measured in serum at 48 h and postoperative day 4. Cox proportional hazards model was used to estimate its contribution with prognosis...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28693838/socioeconomic-status-gender-and-burn-injury-a-retrospective-review
#19
Sharmila Dissanaike, Daniel Ha, Diana Mitchell, Eneko Larumbe
Burn injury rates appear to be influenced by socioeconomic status (SES) and gender globally, but the impact of poverty and gender on burn injury has not been studied in a developed country. This study was a retrospective chart review conducted at a regional burn center in the Southwest US that included 340 patients with TBSA burns >15%. SES was determined using zip code and US census data. The distribution of mechanism of injury was significantly different by gender (χ(2)(6) = 36.14, p < 0001), but not significantly different by SES (χ(2)(12) = 19...
June 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28701264/impact-of-rural-urban-status-on-survival-after-mastectomy-without-reconstruction-versus-mastectomy-with-reconstruction
#20
Elaine Jayne Buckley, Whitney E Zahnd, David J Rea, John D Mellinger, Sabha Ganai
BACKGROUND: Disparities in access to care exist for breast cancer patients, including access to surgeons performing reconstruction. We hypothesized rural patients have delayed time to surgery after mastectomy with reconstruction with implications on survival. METHODS: An observational study was conducted using the National Cancer Database on patients with breast cancer from 2003 to 2007 who underwent mastectomy, with or without reconstruction from 2003 to 2007 (n = 90,319)...
June 29, 2017: American Journal of Surgery
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