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Annals of Surgery

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https://www.readbyqxmd.com/read/27906763/travel-burdens-of-selective-referral-for-surgical-patients-don-t-let-the-perfect-be-the-enemy-of-the-good
#1
Hari Nathan
No abstract text is available yet for this article.
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906762/complications-in-postmastectomy-breast-reconstruction-one-year-outcomes-of-the-mastectomy-reconstruction-outcomes-consortium-mroc-study
#2
Edwin G Wilkins, Jennifer B Hamill, Hyungjin M Kim, John Y Kim, Richard J Greco, Ji Qi, Andrea L Pusic
OBJECTIVE: In postmastectomy reconstruction, procedure choice is heavily influenced by the relative risks of the various options. This study sought to evaluate complications in a large, multicenter patient population. SUMMARY OF BACKGROUND DATA: Previous studies have reported widely varying complication rates, but have been limited by their single center designs and inadequate controlling for confounders in their analyses. METHODS: Eleven sites enrolled women undergoing first time, immediate, or delayed reconstruction following mastectomy for cancer treatment or prophylaxis...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906761/surgical-education-and-health-care-reform-defining-the-role-and-value-of-trainees-in-an-evolving-medical-landscape
#3
Oluwadamilola M Fayanju, Reena Aggarwal, Rebeccah B Baucom, Cristina R Ferrone, David Massaro, Kyla P Terhune
OBJECTIVE: Health care reform and surgical education are often separated functionally. However, especially in surgery, where resident trainees often spend twice as much time in residency and fellowship than in undergraduate medical education, one must consider their contributions to health care. SUMMARY BACKGROUND DATA: In this short commentary, we briefly review the status of health care in the United States as well as some of the recent and current changes in graduate medical education that pertain to surgical trainees...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906760/improving-the-quality-of-ward-based-surgical-care-with-a-human-factors-intervention-bundle
#4
Maximilian J Johnston, Sonal Arora, Dominic King, Ara Darzi
OBJECTIVE: This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA: Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. METHODS: A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906759/development-of-a-disease-based-hernia-program-and-the-impact-on-cost-for-a-hospital-system
#5
David M Krpata, Ivy N Haskins, Steven Rosenblatt, Sharon Grundfest, Ajita Prabhu, Michael J Rosen
OBJECTIVE: The aim of this study was to assess the impact of developing a hernia program on mesh utilization. BACKGROUND: With the ongoing changes in healthcare, the value of all interventions will see increased scrutiny. Hernia mesh can be one of the most costly components of hernia repairs. A disease-based institutional hernia program that defines roles for mesh utilization and measures outcomes has the potential to add significant value to hospital systems. METHODS: In August 2014, a disease-based hernia program was initiated across a hospital system...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906758/30-day-readmission-after-operative-management-of-adhesive-small-bowel-obstruction
#6
Sean Nurmsoo, Mohammad Hajizadeh
No abstract text is available yet for this article.
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906757/effect-of-an-immersive-preoperative-virtual-reality-experience-on-patient-reported-outcomes-a-randomized-controlled-trial
#7
Kimon Bekelis, Daniel Calnan, Nathan Simmons, Todd A MacKenzie, George Kakoulides
OBJECTIVE: To investigate the effect of exposure to a virtual reality (VR) environment preoperatively on patient-reported outcomes for surgical operations. BACKGROUND: There is a scarcity of well-developed quality improvement initiatives targeting patient satisfaction. METHODS: We performed a randomized controlled trial of patients undergoing cranial and spinal operations in a tertiary referral center. Patients underwent a 1:1 randomization to an immersive preoperative VR experience or standard preoperative experience stratified on type of operation...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27893535/cytoplasmic-hur-status-predicts-disease-free-survival-in-resected-pancreatic-cancer-a-post-hoc-analysis-from-the-international-phase-iii-espac-3-clinical-trial
#8
Talar Tatarian, Wei Jiang, Benjamin E Leiby, Amanda Grigoli, Masaya Jimbo, Nooreen Dabbish, John P Neoptolemos, William Greenhalf, Eithne Costello, Paula Ghaneh, Christopher Halloran, Daniel Palmer, Markus Buchler, Charles J Yeo, Jordan M Winter, Jonathan R Brody
OBJECTIVES: We tested cytoplasmic HuR (cHuR) as a predictive marker for response to chemotherapy by examining tumor samples from the international European Study Group of Pancreatic Cancer-3 trial, in which patients with resected pancreatic ductal adenocarcinoma (PDA) received either gemcitabine (GEM) or 5-fluorouracil (5-FU) adjuvant monotherapy. BACKGROUND: Previous studies have implicated the mRNA-binding protein, HuR (ELAVL1), as a predictive marker for PDA treatment response in the adjuvant setting...
November 23, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27893534/clinical-predictors-of-positive-postoperative-blood-cultures
#9
Libby R Copeland-Halperin, Joshua Stodghill, Erica Emery, Amber W Trickey, Jonathan Dort
OBJECTIVE: To define clinical features of surgical patients in whom postoperative blood cultures are likely to identify pathogens. BACKGROUND: Bacteremia is a worrisome postoperative complication and blood cultures (BCx) are routinely used for evaluation of postoperative bacteremia, but are costly and not always diagnostic. Better methods are needed to select patients in whom BCx identify pathogens. METHODS: We reviewed records of patients ≥18 years old with BCx drawn ≤10 days after surgery in 2013 seeking independent predictors of positive cultures by simple and multiple logistic regression models with statistical significance at α = 0...
November 23, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27893533/half-the-truth-is-often-a-great-lie-over-a-hundred-years-of-controversy-on-pancreatic-fistula-between-pancreaticogastrostomy-and-pancreaticojejunostomy-after-pancreaticoduodenectomy
#10
Zi Yin, Haosheng Jin, Zhixiang Jian
No abstract text is available yet for this article.
November 23, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27893532/the-effect-of-hospital-volume-on-breast-cancer-mortality
#11
Rachel A Greenup, Samilia Obeng-Gyasi, Samantha Thomas, K Houck, Whitney O Lane, Rachel C Blitzblau, Terry Hyslop, E Shelley Hwang
OBJECTIVE: The aim of this study was to determine whether hospital volume was associated with mortality in breast cancer, and what thresholds of case volume impacted survival. BACKGROUND: Prior literature has demonstrated improved survival with treatment at high volume centers among less common cancers requiring technically complex surgery. METHODS: All adults (18 to 90 years) with stages 0-III unilateral breast cancer diagnosed from 2004 to 2012 were identified from the American College of Surgeons National Cancer Data Base (NCDB)...
November 23, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849672/beyond-infrastructure-understanding-why-patients-decline-surgery-in-the-developing-world-an-observational-study-in-cameroon
#12
Benjamin J Lerman, Marcella Alsan, Ngew J Chia, James A Brown, Sherry M Wren
OBJECTIVE: The aim of this study was to quantify and describe a population of patients in rural Cameroon who present with a surgically treatable illness but ultimately decline surgery, and to understand the patient decision-making process and identify key socioeconomic factors that result in barriers to care. BACKGROUND: An estimated 5 billion people lack access to safe, affordable surgical care and anesthesia when needed, and this unmet need resides disproportionally in low-income countries (LICs)...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849671/randomized-controlled-trial-of-pancreaticojejunostomy-versus-stapler-closure-of-the-pancreatic-stump-during-distal-pancreatectomy-to-reduce-pancreatic-fistula
#13
Ragini Kilambi, Anand Narayan Singh
No abstract text is available yet for this article.
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849670/ret-ptc3-rearrangement-in-papillary-thyroid-carcinoma-possible-marker-of-tumor-progression
#14
Sergei V Jargin
No abstract text is available yet for this article.
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849669/hospital-rating-systems-and-implications-for-patient-travel-to-better-rated-hospitals
#15
Arun Subramanian, Joel T Adler, Nilay D Shah, Joseph A Hyder
Publicly reported hospital ratings aim to encourage transparency, spur quality improvement, and empower patient choice. Travel burdens may limit patient choice, particularly for older adults (aged 65 years and more) who receive most medical care. For 3 major hospital ratings systems, we estimated travel burden as the additional 1-way travel distance to receive care at a better-rated hospital.Distances were estimated from publicly available data from the US Census, US News Top Hospitals, Society of Thoracic Surgeons composite rating for coronary artery bypass grafting (STS-CABG), and Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS)...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849668/risk-of-acute-testicular-failure-after-preoperative-radiotherapy-for-rectal-cancer-a-prospective-cohort-study
#16
Christian Buchli, Anna Martling, Massoud Al Abani, Jan-Erik Frödin, Matteo Bottai, Ingmar Lax, Stefan Arver, Torbjörn Holm
OBJECTIVE: The aim of this study was to assess the acute effect of preoperative RT for rectal cancer on endocrine testicular function. BACKGROUND: Preoperative radiotherapy (RT) enhances local control and cancer-specific survival in patients treated for rectal cancer. In case series, a negative acute effect on Leydig cell function has been reported. METHODS: This prospective cohort study included 168 males with rectal or prostate cancer stage I-III...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849667/unintended-consequences-of-the-30-day-mortality-metric-fact-or-fiction
#17
Winta T Mehtsun, Keith D Lillemoe, Jie Zheng, E John Orav, Ashish K Jha
OBJECTIVE: To assess if an incongruous increase in mortality occurs after postoperative day 30. BACKGROUND: In the current climate of public reporting and pay-for-performance, 30-day mortality after inpatient surgery has become a key metric to assess performance. Whereas the intent is to improve quality, there has been increasing concern that reporting 30-day mortality may influence providers' timing of treatment withdrawal. METHODS: We used national Medicare data to identify beneficiaries who underwent 1 of 19 major surgical procedures...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849666/the-opioid-epidemic-and-new-legislation-in-massachusetts-time-for-a-culture-change-in-surgery
#18
Haytham M A Kaafarani, Eric Weil, Sarah Wakeman, David Ring
No abstract text is available yet for this article.
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849665/practice-style-variation-in-medicaid-and-non-medicaid-children-with-complex-chronic-conditions-undergoing-surgery
#19
Jeffrey H Silber, Paul R Rosenbaum, Wei Wang, Shawna R Calhoun, Joseph G Reiter, Orit Even-Shoshan, William J Greeley
OBJECTIVES: With differential payment between Medicaid and Non-Medicaid services, we asked whether style-of-practice differs between similar Medicaid and Non-Medicaid children with complex chronic conditions (CCCs) undergoing surgery. SUMMARY OF BACKGROUND DATA: Surgery in children with CCCs accounts for a disproportionately large percentage of resource utilization at major children's hospitals. METHODS: A matched cohort design, studying 23,582 pairs of children with CCCs undergoing surgery (Medicaid matched to Non-Medicaid within the same hospital) from 2009 to 2013 in 41 Children's Hospitals...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27849664/perioperative-pharmacological-thromboprophylaxis-in-patients-with-cancer-a-systematic-review-and-meta-analysis
#20
Qiang Guo, Bin Huang, Jichun Zhao, Yukui Ma, Ding Yuan, Yi Yang, Xiaojiong Du
OBJECTIVE: To compare the relative effects between pharmacological thromboprophylaxis and no anticoagulation. BACKGROUND: The efficacy and safety of pharmacological thromboprophylaxis in cancer patients undergoing surgery need to be quantified to guide management. METHODS: We searched multiple electronic databases (up to March 31, 2016) for trials of cancer patients undergoing surgery that assessed the relative benefits and harms of perioperative pharmacological thromboprophylaxis...
November 15, 2016: Annals of Surgery
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