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Journal of Surgical Research

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https://www.readbyqxmd.com/read/29103674/functional-outcomes-after-inpatient-rehabilitation-for-trauma-improved-but-unable-to-return-home
#1
Catherine W Lancaster, Charles DiMaggio, Gary Marshall, Stephen Wall, Patricia Ayoung-Chee
BACKGROUND: Twenty-five percent of trauma patients are discharged to postacute care, indicating a loss of physical function and need for rehabilitation. The purpose of this study was to quantify the functional improvements in trauma patients discharged from inpatient rehabilitation facility (IRF) and identify predictors of improvement. MATERIALS AND METHODS: A retrospective cohort study of trauma patients aged ≥ 18 years were admitted to an IRF after discharge from a level-1 trauma center...
November 2, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29100587/assessment-of-risk-factors-for-increased-resource-utilization-in-kidney-transplantation
#2
Steven Craig Vranian, Kelly L Covert, Caitlin R Mardis, John W McGillicuddy, Kenneth D Chavin, Derek Dubay, David J Taber
BACKGROUND: There are only a limited number of studies that have sought to identify patients at high risk for medication errors and subsequent adverse clinical outcomes. This study sought to identify risk factors for increased health care resource utilization in kidney transplant recipients based on drug-related problems and self-administered surveys. METHODS: In this prospective observational study, adult kidney transplant recipients seen in the transplant clinic between September and November 2015 were surveyed for self-reported demographics, medication adherence, and health status/outlook...
October 31, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29100586/trends-of-ureteral-stent-usage-in-surgery-for-diverticulitis
#3
Alexander S Chiu, Raymond A Jean, Jolanta Gorecka, Kimberly A Davis, Kevin Y Pei
BACKGROUND: Many believe that the use of ureteral stents in colorectal surgery for diverticulitis aids prevention and easier identification of ureteral injuries; others argue that the added time, cost, and risks of stent placement negate potential benefits. Even among providers who use stents, selective use is common. Among unclear consensus, it remains unknown if the use of stents is growing. MATERIALS: Patients in the National Inpatient Sample who underwent a partial colectomy or anterior rectal excision for diverticulitis between 2000 and 2013 were included (n = 811,071)...
October 31, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29110965/response-to-er-and-tez-the-use-of-artificial-neural-networks-in-medical-prognostication
#4
LETTER
Tyler J Loftus, Janeen R Jordan
No abstract text is available yet for this article.
October 27, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29037488/what-is-the-mechanism-of-prolonged-ileus-after-colectomy-for-inflammatory-bowel-disease-within-the-eras-protocol
#5
LETTER
Aurélien Venara, Karem Slim
No abstract text is available yet for this article.
October 13, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28988685/socioeconomic-disparities-affect-survival-in-malignant-ovarian-germ-cell-tumors-in-aya-population
#6
L V Bownes, L L Stafman, I I Maizlin, M Dellinger, K W Gow, A B Goldin, M Goldfarb, M Langer, M V Raval, J J Doski, J G Nuchtern, S A Vasudevan, E A Beierle
BACKGROUND: Malignant ovarian germ cell tumors (MOGCTs) are a rare form of ovarian malignancy. Socioeconomic status (SES) has been shown to affect survival in several gynecologic cancers. We examined whether SES impacted survival in adolescent and young adults (AYAs) with MOGCT. MATERIALS AND METHODS: The National Cancer Data Base was used to identify AYAs (aged 15-39 years) with MOGCT from 1998 to 2012. Three SES surrogate variables identified were as follows: insurance type, income quartile, and education quartile...
October 5, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28923559/the-independent-effect-of-cancer-on-outcomes-a-potential-limitation-of-surgical-risk-prediction
#7
Ira L Leeds, Joseph K Canner, Jonathan E Efron, Nita Ahuja, Elliott R Haut, Elizabeth C Wick, Fabian M Johnston
BACKGROUND: Cancer patients are often thought to have worse surgical outcomes. There is a growing view that risk models do not adequately predict these outcomes. This study aims to compare the use of common risk models for benign versus malignant gastrointestinal disease. MATERIALS AND METHODS: The National Surgical Quality Improvement Program (NSQIP) 2005-2015 participant use files were queried for patients undergoing elective surgery for benign and malignant diseases with a primary procedure code for major colon, pancreas, or stomach resection...
September 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28890131/characterization-of-systemic-neutrophil-function-in-patients-undergoing-colorectal-cancer-resection
#8
Jonathan J R Richardson, Charles Hendrickse, Fang Gao-Smith, David R Thickett
BACKGROUND: In patients with colorectal cancer, the generation and maintenance of a systemic inflammatory response is associated with poor outcomes. Neutrophils have been implicated in the prognosis of such patients, but little is known about their functional response to surgery. This study was conducted to characterize neutrophil function of patients undergoing colorectal cancer resection. MATERIALS AND METHODS: Systemic neutrophils were isolated from patients with colorectal cancer who underwent surgical resection preoperatively (day 0) and postoperatively (day 1 and day 3)...
September 7, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28844460/barriers-to-the-implementation-and-uptake-of-simulation-based-training-programs-in-general-surgery-a-multinational-qualitative-study
#9
Shady G Hosny, Maximilian J Johnston, Philip H Pucher, Simon Erridge, Ara Darzi
BACKGROUND: Despite evidence demonstrating the advantages of simulation training in general surgery, it is not widely integrated into surgical training programs worldwide. The aim of this study was to identify barriers and facilitators to the implementation and uptake of surgical simulation training programs. METHODS: A multinational qualitative study was conducted using semi-structured interviews of general surgical residents and experts. Each interview was audio recorded, transcribed verbatim, and underwent emergent theme analysis...
August 24, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078918/association-for-academic-surgery-presidential-address-sticky-floors-and-glass-ceilings
#10
Caprice C Greenberg
This 2017 Presidential Address for the Association for Academic Surgery was delivered on February 8, 2017. It addresses the difficult topic of gender disparities in surgery. Mixing empirical data with personal anecdotes, Dr. Caprice Greenberg provides an insightful overview of this difficult challenge facing the surgical discipline and practical advice on how we can begin to address it.
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078917/the-impact-of-the-robotic-platform-on-assistant-variability-in-complex-gastrointestinal-surgery
#11
Maureen D Moore, Cheguevera Afaneh, Katherine D Gray, Suraj Panjwani, Thomas J Fahey, Alfons Pomp, Rasa Zarnegar
BACKGROUND: Nissen fundoplication is considered an advanced minimally invasive procedure whether performed laparoscopically or robotically. In laparoscopic surgery, it is evident that assistant skill level impacts operative times. However, the robotic platform allows improved surgeon autonomy. We aimed to determine the impact of assistant training level on operative times in robotic Nissen fundoplication (RNF) and laparoscopic Nissen fundoplication (LNF). METHODS: A prospectively maintained Nissen database (2011-2016) from a single academic institution was utilized to collect patient characteristics, operative times, length of stay, intraoperative complications, postoperative complications, readmission rate, and assistant training level...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078916/evaluation-of-a-technical-and-nontechnical-skills-curriculum-for-students-entering-surgery
#12
Edward S Shipper, Sarah E Miller, Brittany N Hasty, Sylvia Bereknyei Merrell, Dana T Lin, James N Lau
BACKGROUND: Prior interventions to address declining interest in surgical careers have focused on creating early exposure and fostering mentorship at the preclinical medical student level. Navigating the surgical environment can be challenging, however, and preclinical students may be more likely to pursue a surgical career if they are given the tools to function optimally. MATERIALS AND METHODS: We designed a 10-wk technical and nontechnical skills curriculum to provide preclinical students with knowledge and skills necessary to successfully navigate the surgical learning environment, followed by placement in high-fidelity surgical simulations and scrubbing in on operative cases with attending surgeons...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078915/effects-of-a-novel-mental-skills-curriculum-on-surgical-novices-attention
#13
RANDOMIZED CONTROLLED TRIAL
Nicholas E Anton, Neelam Mulji, Lisa D Howley, Ashley M Yurco, Daniel Tobben, Eric Bean, Dimitrios Stefanidis
BACKGROUND: Surgery is very cognitively demanding, particularly for novices. Novices are required to direct full attention on the procedure at hand, and additional demands can lead to cognitive overload. Through extensive practice, experts develop spare attentional capacity (SAC) for simultaneous tasks. However, little effort has been made to enhance novices' SAC. Mental skills may enhance attention management and increase SAC. The purpose of this study was to determine the efficacy of a novel mental skills curriculum (MSC) to enhance novices' attention management...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078914/impact-of-nutritional-status-on-outcomes-in-laparoscopy-assisted-gastrectomy
#14
Tomoyuki Nagata, Yuen Nakase, Kei Nakamura, Akira Sougawa, Satoshi Mochiduki, Shozo Kitai, Seishiro Inaba
BACKGROUND: There is a high morbidity rate after digestive surgery in patients with nutritional disorders such as high body mass index and depletion of skeletal muscle. MATERIALS AND METHODS: The ratio of psoas muscle area to trunk area was defined as the Psoas and All trunk Ratio (PandA Ratio) and used as an index of the balance between muscle and adipose tissue. This ratio was determined in 77 patients undergoing laparoscopy-assisted gastrectomy (LAG) for gastric cancer...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078913/naloxone-inhibits-nod-like-receptor-protein-3-inflammasome
#15
Han-Yu Lin, Ya-Ying Chang, Ming-Chang Kao, Chun-Jen Huang
BACKGROUND: Naloxone, an opioid receptor antagonist, possesses potent anti-inflammation effects. We previously confirmed the effects of naloxone on inhibiting upregulation of inflammatory cytokine interleukin-1β (IL-1β). Production of mature form IL-1β is mediated by the nod-like receptor protein 3 (NLRP3) inflammasome, a multiprotein complex composed of NLRP3, and the adaptor protein apoptosis-associated speck-like protein contains a caspase recruitment domain (ASC). We elucidated whether naloxone could inhibit the activation of NLRP3 inflammasome...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078912/mortality-rates-of-severe-traumatic-brain-injury-patients-impact-of-direct-versus-nondirect-transfers
#16
Kartik Prabhakaran, Patrizio Petrone, Gary Lombardo, Christy Stoller, Anthony Policastro, Corrado P Marini
BACKGROUND: Direct transport of patients with severe traumatic brain injury (sTBI) to trauma centers (TCs) that can provide definitive care results in lower mortality rates. This study investigated the impact of direct versus nondirect transfers on the mortality rates of patients with sTBI. METHODS: Data on patients with TBI admitted between January 1, 2012, and December 31, 2013, to our Level I TC were obtained from the trauma registry. Data included patient age, sex, mechanism, and type of injury, comorbidities, Glasgow Coma Scale, Injury Severity scores, prehospital time, time to request and to transfer, time to initiation of multimodality monitoring and goal-directed therapy protocol, dwell time in the emergency department (EDT), and mortality...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078911/resident-postgraduate-year-does-not-influence-rate-of-complications-following-inguinal-herniorrhaphy
#17
Oswaldo Renteria, Ali A Mokdad, Jonathan Imran, Sergio Huerta
BACKGROUND: Previous data indicate that patients who undergo surgery with a postgraduate year 3 (PGY-3) resident as the junior surgeon have a lower rate of recurrence compared with PGY-1 and PGY-2 after an open inguinal herniorrhaphy. Lower PGY level was also associated with increased operative time. We hypothesize that when controlling for surgeon, technique, and hernia type, the outcomes for inguinal herniorrhaphy are the same independent of PGY level. MATERIALS AND METHODS: A retrospective review of all open unilateral inguinal hernia repairs done by residents who assisted the same senior surgeon at the Veterans Affairs North Texas Health Care System was performed...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078910/ramp1-signaling-improves-lymphedema-and-promotes-lymphangiogenesis-in-mice
#18
Toshiaki Mishima, Yoshiya Ito, Nobuyuki Nishizawa, Hideki Amano, Kazutake Tsujikawa, Kagami Miyaji, Masahiko Watanabe, Masataka Majima
BACKGROUND: Secondary lymphedema commonly arises as a complication of cancer surgery and radiation treatment; however, the underlying mechanisms are poorly understood. Receptor activity-modifying protein 1 (RAMP1) forms a complex with calcitonin receptor-like receptor to generate the receptor for calcitonin gene-related peptide. The present study examined whether RAMP1 plays a role in increased lymphangiogenesis during secondary lymphedema. METHODS: A model of lymphedema was generated by surgical removal of pre-existing lymphatic vessels from the subcutaneous tissue on the tails of RAMP1-deficient (RAMP1-/-) mice and their wild-type (WT) counterparts...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078909/infection-prevention-using-affinity-polymer-coated-synthetic-meshes-in-a-pig-hernia-model
#19
Jeffrey A Blatnik, Thimma R Thatiparti, David M Krpata, Sean T Zuckerman, Michael J Rosen, Horst A von Recum
BACKGROUND: Given concern for hernia mesh infection, surgeons often use biologic mesh which may provide reduced risk of infection but at the cost of decreased repair durability. We evaluated mesh coating to provide sustained release of antibiotics to prevent prosthetic mesh infection and also allow a durable repair. MATERIALS AND METHODS: Cyclodextrin-based polymer was crosslinked onto multifilament polyester mesh and loaded with vancomycin (1.75 mg/cm(2)). Pigs received modified meshes (n = 6) or normal, untreated meshes (n = 4), which were implanted into acute 10 × 5 cm ventral hernia, then directly inoculated with 10(6) colony-forming unit (CFU) of methicillin-resistant Staphylococcus aureus (MRSA)...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078908/racial-and-ethnic-disparities-in-treatment-and-survival-of-pediatric-sarcoma
#20
Andrew J Jacobs, Erika B Lindholm, Carolyn Fein Levy, Jonathan D Fish, Richard D Glick
BACKGROUND: Childhood sarcomas are rare and require complex interdisciplinary care including surgery, chemotherapy, and radiation. The goal of this study was to determine if racial or ethnic disparities exist for pediatric sarcoma patients in the United States. METHODS: The United States' National Cancer Institute's Surveillance, Epidemiology, and End Results database was used to identify patients aged 0-21 diagnosed with primary sarcomas from 1973 to 2012. Patients were considered by race and ethnicity...
November 2017: Journal of Surgical Research
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