American journal of surgery最新文献_第10页

Reproductive planning and infertility: Training the next generation of surgeons 生殖计划与不孕症：培训下一代外科医生。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-08-03 DOI: 10.1016/j.amjsurg.2024.115886

{"title":"Reproductive planning and infertility: Training the next generation of surgeons","authors":"","doi":"10.1016/j.amjsurg.2024.115886","DOIUrl":"10.1016/j.amjsurg.2024.115886","url":null,"abstract":"<div><h3>Background</h3><p>Female surgeons face increased rates of fertility challenges compared to the general population. We aim to understand surgical trainees’ understanding and perspectives on family planning.</p></div><div><h3>Methods</h3><p>A 35-question survey was emailed to program directors at all US surgical residency programs for distribution to residents. Descriptive analyses were performed to evaluate resident understanding and perspectives on family planning and fertility treatments.</p></div><div><h3>Results</h3><p>A total of 121 residents responded to the survey. Most were female (n = 78; 65 %). Responders indicated the need to postpone pregnancy during training (female: n = 48, 64 % vs male n = 18, 45 %; p = 0.09). Potential negative career consequences (n = 50; 42 %), limited leave benefits (n = 47; 39 %), and lack of childcare (n = 45; 38 %) were primary reasons for postponing pregnancy. Only nine responders (8 %) received fertility-preservation education.</p></div><div><h3>Conclusion</h3><p>Surgical trainees delay pregnancy for career and social support concerns and are interested in reproductive preservation. Fertility education could provide needed support for trainees.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Addressing the impact of family planning on medical students' perception of entering surgical residency. 解决计划生育对医学生进入外科住院医师培训的影响问题。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-08-03 DOI: 10.1016/j.amjsurg.2024.115888

Madeline Ebert, Grace Elizabeth Lawson, Sophia Dittrich, Sophie Dream

引用次数: 0

Venous thromboembolic events associated with blood product administration in an era of whole blood use 在使用全血的时代，与使用血液制品相关的静脉血栓栓塞事件。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-08-03 DOI: 10.1016/j.amjsurg.2024.115887

引用次数: 0

My thoughts: Navigating the hijab in surgical education: Challenges, progress, and global realities. 我的想法手术教育中的头巾问题：挑战、进步和全球现实。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-08-03 DOI: 10.1016/j.amjsurg.2024.115885

Lindsay Bryant, Shanze Arshad, Huda Kutmah

引用次数: 0

Analysis of pre-admission risk factors for unplanned reintubation in geriatric trauma patients 老年创伤患者入院前意外再次插管的风险因素分析。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-07-31 DOI: 10.1016/j.amjsurg.2024.115882

{"title":"Analysis of pre-admission risk factors for unplanned reintubation in geriatric trauma patients","authors":"","doi":"10.1016/j.amjsurg.2024.115882","DOIUrl":"10.1016/j.amjsurg.2024.115882","url":null,"abstract":"<div><h3>Introduction</h3><p>Reintubation in unplanned scenarios, carries inherent risks and potential complications particularly in vulnerable populations such as geriatric trauma patients. We sought to identify preadmission risk factors for unplanned re-intubation (URI) in geriatric trauma patients and its effects on outcomes.</p></div><div><h3>Methods</h3><p>Analysis of TQIP (2017–2019) of intubated geriatric trauma patients, classified into two groups, those who were successfully extubated and those who required URI. We used logistic regression to assess for preadmission risk factors of URI.</p></div><div><h3>Results</h3><p>Among 23,572 patients, 20.2 % underwent URI. URI had higher mortality (13.7%vs.8.1 %, <em>p</em> < 0.001), in-hospital complications (<em>p</em> < 0.05), longer hospital and ICU LOS (<em>p</em> < 0.001 for both). Higher age (OR = 1.017), smoking (OR = 1.418), CRF(OR = 1.414), COPD (OR = 1.410), alcohol use (OR = 1.365), functionally dependent health status (OR = 1.339), and anticoagulant use (OR = 1.148), increased the risks of URI (<em>p</em> < 0.05 for all).</p></div><div><h3>Conclusion</h3><p>Geriatric patients with comorbidities including age, smoking, CRF, COPD, alcohol use, dependent status, and anticoagulant use are at higher risks of URI that could in turn, be associated with increased rates of mortality, complications, and longer hospital and ICU length of stay.</p></div><div><h3>Level of evidence</h3><p>Level III retrospective study.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A nightmare: Sigmoid volvulus. 一场噩梦：乙状结肠瘤。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-07-30 DOI: 10.1016/j.amjsurg.2024.115883

Sabri Selcuk Atamanalp

引用次数: 0

Role of thymectomy in surgical treatment of renal hyperparathyroidism 胸腺切除术在肾性甲状旁腺功能亢进手术治疗中的作用

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-07-27 DOI: 10.1016/j.amjsurg.2024.115864

{"title":"Role of thymectomy in surgical treatment of renal hyperparathyroidism","authors":"","doi":"10.1016/j.amjsurg.2024.115864","DOIUrl":"10.1016/j.amjsurg.2024.115864","url":null,"abstract":"<div><h3>Introduction</h3><div>The role for routine thymectomy in patients with secondary or tertiary hyperparathyroidism (SHPT, THPT) is unclear. We aim to compare rates of recurrence and complications in patients who underwent subtotal parathyroidectomy with and without thymectomy.</div></div><div><h3>Methods</h3><div>Patients who underwent surgery for renal HPT at a tertiary endocrine surgery center between 2010 and 2022 were reviewed. Presence of parathyroid tissue in resected tissue was identified through pathology reports. A multivariate logistic regression was used to compare baseline characteristics, recurrence rates and complications between those who did and did not undergo thymectomy.</div></div><div><h3>Results</h3><div>Of 107 patients who underwent subtotal parathyroidectomy, 29 (27.1 %) underwent concomitant thymectomy. Recurrence occurred in 15 patients (14 %). Thymectomy did not affect recurrence (OR: 0.33, 95%CI: 0.06–1.28, p = 0.14), but was associated with permanent hypoparathyroidism (OR: 4.62, 95%CI: 1.67–13.18, p = 0.003). Fewer parathyroid specimens increased the odds of thymectomy (p = 0.04). Parathyroid glands were found in 6 thymectomy samples (20.7 %).</div></div><div><h3>Conclusion</h3><div>Thymectomy at the time of subtotal parathyroidectomy for renal HPT was not associated with disease recurrence, but increased likelihood of permanent hypoparathyroidism.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Propofol administration for induction is associated with peri-intubation instability in trauma critical care unit patients 异丙酚诱导与创伤重症监护病房患者围插管不稳定性有关

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-07-23 DOI: 10.1016/j.amjsurg.2024.115858

{"title":"Propofol administration for induction is associated with peri-intubation instability in trauma critical care unit patients","authors":"","doi":"10.1016/j.amjsurg.2024.115858","DOIUrl":"10.1016/j.amjsurg.2024.115858","url":null,"abstract":"<div><h3>Introduction</h3><p>Peri-intubation hypotension is associated with increased hospital length of stay and morbidity. Propofol is associated with alterations in hemodynamics. We hypothesize that using propofol for induction leads to peri-intubation hypotension in trauma critical care patients.</p></div><div><h3>Methods</h3><p>Patients that underwent unplanned intubation in the trauma intensive care unit (TICU) were prospectively enrolled. Peri-intubation vitals and medications were recorded to assess hypotension within 10 min of intubation. Patients were divided into propofol (PROP) or other medication (OTR) groups.</p></div><div><h3>Results</h3><p>Data was complete for 69 patients; 31 PROP and 38 OTR. In OTR there was an 8.8-point (−21.1, 3.6) SBP decrease (p = 0.159) and in PROP there was a 30.8-point (−45.6, −16.0) SBP decrease (p = 0.0002) with significant increases in heart rate (HR) and shock index (SI) (HR p = 0.001, SI p < 0.0001).</p></div><div><h3>Conclusion</h3><p>In patients without hypotension prior to intubation, we observed a statistically significant drop in the patients’ SBP with use of propofol. In trauma critical care unit patients, we recommend considering an induction medication for unplanned intubation other than propofol.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disparities in outpatient rural cholecystectomy outcomes 农村门诊胆囊切除术结果的差异。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-07-20 DOI: 10.1016/j.amjsurg.2024.115852

{"title":"Disparities in outpatient rural cholecystectomy outcomes","authors":"","doi":"10.1016/j.amjsurg.2024.115852","DOIUrl":"10.1016/j.amjsurg.2024.115852","url":null,"abstract":"<div><h3>Background</h3><p>Previous studies showed comparable outcomes for common in-patient general surgery operations, but it is unknown if this extends to outpatient operations. Our aim was to compare outpatient cholecystectomy outcomes between rural and urban hospitals.</p></div><div><h3>Methods</h3><p>A retrospective cohort analysis was done using the Nationwide Ambulatory Surgery Sample for patients 20-years-and-older undergoing cholecystectomy between 2016 and 2018 at rural and urban hospitals. Survey-weighted multivariable regression analysis was performed with primary outcomes including use-of-laparoscopy, complications, and patient discharge disposition.</p></div><div><h3>Results</h3><p>The most common indication for operation was cholecystitis in both hospital settings. On multivariable analysis, rural hospitals were associated with higher transfers to short-term hospitals (adjusted odds ratio [aOR] 2.40, 95%CI 1.61-3.58, p < 0.01) and complications (aOR 1.39, 95%CI 1.11-1.75, p < 0.01). No difference was detected with laparoscopy (aOR 1.93, 95%CI 0.73-5.13, p = 0.19), routine discharge (aOR 1.50, 95%C I0.91-2.45, p = 0.11), or mortality (aOR 3.23, 95%CI 0.10–100.0, p = 0.51).</p></div><div><h3>Conclusions</h3><p>Patients cared for at rural hospitals were more likely to be transferred to short-term hospitals and have higher complications. No differences were detected in laparoscopy, routine discharge or mortality.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Scrubbing In: A medical student's guide to initiating a surgical research journey. Scrubbing In：医科学生的外科研究之旅启动指南。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-07-20 DOI: 10.1016/j.amjsurg.2024.115862

Morgan J Hopp, Xiomara Ortiz-Huertas, Jessica M Fazendin, Sophie Dream

引用次数: 0