American journal of surgery最新文献_第10页

Roses & Thorns of academic surgery: The journey of Dr. Benedict Nwomeh 学术外科的玫瑰与荆棘：本尼迪克特-恩沃梅医生的心路历程。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-19 DOI: 10.1016/j.amjsurg.2024.116105

Shai Stewart, Wendelyn Oslock, Lamario Williams, Nikhil R. Shah, Benedict C. Nwomeh

引用次数: 0

Don't break the (blood) bank: Can waste be minimized in a whole blood program? 不要破坏（血液）银行：全血计划能否最大限度地减少浪费？

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-17 DOI: 10.1016/j.amjsurg.2024.116082

Jordan Lilienstein , Debra Lowry , Andrea Long , Krista Kaups , Alec Chan-Golston , Jessica Gallegos , Gladys Morrissey , James Davis

{"title":"Don't break the (blood) bank: Can waste be minimized in a whole blood program?","authors":"Jordan Lilienstein , Debra Lowry , Andrea Long , Krista Kaups , Alec Chan-Golston , Jessica Gallegos , Gladys Morrissey , James Davis","doi":"10.1016/j.amjsurg.2024.116082","DOIUrl":"10.1016/j.amjsurg.2024.116082","url":null,"abstract":"<div><h3>Background</h3><div>Wastage concerns are a barrier to adopting whole blood (WB) therapy in trauma patients. Converting aging WB to red blood cell units (RBCs) may minimize wastage.</div></div><div><h3>Methods</h3><div>Blood bank records for WB and standard blood products were retrospectively reviewed at a level 1 trauma center from 8/2020 - 3/2023. Secondary analysis of outcomes for patients requiring trauma activation and receiving WB or RBC within 4 h of arrival was performed. Blood wastage and outcomes were compared.</div></div><div><h3>Results</h3><div>WB and type-O RBCs had comparable wastage rates (0.7 vs 0.5 %). 677 WB units were transfused, while 668 were converted and transfused as RBCs. 9 were wasted, none expired. 496 patients met secondary analysis criteria. 168 received WB. WB transfusion ratios were more balanced and outcomes were similar compared to component therapy (COMP).</div></div><div><h3>Conclusion</h3><div>Converting aging WB to RBCs resulted in minimal blood wastage, with similar outcomes and more balanced transfusion ratios compared to COMP.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116082"},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709029","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

If you throw enough mud, eventually some will stick. 如果你扔的泥足够多，最终会有一些粘住。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-17 DOI: 10.1016/j.amjsurg.2024.116101

Sasha A Still

引用次数: 0

A comparison of society guidelines in the management of gallbladder polyps 胆囊息肉治疗的社会指南比较。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-15 DOI: 10.1016/j.amjsurg.2024.116099

Lorena Garcia , Frances Dygean , Emily Bortree , Ryan Seifi , Brian Yu , Julie Ferris , Austin Reifel , Christina Snyder , Patrick Choi , Kathryn T. Chen

{"title":"A comparison of society guidelines in the management of gallbladder polyps","authors":"Lorena Garcia , Frances Dygean , Emily Bortree , Ryan Seifi , Brian Yu , Julie Ferris , Austin Reifel , Christina Snyder , Patrick Choi , Kathryn T. Chen","doi":"10.1016/j.amjsurg.2024.116099","DOIUrl":"10.1016/j.amjsurg.2024.116099","url":null,"abstract":"<div><h3>Background</h3><div>In 2021, European radiology and gastrointestinal societies updated their guidelines regarding the management of gallbladder polyps (GBP). In 2022, the Society of Radiologists in Ultrasound (SRU) also released their guidelines. We compared the two sets to determine the differences in management and outcomes for GBPs.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis from 2018 to 2023 of 118 patients referred for GBPs. Radiologists retrospectively reviewed patient ultrasounds (US) and assigned an SRU category. We applied both sets of guidelines to identify next recommended step and performed a cost analysis.</div></div><div><h3>Results</h3><div>When applying European versus SRU guidelines, 52.5 % (n = 62) versus 16.9 % (n = 20) would have undergone immediate surgery (p < 0.0001). US would have been considered a reasonable next step in 28.8 % (n = 34) vs 42.4 % (n = 50) (p = 0.03). Adherence to SRU guidelines would have resulted in $1837 less spent per person (p < 0.001).</div></div><div><h3>Conclusion</h3><div>Our findings found that adherence to SRU guidelines leads to less surgeries and follow up compared to European guidelines without causing harm. Further studies should be done to validate these findings and support standardized reporting of GBP.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116099"},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685805","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

Family planning impact on medical students’ surgery interest and current policies in the United States: A scoping review 计划生育对医科学生手术兴趣的影响以及美国的现行政策：范围审查。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-14 DOI: 10.1016/j.amjsurg.2024.116086

Sophia Dittrich , Madeline Ebert , Grace Elizabeth Lawson , Kimberly M. Ramonell , Sophie Dream

{"title":"Family planning impact on medical students’ surgery interest and current policies in the United States: A scoping review","authors":"Sophia Dittrich , Madeline Ebert , Grace Elizabeth Lawson , Kimberly M. Ramonell , Sophie Dream","doi":"10.1016/j.amjsurg.2024.116086","DOIUrl":"10.1016/j.amjsurg.2024.116086","url":null,"abstract":"<div><h3>Introduction</h3><div>Previous reviews have examined female residents' experiences while ante- and postpartum. However, to our knowledge, no review exists that synthesizes medical students’ perception of family planning during surgical residencies. We wanted to synthesize current literature on the perceptions of family planning of medical students interested in surgical fields and current medical school policies or resources related to family planning.</div></div><div><h3>Methods</h3><div>A scoping review was performed of databases including MEDLINE (OVID), Scopus, and PubMed in April and September of 2023. Studies were excluded if they were conducted outside the US, occurred before 2003, were opinions, reviews, or editorials, included only non-surgical specialties, focused on only attending years or training years after medical school, and only mentioned “work/life balance” or “lifestyle.”</div></div><div><h3>Results</h3><div>2295 studies were identified, and a final 19 studies were included. Four major themes were identified among the studies, including family planning as a barrier to a career in surgery, fertility, onsite childcare, and parental leave. Most studies examined general barriers medical students perceive about surgery and included at least one survey question related to family planning. Only two studies focused solely on medical students’ knowledge of oocyte preservation, one on on-site childcare at medical schools and one on parental leave during medical school.</div></div><div><h3>Conclusion</h3><div>There is a lack of research examining medical students’ knowledge of family planning during a surgical residency and current childbearing policies and resources offered during residency.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"Article 116086"},"PeriodicalIF":2.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646766","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

Impact of prior cholecystectomy on diagnosis and outcomes of choledochal cyst resection in adults 既往胆囊切除术对成人胆总管囊肿切除术诊断和结果的影响。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-14 DOI: 10.1016/j.amjsurg.2024.116088

Aradhya Nigam , Grace C Bloomfield , Maryam Boumezrag , Salima Mansoor Ali , DongHyang Kwon , Reena C Jha , Thomas M Fishbein , Pejman Radkani , Emily R Winslow

{"title":"Impact of prior cholecystectomy on diagnosis and outcomes of choledochal cyst resection in adults","authors":"Aradhya Nigam , Grace C Bloomfield , Maryam Boumezrag , Salima Mansoor Ali , DongHyang Kwon , Reena C Jha , Thomas M Fishbein , Pejman Radkani , Emily R Winslow","doi":"10.1016/j.amjsurg.2024.116088","DOIUrl":"10.1016/j.amjsurg.2024.116088","url":null,"abstract":"<div><h3>Introduction</h3><div>The diagnosis of choledochal cysts in the adult population is complicated by the expected physiologic dilation of the common bile duct after cholecystectomy. We aimed to compare patients who underwent choledochal cyst resection based on cholecystectomy status.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted of patients who underwent choledochal cyst resection between 1/1/1998-12/31/2021. Patients were categorized based on whether they had undergone cholecystectomy prior to choledochal cyst diagnosis. Preoperative imaging characteristics, pathology findings, and outcomes were evaluated.</div></div><div><h3>Results</h3><div>Amongst 119 patients who underwent excision, 58 (46 %) had and 69 (54 %) had not undergone prior cholecystectomy. Preoperative imaging demonstrated no difference in biliary tract diameter although a greater proportion of patients with a gallbladder in place had an anomalous pancreaticobiliary junction (55 % v 33 %, p < 0.05). Biliary malignancy was observed in a greater proportion of patients with prior cholecystectomy although this was not statistically significant (5 % v 3 %; p = 0.9). Rates of post-operative complications were statistically similar between patient cohorts.</div></div><div><h3>Discussion</h3><div>Radiographic and clinical features were similar among patients who had and had not undergone cholecystectomy. Choledochal cyst patients should be managed uniformly regardless of cholecystectomy status.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116088"},"PeriodicalIF":2.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692682","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

Risk factors and outcomes of cardiac arrest in pediatric traumatic brain injury patients 小儿脑外伤患者心脏骤停的风险因素和结果。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-13 DOI: 10.1016/j.amjsurg.2024.116087

Irim Salik , Sima Vazquez , Nisha Palla , Norbert Smietalo , Richard Wang , Monica Vavilala , Jose F. Dominguez , Iwan Sofjan , Jared M. Pisapia

{"title":"Risk factors and outcomes of cardiac arrest in pediatric traumatic brain injury patients","authors":"Irim Salik , Sima Vazquez , Nisha Palla , Norbert Smietalo , Richard Wang , Monica Vavilala , Jose F. Dominguez , Iwan Sofjan , Jared M. Pisapia","doi":"10.1016/j.amjsurg.2024.116087","DOIUrl":"10.1016/j.amjsurg.2024.116087","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac arrest (CA) in pediatric traumatic brain injury (pTBI) is associated with morbidity. Our objective is to investigate the incidence, risk factors, and outcomes for CA following pTBI.</div></div><div><h3>Methods</h3><div>The Kid Inpatient Database (KID) was queried for patients with pTBI. Patients who experienced CA were identified. Demographics, comorbidities, hospital course, and complications were compared between patients who developed CA and who did not. Risk factors for CA were explored using multivariate analysis.</div></div><div><h3>Results</h3><div>CA patients were more likely to have hypertension, hypertrophic cardiomyopathy, and heart defects (p < 0.01). CA was more likely in patients with subdural bleeding, cerebral edema, herniation, coma, or mechanical ventilation (p < 0.001). CA patients had higher odds of vasopressor and transfusions, tracheostomy, percutaneous endoscopic gastrotomy (p < 0.001), and mortality (p < 0.01). Mechanical ventilation, cerebral edema, heart, vasopressor use, and transfusions were associated with CA on multivariate analysis.</div></div><div><h3>Conclusion</h3><div>Risk factors for CA in pTBI patients include severity of injury and underlying cardiovascular abnormalities. CA was associated with morbidity and resource utilization in pTBI patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"Article 116087"},"PeriodicalIF":2.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643257","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

Comparison of perioperative outcomes of emergency hartmann resections performed by residents versus attending surgeons 住院医生与主治医生进行急诊哈特曼切除术的围手术期结果比较。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-13 DOI: 10.1016/j.amjsurg.2024.116084

Lior Orbach , Shiran Gabay , Tal Montekio , Ariel S. Chai , Yehuda Kariv , Meir Zemel , Adam Abu-Abeid , Guy Lahat , Jonathan B. Yuval

{"title":"Comparison of perioperative outcomes of emergency hartmann resections performed by residents versus attending surgeons","authors":"Lior Orbach , Shiran Gabay , Tal Montekio , Ariel S. Chai , Yehuda Kariv , Meir Zemel , Adam Abu-Abeid , Guy Lahat , Jonathan B. Yuval","doi":"10.1016/j.amjsurg.2024.116084","DOIUrl":"10.1016/j.amjsurg.2024.116084","url":null,"abstract":"<div><h3>Objective</h3><div>The optimal level of resident autonomy in emergency colorectal surgery is unclear. This study assessed perioperative outcomes in patients undergoing emergency colectomy with end stoma based on the presence of an attending surgeon.</div></div><div><h3>Participants</h3><div>A retrospective analysis was conducted at a tertiary teaching hospital, including 360 patients who underwent emergency colectomy with end stoma between 2013 and 2023. The primary outcome was perioperative complications, including mortality.</div></div><div><h3>Results</h3><div>Of the 360 patients, 36 (10 %) had surgery without an attending surgeon present. Baseline characteristics such as age (p = 0.34), Charlson Comorbidity Index (p = 0.313), and sex (p = 0.598) were similar across groups. Perioperative outcomes showed no significant differences in major complications (Clavien-Dindo ≥3, p = 0.176), 90-day complication rate (p = 0.698), or 90-day mortality (p = 0.389). Malignancy-related cases also did not differ in lymph node yield (p = 0.685) or overall survival (log-rank p = 0.574).</div></div><div><h3>Conclusion</h3><div>In this study, Hartmann resections performed by resident teams were not associated with worse perioperative or oncologic outcomes, suggesting that resident autonomy can be safely increased without compromising patient safety.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116084"},"PeriodicalIF":2.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692681","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

The criticality of reasonable accommodations: A scoping review revealing gaps in care for patients with blindness and low vision 合理便利的重要性：范围审查揭示了盲人和低视力患者护理方面的差距。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-13 DOI: 10.1016/j.amjsurg.2024.116085

Grace Keegan , John-Ross Rizzo , Megan A. Morris , Kathie-Ann Joseph

{"title":"The criticality of reasonable accommodations: A scoping review revealing gaps in care for patients with blindness and low vision","authors":"Grace Keegan , John-Ross Rizzo , Megan A. Morris , Kathie-Ann Joseph","doi":"10.1016/j.amjsurg.2024.116085","DOIUrl":"10.1016/j.amjsurg.2024.116085","url":null,"abstract":"<div><h3>Background</h3><div>Health and healthcare disparities for surgical patients with blindness and low vision (pBLV) stem from inaccessible healthcare systems that lack universal design principles or, at a minimum, reasonable accommodations (RA).</div></div><div><h3>Objectives</h3><div>We aimed to identify barriers to developing and implementing RAs in the surgical setting and provide a review of best practices for providing RAs.</div></div><div><h3>Methods</h3><div>We conducted a search of PubMed for evidence of reasonable accommodations, or lack thereof, in the surgical setting. Articles related to gaps and barriers to providing RAs for pBLV or best practices for supporting RAs were reviewed for the study.</div></div><div><h3>Results</h3><div>Barriers to the implementation of reasonable accommodations, and, accordingly, best practices for achieving equity for pBLV, relate to policies and systems, staff knowledge and attitudes, and materials and technology.</div></div><div><h3>Conclusions</h3><div>These inequities for pBLV require comprehensive frameworks that offer, maintain, and support education about disability disparities and RAs in the surgical field. Providing RAs for surgical pBLV, and all patients with disabilities is an important and impactful step towards creating a more equitable and anti-ableist health system.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"241 ","pages":"Article 116085"},"PeriodicalIF":2.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646767","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

Pass/fail and reducing the hidden curriculum for residency applicants. 及格/不及格，减少住院申请人的隐性课程。

IF 2.7 3区医学

American journal of surgery Pub Date : 2024-11-10 DOI: 10.1016/j.amjsurg.2024.116071

Jenna G Alkhatib, Wendelyn M Oslock

引用次数: 0