{"title":"The incidence of “de-novo” diabetes mellitus in patients with acute pancreatitis and its association with outcome and severity","authors":"Prishita Banerji, Yajjat Garg","doi":"10.1016/j.amjsurg.2025.116663","DOIUrl":"10.1016/j.amjsurg.2025.116663","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute pancreatitis (AP) may lead to the development of de-novo diabetes mellitus (DM) due to pancreatic endocrine dysfunction. The incidence and risk factors for this complication remain under-investigated.</div></div><div><h3>Aim</h3><div>To evaluate the incidence of de-novo DM in patients with AP and its association with disease severity.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of 91 patients hospitalised with AP from January 2022 to December 2023 was conducted. Follow-up from January to November 2024 evaluated the development of de-novo DM.</div></div><div><h3>Results</h3><div>De-novo DM occurred in 39 patients (42 %), with a median age of 54 years. Severe AP was observed in 43 %, 31 % of whom required ICU care and 6.5 % underwent necrosectomy. Four patients died. Among DM cases, 67 % required insulin, 28 % oral medication, and 5 % discontinued treatment.</div></div><div><h3>Conclusion</h3><div>De-novo DM is a common and serious consequence of AP. Disease severity strongly correlates with diabetes development and outcomes.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116663"},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312108","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}
Zachary A Koenig, Joshua T Henderson, Iraj Hasan, Sebastian M Brooke
{"title":"Spaced repetition in surgical education: Understanding the barriers and opportunities for broader adoption through a plastic surgery lens.","authors":"Zachary A Koenig, Joshua T Henderson, Iraj Hasan, Sebastian M Brooke","doi":"10.1016/j.amjsurg.2025.116655","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116655","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116655"},"PeriodicalIF":2.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306855","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}
{"title":"Lessons for the surgeon from the early history of the Zollinger Ellison syndrome: The 6th Alexander Walt Historical Lecture Presented at the Midwest Surgical Association 68th Annual Meeting Delavan, Wisconsin July 27, 2025.","authors":"E Christopher Ellison","doi":"10.1016/j.amjsurg.2025.116654","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116654","url":null,"abstract":"<p><p>Long before 1955 and the description of the disease that bears the names of Zollinger and Ellison, surgeons feared complicated peptic ulcer disease refractory to all treatment short of total gastrectomy. This recounting of the initial description is evidence of the essential elements of discovery that remain important in the 21st century and likely beyond including serendipity, expertise, curiosity, persistence, diligent follow-up, observation, and collaboration. The lessons for current and future surgeons are to be prepared, closely follow your patients and use your expertise if clinical outcomes deviate from an expected course and seek collaboration from others until you have an explanation and resolution. Who knows, if the time and place is right, you may even describe a new clinical entity.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116654"},"PeriodicalIF":2.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312114","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}
{"title":"When equal incidence isn't equal: Mortality gaps in breast cancer under 40.","authors":"Margaux Powell, Kathie-Ann Joseph","doi":"10.1016/j.amjsurg.2025.116649","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116649","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116649"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278831","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}
Rachel M Russo, Janine F Elliott, Tandis Soltani, Asanthi Ratnasekera, Mecker G Möller, Pauline K Park
{"title":"Women in surgical innovation (part II): Getting to know yourself, your customer, and your product.","authors":"Rachel M Russo, Janine F Elliott, Tandis Soltani, Asanthi Ratnasekera, Mecker G Möller, Pauline K Park","doi":"10.1016/j.amjsurg.2025.116653","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116653","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116653"},"PeriodicalIF":2.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290619","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}
Apostolos Gaitanidis , Winifred M. Lo , Rachel A. Burke , Eric C. Feliberti , Elexa P. Rallos , Ashley M. May , Adam N. Akari , Marybeth S. Hughes , Peter J. Fagenholz
{"title":"Pancreaticojejunostomy with duct-to-mucosa versus invagination techniques: a propensity-score matching analysis based on pancreatic duct size and gland texture","authors":"Apostolos Gaitanidis , Winifred M. Lo , Rachel A. Burke , Eric C. Feliberti , Elexa P. Rallos , Ashley M. May , Adam N. Akari , Marybeth S. Hughes , Peter J. Fagenholz","doi":"10.1016/j.amjsurg.2025.116646","DOIUrl":"10.1016/j.amjsurg.2025.116646","url":null,"abstract":"<div><h3>Background</h3><div>The superiority of duct-to-mucosa (DTM) and invagination (IVG) techniques for pancreaticoduodenectomy has not been established. This is the largest study to compare their outcomes with granular data regarding parenchymal texture and duct size.</div></div><div><h3>Methods</h3><div>The NSQIP database for patients undergoing open pancreaticoduodenectomy was investigated. Subgroups were based on pancreatic duct size (<3 mm, 3–6 mm, >6 mm) and gland texture (soft, intermediate, hard). Propensity score matching (PSM) was used. The primary outcome was postoperative pancreatic fistula (POPF).</div></div><div><h3>Results</h3><div>After PSM, there were no differences in the rates of POPF in any subgroup by duct size or gland texture. When examining secondary outcomes, the IVG group was associated with shorter duration of postoperative drain presence among patients with 3–6 mm ducts.</div></div><div><h3>Conclusions</h3><div>No differences exist in POPF rates between DTM and IVG techniques in subgroups of patients with similar pancreatic duct size and parenchymal texture. The IVG technique may be associated with earlier drain removal in some patients.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116646"},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262620","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}
Trisha Lal , Richard S. Hoehn , Alberto J. Montero , Amanda L. Amin
{"title":"Deconstructing racial disparities in timely treatment of triple-negative breast cancer: A causal mediation analysis","authors":"Trisha Lal , Richard S. Hoehn , Alberto J. Montero , Amanda L. Amin","doi":"10.1016/j.amjsurg.2025.116651","DOIUrl":"10.1016/j.amjsurg.2025.116651","url":null,"abstract":"<div><h3>Purpose</h3><div>Racial disparities in cancer care are often attributed to race rather than the structural factors through which they emerge. This study quantified how socioeconomic and institutional factors mediate treatment delays in triple-negative breast cancer (TNBC).</div></div><div><h3>Methods</h3><div>Using the National Cancer Database (2004–2022), we identified patients with stage I-III TNBC who initiated definitive treatment. Race/ethnicity was categorized as non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic, or Other. Treatment delay was defined as >30 days from diagnosis to first treatment. Causal mediation analysis estimated the contribution of education, income, comorbidities, insurance status, and facility, stratified by treatment sequence.</div></div><div><h3>Results</h3><div>Delays were most pronounced among patients receiving chemotherapy first. Mediators explained 40 %, 46 %, and 23 % of the treatment delays among NHB, Hispanic, and Other patients, respectively. Education was the strongest mediator.</div></div><div><h3>Conclusions</h3><div>Targeting chemotherapy-first patients, particularly through educational interventions, may be key to reducing disparities in timely treatment for TNBC.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116651"},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262618","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}
{"title":"Beyond the OR: Building your niche and brand as a path to career growth in academic surgery.","authors":"Isabella Faria, Lisa K Cannada","doi":"10.1016/j.amjsurg.2025.116652","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116652","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116652"},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273523","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}
Meghan Lemons , Dylan T. Vance , Allianna Mitchell , Hannah G. Geoffroy , Ellie M. Helton , Lyndsey J. Kilgore
{"title":"Redrawing the surgical line: The role of female surgeon mentorship in shaping female medical students’ perceptions of surgery","authors":"Meghan Lemons , Dylan T. Vance , Allianna Mitchell , Hannah G. Geoffroy , Ellie M. Helton , Lyndsey J. Kilgore","doi":"10.1016/j.amjsurg.2025.116650","DOIUrl":"10.1016/j.amjsurg.2025.116650","url":null,"abstract":"<div><h3>Background</h3><div>Although females comprise the majority of medical students in the United States, they remain underrepresented in surgical specialties.</div></div><div><h3>Methods</h3><div>A medical student chapter of the Association of Women Surgeons (AWS) organized shadowing experiences with female surgeons for preclinical students. Pre- and post-surveys were administered assessing perceptions of surgery, confidence in finding a mentor, and interest in surgical careers.</div></div><div><h3>Results</h3><div>Twenty-six female students participated. After shadowing, they felt more comfortable with surgeons (p = 0.011), more supported by surgeons (p = 0.031), and more confident in finding a surgical mentor (p = 0.037). Comments about the experience were positive and they looked forward to exploring surgery further with female surgeons.</div></div><div><h3>Conclusions</h3><div>Early exposure to female surgeon role models positively affects female medical students’ perceptions of surgery and access to mentorship. Expanding such shadowing opportunities across all medical schools would further support female medical students considering pursuing a surgical specialty.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"250 ","pages":"Article 116650"},"PeriodicalIF":2.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145262619","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}