JAMASurgery Tag

22 Feb

Posted at 01:42h in Accidents & Violence, Author Interviews, JAMA
MedicalResearch.com Interview with: Benjamin N. Breyer, MD, MAS Department of Urology Department of Epidemiology and Biostatistics University of California, San Francisco Adrian M. Fernandez, MD Department of Urology University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: This is a cross-sectional study utilizing data from the National Electronic Injury Surveillance System (NEISS) to identify injuries and hospitalizations related to electric bicycles accidents in the United States from 2017-2022.  The NEISS database collates injury data associated with products, including electric bicycles, and samples a nationally representative selection of emergency departments. National estimates of e-bicycle injuries and hospitalizations were derived using estimates accounting for NEISS complex survey design.

16 Nov

Posted at 15:49h in Author Interviews, Dermatology, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_61061" align="alignleft" width="142"]Peter C. Minneci, MDChair of Surgery at Nemours Children’s Health Delaware Valley Dr. Minneci[/caption] Peter C. Minneci, MD Chair of Surgery at Nemours Children’s Health Delaware Valley MedicalResearch.com: What is the background for this study?  Would you briefly explain the symptoms/course of pilonidal disease?  Response: Pilonidal disease is relatively common and affects up to 1% of the population starting in adolescence and up until young adulthood. Pilonidal disease occurs when cysts or sinuses form between the buttocks. It is believed to be an inflammatory reaction to hair or debris that gets caught in the crease of the buttocks. Risk factors for the condition include a sedentary lifestyle, hygiene and obesity. [caption id="attachment_61062" align="alignleft" width="150"] Pilonidal Cyst
DermNet Image[/caption] Pilonidal disease can be intermittent or chronic and recurs about 33% of the time, with 80% of recurrences taking place within a year of initial treatment. These recurrences contribute to a high degree of psychosocial stress in patients, who often miss school or sports and may avoid social activities. Pilonidal cysts may become infected, in which case patients must take antibiotics or undergo surgery.   Standard treatment for pilonidal disease involves removal of hair with razors or creams, as well as recommendations such as keeping the area clean. In recent years, some practitioners have begun using laser epilation as an additional strategy to prevent recurrence by providing more durable hair removal. However, it’s important to point out that this is not covered by insurance. In addition, as a provider, I have found that my patients that do have the means to pay often don’t comply with the number of sessions needed to fully remove the hair due to many different factors including pain and discomfort during the procedure.  

30 Aug

Posted at 20:16h in Author Interviews, Gender Differences, JAMA, Surgical Research, Vanderbilt
MedicalResearch.com Interview with: [caption id="attachment_60825" align="alignleft" width="143"]Christopher Wallis, MD, PhDAssistant Professor of Urology Department of Surgery University of Toronto and Urologic Oncologist Mount Sinai Hospital  Dr. Wallis[/caption] Christopher Wallis, MD, PhD Assistant Professor of Urology Department of Surgery University of Toronto and Urologic Oncologist Mount Sinai Hospital   MedicalResearch.com:  Could you give a little context - what was the question you were looking at?
  • We have been studying how the primary treating surgeons sociocultural characteristics impact the recovery of patients they are looking after.
  • Specifically, we have been studying the effect of surgeon sex on outcomes such as death, complications and readmission after common and complex surgeries. These are outcomes that are important to patients and the health system.
  • Previously, we showed that patients with a female surgeon had better short term (30 day) outcomes than similar patients having surgery with a man. This study asked the question of whether the sex of a patient’s surgeon affects patients’ longer term outcomes at 90 days and 1 year, after surgery.

10 Jul

Posted at 15:24h in Anesthesiology, Author Interviews, Cannabis, JAMA, Opiods, Surgical Research, University Texas
MedicalResearch.com Interview with: [caption id="attachment_60589" align="alignleft" width="160"]Paul Potnuru, MDAssistant Professor Anesthesiology, Critical Care and Pain Medicine The John P. and Kathrine G. McGovern Medical School The University of Texas Health Science Center at Houston Dr. Potnuru[/caption] Paul Potnuru, MD Assistant Professor Anesthesiology, Critical Care and Pain Medicine The John P. and Kathrine G. McGovern Medical School The University of Texas Health Science Center at Houston UTHealth MedicalResearch.com: What is the background for this study? Response: The use of cannabis is on the rise in the United States, as it becomes increasingly legally accepted and is viewed as harmless. Furthermore, the potency of cannabis is steadily increasing over time. There is some evidence from previous studies that compared to non-users, cannabis users require more anesthetics, have higher pain after surgery that requires more opioids, and have an increased risk of postoperative nausea and vomiting. Given this context of increased usage and potential risks during surgery, we conducted a study to examine the impact of cannabis use on patients undergoing surgery.

13 Jan

Posted at 18:16h in Author Interviews, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_59920" align="alignleft" width="175"]Casey HribarFourth-year medical student University of North Carolina Casey Hribar[/caption] Casey Hribar Fourth-year medical student University of North Carolina MedicalResearch.com: What is the background for this study? Response: Several great pieces of literature already exist about patient perception of doctors wearing white coats, formal attire, business attire, and the like. But recently, scrubs are garnering favor, especially as a result of the COVID-19 pandemic. While there has been some interest in what is worn over scrubs (jackets, vests, name tags, etc.), to our knowledge, there has not been any investigation into scrub color. Scrubs are a highly variable article of clothing, from fit, to pockets, pattern, and color, and it makes sense that these variations could have their own associated perceptions. Our study served as a way to open up the conversation around scrubs and the potential impact of their color on patients.

09 Dec

Posted at 20:00h in Author Interviews, Gender Differences, JAMA
MedicalResearch.com Interview with: [caption id="attachment_58481" align="alignleft" width="200"]Christopher Wallis Dr. Wallis[/caption] Christopher J. D. Wallis, MD, PhD Assistant Professor, Division of Urology University of Toronto Urologic Oncologist, Division of Urology Mount Sinai Hospital and University Health Network MedicalResearch.com: What is the background for this study? Response: Previous research has shown that female and male physicians communicate differently with patients. Further, there is evidence that female physicians, including surgeons, spend more time with patients. This, coupled with evidence that female patients may experience disparities in the management of their pain, led us to consider that communication differences may underpin differences in surgical outcomes previously noted (eg. Wallis et al, BMJ 2017) between male and female physicians. We postulated that there may be a differential association between surgeon sex and patient sex in behaviours that would translate into clinically important outcomes.

27 Oct

Posted at 15:42h in Author Interviews, Brigham & Women's - Harvard, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_58312" align="alignleft" width="200"]Joel S. Weissman, PhD Deputy Director/Chief Scientific Officer Center for Surgery and Public Health Brigham and Women's Hospital/Harvard Medical School Professor of Surgery (Health Policy) Harvard Medical School Dr. Weissman[/caption] Joel S. Weissman, PhD Deputy Director/Chief Scientific Officer Center for Surgery and Public Health Brigham and Women's Hospital/Harvard Medical School Professor of Surgery (Health Policy) Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Over time, the military health system has been shifting care for its soldiers and their families away from big military treatment facilities (MTFs), allowing soldiers and their families to get care from civilian hospitals.  But this has had an unintended consequence.  Unfortunately, it means that military surgeons are getting fewer cases, and they are worried about maintaining their skills as surgeons.  But some surgeries count more than others to help prepare the surgeon for battlefield casualties. 

07 Sep

Posted at 23:35h in Author Interviews, Cost of Health Care, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_58033" align="alignleft" width="133"]Andrew P. Loehrer, MD, MPH Assistant Professor Department of Surgery, Division of Surgical Oncology Dartmouth-Hitchcock Dr. Loehrer[/caption] Andrew P. Loehrer, MD, MPH Assistant Professor Department of Surgery, Division of Surgical Oncology Dartmouth-Hitchcock MedicalResearch.com: What is the background for this study? Response: Patient cost sharing represents the portion of costs covered by insurance that individuals pay out of pocket, including deductibles, co-payment, and co-insurance. Cost sharing is increasingly common and also increasingly expensive for patients with commercial health insurance across the United States. While designed to increase patient responsibility for health care spending, prior work has shown that higher cost sharing is also associated with decreased use of health care overall, both needed and discretionary. However, little work has been done as to how high cost sharing may affect common and costly conditions like acute appendicitis and acute diverticulitis. 

20 Nov

Posted at 16:39h in Accidents & Violence, Author Interviews, PTSD, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_52215" align="alignleft" width="147"]Michael A. Vella, M.D., M.B.A. Assistant Professor of Surgery Division of Acute Care Surgery and Trauma University of Rochester School of Medicine and Dentistry Dr. Vella[/caption] Michael A. Vella, M.D., M.B.A. Assistant Professor of Surgery Division of Acute Care Surgery and Trauma University of Rochester School of Medicine and Dentistry MedicalResearch.com: What is the background for this study? Response: There is a lot of (appropriate) focus on the mortality statistics related to gun violence, but sometimes we forget about the large number of survivors of gunshot wounds.  We wanted to specifically look at the long term physical and mental health outcomes in this patient population.

12 Apr

Posted at 16:27h in Author Interviews, Cancer Research, Health Care Systems, JAMA, Outcomes & Safety, Surgical Research, Yale
MedicalResearch.com Interview with: [caption id="attachment_48489" align="alignleft" width="133"]Daniel J. Boffa, MDAssociate Professor of Thoracic SurgeryYale School of Medicine Dr. Boffa[/caption] Daniel J. Boffa, MD Associate Professor of Thoracic Surgery Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prominent cancer hospitals have been sharing their brands with smaller hospitals in the community.  We conducted a series of nationally representative surveys and found that a significant proportion of the U.S. public assumes that the safety of care is the same at all hospitals that share the same respected brand.  In an effort to determine if safety was in fact the same, we examined complex surgical procedures in the Medicare database. We compared the chance of dying within 90 days of surgery between top-ranked hospitals, and the affiliate hospitals that share their brands.  When taking into account differences in patient age, health, and type of procedure, Medicare patients were 1.4 times more likely to die after surgery at the affiliate hospitals, compared to those having surgery at the top-ranked cancer hospitals.

09 Apr

Posted at 01:15h in Author Interviews, JAMA, Race/Ethnic Diversity, Surgical Research, Transplantation, Yale
MedicalResearch.com Interview with: [caption id="attachment_48457" align="alignleft" width="135"]Sanjay Kulkarni, MD MHCM FACSAssociate Professor of Surgery & MedicineSurgical Director – Kidney Transplant ProgramMedical Director – Center for Living Organ DonorsScientific Director – Yale Transplant ResearchNew Haven, CT 06410 Dr. Kulkarni[/caption] Sanjay Kulkarni, MD MHCM FACS Associate Professor of Surgery & Medicine Surgical Director – Kidney Transplant Program Medical Director – Center for Living Organ Donors Scientific Director – Yale Transplant Research New Haven, CT 06410 MedicalResearch.com: What is the background for this study? Response: The kidney allocation system changed in December of 2014. The aim of the new system was to increase transplant in patients who were highly sensitized (difficult matches based on reactive antibodies) and to improve access to underserved populations.

27 Feb

Posted at 18:06h in Addiction, Author Interviews, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_43721" align="alignleft" width="144"]Calista Harbaugh, MD House Officer, General Surgery Clinician Scholar, National Clinician Scholars Program Research Fellow, Michigan Opioid Prescribing Engagement Network University of Michigan  Dr. Harbaugh[/caption] Calista Harbaugh, MD House Officer, General Surgery Clinician Scholar, National Clinician Scholars Program Research Fellow Michigan Opioid Prescribing Engagement Network University of Michigan  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Nonmedical prescription opioid use and prescription opioid-related overdose remain significant concerns among adolescents and young adults. Among adolescents and young adults prescribed an opioid after surgery, prior work found that 4.8% of opioid-naïve patients develop new persistent use, filling additional opioid prescriptions at 3-6 months after surgery. This work found associations of persistent use with diagnoses such as chronic pain disorders, depression, anxiety, and prior substance use disorder. It is likely that for young patients, family members may also play an important role in development of new persistent use, but this has not previously been explored. We performed this study to evaluate whether long-term opioid use among family members was associated with prescription opioid fills among adolescents and young adults perioperatively – and we found that opioid-naïve adolescents and young adults who have 1 or more family members with long-term opioid use are more likely to fill at the time of surgery, during recovery, and in the long-term with a near-doubling of rates of new persistent use.

07 Nov

Posted at 20:06h in Author Interviews, JAMA, Opiods, Surgical Research, University of Michigan
MedicalResearch.com Interview with: Joceline Vu, MD Resident, PGY-5 Department of Surgery University of Michigan  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study examined how much opioid patients use after surgery, and looked at factors that might predispose some patients to use more or less. Patient opioid use after surgery is an interesting question that’s gained a lot of attention recently, because it’s different from other uses for opioids. If you have chronic pain, you’re probably going to use all of your prescription. But if you have surgery, you may not take all of your pills, and this leaves people with leftover pills that can be dangerous later. From this study, we found that patients only use, on average, about quarter of their prescription, meaning that a lot of them are left with leftover pills. Moreover, we found that the biggest determinant of how much they used wasn’t how much pain they reported, or any other factor—it was how big their original prescription was. What this means is that opioid use after surgery isn’t just determined by pain, but also by what surgeons prescribe. It’s important to keep this in mind as we try to reduce unnecessary opioid prescribing after surgical procedures. 

12 Oct

Posted at 17:05h in Author Interviews, Baylor College of Medicine Houston, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_45244" align="alignleft" width="263"]Segments of the aorta, including: Thoracic aorta Ascending aorta Tortic arch Descending thoracic aorta Abdominal aorta Suprarenal abdominal aorta Infrarenal abdominal aorta Wikipedia Image Segments of the aorta, including: Thoracic aorta Ascending aorta Tortic arch Descending thoracic aorta Abdominal aorta Suprarenal abdominal aorta Infrarenal abdominal aorta Wikipedia Image[/caption] Scott A. LeMaire, MD Jimmy and Roberta Howell Professor of Cardiovascular Surgery Vice Chair for Research, Michael E. DeBakey Department of Surgery Professor of Molecular Physiology and Biophysics Director of Research, Division of Cardiothoracic Surgery Baylor College of Medicine Department of Cardiovascular Surgery Texas Heart Institute Baylor St. Luke’s Medical Center CHI St. Luke’s Health Editor-in-Chief, Journal of Surgical Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: We performed this study because of concerns about the potential association between fluoroquinolones and aortic aneurysms and dissection raised in two large clinical studies. This concern was noted by the US Food and Drug Administration in May 2016, but the evidence was not deemed sufficient to warrant a warning. Hence, there was a clear need for additional studies to evaluate the problem. Our study was designed to determine whether there is biological evidence that ciprofloxacin—the most commonly prescribed fluoroquinolone—exacerbates aortic disease in a well-established mouse model. The model uses high-fat diet and angiotensin II infusion to stress the aorta and cause aneurysm and dissection. Using this model, we compared mice that received ciprofloxacin to control mice that received only vehicle, and we found that mice that received ciprofloxacin had significant increases in the incidence of aortic dilatation, severe aortic aneurysm and dissection, and aortic rupture and premature death. Importantly, these findings were consistent in male and female mice. Further, we investigated the potential underlying mechanisms and found that the aortas from mice that received ciprofloxacin had decreased levels of lysyl oxidase, increased levels of matrix metalloproteinases, and increased levels of apoptosis and necroptosis.

03 Oct

Posted at 11:38h in Author Interviews, JAMA, Orthopedics, Surgical Research
MedicalResearch.com Interview with: "Meniscus adalah tisu/rawan berbentuk huruf C yang berfungsi mencegah dua tulang bergesel di antara satu sama lain di bahagian lutut. Tisu meniscus yang koyak berpunca kebiasaannya daripada bersukan yang melibatkan pergerakan lutut yang banyak. Warga emas" by Rawatan Alternatif Shah Alam is licensed under CC BY 2.0 Victor A. van de Graaf, MD OLVG Ziekenhuis Amsterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although meniscal surgeries are among the most frequently performed surgical procedures in orthopedic surgery, until just recently there were hardly any randomized trials proving its superiority over conservative treatment. In this randomized clinical trial, including 321 patients with non-obstructive (e.g. no locking of the knee joint) meniscal tears, we found physical therapy non-inferior to arthroscopic partial meniscectomy. 

12 Sep

Posted at 13:00h in Accidents & Violence, Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_44411" align="alignleft" width="200"]Adil Haider, MD, MPH, FACS Kessler Director for the Center for Surgery and Public Health Brigham and Women’s Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health Deputy Editor of JAMA Surgery Dr. Haider[/caption] Adil Haider, MD, MPH, FACS Kessler Director for the Center for Surgery and Public Health Brigham and Women’s Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health Deputy Editor of JAMA Surgery MedicalResearch.com: What is the background for this study? Response: Firearm-related mortality is a public health issue. However, in the US, due in part to lack of funding, there is not enough research to inform the debate about firearms. The question our group sought to answer was to understand if the presence of a semi-automatic weapon increased the number of victims killed or hurt during an active shooter incident. We chose to focus on these incidents given the availability of an FBI database detailing these active shooter incidents based on a strict definition and the similarities between such incidents that make a comparison valid.