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Publisher: Elsevier   (Total: 3043 journals)

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Showing 1 - 200 of 3043 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 22, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 21, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 84, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 350, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 240, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 23, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Acute Pain     Full-text available via subscription   (Followers: 13)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 26, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 41, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 50, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 35, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 61)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 3, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 353, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 17)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 325, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 405, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 39, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 54, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 10, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 8, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 6)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 49, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 39, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 8, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 45, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 237, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 57, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 5)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 22, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 57, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 11)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 166, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 160, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (Followers: 1, SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover American Journal of Surgery
  [SJR: 1.286]   [H-I: 125]   [34 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0002-9610
   Published by Elsevier Homepage  [3043 journals]
  • Outpatient beta-blockers and survival from sepsis: Results from a national
           cohort of Medicare beneficiaries
    • Authors: Kathleen E. Singer; Courtney E. Collins; Julie M. Flahive; Allison S. Wyman; M. Didem Ayturk; Heena P. Santry
      Pages: 577 - 582
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Kathleen E. Singer, Courtney E. Collins, Julie M. Flahive, Allison S. Wyman, M. Didem Ayturk, Heena P. Santry
      Background Elderly Americans suffer increased mortality from sepsis. Given that beta-blockers have been shown to be cardioprotective in critical care, we investigated outpatient beta-blocker prescriptions and mortality among Medicare beneficiaries admitted for sepsis. Methods We queried a 5% random sample of Medicare beneficiaries for patients admitted with sepsis. We used in-hospital and outpatient prescription drug claims to compare in-hospital and 30-day mortality based on pre-admission beta-blocker prescription and class of beta-blocker prescribed using univariate tests of comparison and multivariable logistic regression models and another class of medications for control. Results Outpatient beta-blocker prescription was associated with a statistically significant decrease in in-hospital and 30-day mortality. In multivariable modeling, beta-blocker prescription was associated with 31% decrease in in-hospital mortality and 41% decrease in 30-day mortality. Both cardioselective and non-selective beta-blockers conferred mortality benefit. Conclusions Our data suggests that there may be a role for preadmission beta-blockers in reducing sepsis-related mortality.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.007
       
  • How can surgeons facilitate resident intraoperative decision-making'
    • Authors: Katherine A. Hill; Mohini Dasari; Eliza B. Littleton; Giselle G. Hamad
      Pages: 583 - 588
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Katherine A. Hill, Mohini Dasari, Eliza B. Littleton, Giselle G. Hamad
      Background Cognitive skills such as decision-making are critical to developing operative autonomy. We explored resident decision-making using a recollection of specific examples, from the attending surgeon and resident, after laparoscopic cholecystectomy. Methods In a separate semi-structured interview, the attending and resident both answered five questions, regarding the resident's operative roles and decisions, ways the attending helped, times when the attending operated, and the effect of the relationship between attending and resident. Themes were extracted using inductive methods. Results Thirty interviews were completed after 15 cases. Facilitators of decision-making included dialogue, safe struggle, and appreciation for retraction. Aberrant case characteristics, anatomic uncertainties, and time pressures provided barriers. Attending-resident mismatches included descriptions of transitioning control to the attending. Conclusions Reciprocal dialogue, including concept-driven feedback, is helpful during intraoperative teaching. Unanticipated findings impede resident decision-making, and we describe differences in understanding transfers of operative control. Given these factors, we suggest that pre-operative discussions may be beneficial.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.006
       
  • Arginine vasopressin, copeptin, and the development of relative AVP
           deficiency in hemorrhagic shock
    • Authors: Carrie A. Sims; Yuxia Guan; Meredith Bergey; Rebecca Jaffe; Lilias Holmes-Maguire; Niels Martin; Patrick Reilly
      Pages: 589 - 595
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Carrie A. Sims, Yuxia Guan, Meredith Bergey, Rebecca Jaffe, Lilias Holmes-Maguire, Niels Martin, Patrick Reilly
      Background Arginine vasopressin (AVP) is critical for maintaining vasomotor tone and low levels have been associated with the development of irreversible shock. We investigated the clinical relationship between AVP, copeptin (the C-terminal fragment of the AVP precursor), and the development of relative AVP deficiency following hemorrhagic shock. Methods A prospective, observational study of 21 hypotensive (SBP<90 mmHg X 2) or presumptively bleeding trauma patients was conducted. Demographics, mechanism of injury, vital signs, laboratory values, transfusions, crystalloid volume, and blood samples were collected on arrival and serially for 48 h. AVP and copeptin were measured post hoc. Results AVP and copeptin levels were markedly elevated on admission, but decreased rapidly over time (p < 0.001). AVP and copeptin levels were positively correlated on admission (r = 0.769, p < 0.001), in the ICU (r = 0.768, p < 0.001), and at 48 h (r = 0.537, p = 0.02). Initial AVP and copeptin levels predicted the need for ≥10 unit blood product transfusion (AUC = 81% and 87%, respectively). The development of a relative AVP deficiency occurred frequently and was associated with an increased need for blood product transfusion. Conclusion Copeptin correlates well with AVP and initial values predict the need for massive transfusion in trauma patients. Copeptin demonstrates promise as a clinical biomarker in hemorrhagic shock.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.015
       
  • Pregnancy outcomes in female physicians in procedural versus
           non-procedural specialties
    • Authors: Rebecca E. Scully; Amy R. Stagg; Nelya Melnitchouk; Jennifer S. Davids
      Pages: 599 - 603
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Rebecca E. Scully, Amy R. Stagg, Nelya Melnitchouk, Jennifer S. Davids
      Background Procedural based medical specialties require a longer training period and more intensive physical demands. The impact of working in procedural versus nonprocedural fields on pregnancy outcomes is not well understood. Methods Data from 1559 US attending female physician mothers was gathered via an anonymous, IRB-approved online survey. Results Of the cohort, 400 (25.7%) reported practicing in a procedural field. Women in procedural fields were slightly older at the time of their most recent pregnancy. Rates of assistive reproductive technology use (procedural: 20.2% vs nonprocedural: 23.3%, P = 0.2), missing work during pregnancy (28.2% vs 24.5%, P = 0.13), cesarean delivery rate (36.0% vs 34.5%, P = 0.61), and missed work due to preterm labor (12.3% vs 12.5%, P = 0.91) were similar between the two groups. Conclusion Although proceduralists were more likely to delay pregnancy, women in procedural fields had comparable rates of reproductive assistance, cesarean delivery, and missed work due to pregnancy-related complications despite the perceived challenges facing this group.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.016
       
  • Predicting delayed discharge in a multimodal Enhanced Recovery Pathway
    • Authors: Deborah S. Keller; Irlna Tantchou; Juan R. Flores-Gonzalez; Daniel P. Geisler
      Pages: 604 - 609
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Deborah S. Keller, Irlna Tantchou, Juan R. Flores-Gonzalez, Daniel P. Geisler
      Background Despite advances with Enhanced Recovery Pathways(ERP), some patients have unexpected prolonged lengths of stay(LOS). Our goal was to identify the patient and procedural variables associated with delayed discharge despite an established ERP. Methods A divisional database was reviewed for minimally invasive colorectal resections with a multimodal ERP(8/1/13–7/31/15). Patients were stratified into ERP success or failure based on length of stay ≥5 days. Logistic regression modeling identified variables predictive of ERP failure. Results 274 patients were included- 229 successes and 45 failures. Groups were similar in demographics. Failures had higher rates of preoperative anxiety(p = 0.0352), chronic pain(p = 0.0040), prior abdominal surgery(p = 0.0313), and chemoradiation(p = 0.0301). Intraoperatively, failures had higher conversion rates(13.3% vs. 1.7%, p = 0.0002), transfusions(p = 0.0032), and longer operative times(219.8 vs. 183.5min,p = 0.0099). Total costs for failures were higher than successes($22,127 vs. $13,030,p = 0.0182). Variables independently associated with failure were anxiety(OR 2.28, p = 0.0389), chronic pain(OR 10.03, p = 0.0045), and intraoperative conversion(OR 8.02, p = 0.0043). Conclusions Identifiable factors are associated with delayed discharge in colorectal surgery. By prospectively preparing for patient factors and changing practice to address procedural factors and ERP adherence, postoperative outcomes could be improved.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.008
       
  • Clonidine restores vascular endothelial growth factor expression and
           improves tissue repair following severe trauma
    • Authors: Tyler J. Loftus; Andrew J. Thomson; Kolenkode B. Kannan; Ines G. Alamo; Jessica K. Millar; Jessica M. Plazas; Elizabeth E. Whitley; Philip A. Efron; Alicia M. Mohr
      Pages: 610 - 615
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Tyler J. Loftus, Andrew J. Thomson, Kolenkode B. Kannan, Ines G. Alamo, Jessica K. Millar, Jessica M. Plazas, Elizabeth E. Whitley, Philip A. Efron, Alicia M. Mohr
      Background We hypothesized that clonidine and propranolol would increase VEGF and VEGF-receptor expression and promote lung healing following severe trauma and chronic stress. Methods Sprague-Dawley rats were subjected to lung contusion (LC), lung contusion/hemorrhagic shock (LCHS), or lung contusion/hemorrhagic shock/daily restraint stress (LCHS/CS). Clonidine and propranolol were administered daily. On day seven, lung VEGF, VEGFR-1, VEGFR-2, and HMGB1 were assessed by PCR. Lung injury was assessed by light microscopy (*p < 0.05). Results Clonidine increased VEGF expression following LCHS (43%*) and LCHS/CS (46%*). Clonidine increased VEGFR-1 and R-2 expression following LCHS/CS (203%* and 47%*, respectively). Clonidine decreased HMGB1 and TNF-alpha expression following LCHS/CS (22%* and 58%*, respectively.) Clonidine decreased inflammatory cell infiltration and total Lung Injury Score following LCHS/CS. Propranolol minimally affected VEGF and did not improve lung healing. Conclusions Clonidine increased VEGF and VEGF-receptor expression, decreased HMGB1 expression, decreased lung inflammation, and improved lung tissue repair.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.019
       
  • Mobile health apps and recovery after surgery: What are patients willing
           to do'
    • Authors: Jonathan S. Abelson; Matthew Symer; Alex Peters; Mary Charlson; Heather Yeo
      Pages: 616 - 622
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Jonathan S. Abelson, Matthew Symer, Alex Peters, Mary Charlson, Heather Yeo
      Background Mobile health technologies (mHealth) may improve post-operative care but it is unknown if patients are willing to use this technology. Methods We surveyed 800 NY State residents to determine their willingness to engage in mHealth after surgery and compared socioeconomic factors that may affect willingness to engage. Results A majority of respondents reported willingness to wear a tracker on their wrist (80.6%), fill out a survey (74.3%), send pictures of their wound to their surgeon (66.3%), and share updates with friends/family (59.1%). Older age was associated with lower likelihood of having a smartphone, but not associated with willingness to engage with other features. Hispanic ethnicity was associated with lower likelihood of wearing a tracker while Black race was associated with lower willingness to send pictures. Conclusions Overall, potential users of mHealth are interested and willing to use mHealth. Older respondents are as willing as younger respondents to engage with mHealth. Individuals with Hispanic ethnicity and Black race may be less willing to engage and therefore may require education regarding benefits of this technology.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.009
       
  • Parental leave policies in graduate medical education: A systematic review
    • Authors: Laura S. Humphries; Sarah Lyon; Rebecca Garza; Daniel R. Butz; Benjamin Lemelman; Julie E. Park
      Pages: 634 - 639
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Laura S. Humphries, Sarah Lyon, Rebecca Garza, Daniel R. Butz, Benjamin Lemelman, Julie E. Park
      Background A thorough understanding of attitudes toward and program policies for parenthood in graduate medical education (GME) is essential for establishing fair and achievable parental leave policies and fostering a culture of support for trainees during GME. Methods A systematic review of the literature was completed. Non-cohort studies, studies completed or published outside of the United States, and studies not published in English were excluded. Studies that addressed the existence of parental leave policies in GME were identified and were the focus of this study. Results Twenty-eight studies addressed the topic of the existence of formal parental leave policies in GME, which was found to vary across time and ranged between 22 and 90%. Support for such policies persisted across time. Conclusions Attention to formal leave policies in GME has traditionally been lacking, but may be increasing. Negative attitudes towards parenthood in GME persist. Active awareness of the challenges faced by parent-trainees combined with formal parental leave policy implementation is important in supporting parenthood in GME.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.023
       
  • Impact of rural-urban status on survival after mastectomy without
           reconstruction versus mastectomy with reconstruction
    • Authors: Elaine Jayne Buckley; Whitney E. Zahnd; David J. Rea; John D. Mellinger; Sabha Ganai
      Pages: 645 - 650
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Elaine Jayne Buckley, Whitney E. Zahnd, David J. Rea, John D. Mellinger, Sabha Ganai
      Background Disparities in access to care exist for breast cancer patients, including access to surgeons performing reconstruction. We hypothesized rural patients have delayed time to surgery after mastectomy with reconstruction with implications on survival. Methods An observational study was conducted using the National Cancer Database on patients with breast cancer from 2003 to 2007 who underwent mastectomy, with or without reconstruction from 2003 to 2007 (n = 90,319). Results Patients with, and without, reconstruction varied by demographics, facility type and stage. Time to surgery was longer for mastectomy with reconstruction. Unadjusted analysis demonstrated marginally decreased survival for rural patients undergoing mastectomy alone but not for mastectomy with reconstruction. Cox proportional hazards analysis revealed no significant differences by rural-urban status, but a survival advantage was seen after mastectomy with reconstruction, which persisted up to a delay of 180 days. Conclusion Patients who underwent reconstruction had improved survival. Time to surgery is shorter for rural patients (for all types of mastectomy). We found no significant rural-urban disparity in survival.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.014
       
  • Mesh cruroplasty in laparoscopic repair of paraesophageal hernias is not
           associated with better long-term outcomes compared to primary repair
    • Authors: Vernissia Tam; James D. Luketich; Ryan M. Levy; Neil A. Christie; Omar Awais; Manisha Shende; Katie S. Nason
      Pages: 651 - 656
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Vernissia Tam, James D. Luketich, Ryan M. Levy, Neil A. Christie, Omar Awais, Manisha Shende, Katie S. Nason
      Background Equipoise still exists regarding routine mesh cruroplasty during laparoscopic paraesophageal hernia (PEH). We aimed to determine whether selective mesh cruroplasty is associated with differences in recurrence and patient-reported outcomes. Methods We compared symptom outcomes (n = 688) and radiographic recurrences (n = 101; at least 10% [or 2 cm] of stomach above hiatus) for 795 non-emergent PEH repair with fundoplication (n = 106 with mesh). Results Heartburn, regurgitation, epigastric pain, and anti-reflux medication use decreased significantly in both groups while postoperative dysphagia (mesh; p = 0.14), and bloating (non-mesh; p = 0.32), were unchanged. Radiographic recurrence rates were similar (15 mesh [22%] versus 86 non-mesh [17%]; p = 0.32; median 27 [IQR 14, 53] months), but was associated with surgical dissatisfaction (13% vs 4%; p = 0.007). Conclusions Selective mesh cruroplasty was not associated with differences in symptom outcomes or radiographic recurrence rates during laparoscopic PEH repair. Radiographic recurrence was associated with dissatisfaction, emphasizing the need for continued focus on reducing recurrences.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.011
       
  • Characteristics of palliative care consultation at an academic level one
           trauma center
    • Authors: Emily B. Rivet; Paula Ferrada; Tara Albrecht; J. Brian Cassel; Beth Broering; Danielle Noreika; Egidio Del Fabbro
      Pages: 657 - 660
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Emily B. Rivet, Paula Ferrada, Tara Albrecht, J. Brian Cassel, Beth Broering, Danielle Noreika, Egidio Del Fabbro
      Background The current status of palliative care consultation for trauma patients has not been well characterized. We hypothesized that palliative care consultation currently is requested for patients too late to have any clinical significance. Methods A retrospective chart review was performed for traumatically injured patients' ≥18 years of age who received palliative care consultation at an academic medical center during a one-year period. Results The palliative care team evaluated 82 patients with a median age of 60 years. Pain and end of life were the most common reasons for consultation; interventions performed included delirium management and discussions about nutritional support. For decedents, median interval from palliative care consultation to death was 1 day. Twenty seven patients died (11 in the palliative care unit, 16 in an ICU). Nine patients were discharged to hospice. Conclusions Most consultations were performed for pain and end of life management in the last 24 h of life, demonstrating the opportunity to engage the palliative care service earlier in the course of hospitalization.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.010
       
  • Utilizing trauma admissions as an opportunity to identify developmental
           and behavioral concerns
    • Authors: Stephanie K. Serres; Catherine Chen
      Pages: 661 - 665
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Stephanie K. Serres, Catherine Chen
      Background Developmental and behavioral problems are often underdiagnosed in the pediatric population, and are risk factors for injury from trauma. Early intervention for these concerns yields improved outcomes. No prior research has screened for these difficulties during pediatric trauma admissions. Methods The current study utilized “The Survey of Wellbeing of Young Children” (SWYC) to assess for possible areas of concern by parent report. Concerns were compared to the presence of screening documented in their pediatrician's last well-child visit note. Results Of the 27 participants, 59.3% had developmental, behavioral, parental, or familial concerns. Overall, 46.2% of pediatricians had formally screened for concerns at the child's last well child visit, resulting in 25.9% being identified with new concerns found on the SWYC. Conclusions Pediatric trauma admissions provide an important opportunity to screen for behavioral and developmental concerns in a population that is at risk for these concerns and that could greatly benefit from having problems identified.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.07.001
       
  • The effects of red cell transfusion donor age on nosocomial infection
           among trauma patients
    • Authors: Tyler J. Loftus; Ryan M. Thomas; Travis W. Murphy; Linda L. Nguyen; Frederick A. Moore; Scott C. Brakenridge; Philip A. Efron; Alicia M. Mohr
      Pages: 672 - 676
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Tyler J. Loftus, Ryan M. Thomas, Travis W. Murphy, Linda L. Nguyen, Frederick A. Moore, Scott C. Brakenridge, Philip A. Efron, Alicia M. Mohr
      Background We hypothesized that packed red blood cell (PRBC) transfusions from older donors would be associated with fewer nosocomial infections among trauma patients. Methods We performed a four-year retrospective analysis of 264 consecutive adult trauma patients who received ≥1 PRBC transfusion during admission. The capacity of donor age to predict nosocomial infection was assessed by logistic regression. Results Thirty-three percent of all patients developed a nosocomial infection. Donor age was significantly higher among patients with nosocomial infection (40.3 vs. 37.6 years, p = 0.035), and the incidence of infection was directly proportional to donor age. The association between donor age and infection was strongest among recipients age ≥60 years, and was significant on multivariate regression for this cohort (OR 1.07 (95% CI 1.01–1.13), p = 0.024). Conclusions Among trauma patients receiving PRBC transfusions, blood from older donors may be associated with increased risk for nosocomial infection.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.07.004
       
  • Socioeconomic status, gender, and burn injury: A retrospective review
    • Authors: Sharmila Dissanaike; Daniel Ha; Diana Mitchell; Eneko Larumbe
      Pages: 677 - 681
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Sharmila Dissanaike, Daniel Ha, Diana Mitchell, Eneko Larumbe
      Burn injury rates appear to be influenced by socioeconomic status (SES) and gender globally, but the impact of poverty and gender on burn injury has not been studied in a developed country. This study was a retrospective chart review conducted at a regional burn center in the Southwest US that included 340 patients with TBSA burns >15%. SES was determined using zip code and US census data. The distribution of mechanism of injury was significantly different by gender (χ2(6) = 36.14, p < 0001), but not significantly different by SES (χ2(12) = 19.68, p = 0.073). Burn rates in women was found to have a significant and linear increase (χ2 = 13.8513, p = 0.001) with increasing poverty. Women had higher frequencies of being burned at home, and men had higher frequencies of being burned at work. While poverty did not appear to increase the risk of burn injury overall in a mixed population, it was associated with a significant increase in the risk of burn injury in women. Thus, strategies for decreasing risk factors should be targeted toward low SES females and the working male.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.012
       
  • Intraoperative cholangiography during cholecystectomy among hospitalized
           medicare beneficiaries with non-neoplastic biliary disease
    • Authors: Elizabeth J. Lilley; John W. Scott; Wei Jiang; Anna Krasnova; Nikhila Raol; Navin Changoor; Ali Salim; Adil H. Haider; Joel S. Weissman; Eric B. Schneider; Zara Cooper
      Pages: 682 - 686
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Elizabeth J. Lilley, John W. Scott, Wei Jiang, Anna Krasnova, Nikhila Raol, Navin Changoor, Ali Salim, Adil H. Haider, Joel S. Weissman, Eric B. Schneider, Zara Cooper
      Background Prior studies of Medicare beneficiaries with both neoplastic and non-neoplastic indications for cholecystectomy demonstrated a reduced risk of common bile duct (CBD) injury when intraoperative cholangiography (IOC) was used. We sought to determine the association between IOC and CBD injury during inpatient cholecystectomy for non-neoplastic biliary disease and compare survival among those with or without CBD injury. Methods Retrospective study of patients ≥66 who underwent inpatient cholecystectomy (2005–2010) for gallstones, cholecystitis, cholangitis, or gallbladder obstruction. The association between IOC and CBD injury was analyzed using multivariable logistic regression and survival after cholecystectomy was analyzed using multivariable Cox regression. Results Among 472,367 patients who underwent cholecystectomy, 0.3% had a CBD injury. IOC was associated with increased CBD injury (adjusted OR 1.41[1.27–1.57]). CBD injury was associated with increased hazards of death (adjusted HR 1.37[1.25–1.51]). Conclusions IOC in patients with non-neoplastic biliary disease was associated with increased odds of CBD injury. This likely reflects its selective use in patients at higher risk of CBD injury or as a confirmatory test when an injury is suspected.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.021
       
  • A review of reported surgical techniques in fertility preservation for
           prepubertal and adolescent females facing a fertility threatening
           diagnosis or treatment
    • Authors: Kristine S. Corkum; Monica M. Laronda; Erin E. Rowell
      Pages: 695 - 700
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Kristine S. Corkum, Monica M. Laronda, Erin E. Rowell
      Background Ovarian tissue cryopreservation is increasing as a preferred option for fertility preservation for prepubertal and young adolescent females facing a fertility threatening diagnosis or treatment. Data sources Ovid MEDLINE and PubMed searches for terms related to ovarian tissue removal for fertility preservation revealed there is no current consensus on operative technique for surgical ovarian cortical tissue removal in adult females. Additionally, there are limited published reports of surgical approach and outcomes in the pediatric population. In total, 22 publications were reviewed for their operative approach, ovarian tissue harvesting techniques, complications and outcomes. Conclusions Reported operative approaches and techniques for ovarian tissue cryopreservation for pediatric and adolescent patients are variable. Further investigations into operative technique and tissue harvesting that maintains healthy ovarian follicles for transplant will help establish standard technical principles for surgery in pediatric and adolescent females undergoing fertility preservation.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.013
       
  • Sustaining a career in surgery
    • Authors: Mary L. Brandt
      Pages: 707 - 714
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Mary L. Brandt
      Surgery is a demanding career with great rewards and equally great challenges. In order to sustain our careers as well as the careers of our colleagues, it is important to understand and address the physical, psychological and spiritual challenges of surgery. With rare exception, the majority of surgery residents and practicing surgeons who prematurely leave surgery do so because they find the work to be physically, emotionally or spiritually incompatible with the vision they have for their life. Understanding these issues and providing solutions to improve surgeon wellness can help prevent societal loss of these highly trained professionals and suffering for surgeons and their families.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.06.022
       
  • Skill learning from kinesthetic feedback
    • Authors: David Pinzon; Roberto Vega; Yerly Paola Sanchez; Bin Zheng
      Pages: 721 - 725
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): David Pinzon, Roberto Vega, Yerly Paola Sanchez, Bin Zheng
      Background It is important for a surgeon to perform surgical tasks under appropriate guidance from visual and kinesthetic feedback. However, our knowledge on kinesthetic (muscle) memory and its role in learning motor skills remains elementary. Objectives To discover the effect of exclusive kinesthetic training on kinesthetic memory in both performance and learning. Methods In Phase 1, a total of twenty participants duplicated five 2 dimensional movements of increasing complexity via passive kinesthetic guidance, without visual or auditory stimuli. Five participants were asked to repeat the task in the Phase 2 over a period of three weeks, for a total of nine sessions. Results Subjects accurately recalled movement direction using kinesthetic memory, but recalling movement length was less precise. Over the nine training sessions, error occurrence dropped after the sixth session. Conclusions Muscle memory constructs the foundation for kinesthetic training. Knowledge gained helps surgeons learn skills from kinesthetic information in the condition where visual feedback is limited.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2016.10.018
       
  • The clinical implication of the number of lymph nodes harvested during
           sentinel lymph node biopsy and its effects on survival outcome in patients
           with node-negative breast cancer
    • Authors: Mi Kyoung Kim; Hyung Seok Park; Jee Ye Kim; Sanghwa Kim; Sanggeun Nam; Seho Park; Seung Il Kim
      Pages: 726 - 732
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Mi Kyoung Kim, Hyung Seok Park, Jee Ye Kim, Sanghwa Kim, Sanggeun Nam, Seho Park, Seung Il Kim
      Background The optimal number of sentinel lymph nodes (SLN) that need to be harvested to achieve favorable survival outcome during a SLN biopsy (SLNB) has not yet been established. Methods Six hundred and thirteen patients with clinically node-negative breast cancer who underwent SLNB were reviewed. Survival outcomes according to the number of total harvested lymph nodes (THLNs), defined as the sum of enumerated SLNs and non-SLNs were analyzed. Results Patients with only 1 THLN showed lower recurrence-free survival (RFS) as compared to those with ≥2 THLNs (p = 0.049). In multivariate analysis, only 1 THLN was associated with poor RFS (HR = 2.711; p = 0.029). Conclusions Removing at least 2 lymph nodes during SLNB may be acceptable. Harvesting only 1 lymph node should be undertaken cautiously because of false negative results and increasing the subsequent recurrence rate.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2016.10.019
       
  • Risk of post-procedural bleeding in children on intravenous fish oil
    • Authors: Prathima Nandivada; Lorenzo Anez-Bustillos; Alison A. O'Loughlin; Paul D. Mitchell; Meredith A. Baker; Duy T. Dao; Gillian L. Fell; Alexis K. Potemkin; Kathleen M. Gura; Ellis J. Neufeld; Mark Puder
      Pages: 733 - 737
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Prathima Nandivada, Lorenzo Anez-Bustillos, Alison A. O'Loughlin, Paul D. Mitchell, Meredith A. Baker, Duy T. Dao, Gillian L. Fell, Alexis K. Potemkin, Kathleen M. Gura, Ellis J. Neufeld, Mark Puder
      Background Intestinal failure-associated liver disease (IFALD) can be treated with parenteral fish oil (FO) monotherapy, but practitioners have raised concerns about a potential bleeding risk. This study aims to describe the incidence of clinically significant post-procedural bleeding (CSPPB) in children receiving FO monotherapy. Methods A retrospective chart review was performed on patients at our institution treated with intravenous FO for IFALD. CSPPB was defined as bleeding leading to re-operation, transfer to the intensive care unit, re-admission, or death, up to one month after any invasive procedure. Results From 244 patients reviewed, 183 underwent ≥1 invasive procedure(s) (n = 732). Five (0.68%, 95% CI 0.22–1.59%) procedures resulted in CSPPB. FO therapy was never interrupted. No deaths due to bleeding occurred. Conclusions Findings suggest that FO therapy is safe, with a CSPPB risk no greater than that reported in the general population. O3FA should not be held in preparation for procedures or in the event of bleeding.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2016.10.026
       
  • Methocarbamol use is associated with decreased hospital length of stay in
           trauma patients with closed rib fractures
    • Authors: Asad E. Patanwala; Ohoud Aljuhani; Brian J. Kopp; Brian L. Erstad
      Pages: 738 - 742
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Asad E. Patanwala, Ohoud Aljuhani, Brian J. Kopp, Brian L. Erstad
      Background The objective of this study was to evaluate the effect of methocarbamol on hospital length of stay in patients with closed rib fracture injuries. Methods This was a retrospective cohort study conducted in an academic medical center in the United States. Adult trauma patients, who sustained closed rib fractures, were included. Patients were categorized based on whether they received methocarbamol or not during admission. The primary outcome of interest was time to hospital discharge in days (i.e. length of hospital stay). A Cox Proportional Hazards Model was constructed to determine if methocarbamol use was associated with a greater likelihood of earlier discharge. Results A total of 592 patients were included in the final study cohort. Of these, 329 received methocarbamol and 263 did not receive methocarbamol. In the Cox Proportional Hazards Model methocarbamol use was associated with a greater likelihood of being discharged from the hospital (HR 1.47, 95% CI 1.21 to 1.78, p < 0.001). . Conclusions The use of methocarbamol after traumatic rib fractures may result in a reduction in the length of hospital stay.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.01.003
       
  • Exploring the usage of a mobile phone application in transplanted patients
           to encourage medication compliance and education
    • Authors: Alana Zanetti-Yabur; Amanda Rizzo; Nicole Hayde; Anthony C. Watkins; Juan P. Rocca; Jay A. Graham
      Pages: 743 - 747
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Alana Zanetti-Yabur, Amanda Rizzo, Nicole Hayde, Anthony C. Watkins, Juan P. Rocca, Jay A. Graham
      Background Medication non-adherence in transplant patients is a grave problem that results in increased rejection episodes, graft loss and significant morbidity. Methods The efficacy of users and non-users of a mobile phone application (mobile app) in promoting medication adherence was investigated. The Beliefs about Medicine Questionnaire (BMQ) and Morisky Medication Adherence Scale (MMAS-8) were used in these cohorts to assess the predilection for poor adherence. Serum tacrolimus, creatinine levels, and rejection episodes were also recorded. Lastly, the patients were tested on their recall of their immunosuppression. Results Overall, patients had extremely negative beliefs about medication reflected in their tendency toward higher predicted rates of non-adherence. Interestingly, though not significant, app users had higher rates of medication recollection. Conclusions The high-risk nature of this population demands efforts to abrogate non-adherence. Caregivers are charged with the responsibility to offer patients a feasible option to safeguard treatment compliance. Mobile apps are a potentially powerful tool, which can be used to decrease non-adherence.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.01.026
       
  • Preoperative adrenal biopsy does not affect overall survival
           in adrenocortical carcinoma
    • Authors: Paritosh Suman; Natalie Calcatera; Chi-Hsiung Wang; Tricia A. Moo-Young; David J. Winchester; Richard A. Prinz
      Pages: 748 - 751
      Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4
      Author(s): Paritosh Suman, Natalie Calcatera, Chi-Hsiung Wang, Tricia A. Moo-Young, David J. Winchester, Richard A. Prinz
      Background The impact of preoperative biopsy on overall survival (OS) in adrenocortical carcinoma (ACC) is unclear. We analyzed the National Cancer Data Base (NCDB) for factors associated with preoperative adrenal biopsy and its effect on OS in ACC. Methods The NCDB was queried from 2003 to 2012 for M0 ACC. Patients with or without preoperative biopsy were compared for factors associated with an increased rate of biopsy. Survival analysis was performed after adjusting for patient and tumor-related variables. Results There were 1782 patients with M0 ACC of whom 332 (19%) had a preoperative biopsy. Treatment outside academic cancer centers (OR 1.36, 95% CI 1.04–1.77, P = 0.023) and male gender (OR 1.45, 95% CI 1.11–1.88, P = 0.006) were associated with an increased rate of biopsy. In patients undergoing adrenalectomy with negative margins, biopsy failed to impact OS (log-rank P = 0.225, HR 1.20, 95% CI 0.84–1.72, P = 0.306). Conclusions Preoperative adrenal biopsy continues to be performed for ACC with no added survival benefit. Adrenalectomy offers the best chance of survival in patients with ACC.

      PubDate: 2017-09-18T04:19:05Z
      DOI: 10.1016/j.amjsurg.2017.01.039
       
  • Targeting resuscitation to normalization of coagulating status: Hyper and
           hypocoagulability after severe injury are both associated with increased
           mortality
    • Authors: Hunter B. Moore; Ernest E. Moore; Ioannis N. Liras; Charles Wade; Benjamin R. Huebner; Clay Cothren Burlew; Fredric M. Pieracci; Angela Sauaia; Bryan A. Cotton
      Abstract: Publication date: Available online 5 October 2017
      Source:The American Journal of Surgery
      Author(s): Hunter B. Moore, Ernest E. Moore, Ioannis N. Liras, Charles Wade, Benjamin R. Huebner, Clay Cothren Burlew, Fredric M. Pieracci, Angela Sauaia, Bryan A. Cotton


      PubDate: 2017-10-14T08:18:13Z
      DOI: 10.1016/j.amjsurg.2017.08.036
       
  • The hypercoagulability paradox of chronic kidney disease: The role of
           fibrinogen
    • Authors: Geoffrey R. Nunns; Ernest E. Moore; Michael P. Chapman; Hunter B. Moore; Gregory R. Stettler; Erik Peltz; Clay C. Burlew; Christopher C. Silliman; Anirban Banerjee; Angela Sauaia
      Abstract: Publication date: Available online 5 October 2017
      Source:The American Journal of Surgery
      Author(s): Geoffrey R. Nunns, Ernest E. Moore, Michael P. Chapman, Hunter B. Moore, Gregory R. Stettler, Erik Peltz, Clay C. Burlew, Christopher C. Silliman, Anirban Banerjee, Angela Sauaia


      PubDate: 2017-10-14T08:18:13Z
      DOI: 10.1016/j.amjsurg.2017.08.039
       
  • Redefining the abdominal seatbelt sign: Enhanced CT imaging metrics
           improve injury prediction
    • Authors: Michael C. Johnson; Brian J. Eastridge
      Abstract: Publication date: Available online 5 October 2017
      Source:The American Journal of Surgery
      Author(s): Michael C. Johnson, Brian J. Eastridge


      PubDate: 2017-10-14T08:18:13Z
      DOI: 10.1016/j.amjsurg.2017.08.041
       
  • Operative versus non-operative management in the care of patients with
           complicated appendicitis
    • Authors: Thomas S. Helling; Douglas F. Soltys; Samantha Seals
      Abstract: Publication date: Available online 5 October 2017
      Source:The American Journal of Surgery
      Author(s): Thomas S. Helling, Douglas F. Soltys, Samantha Seals


      PubDate: 2017-10-14T08:18:13Z
      DOI: 10.1016/j.amjsurg.2017.07.039
       
  • Not every trauma patient with a radiographic head injury requires transfer
           for neurosurgical evaluation: Application of the brain injury guidelines
           to patients transferred to a level 1 trauma center
    • Authors: Gweniviere Kayla Capron; Mary Beth Voights; Henry R. Moore; Derek B. Wall
      Abstract: Publication date: Available online 5 October 2017
      Source:The American Journal of Surgery
      Author(s): G.K. Capron, M.B. Voights, H.R. Moore, D.B. Wall


      PubDate: 2017-10-14T08:18:13Z
      DOI: 10.1016/j.amjsurg.2017.09.002
       
  • Returning from the acidotic abyss: Mortality in trauma patients with a
           pH &lt; 7.0
    • Authors: Samuel W. Ross; Bradley W. Thomas; A. Britton Christmas; Kyle W. Cunningham; Ronald F. Sing
      Abstract: Publication date: Available online 5 October 2017
      Source:The American Journal of Surgery
      Author(s): Samuel W. Ross, Bradley W. Thomas, A. Britton Christmas, Kyle W. Cunningham, Ronald F. Sing


      PubDate: 2017-10-14T08:18:13Z
      DOI: 10.1016/j.amjsurg.2017.08.033
       
  • Is routine head CT indicated in awake stable older patients after a ground
           level fall'
    • Authors: Rebecca Sartin; Christine Kim; Sharmila Dissanaike
      Abstract: Publication date: Available online 5 October 2017
      Source:The American Journal of Surgery
      Author(s): Rebecca Sartin, Christine Kim, Sharmila Dissanaike


      PubDate: 2017-10-14T08:18:13Z
      DOI: 10.1016/j.amjsurg.2017.07.038
       
  • Hospital admission unnecessary for successful uncomplicated radiographic
           reduction of pediatric intussusception
    • Authors: Michael U. Mallicote; Mubina A. Isani; Anne S. Roberts; Nicole E. Jones; Kanika A. Bowen-Jallow; Rita V. Burke; James E. Stein; Christopher P. Gayer
      Abstract: Publication date: Available online 5 October 2017
      Source:The American Journal of Surgery
      Author(s): Michael U. Mallicote, Mubina A. Isani, Anne S. Roberts, Nicole E. Jones, Kanika A. Bowen-Jallow, Rita V. Burke, James E. Stein, Christopher P. Gayer


      PubDate: 2017-10-14T08:18:13Z
      DOI: 10.1016/j.amjsurg.2017.08.040
       
  • Liver resection for metastases not of colorectal, neuroendocrine,
           sarcomatous, or ovarian (NCNSO) origin: A multicentric study
    • Authors: Ismail Labgaa; Ksenija Slankamenac Erik Schadde Ghalib Jibara Kutaiba Alshebeeb
      Abstract: Publication date: Available online 7 October 2017
      Source:The American Journal of Surgery
      Author(s): Ismail Labgaa, Ksenija Slankamenac, Erik Schadde, Ghalib Jibara, Kutaiba Alshebeeb, Gilles Mentha, Pierre-Alain Clavien, Myron Schwartz
      Background Liver resection is a well-established treatment for colorectal, neuroendocrine and sarcomatous metastases but remains ill-defined for metastases from other primary sites. This study aimed to analyze the outcomes of hepatic resection for metastases not of colorectal, neuroendocrine, sarcomatous, or ovarian (NCNSO) origin and to identify predictors of outcome. Methods Retrospective analysis of patients undergoing resection for NCNSO metastases in three western centers. Patients were analyzed according to the primary cancer. Outcomes were recurrence and survival. Results We analyzed 188 patients, divided in: gastrointestinal (59), breast (59) and “others” (70). Median time to recurrence was 15.3 months, while median survival was 52 months. Survival at 1, 3, and 5 years was 78%, 60.4% and 47.8%, respectively. In term of prognostic factors, metastases >35 mm from gastrointestinal tumors were associated with lower survival (p = 0.029) and age>60 years was associated with better survival in breast metastases (p = 0.018). Conclusions Liver resection for NCNSO metastases is feasible and results in long-term survival are similar to colorectal metastases. In gastrointestinal metastases, size (<35 mm) could be used to select patients.

      PubDate: 2017-10-08T07:24:36Z
       
  • Disparities in incidence of early- and late-onset colorectal cancer
           between Hispanics and Whites: A 10-year SEER database study
    • Authors: Jenna Koblinski; Jana Jandova; Valentine Nfonsam
      Abstract: Publication date: Available online 6 October 2017
      Source:The American Journal of Surgery
      Author(s): Winifred Y. Tung, Albert Lin


      PubDate: 2017-10-08T07:24:36Z
      DOI: 10.1016/j.amjsurg.2017.03.035
       
  • Disparate effects of catecholamines under stress conditions on endothelial
           glycocalyx injury: An in vitro model
    • Authors: Jonathan V. Martin; David M. Liberati; Lawrence N. Diebel
      Abstract: Publication date: Available online 6 October 2017
      Source:The American Journal of Surgery
      Author(s): Jonathan V. Martin, David M. Liberati, Lawrence N. Diebel


      PubDate: 2017-10-08T07:24:36Z
      DOI: 10.1016/j.amjsurg.2017.09.018
       
  • Endostapler versus hem-o-lok clip to secure the appendiceal stump and
           mesoappendix during laparoscopic appendectomy
    • Authors: Mohammed H. Al-Temimi; Mendy A. Berglin; Edwin G. Kim; Deron J. Tessier; Samir D. Johna
      Abstract: Publication date: Available online 6 October 2017
      Source:The American Journal of Surgery
      Author(s): Mohammed H. Al-Temimi, A. Berglin, Edwin G. Kim, Deron J. Tessier, Samir D. Johna


      PubDate: 2017-10-08T07:24:36Z
      DOI: 10.1016/j.amjsurg.2017.08.031
       
  • What happens after a failed LIFT for anal fistula'
    • Authors: Moriah Wright; Alan Thorson; Garnet Blatchford; Maniamparampil Shashidharan; Jennifer Beaty; Noelle Bertelson; Piyush Aggrawal; Lindsay Taylor; Charles A. Ternent
      Abstract: Publication date: Available online 6 October 2017
      Source:The American Journal of Surgery
      Author(s): Moriah Wright, Alan Thorson, Garnet Blatchford, Maniamparampil Shashidharan, Jennifer Beaty, Noelle Bertelson, Piyush Aggrawal, Lindsay Taylor, Charles A. Ternent


      PubDate: 2017-10-08T07:24:36Z
      DOI: 10.1016/j.amjsurg.2017.08.042
       
  • Low-grade blunt hepatic injury and benefits of intensive care unit
           monitoring
    • Authors: Jeffrey C. Perumean; Marco Martinez; Rachel Neal; James Lee; Taofeek Olajire-Aro; Jon B. Imran; Brian H. Williams; Herb A. Phelan
      Abstract: Publication date: Available online 6 October 2017
      Source:The American Journal of Surgery
      Author(s): Jeffrey C. Perumean, Marco Martinez, Rachel Neal, James Lee, Taofeek Olajire-Aro, Jon B. Imran, Brian H. Williams, Herb A. Phelan


      PubDate: 2017-10-08T07:24:36Z
      DOI: 10.1016/j.amjsurg.2017.09.003
       
  • Table of Contents (3 pgs)
    • Abstract: Publication date: October 2017
      Source:The American Journal of Surgery, Volume 214, Issue 4


      PubDate: 2017-09-18T04:19:05Z
       
 
 
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