Journal of the American College of Surgeons
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Parathyroid carcinoma is a rare endocrine malignancy that lacks an established system for risk categorization. This study evaluated a prognostic scoring system for recurrence-free survival (RFS) of patients with parathyroid carcinoma. ⋯ A prognostic scoring system using vascular invasion, age, and serum calcium level at initial parathyroidectomy can be used to predict RFS. This categorization might be helpful for clinical decisions relative to the timing and use of adjuvant therapy. Comprehensive validation using multiple cohorts will be needed to confirm applicability.
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Outpatient laparoscopic appendectomy is being used increasingly as a treatment option for acute, uncomplicated appendicitis. This was a prospective validation study in a large, urban, public safety-net hospital. ⋯ Outpatient appendectomy is safe in a public hospital and results in shorter hospital length of stay and decreased healthcare costs. Strict criteria for discharge are important to identify patients who should be admitted for observation.
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The aim of this study was to explore the impact of antiviral therapy (AVT) on short- and long-term outcomes after rehepatectomy for patients with recurrent hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). ⋯ Preoperative AVT decreased viral reactivation rate, and AVT initiated either before or after rehepatectomy contributed to better long-term prognoses after rehepatectomy for recurrent HBV-related HCC.
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Meta Analysis
Patient-Reported Outcomes Measurement Information System (PROMIS) Use in Surgical Care: A Scoping Study.
Surgeons recognize the importance of patient reported outcomes in the evaluation of health care. Documenting health related quality of life (HRQOL) can enhance surgical quality improvement efforts. Systematic documentation of HRQOL began in 1963. Currently, multiple varied and unstandardized instruments make it difficult to compare quality of life measures across studies. The NIH developed the Patient Reported Outcomes Measurement Information System (PROMIS) to provide a standardized assessment designed to complement traditional outcomes measures. ⋯ This study revealed that PROMIS performed efficiently, accurately, and reliably in assessing patient-reported HRQOL in multidisciplinary surgical publications.
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Observational Study
Association between State Medical Malpractice Environment and Postoperative Outcomes in the United States.
The US medical malpractice system assumes that the threat of liability should deter negligence, but it is unclear whether malpractice environment affects health care quality. We sought to explore the association between state malpractice environment and postoperative complication rates. ⋯ Higher risk malpractice environments were not consistently associated with a lower likelihood of surgical postoperative complications, bringing into question the ability of malpractice lawsuits to promote health care quality.