Journal of the American College of Surgeons
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Despite high satisfaction rates, reduction mammaplasty can have complications such as hematoma. Factors such as age, tobacco use, and comorbidities are known contributors, whereas the influence of race, BMI, certain medications, and blood pressure (BP) remain contentious. This study investigates hematoma risk factors in young women undergoing reduction mammaplasty. ⋯ Age, ketorolac use, and intra- and postoperative BP peaks and variability are risk factors for hematoma in reduction mammaplasty. This emphasizes the importance of perioperative BP management and optimizing pain management protocols.
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Appropriate follow-up of incidental adrenal masses (IAMs) is infrequent. We implemented a quality improvement (QI) program to improve management of IAMs. ⋯ This simple, moderately labor-intensive QI intervention was associated with increased IAM evaluation initiated by PCPs.
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This presidential address, given during the Annual Symposium of the Excelsior Surgical Society of the American College of Surgeons, explores the origins of the expeditionary surgeon. The essential traits of such a surgeon-leader are defined using examples from history and are then used to examine the leadership of Edward D Churchill during World War II as the prototypical expeditionary surgeon. In the future, identifying key military surgical leaders as expeditionary surgeons would serve our nation's interests well in preserving our fighting force on the battlefield. Consideration should be given to formally training and designating such surgical leaders for the military and other austere settings.
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Despite representing 4% of the global population, the US has the fifth highest number of intentional homicides in the world. Peripartum people represent a unique and vulnerable subset of homicide victims. This study aimed to understand the risk factors for peripartum homicide. ⋯ Compared with nonperipartum peers, peripartum people are at increased risk for homicide due to intimate partner violence, specifically due to firearm violence. Increasing rates of peripartum homicide occur in states with policies that are restrictive to abortion access. There is a dire need for universal screening and interventions for peripartum patients. Research and policies to reduce violence against pregnant people must also consider the important role that abortion access plays in protecting safety.