Annals of surgery
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Observational Study
Trending Fibrinolytic Dysregulation: Fibrinolysis Shutdown in the Days After Injury Is Associated With Poor Outcome in Severely Injured Children.
To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. ⋯ Fibrinolysis shutdown is common postinjury and predicts poor outcomes. Severe TBI is associated with sustained shutdown. Empiric antifibrinolytics for children should be questioned; thromboelastography-directed selective use should be considered for documented HF.
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In 2015, the American Gastroenterological Association recommended the discontinuation of radiographic surveillance after 5 years for patients with stable pancreatic cysts. The current study evaluated the yield of continued surveillance of pancreatic cysts up to and after 5 years of follow up. ⋯ Cyst size stability at the 5-year time point did not preclude future growth, cross-over to resection, or carcinoma development. Patients who were stable at 5 years had a nearly 3-fold higher risk of developing cancer compared with the general population and should continue long-term surveillance.
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To determine if intraoperative molecular imaging (IMI) can improve detection of malignant pulmonary nodules. ⋯ These data suggest that combining IMI with PET may provide superior oncologic outcomes for patients with resectable lung cancer.
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We present 8-year follow-up data from the intern class of 2007 to 2008 using a novel, nonparametric predictive model to identify those residents who are at greatest risk of not completing their training. ⋯ This is the first longitudinal cohort study to identify factors at the start of training that put residents at risk for not completing training. Data from this study offer a method to identify interns at higher risk for attrition at the start of training, and next steps would be to create and test interventions in a directed fashion.