Annals of surgery
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Biography Historical Article
The University of Pennsylvania Medical School Commencement of 1889: Aequanimitas and the Agnew Clinic.
Academic commencements ceremonies usually do not result in memorable occasions and once ended usually are forgotten. Not so for the University of Pennsylvania's School of Medicine commencement on May 1,1889, which was marked by an address by William Osler, the retirement of the renowned Professor of Surgery, D. Hayes Agnew, and the presentation to the University of Thomas Eakins' remarkable masterpiece, "The Agnew Clinic." Osler had been on the faculty of the University for 5 years and in his keynote address, Aequanimitas, he laid out 2 elements, imperturbability and equanimity, that he stated would "make or mar" the lives of the students he was addressing. ⋯ To honor him on this occasion of his retirement the 3 classes of medical students had commissioned Eakins to paint a portrait of their revered professor, which was presented on this commencement day and accepted by Trustee Dr S. Weir Mitchell on behalf of the University. The day was indeed one to be remembered.
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Randomized Controlled Trial Multicenter Study
Influence of the Retrocolic Versus Antecolic Route for Alimentary Tract Reconstruction on Delayed Gastric Emptying After Pancreatoduodenectomy: A Multicenter, Noninferiority Randomized Controlled Trial.
This study aimed to determine whether retrocolic alimentary tract reconstruction is noninferior to antecolic reconstruction in terms of DGE incidence after pancreatoduodenectomy (PD) and investigated patients' postoperative nutritional status. ⋯ This trial could not demonstrate the noninferiority of retrocolic to antecolic alimentary tract reconstruction in terms of DGE incidence. The alimentary tract should not be reconstructed via the retrocolic route after PD, to prevent DGE.
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Multicenter Study
Multi-institutional Development and External Validation of a Nomogram to Predict Recurrence After Curative Resection of Pancreatic Neuroendocrine Tumors.
To develop a nomogram estimating the probability of recurrence free at 5 years after resection for localized grade 1 (G1)/ grade 2 (G2) pancreatic neuroendocrine tumors (PanNETs). ⋯ Our externally validated nomogram predicts the probability of recurrence-free survival at 5 years after PanNETs curative resection, with improved accuracy over current staging systems. Estimating individual recurrence risk will guide the development of personalized surveillance programs after surgery.
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To evaluate the association between the introduction of the Affordable Care Act (ACA) Health Insurance Marketplaces ("Marketplaces") and financial protection for patients undergoing surgery. ⋯ The ACA's insurance Marketplaces were associated with improved financial protection among low-income surgical patients eligible for both cost-sharing and premium subsidies, but not in middle-income patients eligible for only premium subsidies.