Annals of surgery
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Observational Study
HLA-A Locus is Associated With Sepsis and Septic Shock After Traumatic Injury.
Determine whether variation in the HLA region is associated with the development of post-traumatic sepsis and septic shock. ⋯ This is the first study to apply next-generation sequencing techniques to evaluate associations between immunogenetic factors and post-traumatic sepsis and septic shock. Associations with class I HLA variants are novel as they implicate adaptive immunity in post-traumatic sepsis. These findings are a step towards developing a panel of genetic markers assessing risk of infection-related complications as we move towards more personalized medicine.
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The gold standard of safe-guarding the quality of published science is peer review. However, this long-standing system has not evolved in today's digital world, where there has been an explosion in the number of publications and surgical journals. A journal's quality depends not only on the quality of papers submitted but is reflected upon the quality of its peer review process. ⋯ This review identifies the potential causes of the peer-review crisis, outlines the incentives and drawbacks of being a reviewer, summarizes the currently established common practices of rewarding reviewers and the existing and potential solutions to the problem. The magnitude of the problem and unsustainability that will make it perish are discussed along with its current flaws. Finally, recommendations are made to address many of the weaknesses of the system with the hope to revive it.
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To perform the first systematic review of all available GAS publications across all procedures to assess outcomes reported in the literature and the methods used for outcome assessment. ⋯ Our review found high patient satisfaction for genital procedures but little concordance between study methods, with almost 90% of patient-focused outcome metrics appearing only once or twice. Standardization of outcome instruments and measurement methods through patient-inclusive, multidisciplinary consensus efforts is the essential next step for quality improvement. As GAS continues to mature, building on current foundations with the goal of improving both surgical and patient-reported outcomes is essential.
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To identify what strategies supervisors use to entrust autonomy during surgical procedures and to clarify the consequences of each strategy for a resident's level of autonomy. ⋯ This study provides new insights into how supervisors regulate autonomy in the operating room. This insight is useful toward analyzing whether supervisors meet learning needs of residents as effectively as possible.
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The study objectives were to characterize surgical outcomes for malignant small bowel obstruction (MaSBO) as compared to other small bowel obstructions (SBO) and to develop a prediction model for postoperative mortality for MaSBO. ⋯ Surgery for MaSBO is associated with substantial morbidity and mortality, necessitating careful patient evaluation before operative intervention.