JAMA Surgery Current Issue http://www.elizeaboutbeauty.com/journals/jamasurgery en-us Wed, 14 Apr 2021 00:00:00 GMT Wed, 14 Apr 2021 11:43:44 GMT Silverchair jamams@jamanetwork.org support@www.elizeaboutbeauty.com Assessment of the Frequency of Dual Allergy to Penicillins and Cefazolin http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2777647 Wed, 14 Apr 2021 00:00:00 GMT Sousa-Pinto B, Blumenthal KG, Courtney L, et al. This systematic review and meta-analysis examines the incidence of dual allergy to cefazolin and natural penicillins. 156 4 e210021 10.1001/jamasurg.2021.0021 2777647 Racial and Ethnic Differences in Deceased Organ Donation Ratio Over Time in the US http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2776217 Wed, 14 Apr 2021 00:00:00 GMT Kernodle AB, Zhang W, Motter JD, et al. This population-based cohort study examines changes by race/ethnicity in deceased organ donation over time in the US. 156 4 e207083 10.1001/jamasurg.2020.7083 2776217 JAMA Surgery http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2778672 Thu, 01 Apr 2021 00:00:00 GMT Mission Statement: To promote the art and science of surgery by publishing relevant peer-reviewed research to assist the surgeon in optimizing patient care. JAMA Surgery will also serve as a forum for the discussion of issues pertinent to surgery, such as the education and training of the surgical workforce, quality improvement, and the ethics and economics of health care delivery. 156 4 299 299 10.1001/jamasurg.2020.4425 2778672 Effect of Clear vs Standard Covered Masks on Communication With Patients During Surgical Clinic Encounters http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2777511 Thu, 01 Apr 2021 00:00:00 GMT Kratzke IM, Rosenbaum ME, Cox C, et al. This randomized clinical trial evaluates the effects of clear vs standard covered masks on patient perceptions of communication with surgeons during outpatient surgical clinic encounters. 156 4 372 378 10.1001/jamasurg.2021.0836 2777511 Benefits of Clear Masks in Communication With Patients http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2777510 Thu, 01 Apr 2021 00:00:00 GMT Schwarze ML, Kalbfell EL. Adapting to new safety standards during COVID-19 has likely been easier for surgeons who are accustomed to wearing a mask. Although wearing masks outside the operating room has become the new normal, it may not be as easy for patients as it is for us. In this issue of JAMA Surgery, Kratzke et al demonstrate that patients whose surgeon wore a clear mask were significantly more likely to give a top-box rating (4 on a Likert scale of 1-4) for providing easy-to-understand information, knowledge of patient information, displaying empathy, and generating trust. Although there was no significant difference in patient-reported comfort with the surgeon operating on them, it is unclear whether this study was powered to detect such a difference. 156 4 378 379 10.1001/jamasurg.2021.0848 2777510 Empowering Resident Physicians to Lead by Teaching Principles of Quality and Safety in Surgery http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2776434 Thu, 01 Apr 2021 00:00:00 GMT Mavroudis CL, Dowzicky P, Kelz RR. This article describes the Wellness and Quality Improvement curriculum, which seeks to combine quality improvement in surgery with personal wellness initiatives for first-year and second-year surgical resident physicians. 156 4 393 394 10.1001/jamasurg.2020.6667 2776434 Evaluating Growth Patterns of Abdominal Aortic Aneurysm Diameter With Serial Computed Tomography Surveillance http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2776432 Thu, 01 Apr 2021 00:00:00 GMT Olson SL, Wijesinha MA, Panthofer AM, et al. This secondary analysis of a randomized clinical trial assesses the growth patterns and rates of abdominal aortic aneurysms as documented on serial computed tomography scans. 156 4 363 370 10.1001/jamasurg.2020.7190 2776432 Five-Year Survival Outcomes of Hybrid Minimally Invasive Esophagectomy http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2776431 Thu, 01 Apr 2021 00:00:00 GMT Nuytens F, Dabakuyo-Yonli T, Meunier B, et al. This follow-up study of a randomized clinical trial evaluates the survival, complications, and risk factors associated with hybrid minimally invasive esophagectomy and open esophagectomy among adults with esophagus cancer. 156 4 323 332 10.1001/jamasurg.2020.7081 2776431 Balancing Watching vs Waiting During Imaging Surveillance of Small Abdominal Aortic Aneurysms http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2776428 Thu, 01 Apr 2021 00:00:00 GMT Kim GY, Corriere MA. The primary outcomes of the Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (N-TA3-CT) trial did not suggest a benefit from oral doxycycline over placebo on abdominal aortic aneurysm (AAA) growth. Clinicians treating patients with small, asymptomatic AAA therefore remain in the familiar (and somewhat anxious) situation of needing long-term imaging surveillance without evidence-based treatments demonstrated to prevent growth. A secondary analysis of the N-TA3-CT data set by Olson et al in this issue of JAMA Surgery takes advantage of a unique cohort of more than 250 patients with small aneurysms who were studied with serial computed tomography imaging. None of the patients in the current study with a baseline maximum transverse aneurysm diameter less than 4.25 cm exceeded diameter-based repair thresholds at 2 years, suggesting that patients in this category may not require imaging surveillance on an annual basis. Less frequent surveillance would potentially benefit patients through lower risk (including less contrast and radiation exposure) and decreased costs. 156 4 370 371 10.1001/jamasurg.2020.7258 2776428 Complications and Survival After Hybrid Minimally Invasive Esophagectomy http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2776427 Thu, 01 Apr 2021 00:00:00 GMT Gray KD, Molena D. In this 5-year follow-up to the Multicentre Randomized Controlled Phase III (MIRO) trial, Nuytens and colleagues reported long-term outcomes of 207 patients who were randomized to undergo hybrid minimally invasive esophagectomy (HMIE; thoracotomy plus laparoscopic gastric mobilization) or open esophagectomy between 2009 to 2012 regarding survival, patterns of recurrence, and prognostic factors. Unlike other contemporary randomized clinical trials that compare an open approach with entirely minimally invasive esophagectomy (MIE), this study included open thoracotomy in both arms. Despite this, a surprising 50% reduction in major pulmonary complications was reported after HMIE (odds ratio, 0.50; 95% CI, 0.26-0.96), predominantly because of a reduction in incidence of pneumonia and major bronchial sputum that required bronchoscopy. 156 4 332 333 10.1001/jamasurg.2020.7082 2776427 Error in Abstract and Results http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2776214 Thu, 01 Apr 2021 00:00:00 GMT The Review “Guidelines for Opioid Prescribing in Children and Adolescents After Surgery: An Expert Panel Opinion,â€?published online November 11, 2020, contained an error in the Abstract and Results. The statement “Twenty guideline statements were generated from a 2-day in-person meeting and subsequently reviewed, edited, and endorsed externally by pediatric surgical specialists, the American Pediatric Surgery Association Board of Governors, the American Academy of Pediatrics Section on Surgery Executive Committee, and the American College of Surgeons Board of Regentsâ€?should have omitted the American Academy of Pediatrics Section on Surgery Executive Committee. The error has been corrected online. 156 4 403 403 10.1001/jamasurg.2021.0003 2776214 Variations in Persistent Use of Low-Value Breast Cancer Surgery http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775941 Thu, 01 Apr 2021 00:00:00 GMT Wang T, Bredbeck BC, Sinco B, et al. This study identifies variation and determinants of persistent use of low-value breast cancer surgical care. 156 4 353 362 10.1001/jamasurg.2020.6942 2775941 Early Corticosteroid Cessation vs Long-term Corticosteroid Therapy in Kidney Transplant Recipients http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775940 Thu, 01 Apr 2021 00:00:00 GMT Woodle E, Gill JS, Clark S, et al. This randomized clinical trial compares long-term kidney transplant outcomes of patients randomized to continue or withdraw corticosteroids. 156 4 307 314 10.1001/jamasurg.2020.6929 2775940 Early Steroid Cessation After Kidney Transplant http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775936 Thu, 01 Apr 2021 00:00:00 GMT Matas AJ. Early in transplant history, high-dose steroids with a very slow taper, plus azathioprine, were the mainstay of maintenance immunosuppression; steroids were also used for rejection treatment. Steroid-associated complications—new-onset diabetes, avascular necrosis of the hip, premature onset of cataracts, mood changes, Cushingoid appearance, and skin changes—were common. Development of more powerful immunosuppressants led to steroid withdrawal trials, typically enrolling patients who were stable and at low risk, 3 to 6 months posttransplant. These trials were associated with an increased incidence of rejection and graft loss. 156 4 314 314 10.1001/jamasurg.2020.6959 2775936 Effect of a Predictive Model on Planned Surgical Duration Accuracy, Patient Wait Time, and Presurgical Resource Use http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775620 Thu, 01 Apr 2021 00:00:00 GMT Strömblad CT, Baxter-King RG, Meisami A, et al. This randomized clinical trial assesses accuracy and real-world outcomes of the implementation of a machine learning model that predicts surgical case duration in colorectal and gynecological services at a single academic center. 156 4 315 321 10.1001/jamasurg.2020.6361 2775620 Extracorporeal Membrane Oxygenation and Coronavirus Disease 2019—Reply http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775619 Thu, 01 Apr 2021 00:00:00 GMT Mustafa AK, Tatooles AJ. In Reply We are writing in reference to the Letters to the Editors on our recently published article, “Extracorporeal Membrane Oxygenation for Patients With COVID-19 in Severe Respiratory Failure.â€?We appreciate the comments from the authors. We would like to take this opportunity to not only respond to their queries, but also provide updates on the final outcomes of the patients presented in the article. 156 4 403 403 10.1001/jamasurg.2020.6640 2775619 Extracorporeal Membrane Oxygenation and Coronavirus Disease 2019 http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775618 Thu, 01 Apr 2021 00:00:00 GMT Venkata C, Sermadevi V, Plisco M. To the Editor We read with interest the study by Mustafa et al describing the experience of venovenous extracorporeal membrane oxygenation (ECMO) for coronavirus disease 2019 (COVID-19)–induced acute respiratory distress syndrome (ARDS), published in JAMA Surgery. 156 4 402 403 10.1001/jamasurg.2020.6637 2775618 Extracorporeal Membrane Oxygenation and Coronavirus Disease 2019 http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775617 Thu, 01 Apr 2021 00:00:00 GMT Kopanczyk R, Al-Qudsi OH, Bhatt AM. To the Editor We have read with great interest the report by Mustafa et al describing their venovenous extracorporeal membrane oxygenation (ECMO) experience in patients with severe coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome. Specifically, we commend their use of a dual-stage right atrium–to–pulmonary artery cannula, thereby promoting right ventricular (RV) support. Right ventricular dysfunction is a well-described complication of acute respiratory distress syndrome and is associated with increased mortality. Given the distinct pathophysiology involving the angiotensin-converting enzyme 2 receptor in combination with endothelial dysfunction, patients with COVID-19 acute respiratory distress syndrome may be at an increased risk of developing RV dysfunction. There have been multiple reports demonstrating RV failure in this particular patient population with abnormal RV longitudinal strain as an independent predictor of mortality. In our single-center experience, RV dysfunction in patients with COVID-19 supported with conventionally cannulated venovenous ECMO was common. 156 4 401 402 10.1001/jamasurg.2020.6634 2775617 Extracorporeal Membrane Oxygenation and Coronavirus Disease 2019 http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775616 Thu, 01 Apr 2021 00:00:00 GMT Shekar K, Worku E, Brodie D. To the Editor Mustafa et al reported impressive outcomes in 40 consecutive patients receiving extracorporeal membrane oxygenation (ECMO) for severe coronavirus disease 2019 (COVID-19)–related acute respiratory distress syndrome. Recently, Schmidt et al described similarly encouraging results in 83 patients. However, they arrive at these outcomes through distinctly different approaches. Mustafa et al emphasize right ventricular support in addition to gas exchange. Acute right ventricular dysfunction is common in acute respiratory distress syndrome and is a negative prognostic indicator. The COVID-19 cohort may be at elevated risk of acute cor pulmonale because of coagulation disturbance and pulmonary thromboembolism. Mustafa et al applied a venopulmonary artery (V-PA) configuration through a single dual-lumen catheter inserted via the internal jugular vein. This strategy delivers oxygenated blood directly to the main pulmonary artery, draining the right atrium and bypassing the right ventricle. Schmidt et al applied venovenous ECMO by femoro-jugular cannulation returning oxygenated blood to the right atrium. However, 81% of patients were positioned prone during ECMO support. Prone positioning may provide right ventricular protection. 156 4 400 401 10.1001/jamasurg.2020.6631 2775616 Extracorporeal Membrane Oxygenation and Coronavirus Disease 2019 http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775615 Thu, 01 Apr 2021 00:00:00 GMT Kalbhenn J, Priebe H. To the Editor We read with great interest the Research Letter by Mustafa et al. The authors interpret their findings as demonstrating “promising outcomesâ€?and as suggesting safety and effectiveness of venovenous extracorporeal membrane oxygenation (ECMO) in patients with coronavirus disease 2019 (COVID-19). However, several clarifications are required before valid conclusions are possible. 156 4 400 400 10.1001/jamasurg.2020.6628 2775615 Embracing Patient-Centric Endeavors to Improve Operating Room Efficiency http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775612 Thu, 01 Apr 2021 00:00:00 GMT Farber A. The operating room suite is an important driver of clinical output and revenue and, as such, is critical to hospital operational success. Because of multiple overlapping, interdependent and yet autonomous processes, achieving operational efficiency in the operating room has been challenging. There have been a number of endeavors to improve efficiency through optimization of first-case starts, surgical turnover time, and management of add-on cases. The duration of surgical operations has been associated with clinical outcomes, and there is evidence that its accurate prediction may improve operational efficiency. However, precise prediction of surgical cases based on historical data are fraught with error. 156 4 322 322 10.1001/jamasurg.2020.6362 2775612 Sentinel Contributions of VA Surgeons in Shaping the Face of Health Care http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775353 Thu, 01 Apr 2021 00:00:00 GMT Lipshy KA, Itani K, Chu D, et al. This Special Communication reviews the surgical accomplishments of the US Department of Veterans Affairs in the past century. 156 4 380 386 10.1001/jamasurg.2020.6372 2775353 Risk of Hematologic Malignant Neoplasms From Abdominopelvic CT Radiation http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775351 Thu, 01 Apr 2021 00:00:00 GMT Lee K, Lee S, Park J, et al. This cohort study assesses the risk of hematologic malignant neoplasms associated with perioperative abdominopelvic computed tomography radiation in patients who underwent appendectomy for acute appendicitis. 156 4 343 351 10.1001/jamasurg.2020.6357 2775351 The Need for an Improved Evidence Base to Inform the Health Care Decision-making Process—Reply http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775350 Thu, 01 Apr 2021 00:00:00 GMT Tarride J, Paterson J, Anvari M. In Reply We thank Xia and colleagues for their Letter to the Editor regarding our article published in JAMA Surgery, which evaluated 5-year health care expenditures after publicly funded Roux-en-Y gastric bypass compared with no surgery, based on data from the Ontario Bariatric Registry linked to administrative databases. Using propensity scoring–matching methods and a difference-in-difference approach, we found that health care expenditures in the 3 years after Roux-en-Y gastric bypass were relatively greater among surgical patients than matched comparators but were similar thereafter. 156 4 399 400 10.1001/jamasurg.2020.6384 2775350 The Need for an Improved Evidence Base to Inform the Health Care Decision-making Process http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775349 Thu, 01 Apr 2021 00:00:00 GMT Xia Q, Campbell J, Palmer AJ. The study by Tarride and colleagues found that the total health care expenditures decreased over time for patients undergoing Roux-en-Y gastric bypass by using a difference-in-differences approach. Costs were found to be higher in the Roux-en-Y gastric bypass cohort compared with that of the control group in the first 3 years but were similar in years 4 and 5. 156 4 398 399 10.1001/jamasurg.2020.6378 2775349 Low-Dose Computed Tomography Modalities as a Part of Clinical Practice in Acute Appendicitis Imaging http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775347 Thu, 01 Apr 2021 00:00:00 GMT Haijanen J, Sula S, Salminen P. Suspicion of appendicitis is globally one of the most common reasons for emergency surgical visits, with appendectomy as the standard treatment for all appendicitis cases for more than a century, even though both epidemiological and clinical data have shown uncomplicated and complicated acute appendicitis being distinct entities instead of consecutive events. Antibiotics are shown to be a safe and efficient alternative to appendectomy for patients with imaging-confirmed, uncomplicated appendicitis, both in adults and children, setting new standards for preinterventional appendicitis diagnostics and shifting the emphasis from solely assessing the presence of appendicitis toward distinguishing between uncomplicated and complicated appendicitis with high accuracy. This requires imaging, with computed tomography (CT) being the gold standard in adults. However, the main disadvantage of CT is exposure to radiation. The high appendicitis incidence in adolescents and young adults more sensitive to the late effects of radiation emphasizes the need to reduce the CT dose. 156 4 351 352 10.1001/jamasurg.2020.6358 2775347 Neoadjuvant Chemotherapy in Pancreatic Cancer—Reply http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775059 Thu, 01 Apr 2021 00:00:00 GMT Perri G, Katz MG. In Reply We appreciate our colleaguesâ€?interest in our article. Hank and colleagues question the “poorâ€?median overall survival of patients reported in our study (20 months), which they attribute to a low resection rate following fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) (27%) or gemcitabine and nab-paclitaxel (16%). They argue that “standard of care shown in larger randomized clinical trials is adjuvant combination chemotherapy,â€?implying that had our patients undergone pancreatectomy primarily, they would have enjoyed the longevity of patients enrolled in those trials. Respectfully, what our colleagues fail to emphasize is the apples vs oranges comparison they are making. Our study specifically evaluated all patients who we treated primarily for localized pancreatic cancer with FOLFIRINOX or gemcitabine and nab-paclitaxel, irrespective of their clinical profile. We included patients with a poor performance status, severe comorbidities, advanced age, and those with extreme serum cancer antigen 19-9 levels or locally advanced disease, regardless of the likelihood that they would be viewed as an appropriate surgical candidate by any thoughtful surgeon. In contrast, patients enrolled after recovery from pancreatectomy to the European Study Group for Pancreatic Cancer–Trial 5F (ESPAC-5F) and particularly the the Partenariat de Recherche en Oncologie Digestive (PRODIGE) 24/Canadian Cancer Trials Group PA6 Trial represent a robust, super selected, and ultimately small fraction of patients who typically present for treatment of localized pancreatic cancer. 156 4 398 398 10.1001/jamasurg.2020.6279 2775059 Neoadjuvant Chemotherapy in Pancreatic Cancer http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775058 Thu, 01 Apr 2021 00:00:00 GMT Jain A, Yip D, Gananadha S. To the Editor We congratulate Perri et al for publishing the comparative analysis of fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) vs gemcitabine and nab-paclitaxel chemotherapy for localized pancreatic adenocarcinoma (PDAC). 156 4 396 397 10.1001/jamasurg.2020.6276 2775058 Neoadjuvant Chemotherapy in Pancreatic Cancer http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2775057 Thu, 01 Apr 2021 00:00:00 GMT Hank T, BĂĽchler MW, Neoptolemos JP. To the Editor The Invited Commentary on the study by Perri et al says that “larger and prospective trials…are required to inform management strategies and to improve patient outcomesâ€?for pancreatic ductal adenocarcinoma yet fails to mention the large existing evidence base. 156 4 397 397 10.1001/jamasurg.2020.6273 2775057 Hereditary Diffuse Gastric Cancer Syndrome and the Role of CDH1 http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2774749 Thu, 01 Apr 2021 00:00:00 GMT Gamble LA, Heller T, Davis JL. This narrative review assesses current management guidelines for hereditary diffuse gastric cancer syndrome, their rationale and supporting data, and explores the molecular underpinnings of this hereditary cancer syndrome for which surgery maintains a central role. 156 4 387 392 10.1001/jamasurg.2020.6155 2774749 Rates of Parathyroidectomy in Older Adults With Primary Hyperparathyroidism http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2774748 Thu, 01 Apr 2021 00:00:00 GMT Seib CD, Suh I, Meng T, et al. This cohort study identifies patient characteristics associated with use of parathyroidectomy for the management of primary hyperparathyroidism in older adults. 156 4 334 342 10.1001/jamasurg.2020.6175 2774748 Preoperative Model and Patient Selection for Neoadjuvant Therapy for Intrahepatic Cholangiocarcinoma—Reply http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2774746 Thu, 01 Apr 2021 00:00:00 GMT Tsilimigras DI, Pawlik TM. In Reply We thank Wei for their interest in our work. In our recent article, we developed a risk score based on relevant clinical factors to predict the likelihood of very early recurrence (VER) in the preoperative and postoperative setting following curative-intent resection for intrahepatic cholangiocarcinoma (ICC). Using this preoperative risk score, patients were categorized as having low, medium, and high risk according to the risk to develop VER (6-month recurrence-free survival: low, 87.7%; medium, 72.3%; high, 49.5%). To enhance the applicability of the model, we also developed an easy-to-use online calculator, while also providing a simple scoring system that did not require the use of an online formula. We validated the accuracy of the model in an external validation setting confirming the external applicability of the model. The striking finding of our study was that approximately 1 in 4 patients (22.3%) developed a VER (ie, recurrence within 6 months) following curative-intent resection for ICC. Importantly, the median survival time among individuals who developed VER was only 13.8 months, suggesting that there is a group of patients with ICC who, although presenting with technically resectable disease, did not seem to benefit from resection. 156 4 395 396 10.1001/jamasurg.2020.6188 2774746 Preoperative Model and Patient Selection for Neoadjuvant Therapy for Intrahepatic Cholangiocarcinoma http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2774745 Thu, 01 Apr 2021 00:00:00 GMT Wei F. To the Editor With great interest, I read the article by Tsilimigras et al published recently in JAMA Surgery. In this article, Tsilimigras et al reported that they had developed a preoperative model to help clinicians select patients with intrahepatic cholangiocarcinoma (ICC) for an alternative treatment approach, such as neoadjuvant therapy. I would like to discuss some of my concerns about this article and demonstrate that this information is not clinically usable and can be misleading. 156 4 395 395 10.1001/jamasurg.2020.6182 2774745 Undertreatment of Primary Hyperparathyroidism http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2774744 Thu, 01 Apr 2021 00:00:00 GMT Almquist M, Nilsson M. All diseases are not equal. Some are rapidly fatal, others harmless; a few attract the attention of media, and some are almost forgotten. Primary hyperparathyroidism (pHPT) is a condition that remains undertreated. This condition, albeit benign, increases the risk of osteoporosis, a strong risk factor for fractures, which in the elderly population are very serious; the 1-year mortality after a hip fracture is around 25%. Primary hyperparathyroidism also increases the risk of kidney stones and kidney failure, and the second of these has a 1-year mortality rate of 18%. Hence, pHPT, with its associated complications, should receive strong attention from the endocrine community, since pHPT is easily corrected by parathyroidectomy. However, in the study in this issue of JAMA Surgery by Seib et al, which includes data on 210â€?06 patients with pHPT, only 30% of patients fulfilling consensus criteria for surgery underwent an operation for pHPT. One may ask why. The study does not answer this question. But neither pHPT nor its most serious sequel, osteoporosis, are associated with severe symptoms; the patient group, older women, is generally not a vocal, outspoken group; and the disease receives little or no attention in the media. 156 4 342 342 10.1001/jamasurg.2020.6239 2774744 Lessons From the Country Music Industry on Closing the Gender Gap http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2774568 Thu, 01 Apr 2021 00:00:00 GMT Weaver M. This Viewpoint describes a significant step toward equal gender opportunity in the country music industry and proposes that the field of vascular surgery swiftly follow suit. 156 4 304 306 10.1001/jamasurg.2020.5022 2774568 Personal Communication Devices Among Surgeons http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2774479 Thu, 01 Apr 2021 00:00:00 GMT Cohen TN, Jain M, Gewertz BL. This Viewpoint examines the relationship that surgeons have with their personal communication device through the discussion of potential benefits, harms, considerations for burnout, and opportunities to improve the system. 156 4 302 304 10.1001/jamasurg.2020.5627 2774479 Toward IDEAL Adoption of Robotic Surgery Into Clinical Practice http://www.elizeaboutbeauty.com/journals/jamasurgery/fullarticle/2773527 Thu, 01 Apr 2021 00:00:00 GMT Sheetz KH, Massarweh NN. This Viewpoint discusses the Idea, Development, Exploration, Assessment, Long-term (IDEAL) framework specifically in the context of transcatheter aortic valve replacement. 156 4 301 302 10.1001/jamasurg.2020.5542 2773527 4887王中王鉄算 盘开奖结果小说