JAMA Surgery

Surgeons sponsored for H-1B visas represent a small fraction of the US workforce but are overrepresented in rural and high-poverty counties, where surgical shortages are most pronounced. ja.ma/41RI3ZM

Preoperative circulating tumor DNA (#ctDNA) detection in early-stage esophageal squamous cell carcinoma was associated with nodal metastasis and poorer survival, supporting its use for risk stratification. ja.ma/4syXoJC

Cardiac surgery outcomes at Veterans Affairs hospitals remained stable over 20 years despite rising patient risk and procedural complexity, indicating maintenance of high-quality #CardiacSurgery care for US veterans. ja.ma/3OdPGGV

Delayed diagnosis of anastomotic leak after #ColonResection was associated with increased mortality, more complications, and longer hospital stay, highlighting the importance of early detection and intervention. ja.ma/3OnBlYl

A pretransplant Liver Immune Frailty Index based on plasma fractalkine and matrix metalloproteinase 3 levels stratified patients by 1-year mortality risk following #LiverTransplant, enabling improved candidate assessment. ja.ma/3QkwmIB

Level I and II trauma centers in the US operated above 80% occupancy for adult inpatient beds and demonstrated limited reserve, with a sustained daily influx of 241 patients saturating available trauma beds nationwide within 90 days. ja.ma/41Zqnvg

High-risk surgical procedures resulted in significant reductions in rapid eye movement and deep sleep through postoperative day 7, while intermediate-risk procedures caused milder, transient disruptions. ja.ma/4vvPOCz

Cryopreserved platelets were associated with similar adverse events but were less effective than conventional liquid-stored platelets for bleeding during cardiac surgery, indicating no need for changes in current transfusion practice. ja.ma/4e4sqFB

A systematic review found that hospital admissions for #Diverticulitis consistently peaked in warmer months and were lowest in winter across multiple continents, indicating environmental or behavioral influences on disease onset. ja.ma/4cf3uZy

Surgeons sponsored for H-1B visas represent a small fraction of the US workforce but are overrepresented in rural and high-poverty counties, where surgical shortages are most pronounced. ja.ma/4cxRMtt

📊 JAMA Clinical Guidelines Synopsis: The 2024 guideline from the @American_Heart and @ACCinTouch recommends continuing statins and β-blockers for patients undergoing noncardiac surgery. ja.ma/48qHiuk

Consensus guidelines recommend distinguishing infectious vs noninfectious mastitis, favor minimally invasive interventions for management, and guide use of antibiotics, imaging, and surgery for common breast conditions. ja.ma/4bYHYZ0

Among patients with kidney failure undergoing dialysis and coronary artery bypass grafting, men had better 5-year survival than women after arterial grafting; both sexes benefited from LIMA grafting vs saphenous vein grafting. ja.ma/41J6WXu

Interview with Eva B. Deerenberg, MD, PhD, and Rudolf van den Berg, BSc, authors of Small Bites vs Large Bites for Closure of Abdominal Midline Incisions: A Randomized Clinical Trial. Hosted by Jamie Coleman, MD. ja.ma/3NBnLjZ

Small-bites fascial closure after elective midline laparotomy reduced long-term risk and size of incisional hernia vs traditional large-bites technique, supporting small bites as standard practice for abdominal closure. ja.ma/4di06iV

Surgeons sponsored for H-1B visas represent a small fraction of the US workforce but are overrepresented in rural and high-poverty counties, where surgical shortages are most pronounced. ja.ma/4rQVVhC

Among patients with #Diabetes and peripheral arterial disease, rates of major amputation after minor amputation are similar in Veterans Affairs hospitals and non-VA centers, supporting comparable limb salvage outcomes. ja.ma/4dI39Rx

Jamie Coleman, MD, interviews Maxine Germes, MD, and Maxime Collard, MD, about oncologic risk and the role of shared decision-making in antibiotic-only management. 🎧 Listen now: ja.ma/47QCXjW

Incidental appendiceal tumors were rare after appendectomy for #Appendicitis, and aggressive malignancies were reliably excluded by strict preoperative selection criteria, indicating oncologic safety of antibiotic-only management. ja.ma/4bIumku

Ventral hernia reimbursement reform by #CMS was linked to lower episode spending and reduced professional fees, with no significant increase in complex procedures or postoperative billing. ja.ma/3NWZR2i