Physiologic readiness and subjective workload of performing operations: A prospective observational study of attending and trainee surgeons.

Physical health and perceived workload are determinants of career satisfaction and longevity for surgeons. The aim of this prospective observational study was to determine if biometric indicators of physical recovery among surgeons are associated with perceived workload during operations. The primary outcome was whether there was an association between surgeon self-assessment and a physiologic recovery score based on heart rate variability measured with a wearable biometric sensor.

Living on the edge: Role of adjuvant therapy after resection of primary lung cancer within 2 millimeters of a T-stage cutoff.

Objectives: To evaluate the use of systemic therapy and overall survival in patients with resected non-small cell lung cancer whose pathologic tumor size was within 2 mm of a T-stage cutoff.

Methods: This was retrospective cohort study using the National Cancer Database of patients who underwent resection of tumors within 2 mm of the T1c/T2a, T2a/T2b, and T2b/T3 T-stage cutoffs. Patients with nodal involvement or whose T stage was determined on the basis of pathologic features other than tumor size were excluded.

Outcomes of single-lung retransplantation after double-lung transplantation.

Objective: To compare outcomes of single-lung retransplantation (SLRTx) and double-lung retransplantation (DLRTx) after an initial double-lung transplantation.

Methods: The Organ Procurement and Transplantation Network/United Network for Organ Sharing database between May 2005 and December 2022 was retrospectively analyzed. Multiorgan transplantations, repeated retransplantations, and lung retransplantations when the status of the initial transplantation was unknown were excluded.

Ethical considerations in lung re-transplantation.

Purpose Of Review: Patients undergoing re-transplantation constitute a growing proportion of annual lung transplants. It is necessary to consider ethical considerations of re-transplantation in parallel with clinical progress.

Recent Findings: Most clinical data demonstrate patients undergoing re-transplantation have worse survival outcomes; however, there is limited discussion of the ethical principles surrounding re-transplantation.

Initial management and outcomes of nonmalignant esophageal perforations: A Nationwide Inpatient Sample analysis.

Background: Management of esophageal perforation includes open surgery, minimally invasive surgery, and endoscopic stent placement. This study analyzed initial treatment and the associated short-term outcomes.

Methods: A retrospective study using the National Inpatient Sample between October 2015 and December 2019 identified adults >18 years with esophageal perforation undergoing an initial nonelective esophageal procedure categorized into either open surgery, minimally invasive surgery, or endoscopic stent placement.

What constitutes a 'successful' recovery? Patient perceptions of the recovery process after a traumatic injury.

Background: As the number of patients surviving traumatic injuries has grown, understanding the factors that shape the recovery process has become increasingly important. However, the psychosocial factors affecting recovery from trauma have received limited attention. We conducted an exploratory qualitative study to better understand how patients view recovery after traumatic injury.

Implementation Challenges Using a Novel Method for Collecting Patient-Reported Outcomes After Injury.

Background: Monitoring longitudinal patient-reported outcomes after injury is important for comprehensive trauma care. Current methodologies are resource-intensive and struggle to engage patients.

Materials And Methods: Patients ≥18 y old admitted to the trauma service were prospectively enrolled.

Patient-reported outcomes in trauma: a scoping study of published research.

More people are surviving traumatic injury, but disability and reduced quality of life are frequent. Investigators are now focusing on patient-reported outcomes (PROs) to better understand this problem. We performed a scoping study of the literature to explore trends in the study of PROs after injury.

The association between angioembolization and splenic salvage for isolated splenic injuries.

Background: Recent data suggest improved splenic salvage rates when angioembolization (AE) is routinely employed for high-grade splenic injuries; however, protocols and salvage rates vary among centers.

Materials/methods: Adult patients with isolated splenic injuries were identified using the National Trauma Data Bank, 2013-2014. Patients were excluded if they underwent immediate splenectomy or died in the emergency department.

National Readmission Patterns of Isolated Splenic Injuries Based on Initial Management Strategy.

Importance: Options for managing splenic injuries have evolved with a focus on nonoperative management. Long-term outcomes, such as readmissions and delayed splenectomy rate, are not well understood.

Objective: To describe the natural history of isolated splenic injuries in the United States and determine whether patterns of readmission were influenced by management strategy.

No breakpoint for mortality in pediatric rib fractures.

Background: Rib fracture number correlates with mortality in adult trauma patients, sharply rising above six fractured ribs. Because of the pliability of younger ribs, pediatric ribs are believed to require more energy to fracture. We hypothesized this will result in a different rib fracture-associated pediatric mortality rate.

Verbal communication with the Blom low profile and Passy-Muir one-way tracheotomy tube speaking valves.

Objective: To investigate physiologic parameters, voice production abilities, and functional verbal communication ratings of the Blom low profile voice inner cannula and Passy-Muir one-way tracheotomy tube speaking valves.

Study Design: Case series with planned data collection.

Setting: Large, urban, tertiary care teaching hospital.

Effect of provider experience on clinician-performed ultrasonography for hydronephrosis in patients with suspected renal colic.

Study Objective: Hydronephrosis is readily visible on ultrasonography and is a strong predictor of ureteral stones, but ultrasonography is a user-dependent technology and the test characteristics of clinician-performed ultrasonography for hydronephrosis are incompletely characterized, as is the effect of ultrasound fellowship training on predictive accuracy. We seek to determine the test characteristics of ultrasonography for detecting hydronephrosis when performed by clinicians with a wide range of experience under conditions of direct patient care.

Methods: This was a prospective study of patients presenting to an academic medical center emergency department with suspected renal colic.