Stop-It Randomized Clinical Trial (RCT) for Intra-Abdominal Infection (IAI) Revisited: Multivariate Analyses To Identify Treatment Effects 4 Days Antibiotic Agents Versus Resolution Signs/Symptoms + 2 Days and Drivers of Outcomes.

: The STOP-IT randomized clinical trial (RCT) pioneered limiting antibiotic agents in intra-abdominal infection (IAI) with adequate surgical source control, but NIH funding ended before an adequate power sample size was enrolled to determine equivalence between STOP-IT study regimens: four days of antibiotic agents (4-days) after source control versus antibiotic agents until resolution of signs and symptoms of IAI plus two days (standard of care [SOC]). The objective of this investigation was to identify possible significant treatment effects 4-days versus SOC, and independent variables defining and predicting outcomes. : De-identified data from 518 STOP-IT subjects were analyzed retrospectively in two groups: 4-days (n = 258) and SOC (n = 260), and separately as one group (n = 518).

Pre-operative cardiopulmonary, metabolic, abdominal, and somatic variations by race in men with obesity resolve after Laparoscopic Roux-en-Y gastric bypass (LRYGB): Dyslipidemia and psychologicals by race persist.

Background: Whether/how LRYGB men vary by race in clinical characteristics/post-operative outcomes is unknown.

Objective: Identify male pre-/post LRYGB clinical/outcomes variations by race.

Methods: Data from 17,734 LYRGB BOLD database men were analyzed in five groups: African American (AA, n = 1310), Caucasian (C, n = 14,168), Asian (A, n = 53), Hispanic (H, n = 1519), and Other (O, Pacific Islander, Native American, or more than one race, n = 684).

Factors influencing resilience and burnout among resident physicians - a National Survey.

Background: Residency training exposes young physicians to a challenging and high-stress environment, making them vulnerable to burnout. Burnout syndrome not only compromises the health and wellness of resident physicians but has also been linked to prescription errors, reduction in the quality of medical care, and decreased professionalism. This study explored burnout and factors influencing resilience among U.

Outcomes following laparoscopic Roux-en-Y gastric bypass (LRYGB) vary by sex: Analysis of 83,059 women and men with morbid obesity.

Background: Previously we have reported variation in pre-operative clinical characteristics between women and men undergoing laparoscopic roux-en-Y gastric bypass (LRYGB). However, variation by sex in post-operative outcomes following LRYGB has not been investigated.

Methods: Pre-operative data was compared to follow-up data at 12 months after surgery on 83,059 patients from the Surgical Review Corporation's BOLD database.

Variation in Clinical Characteristics of Women Men Preoperative for Laparoscopic Roux-en-Y Gastric Bypass: Analysis of 83,059 Patients.

Variation by sex in preoperative clinical characteristics of female and male laparoscopic Roux-en-Y gastric bypass (LRYGB) patients has not been evaluated comprehensively. The objective of our study was to identify clinical differences between morbidly obese women and men seeking LRYGB. Data from 83,059 patients in the Surgical Review Corporation's Bariatric Outcomes Longitudinal Database who were about to undergo LRYGB was analyzed in two groups: women (n = 65,325) and men (n = 17,734).

Prospectively validated preoperative prediction of weight and co-morbidity resolution in individual patients comparing five bariatric operations.

Background: No method preoperatively predicts the postoperative bariatric surgery outcomes in individual patients. Decisions for or against surgery and operation choice remain subjective. Only 1% of qualifying patients embrace bariatric surgery.

In the superobese, weight loss and resolution of obesity comorbidities after biliopancreatic bypass and/or duodenal switch vary according to health insurance carrier: Medicaid vs Medicare vs Private insurance vs Self-Pay in 1681 Bariatric Outcomes Longitudinal Database patients.

Background: Differences in Medicaid vs Medicare vs Private vs Self-Pay duodenal switch (DS) results are unknown. This study identified DS outcomes variations by health insurance.

Methods: Data from 1,681 DS patients were analyzed retrospectively: Medicaid (n = 138), Medicare (n = 313), Private insurance (n = 1,171), and Self-Pay (n = 59).

Preoperative simultaneous fractionated cisplatin and radiation therapy in the treatment of advanced operable stage III and IV squamous cell carcinoma of the head and neck.

Background: In Stage III/IV head and neck squamous cell carcinoma of the head and neck, multidisciplinary treatment is not standardized. This study evaluated preoperative simultaneous radiation therapy and Cisplatin 20 mg/M(2)/4 days during weeks 1, 4, and 7 of irradiation (CTRT).

Methods: Records of 143 CTRT and 48 patients treated with other surgery/radiation/chemotherapy regimens (CONTROL) were reviewed.

Gastric bypass: a family affair--41 families in which multiple members underwent bariatric surgery.

Background: The effects of multiple family members undergoing Roux-en-Y gastric bypass (RYGB) are unknown. The objective of our study was to evaluate RYGB in multiple-patient families compared with case-matched controls.

Methods: A total of 91 RYGB patients (family group) from 41 families with ≥ 2 bariatric surgeries were compared with 91 other RYGB patients (controls), case-matched by gender, age (± 5 yr), and body mass index (± 5 kg/m(2)).

Operative Nd:YAG laser plus postoperative hyperbaric oxygen reduces surgical morbidity after radical head and neck cancer surgery and complex reconstruction.

Unlabelled: Complications after radical head and neck cancer surgery in irradiated patients are frequent and life-threatening. Hemorrhage, salivary fistulas, wound infections that expose the carotid sheath, among others, make these patients difficult management challenges in the ICU. We studied the effects of Nd:YAG laser surgery plus hyperbaric oxygen (HBO2) therapy on radical head and neck resections and complex reconstruction as a means of reducing postoperative morbidity and mortality.

The systemic mediator-associated response test identifies patients in failed sepsis clinical trials among whom novel drugs reduce mortality.

Background: Clinical trials using American College of Chest Physicians/Society of Critical Care Medicine Consensus sepsis definitions as entry criteria fail to reduce septic mortality. We hypothesized that the systemic mediator-associated response test (SMART) methodology could match sepsis therapies biologically to individual patients by relating baseline data statistically to outcomes and treatment effects. This article reports the SMART analyses of four failed sepsis investigations.

Non-transectional open gastric bypass as the definitive bariatric procedure for 61 patients with BMI of 70 and higher.

Background: Technical difficulties in laparoscopic gastric bypass for severely obese patients have led to sleeve gastrectomy first and then laparoscopic gastric bypass as a second stage after significant weight loss. Rather than commit these fragile patients to two operations, we have done open gastric bypass as a definitive surgical treatment for extreme obesity.

Methods: Office records of 61 patients with body mass index (BMI) of 70 and higher were reviewed.

Prospectively validated prediction of physiologic variables and organ failure in septic patients: The Systemic Mediator Associated Response Test (SMART).

Objective: Conventional outcomes research provides only percentage risk of such end points as mortality rate, utilization of resources, and/or broad groupings of multiple organ system dysfunction. These prognostications generally are not applicable to individual patients. The purpose of the present study was to determine whether the Systemic Mediator Associated Response Test (SMART) methodology could identify interactions among demographics, physiologic variables, standard hospital laboratory tests, and circulating cytokine concentrations that predicted continuous and dichotomous dependent clinical variables, in advance, in individual patients with severe sepsis and septic shock, and whether these independent variables could be integrated into prospectively validated predictive models.