Introduction: The management of adhesive small-bowel obstruction (aSBO) continues to have wide variation, with no one management strategy accepted as the optimal. The first objective was to evaluate the methods of management and the variations in the management of aSBO at our institution and evaluate the outcomes of those management strategies. The second objective was to compare our outcomes to those of a published study by which patients were managed using an institutional protocol for aSBO.
View Article and Find Full Text PDFBackground: Traumatic injuries remain one of the leading causes of death in the United States. Patients who survive traumatic injuries but return to the emergency department with repeat injuries are said to suffer from injury recidivism. Numerous studies have described trends in injury recidivism using trauma registry and survey data.
View Article and Find Full Text PDFBackground: Access to health care is an important issue, particularly in remote areas. Since 2010, 106 rural hospital have closed in the United States, potentially limiting geographic access to health care. The aim of this study was to evaluate the impact of these hospital closures on the proportion of the population who can reach a secondary care facility, by road, within 15, 30, 45, or 60 min.
View Article and Find Full Text PDFIntroduction: Medical students applying for general surgery residencies often require a letter of recommendation (LOR) from the Surgical Chair. However, LORs may reveal gender and ethnic bias. This study examines the presence of implicit bias in general surgery resident selection by evaluating chair LORs.
View Article and Find Full Text PDFJ Gastrointest Surg
March 2019
Cirrhotic liver disease is an important cause of peri-operative morbidity and mortality in general surgical patients. Early recognition and optimization of liver dysfunction is imperative before any elective surgery. Patients with MELD <12 or classified as Child A have a higher morbidity and mortality than matched controls without liver dysfunction, but are generally safe for elective procedures with appropriate patient education.
View Article and Find Full Text PDF