Academic Advancement in Global Surgery: Appointment, Promotion, and Tenure: Recommendations From the American Surgical Association Working Group on Global Surgery.

: There is growing interest in global surgery among US academic surgical departments. As academic global surgery is a relatively new field, departments may have minimal experience in evaluation of faculty contributions and how they integrate into the existing academic paradigm for promotion and tenure. The American Surgical Association Working Group on Global Surgery has developed recommendations for promotion and tenure in global surgery, highlighting criteria that: (1) would be similar to usual promotion and tenure criteria (eg, publications); (2) would likely be undervalued in current criteria (eg, training, administrative roles, or other activities that are conducted at low- and middle-income partner institutions and promote the partnerships upon which other global surgery activities depend); and (3) should not be considered (eg, mission trips or other clinical work, if not otherwise linked to funding, training, research, or building partnerships).

Ensuring Equity, Diversity, and Inclusion in Academic Surgery: An American Surgical Association White Paper.

Objective: The leadership of the American Surgical Association (ASA) appointed a Task Force to objectively address issues related to equity, diversity, and inclusion with the discipline of academic surgery.

Summary Of Background Data: Surgeons and the discipline of surgery, particularly academic surgery, have a tradition of leadership both in medicine and society. Currently, we are being challenged to harness our innate curiosity, hard work, and perseverance to address the historically significant deficiencies within our field in the areas of diversity, equity, and inclusion.

Global surgery opportunities for U.S. surgical residents: an interim report.

Introduction: In 2011, the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Surgery developed guidelines that allowed time spent and cases performed outside of the United States by surgical residents from ACGME-accredited training programs to be applied toward program completion. We hypothesized that the number of programs with global surgical rotations would have increased after that important development. We also sought to determine the characteristics that led to sustainment of such programs.

The attitude and perceptions of work-life balance: a comparison among women surgeons in Japan, USA, and Hong Kong China.

Background: The objective of the present study was to explore how women surgeons manage their work-life balance in three environmental and cultural settings.

Method: Members of the Japan Association of Women Surgeons (JAWS), the United States of America (US) based Association of Women Surgeons (AWS), and the Women's Chapter of the College of Surgeons of Hong Kong (WCHK) were surveyed.

Results: Among 822 women surgeons contacted, 252 responded (response rate 31.

Reactions of surgical program directors to a web-based interactive educational program focusing on cognitive skills.

Objective: To assess reactions by program directors (PDs) to a preview of a scenario from the Fundamentals of Surgery Curriculum (FSC), which is a case-based interactive curriculum developed by the American College of Surgeons's (ACS) Division of Education and designed to be delivered online to first-year (PGY-1) surgical residents.

Design: After previewing a scenario, each PD completed a questionnaire requesting age and ratings of comfort using computers, the scenario's utility in addressing 9 educational goals (eg, provides a solid foundation for future learning), and 6 separate features of the scenario (eg, ease of use and feasibility). All ratings were based on a 1-9 scale.

Comparison of palpation-guided versus ultrasound-guided fine-needle aspiration biopsies of thyroid nodules in an outpatient endocrinology practice.

Objective: To investigate the role of thyroid ultrasonography in our outpatient endocrine practice.

Methods: We compared the efficacy of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules with that of palpation-guided aspiration (P-FNAB) and determined the malignancy rates of palpable and nonpalpable nodules. All patients referred for assessment of thyroid nodular disease from October 1997 through August 2001 were included in the study.

Prophylactic mastectomy: pathologic findings in high-risk patients.

Background: According to recently published data, prophylactic mastectomy (PM) appears to prevent about 90% of the expected malignant neoplasms in women with a family history of breast cancer.

Objectives: To identify the frequency of high-risk lesions in PM specimens and to determine occurrence of any new primary breast cancer following PM.

Design: We performed a retrospective study of women undergoing unilateral or bilateral PM.

The normal breast epithelium of women with breast cancer displays an aberrant response to estradiol.

Breast epithelial response to estradiol may play an important role in breast cancer etiology. We have examined the relationship between serum estradiol and progesterone levels and normal breast epithelial expression of estrogen receptor (ER) alpha, progesterone receptor (PgR), and epithelial proliferation (as reflected by the Ki-67 labeling index) in 121 women (50 newly diagnosed breast cancer cases and 71 benign breast disease controls). Simultaneous samples of grossly normal breast tissue and venous blood were obtained from women undergoing breast surgery.

Hyperparathyroidism and pregnancy.

Background: Hyperparathyroidism during pregnancy can carry significant morbidity to both mother and fetus. Surgery is the definitive treatment of choice although medical management is occasionally warranted. This report looks at 6 cases of hyperparathyroidism during pregnancy and reviews the morbidity and mortality of this entity.

Periareolar Breast Abscess: Redefining the Disease and Its Treatment.

Periareolar breast abscess has been an elusive condition, with much debate about its etiology over the last several decades. Presenting symptoms include nipple discharge, mastalgia, and recurrent abscesses with draining fistulas. Many experts disagree about whether this condition develops when inflammation of the duct leads to dilation or whether it begins with dilation that leads to inflammation.

Estrogen receptor expression in benign breast epithelium and breast cancer risk.

Background: Estrogen exposure is a major risk factor for breast cancer. Increased estrogen responsiveness of breast epithelium may enhance this effect. We examined the relationship between breast cancer diagnosis and 1) the presence and absence of estrogen receptor expression in benign breast epithelium, 2) the level of expression and 3) its variation during the menstrual cycle, and 4) other established risk factors.

Increased risk of breast cancer in splenectomized patients undergoing radiation therapy for Hodgkin's disease.

Purpose: Second malignancies have been reported among patients who were treated by radiation therapy or chemotherapy alone or in combination. Studies have implied an increased risk of breast cancer in women who received radiotherapy as part of their treatment for Hodgkin's disease. This review was performed to determine if there is an association between splenectomy and subsequent breast cancer.

Hypokalemia in a patient with pheochromocytoma.

Objective: To report the occurrence of hypokalemia in a patient with pheochromocytoma.

Methods: We present a case report and discuss the possible role of hyperepinephrinemia as a cause of hypokalemia.

Results: A patient with pheochromocytoma had hypokalemia associated with vomiting, but hypokalemia recurred after repletion of potassium and cessation of vomiting.

Pathogenesis-based treatment of recurring subareolar breast abscesses.

Background: When a subareolar breast abscess (SBA) is incised and drained, an extraordinarily high frequency of recurrence is noted.

Methods: To develop a pathogenesis-based treatment plan, 24 women with a total of 84 abscesses were monitored.

Results: In nine women SBA was under the left areola, under the right, in 7 and in eight the SBA occurred either simultaneously or sequentially under both areolae.