Donor-Derived Disseminated Toxoplasmosis in a Liver Transplant Recipient With Documented Sulfa Allergy.

Transplant recipients who are seronegative for and receive an organ from a seropositive donor are at high risk for donor-derived toxoplasmosis in the absence of prophylaxis. While the risk in cardiac transplant recipients is well known, this infection is often underrecognized in noncardiac transplant recipients. Toxoplasmosis in transplant patients is associated with high mortality, and diagnosis is challenging as the presentation is nonspecific.

It's not that SIMPL-Identifying deficiencies in general surgery trainees' autonomy and competence performing parathyroidectomy and thyroidectomy.

Background: Although many parathyroid and thyroid operations are performed by nonfellowship-trained general surgeons in the United States, there is growing uncertainty of whether graduating residents can perform these procedures competently. This study investigates trends in competency and autonomy among general surgery residents performing parathyroid and thyroid operations using a national survey-based dataset.

Methods: A retrospective analysis of the Society for Improving Medical Professional Learning database was performed.

Fertility Concerns Related to Surgery for Colorectal Cancer: An Under-Discussed Topic.

As the incidence of colorectal cancer (CRC) increases among younger adults, the need for discussions regarding treatment-related infertility is growing. The negative impacts of gonadotoxic chemotherapy and pelvic radiation are well documented, but the role that surgical intervention for CRC plays in infertility is less clear. Additionally, treatment-related infertility counseling occurs infrequently.

Colorectal Cancer Outcomes: A Comparative Review of Resource-Limited Settings in Low- and Middle-Income Countries and Rural America.

Colorectal cancer remains a significant global health challenge, particularly in resource-limited settings where patient-centered outcomes following surgery are often suboptimal. Although more prevalent in low- and middle-income countries (LMICs), segments of the United States have similarly limited healthcare resources, resulting in stark inequities even within close geographic proximity. This review compares and contrasts colorectal cancer outcomes in LMICs with those in resource-constrained communities in rural America, utilizing an established implementation science framework to identify key determinants of practice for delivering high-quality colorectal cancer care.

Characteristics of High-Quality Multi-Hospital Health Systems Performing Major Cancer Surgery.

Objective: To identify characteristics associated with high- and low-quality multi-hospital systems for major cancer surgery.

Background: Although multi-hospital health systems provide most inpatient healthcare in the US, our understanding of how these systems can optimize surgical quality among their hospitals remains limited. Identifying the structural characteristics (e.

Heterogeneity in the surgical approach to recurrent abdominal wall hernias: an opportunity for quality improvement.

Background: Despite being a challenging and morbid clinical problem, operative approaches to recurrent abdominal wall hernia repairs receive little attention. Given this, we performed a retrospective study to evaluate surgical techniques of recurrent abdominal wall hernias requiring reoperation.

Methods: Adult patients from the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry (MSQC-COHR) were included in this study.

Thyroid Cancer-Related Fear & Anxiety in Patients With Benign Thyroid Nodules: A Mixed-Methods Study.

Introduction: Thyroid cancer diagnosis often evokes strong negative emotions in patients, yet little is understood about such responses in those with benign thyroid nodules. This study explored the impact of a hypothetical cancer diagnosis, the provision of treatment information, and emotional support from surgeons on patients with benign nodules.

Methods: Patients within 30 d of a thyroid nodule biopsy were asked to imagine their nodule was cancerous and write down their feelings about this diagnosis.

Over- and underreporting of prices: most hospitals are not compliant with the Hospital Price Transparency Rule.

Concern has been raised about the effectiveness of the Hospital Price Transparency Rule to facilitate a clear understanding of health care prices due to poor reporting by hospitals. However, the relationship between what services the hospital provides and what prices they report is not clear. We assessed reported prices in the Turquoise Health database and compared them at the hospital level with the CMS Provider of Services File to identify if a shoppable service was provided at a hospital.

Social vulnerability and perioperative outcomes after colectomy for colon cancer.

Background: The Social Vulnerability Index (SVI) has previously been demonstrated to correlate with worse postoperative outcomes after surgery, but the association of SVI with short- and long-term outcomes after colon cancer surgery has been underexplored.

Methods: This is a retrospective cross-sectional study of Medicare patients aged 65 to 99 years who underwent colectomy for colon cancer between 2016 and 2020, merged with SVI at the census tract level. We tested the association between SVI with emergent colectomy and 30-day and 1-year mortality using a multivariable logistic regression model adjusted for patient demographics and hospital characteristics.

Social Capital and Surgery Access Among Medicare Beneficiaries.

Objective: To compare the rates of unplanned procedures for access-sensitive surgical conditions among beneficiaries living in census tracts of varying social capital levels.

Background: Access-sensitive surgical conditions are conditions ideally screened for and treated in an elective setting. However, when left untreated, these conditions may result in unplanned (i.

Use of Pulmonary Rehabilitation after Chronic Obstructive Pulmonary Disease Hospitalization: An Analysis of Statewide Patient and Hospital Data.

Pulmonary rehabilitation (PR) is a clinically effective and cost-effective outpatient treatment for chronic obstructive pulmonary disease (COPD) that remains highly underused. Existing analyses of PR use patterns have been focused largely on patient characteristics, but hospital-level analysis is lacking and is needed to inform interventions aimed at improving use after COPD hospitalization. To evaluate PR use across hospitals after COPD hospitalization in the state of Michigan, with the goal of characterizing hospital-level variation and identifying the characteristics of high-performing hospitals.

Trends in Opioid Prescribing and New Persistent Opioid Use After Surgery in the United States.

Objective: To define recent trends in opioid prescribing after surgery and new persistent opioid use in the United States.

Summary Background Data: New persistent opioid use after surgery among opioid-naïve individuals has emerged as an important postoperative complication. In response, initiatives to promote more appropriate post-operative opioid prescribing have been adopted in recent years.

Association of Hospital System Affiliation with Spending and Postoperative Outcomes: A Longitudinal Study of Hospital Mergers And Acquisitions From 2010 To 2018.

Objective: To determine whether hospital system affiliation was associated with changes in surgical episode spending or postoperative outcomes.

Background: Over 70% of US hospitals are now part of a hospital system. The presumed benefits of hospital consolidation include concentrating volume and expertise, care integration, and investment in quality improvement.

Duration of New-Onset Depressive Symptoms During Medical Residency.

Importance: The implications of new-onset depressive symptoms during residency, particularly for first-year physicians (ie, interns), on the long-term mental health of physicians are unknown.

Objective: To examine the association between and persistence of new-onset and long-term depressive symptoms among interns.

Design, Setting, And Participants: The ongoing Intern Health Study (IHS) is a prospective annual cohort study that assesses the mental health of incoming US-based resident physicians.

Variation in Postoperative Outcomes Across Federally Designated Hospital Star Ratings.

Importance: Despite widespread use to guide patients to hospitals providing the best care, it remains unknown whether Centers for Medicare & Medicaid Services (CMS) hospital star ratings are a reliable measure of hospital surgical quality.

Objective: To examine the CMS hospital star ratings and hospital surgical quality measured by 30-day postoperative mortality, serious complications, and readmission rates for Medicare beneficiaries undergoing colectomy, coronary artery bypass graft, cholecystectomy, appendectomy, and incisional hernia repair.

Design, Setting, And Participants: This cohort study evaluated 100% Medicare administrative claims for nonfederal acute care hospitals with a CMS hospital star rating for calendar years 2014-2018.