Category: Surgery

Cardiology, Surgery

Screening for Asymptomatic #Carotid #Artery Stenosis Lack of Clinical Benefit, Potential for Harm

In the Recommendation Statement published in this issue of JAMA,1 the US Preventive Services Task Force (USPTF) has reaffirmed its 2014 recommendation, stating that “The USPTF recommends against screening for asymptomatic carotid artery stenosis in the general adult population (D recommendation),” based on evidence that the harms of screening for carotid artery stenosis in asymptomatic adults outweigh the benefits, with no new evidence that would … Continue reading Screening for Asymptomatic #Carotid #Artery Stenosis Lack of Clinical Benefit, Potential for Harm

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Cardiology, Surgery

Association of #Fluoroquinolone Use With Short-term Risk of Development of Aortic #Aneurysm

Although fluoroquinolones are commonly prescribed antibiotics in the US, recent international studies have shown an increased risk of aortic aneurysm and dissection after fluoroquinolone use, leading to US Food and Drug Administration warnings limiting use for high-risk patients. It is unclear whether these data are true for the US population and who is truly high risk.. ..Of 47 596 545 prescription fills, 9 053 961 (19%) were fluoroquinolones and … Continue reading Association of #Fluoroquinolone Use With Short-term Risk of Development of Aortic #Aneurysm

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Pain, Surgery

A3091 – Traditional #Acupuncture And Battlefield Acupuncture Use In Mutimodal Perioperative #Anesthesia Care For Our Veteran Patients

Acupuncture techniques have been in existence for centuries, with roots tied to Eastern Asian medicine. Ease of application, low cost, and minimal side effects make traditional acupuncture a perioperative modality that has been linked to decreased morbidity and mortality in patients undergoing surgical procedures and anesthesia (1). In the United States, in light of the opioid epidemic, there is a strong need to decrease perioperative … Continue reading A3091 – Traditional #Acupuncture And Battlefield Acupuncture Use In Mutimodal Perioperative #Anesthesia Care For Our Veteran Patients

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Infectivology, Surgery

A Randomized Trial Comparing #Antibiotics with Appendectomy for #Appendicitis

..In total, 1552 adults (414 with an appendicolith) underwent randomization; 776 were assigned to receive antibiotics (47% of whom were not hospitalized for the index treatment) and 776 to undergo appendectomy (96% of whom underwent a laparoscopic procedure). Antibiotics were noninferior to appendectomy on the basis of 30-day EQ-5D scores (mean difference, 0.01 points; 95% confidence interval [CI], −0.001 to 0.03). In the antibiotics group, … Continue reading A Randomized Trial Comparing #Antibiotics with Appendectomy for #Appendicitis

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Pneumology, Surgery

Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive #Sleep #Apnea

Many adults with obstructive sleep apnea (OSA) use device treatments inadequately and remain untreated.. ..Among 102 participants who were randomized (mean [SD] age, 44.6 [12.8] years; 18 [18%] women), 91 (89%) completed the trial. The mean AHI was 47.9 at baseline and 20.8 at 6 months for the surgery group and 45.3 at baseline and 34.5 at 6 months for the medical management group (mean … Continue reading Effect of Multilevel Upper Airway Surgery vs Medical Management on the Apnea-Hypopnea Index and Patient-Reported Daytime Sleepiness Among Patients With Moderate or Severe Obstructive #Sleep #Apnea

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Cardiology, Neurology, Surgery

Association of New-Onset Atrial #Fibrillation After Noncardiac #Surgery With Subsequent #Stroke and Transient Ischemic Attack

Outcomes of postoperative atrial fibrillation (AF) after noncardiac surgery are not well defined.. ..The median age of the 452 matched patients was 75 years (IQR, 67-82 years) and 51.8% of patients were men. Patients with postoperative AF had significantly higher CHA2DS2-VASc scores than those in the no AF group (median, 4 [IQR, 2-5] vs 3 [IQR, 2-5]; P < .001). Over a median follow-up of 5.4 years … Continue reading Association of New-Onset Atrial #Fibrillation After Noncardiac #Surgery With Subsequent #Stroke and Transient Ischemic Attack

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Infectivology, Surgery

Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic #Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated #Appendicitis

Nonoperative management with antibiotics alone has the potential to treat uncomplicated pediatric appendicitis with fewer disability days than surgery.. ..Patient and family selection of nonoperative management with antibiotics alone (nonoperative group, n = 370) or urgent (≤12 hours of admission) laparoscopic appendectomy (surgery group, n = 698). Main Outcomes and Measures The 2 primary outcomes assessed at 1 year were disability days, defined as the total number of days … Continue reading Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic #Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated #Appendicitis

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Orthopedy, Surgery

Surgery versus Conservative Care for Persistent #Sciatica Lasting 4 to 12 Months

..Among the patients assigned to undergo surgery, the median time from randomization to surgery was 3.1 weeks; of the 64 patients in the nonsurgical group, 22 (34%) crossed over to undergo surgery at a median of 11 months after enrollment. At baseline, the mean score for leg-pain intensity was 7.7 in the surgical group and 8.0 in the nonsurgical group. The primary outcome of the … Continue reading Surgery versus Conservative Care for Persistent #Sciatica Lasting 4 to 12 Months

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