Journal of the American College of Surgeons
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Burnout among physicians affects mental health, performance, and patient outcomes. Surgery residency is a high-risk time for burnout. We examined burnout and the psychological characteristics that can contribute to burnout vulnerability and resilience in a group of surgical trainees. ⋯ High levels of burnout, severe stress, and distress symptoms are experienced throughout general surgery training, with some improvement during lab years. In this cross-sectional study, trainees with burnout and high stress were at increased risk for depression and suicidal ideation. Higher dispositional mindfulness was associated with lower risk of burnout, severe stress, and distress symptoms, supporting the potential of mindfulness training to promote resilience during surgery residency.
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Biography Historical Article
An Evolving Story of Translational Research: A Decade after the Jacobson Promising Investigator Award.
THE THIRD JOAN L AND JULIUS H JACOBSON PROMISING INVESTIGATOR AWARDEE, MARK PUDER, MD, PHD, FACS: In 2005, the Surgical Research Committee (SRC) of the American College of Surgeons was tasked with selecting the recipient of a newly established award, "The Joan L and Julius H Jacobson Promising Investigator Award." According to the Jacobsons, the award, funded by Dr Jacobson, should be given at least once every 2 years to a surgeon investigator at "the tipping point," who can demonstrate that his or her research shows the promise of leading to a significant contribution to the practice of surgery and patient safety. Every year, the SRC receives many excellent nominations and has the difficult task of selecting 1 awardee. ⋯ Dr Puder is now a national and international figure in the field of intestinal failure-associated liver disease and has studied the effect of intravenous lipid emulsions on the etiology and treatment of a once fatal disease in children. Kamal MF Itani, MD, FACS and Brian S Zuckerbraun, MD, FACS, on behalf of the Research Committee of the American College of Surgeons.
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General anesthesia and endotracheal intubation are a luxury rather than a necessity for many video-assisted thoracic surgery (VATS) operations. Twenty-three years ago, I began using local anesthesia and sedation for pleural disease and subsequently, for pericardial and lung disease. ⋯ Video-assisted thoracic surgery using local anesthesia and sedation is safe and effective for many indications. A review of the lessons learned caring for 529 patients will allow any thoracic surgeon and any anesthesiologist to practice this technique.
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Different treatment policies can influence biliary atresia outcomes, but the pathophysiology of expanding fibrosis occurring even after successful portoenterostomy remains unclear. ⋯ Biliary atresia outcomes improved significantly after centralization and standardized management. Resolution of cholestasis and reduction of high-grade portal inflammation postoperatively predict slower fibrosis progression and improved native liver survival, and persisting ductal reaction parallels progressive native liver fibrosis despite COJ.