Journal of the American College of Surgeons
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Comprehensive and multidisciplinary care are critical in rectal cancer treatment. We sought to determine if completeness of preoperative care was associated with pathologic specimen quality and postoperative morbidity. ⋯ Complete preoperative care in rectal adenocarcinoma is associated with higher pathologic specimen quality and reduced postoperative morbidity. This highlights the importance of adherence to guideline-directed care.
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Randomized Controlled Trial
Prevention of Fascial Dehiscence with Onlay Prophylactic Mesh in Emergency Laparotomy: A Randomized Clinical Trial.
Fascial dehiscence (FD) occurs in up to 14.9% of high-risk patients undergoing emergency laparotomy. Although prophylactic mesh can prevent FD, its use in emergency operations remains controversial. ⋯ Prophylactic onlay mesh reinforcement in emergency laparotomy is safe and prevents FD. Surgical site infection, seroma, and nonhealing incisional wound were more common in the mesh group, but associated with low morbidity within 30 days post operation.
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Stand Your Ground: Policy and Trends in Firearm-Related Justifiable Homicide and Homicide in the US.
In recent years, several states have enacted Stand Your Ground (SYG) legislation intended to deter crime. To date, the impact of these laws on justifiable homicide (JH) and homicide (HOM) is unknown. This study was designed to compare JH and HOM rates (JHR, HR) before and after enactment of SYG laws and in states with and without (NoSYG) such legislation. ⋯ Stand Your Ground states had significantly higher JH and HOM rates and significantly greater increases in JH and HOM rates pre- vs post-SYG law enactment compared with NoSYG states. These results raise questions about the potential adverse consequences of policies such as the SYG law in the US.
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Endoscopic ultrasound-guided fine-needle aspiration fails to diagnose up to 25% of patients with pancreatic ductal adenocarcinoma (PDAC). Proteomics can help to overcome this clinical dilemma. We hypothesized that soluble protein signatures can differentiate PDAC from benign tissues. ⋯ Protein signatures from pancreatic specimens can differentiate PDAC from benign tissue. Additional work to validate these findings in a unique sample set is warranted.
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Defining factors associated with remission and relapse of type 2 diabetes (T2D) after Roux-en-Y gastric bypass (RYGB) can allow targeting modifiable factors. We investigated factors associated with T2D remission and relapse after RYGB. ⋯ This longitudinal retrospective analysis shows that preoperative insulin use and age, 1-year weight loss, and regain after that influence T2D remission and relapse after RYGB. Referring patients at a younger age, before insulin is needed, and optimizing weight loss and preventing weight regain after RYGB can improve the rates and durability of T2D remission.