Surgery
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Earlier studies have demonstrated poor concordance between patients' advance care preferences and those endorsed by their surrogate health care decision makers in a medical setting. This study aimed to determine concordance in the perioperative setting among high-risk patients and to identify areas for improvement. ⋯ In all domains except cardiopulmonary resuscitation, concordance was <60% in the preoperative setting and was not improved among dyads who reported prior conversations regarding advance care preferences. Discordance may limit patient autonomy by prolonging undesired interventions or terminating desired interventions prematurely.
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Numerous authors have described the millennial generation, defined as a cohort of people born between the early 1980s and late 1990s, as unique from preceding generations, such as Generation X and the baby boomers. Many surgical educators generally belong to elder generations, and there is some concern that intergenerational differences may be source of friction between teacher and learner. ⋯ However, surgical educators sometimes encounter or propagate uncertainties, conflicts, or stereotypes regarding millennial characteristics and ideal teaching strategies. We review the relevant literature regarding intergenerational teaching strategies as they pertain to training millennial surgery residents.
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Permanent hypoparathyroidism is common after thyroidectomy. The present study evaluated the risk for morbidity in patients operated with total thyroidectomy with and without permanent hypoparathyroidism. ⋯ Patients with permanent hypoparathyroidism after total thyroidectomy have an increased risk of long-term morbidity. These results are a cause of great concern.
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Comparative Study
Differences in long-term quality of life between hemithyroidectomy and total thyroidectomy in patients treated for low-risk differentiated thyroid carcinoma.
The long-term health-related quality-of-life implications of treating low-risk differentiated thyroid cancer with total thyroidectomy or hemithyroidectomy is important to patients but remains poorly understood. ⋯ Long-term quality of life was not significantly different between low-risk differentiated thyroid cancer patients treated with total thyroidectomy compared with hemithyroidectomy. In secondary analyses, worry about recurrence appeared to be higher in individuals treated with hemithyroidectomy. These data highlight previously unreported impact of surgical regimen to the health-related quality-of-life for low-risk differentiated thyroid cancer patients.