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Incentive Spirometry and Pulmonary Complications
The combination of morbid obesity and laparoscopic foregut surgery puts patients undergoing bariatric surgery at higher risk for developing postoperative pulmonary complications. This randomized clinical trial assessed the effect of postoperative incentive spirometry on hypoxemia, oxygen saturation, and pulmonary complications after bariatric surgery. The authors found that using postoperative incentive spirometry after bariatric surgery did not decrease hypoxemia or postoperative pulmonary complications.
Continuing Medical Education
Adverse Obstetrical Outcomes After Appendectomy
Predicting pregnancy outcomes after nonobstetric surgery during pregnancy remains difficult. In a cohort study using the Nationwide Inpatient Sample, Sachs et al identified risk factors for adverse pregnancy outcomes among 19 926 women undergoing appendectomies and cholecystectomies during their pregnancies. The risk factors most associated with adverse pregnancy outcomes were cervical incompetence, preterm labor during the current pregnancy, and vaginitis/vulvovaginitis.
Chemotherapy in Young and Middle-Aged Patients
Chemotherapy use and its survival benefits for patients with young-onset colon cancer are undefined. Using the data from the US Military Health System, Manjelievskaia et al found that young and middle-aged patients were 2 to 8 times more likely to receive postoperative chemotherapy than older patients. However, there was no matched improvement in overall survival among younger patients.
Undertriage of Firearm-Related Injuries
Little is known about the undertriage of trauma patients, mostly because research relies on data from trauma units. In a county with 19 trauma centers, almost 3 in 10 gunshot wounds were treated outside of trauma units with undertriage disproportionately occurring in some of the poorest communities. Amid an increase in firearm injuries in the Chicago area, there is a continued need for better regional coordination between hospitals.
Clinical Review & Education
Oncologic Anthropology: A Novel Disparities Research Tool
Breast cancer mortality rates and the rates of triple-negative disease are higher among African American women. The etiology of these disparities is multifactorial and related to socioeconomic and environmental influences. Similarities in breast cancer epidemiology between African Americans and West (but not East) Africans suggests that ancestral genetics are involved. Oncologic anthropology represents transdisciplinary research to evaluate the interplay of these complex factors.
Highlights. JAMA Surg. 2017;152(5):417. doi:10.1001/jamasurg.2016.3427
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