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Timing of Attrition in Surgical Residency
The timing of general surgery residents’ dropping out of training has not been prospectively evaluated. Yeo et al analyzed data from a national cohort of 836 surgical residents from 2007 to 2016. For all residents, attrition was highest in the first year of training. However, attrition continued into senior years of training for women and individuals of Hispanic ethnicity.
Continuing Medical Education
Author Audio Interview
Antidiabetic Treatment 6 Years After Bariatric Surgery
Few large-scale, long-term prospective cohorts have assessed changes in antidiabetic treatment of individuals who have had bariatric surgery compared with control participants. Thereaux et al extracted antidiabetic drug reimbursements from the French National Health Insurance database. Their analysis confirms that bariatric surgery is responsible for a significant 6-year postoperative antidiabetic treatment discontinuation rate and a low treatment initiation rate, with gastric bypass being the most effective procedure.
Hysterectomy Complications After Morcellation Warning
In 2014, the US Food and Drug Administration (FDA) issued a warning against the use of uterine power morcellation. Multinu et al evaluated the change in hysterectomy complication rates before and after the FDA statement on power morcellation in a cohort of 25 571 US women who had a hysterectomy for uterine fibroids. They found a statistically and clinically significant increase in major and minor complications after the FDA statement compared with the period prior to the statement.
Prehospital Care and Traumatic Cardiac Arrest Outcomes
The association of prehospital advanced life support with outcomes after traumatic cardiac arrest remains uncertain. In this Japanese registry-based study of 4382 patients with traumatic cardiac arrest, Fukuda et al found that advanced life support by physicians was associated with increased chance of 1-month survival compared with both advanced life support by emergency medical service personnel and basic life support.
Clinical Review & Education
What Surgeons Should Know About NOACs
There is uncertainty surrounding the use of non–vitamin K oral anticoagulants (NOACs) during the perioperative period. Verma et al performed a review of 70 articles (that included data from 166 404 patients) on this topic. When prescribed appropriately and administered with adherence to their predictable pharmacokinetic properties, NOACs can be safely used in the perioperative period and offer a convenient option for patients who require oral anticoagulation.
Highlights. JAMA Surg. 2018;153(6):501. doi:10.1001/jamasurg.2017.3675
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