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Controversy Over Liver Transplantation or Resection for Neuroendocrine Liver Metastasis: Tumor Biology Cuts the Deal Ann. Surg. (IF 13.787) Pub Date : 2022-08-17 Dilmurodjon Eshmuminov, Debora J. Studer, Victor Lopez Lopez, Marcel André Schneider, Jan Lerut, Mary Lo, Linda Sher, Thomas Johannes Musholt, Oana Lozan, Nabila Bouzakri, Carlo Sposito, Rosalba Miceli, Shoma Barat, David Morris, Helga Oehler, Teresa Schreckenbach, Peri Husen, Charles B. Rosen, Gregory J. Gores, Toshihiko Masui, Tan-To Cheung, Corina Kim-Fuchs, Aurel Perren, Philipp Dutkowski, Henrik
Background: In patients with neuroendocrine liver metastasis (NELM), liver transplantation (LT) is an alternative to liver resection (LR), although the choice of therapy remains controversial. In this multicenter study we aim to provide novel insight in this dispute. Methods: Following a systematic literature search, 15 large international centers were contacted to provide comprehensive data on their
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Clinicopathologic and Immunohistochemical Characterization of Sarcomatoid Chromophobe Renal Cell Carcinoma: An Analysis of 22 Cases Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Rumeal D. Whaley, Liang Cheng
Sarcomatoid differentiation in chromophobe renal cell carcinoma (ChRCC) is a rare finding and a significant predictor of worse outcomes. When the sarcomatoid component overgrows the conventional component or is the only component on a biopsy, the differential diagnoses encompass a variety of entities. Therefore, we reviewed 22 sarcomatoid ChRCCs and characterized the immunophenotype. Given that renal
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Twin/Multiple Gestations With a Hydatidiform Mole: Clinicopathologic Analysis of 21 Cases With Emphasis on Molecular Genotyping and Parental Contribution Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Deyin Xing, Emily Adams, Ying S. Zou, Laura Morsberger, Lori R. Scanga, Faye F. Gao, Norman Barker, Russell Vang, Brigitte M. Ronnett
Complete hydatidiform moles (CHMs) and partial hydatidiform moles (PHMs) are abnormal gestations characterized by vesicular chorionic villi accompanied by variable trophoblastic hyperplasia, with or without embryonic development. CHMs are purely androgenetic (only paternal [P] chromosome complements), mostly homozygous/monospermic (~85%) but occasionally heterozygous/dispermic, whereas PHMs are overwhelmingly
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Low-grade Fibromyxoid Sarcoma of the Vulva and Vagina: Clinical, Pathologic, and Molecular Characterization of 7 Cases and Review of the Literature Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Danielle Costigan, Paola Dal Cin, Christopher D.M. Fletcher, Marisa R. Nucci, Carlos Parra-Herran, David B. Chapel
Low-grade fibromyxoid sarcoma (LGFMS) is a malignancy with propensity for late relapse that principally affects deep soft tissues of the extremities and trunk. Its occurrence in the lower female genital tract is rare, and thus it may not be always considered in the differential diagnosis. We describe the salient features of 7 vulvovaginal LGFMS identified in the authors’ consultation files. Clinical
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Targeted Next-generation Sequencing Reveals a Wide Morphologic and Immunophenotypic Spectrum of Monomorphic Epitheliotropic Intestinal T-Cell Lymphoma Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Jen-Fan Hang, Chang-Tsu Yuan, Kung-Chao Chang, Ren-Ching Wang, Bo-Jung Chen, Pin-Pen Hsieh, Wan-Ting Huang, Wen-Yu Chuang, Tsung-Wei Chen, Yi-Chen Yeh, Shih-Yao Lin, Cheng-Hsiang Hsiao, Shih-Cheng Chou, Chih-En Tseng, Shien-Tung Pan, Shih-Lung Chang, Shih-Sung Chuang
Primary intestinal T-cell lymphoma (PITL) is highly aggressive and includes celiac disease–related enteropathy-associated T-cell lymphoma (EATL), monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), and primary intestinal peripheral T-cell lymphoma, not otherwise specified (ITCL-NOS). MEITL is the most common PITL in Asia, comprising of monomorphic medium-sized cells typically expressing
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Hepatic Cysts: Reappraisal of the Classification, Terminology, Differential Diagnosis, and Clinicopathologic Characteristics in 258 Cases Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Ayse Armutlu, Brian Quigley, Hegyong Choi, Olca Basturk, Gizem Akkas, Burcin Pehlivanoglu, Bahar Memis, Kee-Taek Jang, Mert Erkan, Burcu Erkan, Serdar Balci, Burcu Saka, Pelin Bagci, Alton B. Farris, David A. Kooby, Diego Martin, Bobby Kalb, Shishir K. Maithel, Juan Sarmiento, Michelle D. Reid, N. Volkan Adsay
The literature on liver cysts is highly conflicting, mostly owing to definitional variations. Two hundred and fifty-eight ≥1 cm cysts evaluated pathologically using updated criteria were classifiable as: I. Ductal plate malformation related (63%); that is, cystic bile duct hamartoma or not otherwise specified-type benign biliary cyst (35 with polycystic liver disease). These were female predominant
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Gastrointestinal Tract Injury by Yttrium-90 Appears Largely Restricted to Resin Microspheres But Can Occur Years After Embolization Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Michael Feely, Rashmi Tondon, Maria Gubbiotti, Kristen M. Stashek, Numbereye Numbere, Aaron R. Huber, Ashwani K. Sharma, Brian S. Geller, Safia N. Salaria, Raul S. Gonzalez
Radioembolization therapy utilizes yttrium-90 (Y90) impregnated resin (SIR-Spheres) or glass (TheraSpheres) microspheres to selectively target hepatic lesions via transarterial radioembolization. Occasional cases of gastrointestinal tract injury, secondary to nontargeted delivery of microspheres, have been reported, but large descriptive pathology series are lacking. We identified 20 cases of histologically
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Cutaneous Myoepithelial Neoplasms on Acral Sites Show Distinctive and Reproducible Histopathologic and Immunohistochemical Features Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Arjun Mehta, Jonathan Davey, Deepa Gharpuray-Pandit, Jose A. Plaza, Steven D. Billings, Petra Balogh, Nairi Tchrakian, Sharmila Selvan, Katharina Wiedemeyer, Jason L. Hornick, Thomas Brenn
Cutaneous myoepithelial neoplasms are a heterogenous group of neoplasms with mixed tumors typically affecting the head and myoepitheliomas showing a predilection for the extremities. Their malignant counterparts, myoepithelial carcinoma, and malignant mixed tumor are exceptionally rare in the skin, and the morphologic criteria for malignancy are only poorly defined. The aim of the present study was
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Outcome-based Validation of Confluent/Expansile Versus Infiltrative Pattern Assessment and Growth-based Grading in Ovarian Mucinous Carcinoma Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Amir Momeni-Boroujeni, HyoChan Song, Lina Irshaid, Sarah Strickland, Carlos Parra-Herran, Aurelia Busca
The growth pattern (confluent/expansile versus infiltrative) in primary ovarian mucinous carcinoma (OMC) is prognostically important, and the International Collaboration on Cancer Reporting (ICCR) currently recommends recording the percentage of infiltrative growth in this tumor type. Histologic grading of OMC is controversial with no single approach widely accepted or currently recognized by the World
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DNA Mismatch Repair–deficient Rectal Cancer Is Frequently Associated With Lynch Syndrome and With Poor Response to Neoadjuvant Therapy Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Lama F. Farchoukh, James Celebrezze, David Medich, Kellie Cunningham, Jennifer Holder-Murray, Matthew Holtzman, Kenneth Lee, Haroon Choudry, Reetesh K. Pai
We evaluated 368 consecutively resected rectal cancers with neoadjuvant therapy for DNA mismatch repair (MMR) protein status, tumor response to neoadjuvant therapy, histopathologic features, and patient survival. Nine (2.4%) rectal cancers were mismatch repair–deficient (MMRD): 8 (89%) Lynch syndrome–associated tumors and 1 (11%) sporadic MLH1-deficient tumor. Of the 9 MMRD rectal cancers, 89% (8/9)
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Clinicopathologic Spectrum of Secondary Solid Tumors of the Prostate of Nonurothelial Origin: Multi-institutional Evaluation of 85 Cases Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Andres M. Acosta, Jennifer B. Gordetsky, Katrina Collins, Adeboye O. Osunkoya, Ankur R. Sangoi, Hiroshi Miyamoto, Chia-Sui Kao, Kiril Trpkov, Geert J.L.H. Van Leenders, Sara E. Wobker, Fiona Maclean, Priti Lal, Reba E. Daniel, Fadi Brimo, Matthew Wasco, Michelle S. Hirsch, Nicholas Baniak, Julio A. Diaz-Perez, Kristine M. Cornejo, Bonnie Choy, Rohit Mehra, Sean R. Williamson, Jonathan I. Epstein, Andres
Secondary involvement of the prostate by urothelial or hematolymphoid neoplasms is relatively common and well-described. In contrast, less is known about the clinicopathologic spectrum of secondary solid tumors of the prostate of nonurothelial origin. This study evaluated a series of secondary nonurothelial solid tumors of the prostate diagnosed at 21 institutions. Eighty-five patients with a median
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SMARCB1-deficient and SMARCA4-deficient Malignant Brain Tumors With Complex Copy Number Alterations and TP53 Mutations May Represent the First Clinical Manifestation of Li-Fraumeni Syndrome Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Martin Hasselblatt, Christian Thomas, Aniello Federico, Karolina Nemes, Pascal D. Johann, Brigitte Bison, Susanne Bens, Sonja Dahlum, Uwe Kordes, Antje Redlich, Lienhard Lessel, Kristian W. Pajtler, Christian Mawrin, Ulrich Schüller, Kay Nolte, Christof M. Kramm, Felix Hinz, Felix Sahm, Caterina Giannini, Judith Penkert, Christian P. Kratz, Stefan M. Pfister, Reiner Siebert, Werner Paulus, Marcel Kool
Atypical teratoid/rhabdoid tumor (AT/RT) is a malignant central nervous system tumor predominantly affecting infants. Mutations of SMARCB1 or (rarely) SMARCA4 causing loss of nuclear SMARCB1 or SMARCA4 protein expression are characteristic features, but further recurrent genetic alterations are lacking. Most AT/RTs occur de novo, but secondary AT/RTs arising from other central nervous system tumors
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IDH1/2 Mutations in Sinonasal Undifferentiated Carcinomas: Previously Undescribed IDH2 R172K and R140x Variants Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Aanchal Kakkar, Amber Rathor, Subiyathul Farah Ashraf, Varsha Singh, Kapil Sikka, Deepali Jain
Sinonasal undifferentiated carcinoma (SNUC) is a rare, poorly defined sinonasal epithelial neoplasm from which several genetically defined entities are emerging. IDH1/2 mutations were recently identified in a subset of SNUC. However, the ideal method for the detection of these mutations remains to be established. Cases diagnosed as SNUC between 2010 and 2020 were retrieved. Immunohistochemistry was
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Nodular Lymphocyte–predominant Hodgkin Lymphoma With Nodular Sclerosis: An Underrecognized Feature Associated With Pattern D Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Siba El Hussein, Xiaoqiong Wang, Hong Fang, Fatima Zahra Jelloul, Wei Wang, Sanam Loghavi, Francisco Vega, Roberto N. Miranda, Tariq Muzzafar, John T. Jr Manning, Joseph D. Khoury, W. Richard Burack, Andrew G. Evans, L. Jeffrey Medeiros
Nodular lymphocyte–predominant Hodgkin lymphoma (NLPHL) with unusual features, including some that can overlap morphologically with classic Hodgkin lymphoma (CHL), have been described. Herein, we describe 12 cases of NLPHL with fibrous bands and capsular fibrosis resembling, in part, nodular sclerosis (NS) CHL. Seven of 12 cases harbored Reed-Sternberg–like cells, further suggestive of CHL, but all
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Recurrent KAT6B/A::KANSL1 Fusions Characterize a Potentially Aggressive Uterine Sarcoma Morphologically Overlapping With Low-grade Endometrial Stromal Sarcoma Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Abbas Agaimy, Blaise A. Clarke, David L. Kolin, Cheng-Han Lee, Jen-Chieh Lee, W. Glenn McCluggage, Patrik Pöschke, Robert Stoehr, David Swanson, Gulisa Turashvili, Matthias W. Beckmann, Arndt Hartmann, Cristina R. Antonescu, Brendan C. Dickson
With the widespread application of next-generation sequencing, the genetic landscape of uterine mesenchymal neoplasms has been evolving rapidly to include several recently identified fusion genes. Although chromosomal rearrangements involving the 10q22 and 17q21.31 loci have been reported in occasional uterine leiomyomas decades ago, the corresponding KAT6B::KANSL1 fusion has been only recently identified
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S100 and CD34 Expressing Mesenchymal Neoplasm With Rare PLEKHH2::ALK Fusion and Response to ALK Inhibition Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-09-01 Joseph D. Coppock, Michael A. Schneider, Lea F. Surrey, Giorgos C. Karakousis, Robert G. Maki, Kumarasen Cooper
The PLEKHH2::ALK fusion is a rarely reported gene fusion identified predominantly in lung adenocarcinomas. Tumors with this fusion have been reported to be of durable response to ALK inhibitors. We herein present the case of a 21-year-old woman with a histomorphologically heterogenous mesenchymal neoplasm of the pelvis, expressing both s100 and CD34, with subsequently identified PLEKHH2::ALK fusion
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Histologic Variants of Kaposi Sarcoma in the Gastrointestinal Tract: A Contemporary Multi-institutional Clinicopathologic Analysis of 46 Cases. Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-08-17 Wei Zheng, Rebecca C Obeng, Rondell P Graham, Shu Lui, Jerome Cheng, Borislav A Alexiev, Brian Quigley, Alyssa Krasinskas, Guang-Yu Yang, David Escobar, Xiuli Liu, Pooja Navale, Michelle D Reid, Maria Westerhoff, Yue Xue
Kaposi sarcoma (KS) can pose diagnostic challenges in biopsy specimens. Multiple histologic variants of cutaneous KS have been described; however, the histomorphologic spectrum of gastrointestinal (GI) KS has not been systematically studied. This large series comprehensively evaluated 46 cases of KS involving the GI tract and identified 7 histomorphologic variants, some that have not been previously
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Antiviral Toxicities in Pediatric Solid Organ Transplant Recipients Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-16 Molly Hayes, Craig L. K. Boge, Anna Sharova, Daniel Vader, Marina Mitrou, Despoina M. Galetaki, Yun Li, Kevin J. Downes
Prophylaxis with valganciclovir (VGCV) is used routinely to prevent cytomegalovirus (CMV) infections in at-risk pediatric solid organ transplant (SOT) recipients. However, the rate and factors associated with toxicities in this population are not well-described. We conducted a retrospective cohort study of children undergoing SOT at our hospital from January 2012 - June 2018. We evaluated the frequency
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Clonal hematopoiesis confers an increased mortality risk in orthotopic heart transplant recipients Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-16 Fernando L. Scolari, Darshan H. Brahmbhatt, Sagi Abelson, Jessie J. F. Medeiros, Markus S. Anker, Nicole L. Fung, Madison Otsuki, Oscar Calvillo-Argüelles, Patrick R. Lawler, Heather J. Ross, Adriana C. Luk, Stefan Anker, John E. Dick, Filio Billia
Novel risk stratification and non-invasive surveillance methods are needed in orthotopic heart transplant (OHT) to reduce morbidity and mortality post-transplant. Clonal hematopoiesis (CH) refers to the acquisition of specific gene mutations in hematopoietic stem cells linked to enhanced inflammation and worse cardiovascular outcomes. The purpose of this study was to investigate the association between
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The Kidney Transplant Equity Index: Improving Racial and Ethnic Minority Access to Transplantation Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Aaron M. Delman, Kevin M. Turner, Latifa S. Silski, Ralph C. III Quillin, Martha Estrada, Kristina Lemon, Madison C. Cuffy, Shimul A. Shah
Objectives: To develop a scalable metric which quantifies kidney transplant (KT) centers’ performance providing equitable access to KT for minority patients, based on the individualized prelisting prevalence of end-stage renal disease (ESRD). Background: Racial and ethnic disparities for access to transplant in patients with ESRD are well described; however, variation in care among KT centers remains
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Translational Epidemiology: An Integrative Approach to Determine the Interplay Between Genetic Ancestry and Neighborhood Socioeconomic Status on Triple Negative Breast Cancer Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Neha Goel, Sina Yadegarynia, Deukwoo Kwon, Susan B. Kesmodel, James W. Harbour, Erin Kobetz, Nipun Merchant, Daniel A. Rodriguez
Objective: To investigate the impact of global and local genetic ancestry and neighborhood socioeconomic status (nSES), on breast cancer (BC) subtype, and gene expression. Background: Higher rates of aggressive BC subtypes [triple negative breast cancer (TNBC)] and worse overall BC survival are seen in black women [Hispanic Black (HB) and non-Hispanic Black (NHB)] and women from low nSES. However
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Intraportal Islet Autotransplantation Independently Improves Quality of Life After Total Pancreatectomy in Patients With Chronic Refractory Pancreatitis Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Srinath Chinnakotla, Gregory J. Beilman, David Vock, Martin L. Freeman, Varvara Kirchner, Ty B. Dunn, Timothy L. Pruett, Stuart K. Amateau, Guru Trikudanathan, Sarah J. Schwarzenberg, Elissa Downs, Matthew Armfield, Karthik Ramanathan, David E.R. Sutherland, Melena D. Bellin
Objective: To determine if islet autotransplantation (IAT) independently improves the quality of life (QoL) in patients after total pancreatectomy and islet autotransplantation (TP-IAT). Background: TP-IAT is increasingly being used for intractable chronic pancreatitis. However, the impact of IAT on long-term islet function and QoL is unclear. Methods: TP-IAT patients at our center >1 year after
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Mental Health Care Following Firearm and Motor Vehicle-related Injuries: Differences Impacting Our Treatment Strategies Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Peter F. Ehrlich, Christian D. Pulcini, Heidi G. De Souza, Matt Hall, Annie Andrews, Bonnie T. Zima, Joel A. Fein, Sofia Chaudhary, Jennifer A. Hoffmann, Eric W. Fleegler, Kristyn N. Jeffries, Monika K. Goyal, Stephen W. Hargarten, Elizabeth R. Alpern
Objective: To compare new mental health diagnoses (NMHD) in children after a firearm injury versus following a motor vehicle collision (MVC). Background: A knowledge gap exists regarding childhood mental health diagnoses following firearm injuries, notably in comparison to other forms of traumatic injury. Methods: We utilized Medicaid MarketScan claims (2010–2016) to conduct a matched case-control
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A Novel Nonantibiotic Gut-directed Strategy to Prevent Surgical Site Infections Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Sanjiv K. Hyoju, Robert Keskey, Gerardo Castillo, Kaylie Machutta, Alexander Zaborin, Olga Zaborina, John C. Alverdy
Objective: To determine the efficacy of an orally delivered phosphate-rich polymer, Pi-PEG, to prevent surgical site infection (SSI) in a mouse model of spontaneous wound infection involving gut-derived pathogens. Background: Evidence suggests that pathogens originating from the gut microbiota can cause postoperative infection via a process by which they silently travel inside an immune cell and
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Evaluation of Fontan-associated Liver Disease and Ethnic Disparities in Long-term Survivors of the Fontan Procedure: A Population-based Study Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Juliet Emamaullee, Sean Martin, Cameron Goldbeck, Brittany Rocque, Arianna Barbetta, Rohit Kohli, Vaughn Starnes
Objectives: Fontan-associated liver disease (FALD) has emerged as a nearly universal chronic comorbidity in patients with univentricular congenital heart disease who undergo the Fontan procedure. There is a paucity of data reporting long-term outcomes and the impact of FALD in this population. Methods: Patients who underwent the Fontan procedure between 1992 and 2018 were identified using California
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Lack of Workplace Support for Obstetric Health Concerns is Associated With Major Pregnancy Complications: A National Study of US Female Surgeons Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Erika L. Rangel, Manuel Castillo-Angeles, Yue-Yung Hu, Ankush Gosain, Sarah Rae Easter, Zara Cooper, Rachel B. Atkinson, Eugene S. Kim
Objective: We sought to assess whether lack of workplace support for clinical work reductions during pregnancy was associated with major pregnancy complications. Background: Surgeons are at high risk of major pregnancy complications. Although rigorous operative schedules pose increased risk, few reduce their clinical duties during pregnancy. Methods: An electronic survey was distributed to US surgeons
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Nationwide Management of Trauma in Child Abuse: Exploring the Racial, Ethnic, and Socioeconomic Disparities Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Bellal Joseph, Joseph V. Sakran, Omar Obaid, Hamidreza Hosseinpour, Michael Ditillo, Tanya Anand, Tanya L. Zakrison
Objective: Child abuse is a major cause of childhood injury, morbidity, and death. There is a paucity of data on the practice of abuse interventions among this vulnerable population. The aim of our study was to identify the factors associated with interventions for child abuse on a national scale. Methods: Retrospective analysis of 2017 to 2018 American College of Surgeons (ACS) Pediatric Trauma
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Single-cell Transcriptomics Reveals Dynamic Role of Smooth Muscle Cells and Enrichment of Immune Cell Subsets in Human Abdominal Aortic Aneurysms Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Frank M. Davis, Lam C. Tsoi, Feiyang Ma, Rachael Wasikowski, Bethany B. Moore, Steven L. Kunkel, Johann E. Gudjonsson, Katherine A. Gallagher
Objective: To determine cell-specific gene expression profiles that contribute to development of abdominal aortic aneurysms (AAAs). Background: AAAs represent the most common pathological aortic dilation leading to the fatal consequence of aortic rupture. Both immune and structural cells contribute to aortic degeneration, however, gene specific alterations in these cellular subsets are poorly understood
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Long-term Outcomes of Parenchyma-sparing and Oncologic Resections in Patients With Nonfunctional Pancreatic Neuroendocrine Tumors <3 cm in a Large Multicenter Cohort Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Louisa Bolm, Martina Nebbia, Alice C. Wei, Amer H. Zureikat, Carlos Fernández-del Castillo, Jian Zheng, Alessandra Pulvirenti, Ammar A. Javed, Yurie Sekigami, Natalie Petruch, Motaz Qadan, Keith D. Lillemoe, Jin He, Cristina R. Ferrone, the PAncreatic Neuroendocrine Disease Alliance (PANDA)
Introduction: The role of parenchyma-sparing resections (PSR) and lymph node dissection in small (<3 cm) nonfunctional pancreatic neuroendocrine tumors (PNET) is unlikely to be studied in a prospective randomized clinical trial. By combining data from 4 high-volume pancreatic centers we compared postoperative and long-term outcomes of patients who underwent PSR with patients who underwent oncologic
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Implementation of a Hepatocellular Carcinoma Screening Program for At-risk Patients Safety-Net Hospital: A Model for National Dissemination Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Rachel M. Lee, Rapheisha Darby, Caroline R. Medin, Grace C. Haser, Meredith C. Mason, Lesley S. Miller, Charles A. Staley, Shishir K. Maithel, Maria C. Russell
Objective: This study aimed to enhance hepatocellular carcinoma (HCC) screening to achieve earlier diagnosis of patients with hepatitis C (HCV) cirrhosis in our Safety-Net population. Background: Adherence to HCC screening guidelines at Safety-Net hospitals is poor. Only 23% of patients with HCC at our health system had a screening exam within 1-year of diagnosis and 46% presented with stage IV disease
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Timing of a Major Operative Intervention After a Positive COVID-19 Test Affects Postoperative Mortality: Results From a Nationwide, Procedure-matched Analysis Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Panos Kougias, Sherene E. Sharath, Nader Zamani, F. Charles Brunicardi, David H. Berger, Mark A. Wilson
Background: Studies indicate that coronavirus disease 2019 (COVID-19) infection before or soon after operations increases mortality, but they do not comment on the appropriate timing for interventions after diagnosis. Objective: We sought to determine what the safest time would be for COVID-19 diagnosed patients to undergo major operative interventions. Methods: High-risk operations, between January
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Feasibility and Safety of Ambulatory Surgery as the Next Management Paradigm in Colorectal Resection Surgery Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Ravi P. Kiran, Koby Herman, Dilara Khoshknabi, Athanasios Angistriotis, James M. Church
Background: Current clinical dogma favors universal inpatient admission after colorectal resection particularly in the presence of an anastomosis. Objective: We evaluate the feasibility and safety of ambulatory surgery in carefully selected patients undergoing colorectal resection/anastomosis. Methods: Between October 2020 and October 2021, all patients undergoing colorectal resection/anastomosis
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The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Secondary and Tertiary Renal Hyperparathyroidism Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Sophie Dream, Lindsay E. Kuo, Jennifer H. Kuo, Stuart M. Sprague, Fiemu E. Nwariaku, Myles Wolf, John A. Jr Olson, Sharon M. Moe, Brenessa Lindeman, Herbert Chen
Objective: To develop evidence-based recommendations for safe, effective, and appropriate treatment of secondary (SHPT) and tertiary (THPT) renal hyperparathyroidism. Background: Hyperparathyroidism is common among patients with chronic kidney disease, end-stage kidney disease, and kidney transplant. The surgical management of SHPT and THPT is nuanced and requires a multidisciplinary approach. There
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The Duration and Magnitude of Postdischarge Venous Thromboembolism Following Colectomy Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Christopher A. Lewis-Lloyd, David J. Humes, Joe West, Oliver Peacock, Colin J. Crooks
Objective: To assess the impact of current guidelines by reporting weekly postoperative postdischarge venous thromboembolism (VTE) rates. Summary Background Data: Disparity exists between the postoperative thromboprophylaxis duration colectomy patients receive based on surgical indication, where malignant resections routinely receive 28 days extended thromboprophylaxis into the postdischarge period
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Preoperative Treatment of Severe Diabetes Mellitus and Hypertension Mitigates Healthcare Disparities and Prevents Adverse Postoperative Discharge to a Nursing Home Ann. Surg. (IF 13.787) Pub Date : 2022-09-01 Luca J. Wachtendorf, Omid Azimaraghi, Valluvan Rangasamy, Miheer Sane, Balachundhar Subramaniam, Rafael Vazquez, Karuna Wongtangman, Timothy T. Houle, Eran Y. Bellin, Oluwaseun Akeju, Tracey Straker, Terry-Ann T. Chambers, Nancy E. Oriol, Matthias Eikermann, for the Health Outcomes and Perioperative Equity (H.O.P.E) group investigators writing committee
Objective: To evaluate whether patients of Black race are at higher risk of adverse postoperative discharge to a nursing home, and if a higher prevalence of severe diabetes mellitus and hypertension are contributing. Background: It is unclear whether a patient’s race predicts adverse discharge to a nursing home after surgery, and if preexisting diseases are contributing. Methods: A total of 368
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PRAME Expression in Cancer. A Systematic Immunohistochemical Study of >5800 Epithelial and Nonepithelial Tumors. Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-08-16 Maciej Kaczorowski, Małgorzata Chłopek, Anna Kruczak, Janusz Ryś, Jerzy Lasota, Markku Miettinen
Preferentially expressed antigen in melanoma (PRAME) is considered a useful marker in the differential diagnosis between malignant melanoma and its melanocytic mimics. Recently PRAME expression was documented in nonmelanocytic tumors, but much of the data are based on mRNA studies. This investigation evaluated PRAME expression in the spectrum of normal tissues and >5800 human tumors using immunohistochemistry
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Bloodless HeartMate 3 explantation and orthotopic heart transplant in a heart failure patient refusing blood products J. Heart Lung Transplant. (IF 13.569) Pub Date : 2022-08-15 Julie W. Doberne, Yasmin Maisonave, Adam DeVore, Nicole Guinn, Jacob N. Schroder
Abstract not available
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Contemporary Risk Scores Predict Clinical Worsening in Pulmonary Arterial Hypertension - An Analysis of FREEDOM-EV J. Heart Lung Transplant. (IF 13.569) Pub Date : 2022-08-15 Raymond L. Benza, Mardi Gomberg-Maitland, Harrison W. Farber, Carmine Dario Vizza, Meredith Broderick, Louis Holdstock, Andrew C. Nelsen, Chunqin Deng, Youlan Rao, R. James White
Background Risk scores integrate clinical variables emphasizing symptoms, exercise capacity, and measures of cardiac strain to predict clinical outcome better than any single value in pulmonary arterial hypertension (PAH). Risk scores have demonstrated prognostic utility for outcomes in registries, and recent studies have suggested that they are also therapy-responsive in controlled trials. Methods
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Living Donor Intestinal Transplantation: Recipient Outcomes. Ann. Surg. (IF 13.787) Pub Date : 2022-08-15 Guosheng Wu, Chaoxu Liu, Xile Zhou, Long Zhao, Weitong Zhang, Mian Wang, Qingchuan Zhao, Tingbo Liang
To examine outcomes of living-donor intestinal transplant (LDITx) recipients.
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Actionable Factors Fostering Health valUe Generation and Scalability of Prehabilitation: A Prospective Cohort Study. Ann. Surg. (IF 13.787) Pub Date : 2022-08-15 Raquel Risco, Rubèn González-Colom, Mar Montané-Muntané, Isaac Cano, Emili Vela, Raquel Sebio, Fernando Dana, Joan Faner, Miquel Coca, Sara Laxe, Josep Roca, Graciela Martínez-Pallí
Prehabilitation has potential for improving surgical outcomes as shown in previous randomized controlled trials. However, a marked efficacy-effectiveness gap is limiting its scalability. Comprehensive analyses of deployment of the intervention in real-life scenarios are required.
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Long-Term Dependency in Older Adults after Surgery or Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer. Ann. Surg. (IF 13.787) Pub Date : 2022-08-15 Dhruvin H Hirpara, Biniam Kidane, Alexander V Louie, Victoria Zuk, Gail Darling, Mathieu Rousseau, Tyler Chesney, Natalie Coburn, Julie Hallet
To examine long-term healthcare dependency outcomes of SBRT to surgery for older adults with stage I non-small cell lung cancer (NSCLC).
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Proteomic Identification and Clinicopathologic Characterization of Splenic Amyloidosis. Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-08-15 April Chiu, Surendra Dasari, Paul J Kurtin, Jason D Theis, Julie A Vrana, Karen L Rech, Linda N Dao, Matthew T Howard, Joanna C Dalland, Ellen D McPhail
The spleen is a commonly encountered specimen in surgical pathology. However, little is known about the incidence, morphologic pattern, and clinical features of spleens involved by amyloidosis. We retrospectively identified 69 spleen amyloid cases typed using a proteomics-based method between 2008 and 2020. The frequency of amyloid types, clinicopathologic features, and distribution of amyloid deposits
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GLI1-Rearranged Enteric Tumor: Expanding the Spectrum of Gastrointestinal Neoplasms with GLI1 gene fusions. Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-08-15 José Jessurun, Christine Orr, Samantha N McNulty, Catherine E Hagen, Hussein Alnajar, David Wilkes, Sarah Kudman, Majd Al Assaad, Princesca Dorsaint, Kentaro Ohara, Feng He, Kenrry Chu, Yong Mei Yin, Jenny Zhaoying Xiang, Lihui Qin, Andrea Sboner, Olivier Elemento, Rhonda K Yantiss, Rondell P Graham, Flora Poizat, Juan Miguel Mosquera
GLI1 encodes a transcription factor that targets cell cycle regulators affecting stem cell proliferation. GLI1 gene fusions were initially described in pericytomas with a t[7;12] translocation and more recently in gastric plexiform fibromyxomas and gastroblastomas. This study describes the clinicopathologic, immunohistochemical, and molecular features of three intestinal-based neoplasms harboring GLI1
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Sporadic and Familial Adenomatous Polyposis-associated Foveolar-type Adenoma of the Stomach. Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-08-15 Tomoaki Naka, Taiki Hashimoto, Hourin Cho, Noriko Tanabe, Teruhiko Yoshida, Yasushi Yatabe, Takaki Yoshikawa, Seiichiro Abe, Shigeki Sekine
Gastric foveolar-type adenoma (FA) is a rare benign neoplasm occurring either sporadically or in patients with familial adenomatous polyposis (FAP). However, the molecular features of FA and the relationship between sporadic and syndromic lesions remain unclear. In this study, we performed clinicopathological, immunohistochemical, and genetic analyses of 18 sporadic and 30 FAP-associated FAs. Most
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Sinonasal Amoebiasis: An Unexpected Cause of Sinonasal Necroinflammatory Disease. Am. J. Surg. Pathol. (IF 6.298) Pub Date : 2022-08-15 Anne C McLean, Justin A Bishop, Jeannette Guarner, Kathleen T Montone, C Paul Morris, Philip Sloan, Lisa M Rooper
While amoebic infection is widely known as a cause of gastroenteritis, keratitis, and meningoencephalitis, amoebae are challenging to recognize at unexpected sites. Despite multiple case reports of sinonasal amoebiasis, amoebic infection is not regularly considered in the differential diagnosis of sinonasal necroinflammatory disease. Here, we aim to characterize the pathologic features of sinonasal
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Place-based heterogeneity in lung transplant recipient outcomes Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-12 Wayne M. Tsuang, Rocio Lopez, Anne Tang, Marie Budev, Jesse D. Schold
Place is defined as a social or environmental area of residence with meaning to a patient. We hypothesize there is an association between place and the clinical outcomes of lung transplant recipients in the United States. In a retrospective cohort study of transplants between January 1, 2010 and December 31, 2019 in the Scientific Registry of Transplant Recipients, multivariable Cox regression models
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Digital consent to improve patient perception of shared decision-making: comparative study between paper and digital consent processes in patients undergoing breast surgery. Br. J. Surg. (IF 11.122) Pub Date : 2022-08-12 Edward Robert St John,Ahmed Ezzat,Nicholas Holford,Hirah Rizki,Katy Hogben,Daniel Richard Leff
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De novo posttransplant membranous nephropathy following BNT162b2 mRNA COVID-19 vaccine in a kidney transplant recipient. Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-12 Nathalie Chavarot,Michael Padden,Lucile Amrouche,Stéphanie Malard,Anne Scemla,Rebecca Sberro-Soussan,Juliette Léon,Christophe Legendre,Jean Paul Duong,Julien Zuber,Dany Anglicheau,Marion Rabant,Pierre Isnard
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Better Operating Room Ventilation as Determined by a Novel Ventilation Index is Associated with Lower Rates of Surgical Site Infections Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Bernard Surial, Andrew Atkinson, Rüdiger Külpmann, Arnold Brunner, Kurt Hildebrand, Benoît Sicre, Nicolas Troillet, Andreas Widmer, Eveline Rolli, Judith Maag, Jonas Marschall
Objective: To assess the impact of operating room (OR) ventilation quality on surgical site infections (SSI) using a novel ventilation index. Summary Background Data: Previous studies compared laminar air flow with conventional ventilation, thereby ignoring many parameters that influence air flow properties. Methods: In this cohort study, we surveyed hospitals participating in the Swiss SSI surveillance
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Errors in Surgery: A Case Control Study Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Katherine M. Marsh, Florence E. Turrentine, Worthington G. Schenk, John B. Hanks, Bruce D. Schirmer, John P. Davis, Timothy L. McMurry, Sarah J. Ratcliffe, Victor M. Zaydfudim, R. Scott Jones
Objective: While errors can harm patients they remain poorly studied. This study characterized errors in the care of surgical patients and examined the association of errors with morbidity and mortality. Summary Background Data: Errors have been reported to cause less than 10% or greater than 60% of adverse events. Such discordant results underscore the need for further exploration of the relationship
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An International Expert Delphi Consensus on Defining Textbook Outcome in Liver Surgery (TOLS) Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Burak Görgec, Andrea Benedetti Cacciaguerra, Timothy M. Pawlik, Luca A. Aldrighetti, Adnan A. Alseidi, Umberto Cillo, Norihiro Kokudo, David A. Geller, Go Wakabayashi, Horacio J. Asbun, Marc G. Besselink, Daniel Cherqui, Tan To Cheung, Pierre-Alain Clavien, Claudius Conrad, Mathieu D’Hondt, Ibrahim Dagher, Christos Dervenis, John Devar, Elijah Dixon, Bjørn Edwin, Mikhail Efanov, Giuseppe M. Ettore
Objective: To reach global expert consensus on the definition of TOLS in minimally invasive and open liver resection among renowned international expert liver surgeons using a modified Delphi method. Summary Background Data: Textbook outcome is a novel composite measure combining the most desirable postoperative outcomes into one single measure and representing the ideal postoperative course. Despite
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Change in Body Mass Index and Attributable Risk of New Onset Hypertension among Obese Living Kidney Donors Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Rhiannon D. Reed, M. Chandler McLeod, Paul A. MacLennan, Vineeta Kumar, Sydney E. Pittman, Andrew G. Maynor, Luke A. Stanford, Gavin A. Baker, Carrie A. Schinstock, John R. Silkensen, Garrett R. Roll, Dorry L. Segev, Babak J. Orandi, Cora E. Lewis, Jayme E. Locke
Objective: To examine whether body mass index (BMI) changes modify the association between kidney donation and incident hypertension. Summary Background Data: Obesity increases hypertension risk in both general and living kidney donor (LKD) populations. Donation-attributable risk in the context of obesity, and whether weight change modifies that risk, is unknown. Methods: Nested case-control study
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Impact of Axillary Lymph Node Dissection and Sentinel Lymph Node Biopsy on Upper Limb Morbidity in Breast Cancer Patients: A Systematic Review and Meta-Analysis Ann. Surg. (IF 13.787) Pub Date : 2022-08-10 Nur Amalina Che Bakri, Richard M. Kwasnicki, Naairah Khan, Omar Ghandour, Alice Lee, Yasmin Grant, Aleksander Dawidziuk, Ara Darzi, Hutan Ashrafian, Daniel R. Leff
Objective: To evaluate the impact of ALND and SLNB on upper limb (UL) morbidity in breast cancer patients. Summary Background: Axillary de-escalation is motivated by a desire to reduce harm of ALND. Understanding the impact of axillary surgery and disparities in operative procedures on post-operative arm morbidity would better direct resources to the point of need and cement the need for de-escalation
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Residual Mitral Regurgitation and Worse Outcomes After LVAD Implant: Culprit or Surrogate? J. Heart Lung Transplant. (IF 13.569) Pub Date : 2022-08-10 Daniel J. Goldstein
Abstract not available
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Early Recurrence After Resection of Locally Advanced Pancreatic Cancer Following Induction Therapy: An International Multicenter Study. Ann. Surg. (IF 13.787) Pub Date : 2022-08-11 Leonard W F Seelen, A Floortje van Oosten, Lilly J H Brada, Vincent P Groot, Lois A Daamen, Marieke S Walma, Bastiaan F van der Lek, Mike S L Liem, Gijs A Patijn, Martijn W J Stommel, Ronald M van Dam, Bas Groot Koerkamp, Olivier R Busch, Ignace H J T de Hingh, Casper H J van Eijck, Marc G Besselink, Richard A Burkhart, Inne H M Borel Rinkes, Christopher L Wolfgang, I Quintus Molenaar, Jin He, Hjalmar
To establish an evidence-based cut-off and predictors for early recurrence in patients with resected locally advanced pancreatic cancer (LAPC).
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Racial and Ethnic Differences in Elective vs. Emergency Surgery for Colorectal Cancer. Ann. Surg. (IF 13.787) Pub Date : 2022-08-11 Ryan Howard, Samantha Hendren, Minal Patel, Vidhya Gunaseelan, Matthew Wixson, Jennifer Waljee, Michael Englesbe, Mark C Bicket
To evaluate differences in presentation and outcomes of surgery for colorectal cancer.
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Segmental vs. Diffuse Main Duct Intraductal Papillary Mucinous Neoplasm: Examination of Main Pancreatic Duct Morphology and Implications for Malignancy Risk and Extent of Surgical Resection. Ann. Surg. (IF 13.787) Pub Date : 2022-08-11 Brett L Ecker, Shannan M Dickinson, Lily V Saadat, Alice J Tao, Alessandra Puliverenti, Vinod P Balachandran, Michael I D'Angelica, Jeffrey A Drebin, T Peter Kingham, William R Jarnagin, Alice C Wei, Mithat Gonen, Kevin C Soares
To determine whether the morphologic features of the main pancreatic duct (MPD) of main-duct-involved-IPMN (i.e., Main duct or mixed main duct/side branch) have implications for risk of malignancy and extent of resection.
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Socioeconomic disparities in abdominal aortic aneurysm repair rates and survival. Br. J. Surg. (IF 11.122) Pub Date : 2022-08-11 Ravi Maheswaran,Thaison Tong,Jonathan Michaels,Paul Brindley,Stephen Walters,Shah Nawaz
BACKGROUND Abdominal aortic aneurysm (AAA) is more prevalent in socioeconomically disadvantaged areas. This study investigated socioeconomic disparities in AAA repair rates and survival. METHODS The study used ecological and cohort study designs, from 31 672 census areas in England (April 2006 to March 2018), the Index of Multiple Deprivation 2010 as the area-level deprivation indicator, and Poisson
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Long-term outcomes of implant-based immediate breast reconstruction with and without radiotherapy: a population-based study. Br. J. Surg. (IF 11.122) Pub Date : 2022-08-11 Jana de Boniface,Hannah Coudé Adam,Axel Frisell,Ira Oikonomou,Dhirar Ansarei,Anna Ljung Konstantinidou,Yihang Liu,Basel Abo Alniaj,Paula Wallmon,Martin Halle,Anna L V Johansson,Helena Sackey
BACKGROUND Radiotherapy (RT) is a risk factor for impaired outcomes after implant-based immediate breast reconstruction (IBR). Large studies including long-term follow-up are relatively scarce. The purpose of this analysis was to assess long-term effects of RT in implant-based IBR, distinguishing between implant removal because of postoperative complications versus patient preference. METHODS This
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More is Better… Until it is Worse: Can Organ Placement Processes Scale to an Increasingly Complex System? Am. J. Transplant. (IF 9.369) Pub Date : 2022-08-11 Joel T Adler,S Ali Husain