General Surgery
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Optimizing Empiric Antibiotic Selection in Hospitalized Patients with Skin and Abdominal Infections: Insights from the INSPIRE 3 and 4 Cluster Randomized Clinical Trials
The INSPIRE 3 and 4 trials demonstrate that computerized provider order entry (CPOE) prompts with patient-specific MDRO risk estimates, combined with education and feedback, significantly reduce empiric extended-spectrum antibiotic use in s
Cutting through the p-value: Assessing Clinical Relevance in Inguinal Hernia Repair Surgical Literature
This analysis reveals pervasive underreporting of clinical relevance thresholds in studies comparing open, laparoscopic, and robotic inguinal hernia repairs, urging a shift beyond p-values to improve evidence-based surgical decisions.
Circulating Trimethylamine N-Oxide: A Novel Biomarker for Predicting Abdominal Aortic Aneurysm Progression and Surgical Risk
Elevated plasma TMAO levels are associated with higher risk of abdominal aortic aneurysm development, rapid aneurysm growth, and need for surgical repair, providing a promising tool for risk stratification and personalized surveillance.
Efficacy and Safety of Shunt Surgery in Idiopathic Normal-Pressure Hydrocephalus: Insights from a Rigorous Randomized Controlled Trial
A double-blind, placebo-controlled trial demonstrates that shunt surgery significantly improves gait velocity and balance in patients with idiopathic normal-pressure hydrocephalus who respond to temporary CSF drainage, with mixed safety out
Minimally Invasive Surgery versus Medical Management for Supratentorial Intracerebral Hemorrhage: Insights from the MIND Trial
The MIND trial compared minimally invasive surgery using the Artemis device to standard medical management for supratentorial intracerebral hemorrhage, finding no significant improvement in 180-day functional outcomes or 30-day mortality wi
Minimally Invasive Surgery vs Medical Management in Supratentorial Intracerebral Hemorrhage: Insights from the MIND Randomized Trial
The MIND trial found no significant functional benefit or mortality reduction with minimally invasive surgery compared to medical management alone in supratentorial intracerebral hemorrhage patients at 180 days.
Hyperbaric Oxygen Therapy Enhances Recovery After Intracranial Aneurysm Surgery
A meta-analysis of 11 RCTs involving over 2000 patients shows hyperbaric oxygen therapy significantly improves neurologic function, independence, and quality of life post-intracranial aneurysm surgery.
Combined Liver–Kidney Transplantation: Four Decades of Transformative Impact and Future Horizons
Since the landmark combined liver–kidney transplant in 1984, advances in surgical techniques, immunosuppression, and donor allocation have revolutionized care for patients with dual organ failure. Emerging innovations, including gene-edited
Optimizing Treatment Selection for Hepatocellular Carcinoma: Machine Learning Guidance in Choosing Liver Transplantation versus Surgical Resection
A machine learning model accurately stratifies patients with hepatocellular carcinoma to guide individualized selection between liver transplantation and surgical resection, improving survival outcomes while addressing donor scarcity and pa
Urgent Surgery Versus Fibrinolytic Therapy in Left-Sided Prosthetic Valve Thrombosis: Insights from a Groundbreaking Randomized Trial
This first randomized trial comparing urgent surgery and fibrinolytic therapy (low-dose t-PA) for symptomatic left-sided prosthetic valve thrombosis finds similar efficacy but higher mortality with surgery and higher residual valve dysfunct
Intensive vs Conventional Intraoperative Blood Pressure Management: Insights from the BP-CARES Trial on Cardiovascular Outcomes After Major Abdominal Surgery
The BP-CARES randomized trial found no cardiovascular benefit of intensive intraoperative blood pressure management (MAP ≥80 mm Hg) over conventional targets in high-risk major abdominal surgery patients.
Innovative Combination of Cryoablation and Intratumoral Immunotherapy Extends Survival in Advanced Metastatic Cancer
A phase II trial demonstrates that multiplex intratumoral immunotherapy combining cryoablation with low-dose immune checkpoint inhibitors significantly prolongs median overall survival to 20.9 months in treatment-refractory metastatic solid
Riociguat Continuation After Balloon Pulmonary Angioplasty Preserves Exercise Capacity in Inoperable CTEPH: Insights from the THERAPY-HYBRID-BPA Trial
The THERAPY-HYBRID-BPA study demonstrates that continuing riociguat after balloon pulmonary angioplasty maintains exercise capacity in patients with inoperable chronic thromboembolic pulmonary hypertension without increasing adverse events.
Reducing Delayed Hyponatremia After Endoscopic Transsphenoidal Surgery: The Role of Postoperative Fluid Restriction
A prospective randomized study demonstrates that postoperative fluid restriction significantly reduces delayed hyponatremia and hospital readmission following endoscopic endonasal transsphenoidal surgery for pituitary tumors.
Optimizing Anesthesia in Elderly NSCLC Patients: Impact of Midazolam and Dexmedetomidine Co-Administration on Hemodynamics and Stress Response
Co-administering midazolam with dexmedetomidine in elderly NSCLC patients undergoing lobectomy enhances hemodynamic stability and reduces perioperative stress response, potentially improving recovery outcomes without increasing adverse even
Harnessing AI in Surgical Education: Deep Language Learning Model-Based Simulation Enhances Undergraduate History-Taking Skills
A randomized controlled trial demonstrates that integrating deep language learning model (DLM) simulations into surgical training significantly improves history-taking skills and communication confidence among senior medical students.
Oral Corticosteroids Fail to Improve Recovery in Vocal Fold Paralysis After Thyroid Surgery: Insights from a Randomized Clinical Trial
A randomized trial shows that a 7-day course of oral corticosteroids does not enhance vocal fold remobilization or voice quality in unilateral vocal fold paralysis following thyroid or parathyroid surgery, underscoring the continued importa
Unexpected Risks of Postoperative 20% Albumin Infusion in High-Risk Cardiac Surgery Patients: Insights from the ALBICS AKI Trial
The ALBICS AKI trial reveals that postoperative infusion of 20% albumin increases acute kidney injury risk in high-risk cardiac surgery patients, challenging prior assumptions about albumin’s nephroprotective role in this setting.
Preoperative versus Postoperative Stereotactic Radiation Therapy for Brain Metastases: Safety, Feasibility, and Efficiency Insights from a Phase 3 Randomized Trial
A phase 3 randomized trial demonstrates that preoperative stereotactic radiation therapy (SRT) for brain metastases offers comparable safety and reduced treatment duration compared to postoperative SRT, potentially improving patient care lo
Intercostal Nerve Block: A Viable Alternative to Thoracic Epidural for Pain Control in Lung Surgery
This randomized trial demonstrates that single-shot intercostal nerve block offers noninferior pain relief compared to thoracic epidural analgesia after thoracoscopic lung resection, with benefits in opioid reduction, mobility, and shorter
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