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  1. Article ; Online: Burnout and Professional Fulfillment in Early and Early-Mid-Career Breast Surgeons.

    Zhang, Jennifer Q / Dong, Joe / Pardo, Jaime / Emhoff, Isha / Serres, Stephanie / Shanafelt, Tait / James, Ted

    Annals of surgical oncology

    2021  Volume 28, Issue 11, Page(s) 6051–6057

    Abstract: Background: Prior work has shown that burnout among breast surgeons is prevalent and highest in those earlier in their clinical practice career. Therefore, we sought to better understand and identify specific contributors to early-career breast surgeon ... ...

    Abstract Background: Prior work has shown that burnout among breast surgeons is prevalent and highest in those earlier in their clinical practice career. Therefore, we sought to better understand and identify specific contributors to early-career breast surgeon burnout.
    Methods: We analyzed data from our 2017 survey of members of the American Society of Breast Surgeons. The 16-items of the Professional Fulfillment Index were used in determining overall burnout and professional fulfillment scores. Multivariable regressions were performed to evaluate factors related to overall burnout and professional fulfillment.
    Results: The mean overall burnout score was 1.23 (0-4 scale; higher score unfavorable) for surgeons in practice < 5 years, compared with 1.39 for surgeons in practice 5-9 years and 1.22 for those in practice ≥ 10 years. The mean professional fulfillment score was 2.71 (0-4 scale; higher score favorable) for surgeons in practice < 5 years, 2.66 for surgeons in practice 5-9 years, and 2.67 for surgeons in practice ≥ 10 years. Multivariable analysis showed that burnout was positively correlated with ≥ 60 work hours per week in the group practicing for < 5 years, and dedicating less than full time to breast surgery in the group in practice 5-9 years. Professional fulfillment was negatively associated with single relationship status in surgeons practicing < 5 years, and dedicating less than full time to breast surgery for those in practice 5-9 years.
    Conclusion: Our study suggests that breast surgeons who have been in practice for 5-9 years have particularly high overall burnout rates and additional support focused on this group of breast surgeons may be needed.
    MeSH term(s) Burnout, Professional/epidemiology ; Humans ; Job Satisfaction ; Personal Satisfaction ; Surgeons ; Surveys and Questionnaires ; United States
    Language English
    Publishing date 2021-04-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-021-09940-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4042: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: The Role of Oncotype DX

    Pardo, Jaime A / Fan, Betty / Mele, Alessandra / Serres, Stephanie / Valero, Monica G / Emhoff, Isha / Alapati, Amulya / James, Ted A

    Annals of surgical oncology

    2021  Volume 28, Issue 3, Page(s) 1320–1325

    Abstract: Introduction: Oncotype DX: Methods: Using the National Cancer Data Base (NCDB), we identified patients diagnosed with T1-T2, clinically N1/N2, estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER +/HER2 -) invasive ductal ... ...

    Abstract Introduction: Oncotype DX
    Methods: Using the National Cancer Data Base (NCDB), we identified patients diagnosed with T1-T2, clinically N1/N2, estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER +/HER2 -) invasive ductal carcinoma of the breast between 2010 and 2015. Patients with an Oncotype DX
    Results: This study included a total of 158 women. RS was low in 56 (35.4%) patients, intermediate in 62 (39.2%) patients, and high in 40 (25.3%) patients. The majority of patients presented with clinical N1 disease (89.2%). Axillary pCR was achieved in 23 (14.6%) patients. When stratifying patients with axillary pCR by RS, 11 (47.8%) patients had a high RS, 6 (26.1%) patients had an intermediate RS, and 6 (26.1%) patients had a low RS. Comparing cohorts by RS, 27.5% of patients with high RS tumors had an axillary pCR, compared with only 9.7% in the intermediate RS group, and 10.7% in the low RS group (p = 0.0268).
    Conclusion: Our findings demonstrate that Oncotype DX
    MeSH term(s) Breast Neoplasms/diagnosis ; Breast Neoplasms/drug therapy ; Breast Neoplasms/metabolism ; Chemotherapy, Adjuvant ; Female ; Humans ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/metabolism ; Predictive Value of Tests ; Receptor, ErbB-2/metabolism ; Receptors, Estrogen/metabolism
    Chemical Substances Receptors, Estrogen ; ERBB2 protein, human (EC 2.7.10.1) ; Receptor, ErbB-2 (EC 2.7.10.1)
    Language English
    Publishing date 2021-01-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-020-09382-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4042: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Axillary lymph node dissection in the era of immediate lymphatic reconstruction: Considerations for the breast surgeon.

    Mele, Alessandra / Fan, Betty / Pardo, Jaime / Emhoff, Isha / Beight, Leah / Serres, Stephanie K / Singhal, Dhruv / Magrini, Leo / James, Ted A

    Journal of surgical oncology

    2021  Volume 123, Issue 4, Page(s) 842–845

    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Female ; Humans ; Lymph Node Excision/adverse effects ; Lymph Node Excision/methods ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Lymphatic Metastasis ; Middle Aged ; Reconstructive Surgical Procedures ; Retrospective Studies ; Sentinel Lymph Node Biopsy/methods
    Language English
    Publishing date 2021-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82063-5
    ISSN 1096-9098 ; 0022-4790
    ISSN (online) 1096-9098
    ISSN 0022-4790
    DOI 10.1002/jso.26355
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    Zs.A 706: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article: Is There a Moral Right to Nonmedical Vaccine Exemption?

    Emhoff, Isha Ann / Fugate, Ellen / Eyal, Nir

    American journal of law & medicine

    2016  Volume 42, Issue 2-3, Page(s) 598–620

    Abstract: A recent measles outbreak in the United States was linked to a single source, yet it spanned eighteen jurisdictions and infected 121 people. ...

    Abstract A recent measles outbreak in the United States was linked to a single source, yet it spanned eighteen jurisdictions and infected 121 people.
    Language English
    Publishing date 2016-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 753043-2
    ISSN 0098-8588
    ISSN 0098-8588
    DOI 10.1177/0098858816658281
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1334: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Impact of geographic distribution of accredited breast centers.

    Pardo, Jaime A / Fan, Betty / Valero, Monica / Alapati, Amulya / Emhoff, Isha / Mele, Alessandra / Serres, Stephanie / Davis, Roger B / James, Ted A

    The breast journal

    2020  Volume 26, Issue 11, Page(s) 2194–2198

    Abstract: The National Accreditation Program for Breast Centers (NAPBCs) is dedicated to improving the quality of care in patients with breast disease. Geographic distribution of health care resources is an important measure of quality, yet little is known ... ...

    Abstract The National Accreditation Program for Breast Centers (NAPBCs) is dedicated to improving the quality of care in patients with breast disease. Geographic distribution of health care resources is an important measure of quality, yet little is known regarding breast center allocation patterns concerning population demand and impact on health outcomes. The purpose of this study was to analyze the distribution of NAPBC programs in the United States (USA) and evaluate the impact on breast cancer survival. Using the Centers for Disease Control and Prevention 2014 data base, we identified the incidence and mortality rates for breast cancer by state. We also determined the concentration of NAPBC programs in each state (ie, the number of centers per 1000 cases of breast cancer). Data were analyzed using Spearman's (nonparametric) rank correlation coefficients. Five hundred and seventy NAPBC programs were identified. Across the United States, there was a mean of 2.8 programs/1000 breast cancer diagnoses. A positive correlation (r = .45) between breast cancer incidence and the number of programs was identified (P = .0009). There was no statistically significant correlation between mortality and NAPBC program concentration (r = -0.20, P = .16). NAPBC-accredited program distribution within the United States correlates with breast cancer incidence per state. However, the number of NAPBC programs per state did not alter overall mortality rates. Added measures beyond survival, as well as further insight into referral patterns to NAPBC programs, may be required to demonstrate the value and impact of NAPBC accreditation.
    MeSH term(s) Accreditation ; Breast Diseases ; Breast Neoplasms/epidemiology ; Breast Neoplasms/therapy ; Databases, Factual ; Female ; Humans ; Referral and Consultation ; United States/epidemiology
    Language English
    Publishing date 2020-10-13
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1289960-4
    ISSN 1524-4741 ; 1075-122X
    ISSN (online) 1524-4741
    ISSN 1075-122X
    DOI 10.1111/tbj.14073
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    Zs.A 4483: Show issues Location:
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  6. Article ; Online: Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES).

    Emhoff, Isha Ann / Lee, Grace Clara / Sylla, Patricia

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society

    2014  Volume 26 Suppl 1, Page(s) 29–42

    Abstract: The surgical management of rectal cancer has evolved over the past century, with total mesorectal excision (TME) emerging as standard of care. As a result of the morbidity associated with open TME, minimally invasive techniques have become popular. ... ...

    Abstract The surgical management of rectal cancer has evolved over the past century, with total mesorectal excision (TME) emerging as standard of care. As a result of the morbidity associated with open TME, minimally invasive techniques have become popular. Natural orifice translumenal endoscopic surgery (NOTES) has been held as the next revolution in surgical techniques, offering the possibility of 'incisionless' TME. Early clinical series of transanal TME with laparoscopic assistance (n = 72) are promising, with overall intraoperative and postoperative complication rates of 8.3% and 27.8%, respectively, similar to laparoscopic TME. The mesorectal specimen was intact in all patients, and 94.4% had negative margins. There was no oncological recurrence in average-risk patients at short-term follow up, and 2-year survival rates in high-risk patients were comparable to that after laparoscopic TME. These preliminary studies demonstrate transanal NOTES TME with laparoscopic assistance to be clinically feasible and safe given careful patient selection, surgical expertise, and appropriate procedural training. We are hopeful that with optimization of transanal instruments and surgical techniques, pure transanal NOTES TME will become a viable alternative to open and laparoscopic TME in the future.
    MeSH term(s) Adenocarcinoma/surgery ; Anal Canal ; Clinical Trials as Topic ; Humans ; Natural Orifice Endoscopic Surgery/methods ; Patient Selection ; Rectal Neoplasms/surgery
    Keywords covid19
    Language English
    Publishing date 2014-01
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 1171589-3
    ISSN 1443-1661 ; 0915-5635
    ISSN (online) 1443-1661
    ISSN 0915-5635
    DOI 10.1111/den.12157
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    Zs.A 3854: Show issues Location:
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  7. Article ; Online: Malpractice Cases in Breast Surgery: An Assessment of Litigation Involving Surgeons.

    Fan, Betty / Pardo, Jaime / Yu-Moe, C Winnie / Janes, Margaret / Falcone, Bianca / Valero, Monica G / Serres, Stephanie K / Emhoff, Isha / James, Ted A

    Annals of surgical oncology

    2021  Volume 28, Issue 13, Page(s) 8109–8115

    Abstract: Introduction: Improving patient safety and quality are priorities in health care. The study of malpractice cases provides an opportunity to identify areas for quality improvement. While the issues surrounding malpractice cases in breast cancer are often ...

    Abstract Introduction: Improving patient safety and quality are priorities in health care. The study of malpractice cases provides an opportunity to identify areas for quality improvement. While the issues surrounding malpractice cases in breast cancer are often multifactorial, there are few studies providing insight into malpractice cases specifically related to common breast cancer surgical procedures. We sought to characterize the factors in liability cases involving breast cancer surgery.
    Methods: Closed cases from 2008 to 2019 involving a breast cancer diagnosis, a primary responsible service of general surgery, surgical oncology, or plastic surgery, and a breast cancer procedure were reviewed using data from the Controlled Risk Insurance Company (CRICO) Strategies Comparative Benchmarking System database, a national repository of professional liability data.
    Results: A total of 174 malpractice cases were reviewed, of which 41 cases were closed with payment. Plastic surgeons were most commonly named (64%, 111/174), followed by general surgeons (30%, 53/174), and surgical oncologists (6%, 10/174). The most common allegation was error in surgical treatment (87%, 152/174), and infection, cosmetic injury, emotional trauma, foreign body, and nosocomial infections represented the top five injury descriptions. On average, indemnity payments were larger for high clinical severity cases. Technical skills, followed by clinical judgment, were the most commonly named contributing factors. The average payment per case was $130,422.
    Conclusion: Malpractice cases predominantly involve technical complications related to plastic surgery procedures. Better understanding of the malpractice environment involving surgical procedures performed for breast cancer may provide practical insight to guide initiatives aimed at improving patient outcomes.
    MeSH term(s) Breast Neoplasms/surgery ; Female ; Humans ; Malpractice ; Oncologists ; Patient Safety ; Retrospective Studies ; Surgeons
    Language English
    Publishing date 2021-06-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-021-10236-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4042: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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