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This was a truly exciting year for. JAMA Surgery. , as the journal experienced several notable accomplishments. First, as evidence of the high-quality scientific publications in. JAMA Surgery. , the impact factor rose from 7.96 to 8.5. This remarkable achievement reflects the hard work of our authors, peer reviewers, and editorial team. The impact factor of 8.5 positions. JAMA Surgery. as the number 2 ranked surgery journal of 200 journals worldwide, a tremendous accomplishment.
To the Editor The multicenter study by Xu et al concluding that recurrence after hepatocellular carcinoma (HCC) resection is associated with sex deserves robust comment. The sophisticated multivariate Cox regression analyses failed to account for smoking status (dose and duration and also cessation after resection) despite smoking being an independent and a dose-related contributing factor for HCC all over the world, including Asia. The mean relative risk was 1.5 but exposure was high, specifically in China, where the prevalence of smoking was almost 50% in men, 22-fold that of women. In a large European cohort, the population attributable fraction for tobacco use in HCC was 48%, more than twice the population attributable fraction of the s.
In Reply We thank Braillon and Regimbeau for their interest in our 2018 publication titled “Risk Factors, Patterns, and Outcomes of Late Recurrence After Liver Resection for Hepatocellular Carcinoma: A Multicenter Study From China.” As Braillon and Regimbeau highlighted in their letter, smoking may be an important contributing factor for the development of hepatocellular carcinoma (HCC). We agree with this point, but we believe that smoking should not be considered as the main cause for HCC development, which did not contribute much to the occurrence of late recurrence after curative resection for HCC. Considering the retrospective nature of our study, all data in our study came from a multicenter database, which actually documented medical.
To the Editor We read with interest the recent article by Krastev et al relating to long-term follow-up of autologous fat transfer (AFT) vs conventional breast reconstruction and their association with breast cancer recurrence. It was notable that patients undergoing AFT had better disease-free and overall survival compared with those who did not undergo AFT. The authors have suggested this may be related to positive benefits of AFT or, more likely, that patients selected for AFT had a more favorable prognosis based on other confounding factors not specifically studied.
In the Research Letter "US Emergency Department Encounters for Firearm Injuries According to Presentation at Trauma vs Nontrauma Centers," published online January 23, 2019, the corresponding author’s second affiliation was corrected to replace "Yale–Drug Abuse, Addiction, and HIV Research Scholars Program" with "Yale–Drug Use, Addiction, and HIV Research Scholars Program."
While we know that bariatric surgery is the most effective treatment for obesity, there are well-documented disparities between ethnic and income groups with regards to access and outcomes. Most studies agree that when comparing black patients with white patients, black patients have higher rates of complications and hospital utilization, with decreased resolution of comorbidities. Whether this is associated with genetics, socioeconomic factors, cultural differences, types of procedure performed, clinician bias, and/or insurer bias remains to be determined.
In Reply On behalf of my colleagues, I thank Gnecchi-Ruscone and Restifo Pecorella for their letter and questions about our research. We agree that the dosage of aspirin is important, but as explained in the Limitations section of our article, we unfortunately do not have that information in the registry. As part of our education program at our quality meetings, we advocated for the use of low-dose aspirin, as recommended in the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed, but we do not know what dose was actually given. In addition, as is the case with all discharge medications, compliance may be an issue, so our study is based on the surgeon’s recommended or prescribed anticoagulation postoperatively.
To the Editor The article by Hood et al states that aspirin offers protection from postoperative venous thromboembolism following total knee arthroplasty that is not inferior to the protection provided by anticoagulants. To achieve efficacy, vitamin K antagonists are given according to the international normalized ratio value, while direct anticoagulants are usually given in fixed dosages. On the other hand, aspirin efficacy is more variable and is difficult to assess in the normal clinical routine. Enteric-coated vs non–enteric-coated tablets, differences in doses, and the influence of body weight all combine to affect the results, in addition to the unpredictable nonadherence of the patients. For these reasons, we would like to know more

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