A Manzella

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Researchers looked at whether people living in disadvantaged neighborhoods were less likely to have their thyroid surgery performed by experienced surgeons (those doing 50+ surgeries annually). They analyzed nearly 376,000 thyroid surgeries and found that patients from communities with worse education and healthcare resources were significantly less likely to see high-volume surgeons—the ones who typically have better outcomes—while uninsured patients and men were also less likely to get these experienced surgeons. This matters because getting surgery from an experienced surgeon leads to fewer complications, and right now the healthcare system is failing patients from poorer, less-educated communities by funneling them toward less-experienced surgeons.

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Researchers examined whether expanding Medicaid (government health insurance for low-income people) helped patients get parathyroid surgery at the best hospitals. They analyzed data from nearly 32,000 patients and found that Medicaid expansion significantly improved access—Medicaid patients in expansion states were 12-21 times more likely to receive surgery at high-quality, high-volume centers compared to those in non-expansion states. However, the study revealed a troubling gap: uninsured and Medicaid patients overall were still much more likely to have surgery at lower-quality, low-volume hospitals compared to privately insured patients, even after expansion. Medicare patients fared reasonably well at high-volume centers. The bottom line is that while Medicaid expansion helped, insurance status remains a major barrier to accessing the best surgical care—and patients without insurance or with Medicaid still face significant disadvantages compared to the privately

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Researchers compared how often patients needed a second surgery after having either half their thyroid removed (lobectomy) or their entire thyroid removed for cancer, before and after 2015 guidelines made the less-invasive half-removal option more acceptable. They found that while doctors increasingly chose the half-removal option after 2015, patients who had it needed fewer immediate second surgeries (likely because doctors got better at doing the procedure right the first time), and they weren't any more likely to need surgery later for cancer recurrence compared to patients who had their whole thyroid removed. The finding matters because it shows that the less-invasive surgery can be a safe and effective option for patients with low-risk thyroid cancer, potentially allowing them to avoid the side effects of removing their entire thyroid while not compromising their long-term outcomes.

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Researchers studied ultrasound images of 119 lymph nodes in patients with thyroid cancer to figure out which visual signs best indicate the cancer has spread to those nodes. They found that four specific signs together—enlarged size, lost fatty tissue in the center, disrupted internal structure, and tiny calcium deposits—are the most reliable combination for identifying cancerous nodes, correctly identifying cancer 88% of the time when all four signs are present. This matters because doctors currently use these ultrasound signs to decide whether to biopsy suspicious lymph nodes, but there's been no clear consensus on which signs matter most; this research provides a concrete answer that could help doctors make faster, more accurate decisions about which patients actually need biopsies.

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Researchers studied whether expanding Medicaid (health insurance for low-income people) helped patients get thyroid surgery at the best hospitals—ones that perform many surgeries and have better outcomes. They found that while Medicaid expansion did get more low-income people insured, those patients still ended up having surgery at smaller, lower-volume hospitals instead of the best ones, whereas privately insured patients went to high-volume centers. This matters because patients who have surgery at experienced, high-volume hospitals recover better and have fewer complications, so Medicaid patients are being disadvantaged even with expanded insurance coverage.

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Researchers tracked cancer surgeries for the pancreas and liver during COVID-19 to see if the pandemic disrupted treatment. They found that pancreatic cancer surgeries continued at normal rates throughout the pandemic, while liver cancer surgeries dropped briefly at the start but quickly returned to normal levels—and more pancreatic cancer patients received chemotherapy before surgery during the pandemic. This matters because it shows hospitals prioritized cancer operations during COVID-19, meaning patients with these deadly cancers didn't face major treatment delays, though the increased use of pre-surgery chemotherapy suggests doctors may have changed their approach to managing these patients.

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Researchers analyzed 68 lawsuits filed against surgeons for malpractice after thyroid surgery between 1949 and 2022, looking at what factors determined whether surgeons won or lost. Surgeons won about 78% of cases overall, and won even more often (92%) when cases were tried at academic hospitals or handled by surgeons with specialized endocrine training—they also won more frequently in states with legal protections for doctors. The most common problem leading to lawsuits was nerve damage during surgery, and when patients did win, they received damage awards averaging around $570,000.

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Researchers looked at whether hospitals that perform more of a specific cancer surgery (called CRS/HIPEC, which involves removing tumors and bathing the abdomen with heated chemotherapy) get better results than hospitals that do fewer of these operations. They examined over 5,000 procedures across 149 hospitals between 2020 and 2022. They found no meaningful difference in patient outcomes—including complications, deaths, hospital stays, or readmissions—regardless of whether a hospital performed 4 cases a year or 47 cases a year. The only minor difference was that low-volume hospitals sent more patients to the ICU after surgery, but this didn't translate to worse overall results. This matters because it shows that for this particular procedure, hospitals don't need to do hundreds of these surgeries to get good results—experience at a basic level is apparently enough, at least in well-equipped academic medical centers.

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Researchers examined surgery records from 515 U.S. hospitals between 2019 and 2022 to see how COVID-19 affected surgeries on the thyroid, parathyroid, and adrenal glands. When the pandemic started in early 2020, most of these surgeries dropped sharply, but patients needing emergency adrenal cancer surgery still got treated; outpatient procedures bounced back to normal levels within a couple of years, while hospital-based thyroid and parathyroid surgeries remained below pre-pandemic numbers through 2022. This matters because patients waiting for these surgeries faced delays and complications, and the data shows that the healthcare system's recovery was uneven—some patients got faster access to care than others depending on the type of surgery and whether it required overnight hospitalization.

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Researchers examined how COVID-19 affected surgery rates for gut cancers across the United States from 2019 to 2022, analyzing nearly 96,000 operations on the esophagus, stomach, colon, and rectum. They found that surgery for esophageal and rectal cancers dropped significantly and stayed low throughout the pandemic, while stomach and colon cancer surgeries initially fell but bounced back to normal levels within a few months. This matters because delays in cancer surgery can allow tumors to grow and spread, potentially worsening patient outcomes and survival rates.

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Researchers ran a 2-week intensive training program for 30 medical students preparing to become surgeons and measured whether it helped them feel more confident and less like frauds in their abilities. The training significantly boosted students' confidence in surgical skills and knowledge, but it did nothing to reduce imposter syndrome—the nagging feeling that they don't actually deserve their success and will be exposed as incompetent. Women started the program feeling more like frauds than men did, and people who had taken time away from medicine showed stronger signs of imposter syndrome overall.

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Researchers examined whether expanding Medicaid (government health insurance for low-income people) under the Affordable Care Act changed who could get surgery for benign thyroid, parathyroid, and adrenal gland problems. They found that Medicaid expansion did increase insurance coverage overall, but Medicaid patients were less likely to receive surgery for parathyroid and adrenal conditions compared to privately insured patients—revealing that insurance gaps still exist even after the expansion. This matters because it shows that simply giving people insurance isn't enough; there are still barriers preventing some patients from accessing the surgeries they need.

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Researchers tested a rapid DNA machine (ANDE 6C) designed to quickly identify people from bone, teeth, and muscle tissue—especially useful after disasters when bodies are hard to identify. The machine worked best on teeth samples (50% success) but performed poorly on muscle tissue (0% success), yet it still processed samples much faster and more simply than traditional lab methods. The machine could become a practical tool for identifying disaster victims and unknown remains in laboratories, but it requires special equipment and trained technicians to prepare the tissue samples beforehand—meaning it won't work as a field-portable solution, and labs would need backup samples available in case the first attempt fails.

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Doctors who perform MRI scans use gadolinium contrast dye to get better images, but experts were concerned that this dye might accumulate in the brain and body over time. This study surveyed 10 experienced radiologists in Brazil about their practices with different types of gadolinium dyes to figure out the safest way to use them. The experts agreed that gadolinium is safe for acute reactions and serious kidney problems are rare, but they preferred using certain types of gadolinium (macrocyclic agents) over others and recommended using smaller doses to reduce the buildup in the body. Most experts also agreed not to use it in pregnant patients. The main takeaway is that doctors need better training to understand gadolinium risks so they use only the amount necessary and choose the safest types available.

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Researchers tested whether a rapid DNA machine used by police could work with standard cotton swabs instead of the special swabs it was designed for. They found that the machine's success rate dropped significantly when conventional swabs were used instead of the manufacturer's swabs, though they suggest a modified procedure might help recover some of that lost accuracy.

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Researchers reviewed 19 studies from New Zealand, Iceland, and Italy examining whether people living near geothermal power plants that produce heat and electricity suffer health problems from the gases these plants release, particularly hydrogen sulfide. They found that exposure to low levels of hydrogen sulfide increases respiratory problems, asthma, lung cancer, and respiratory disease deaths, while high-level exposure paradoxically shows lower cancer rates but more hospitalizations for breathing and heart problems. The evidence suggests geothermal emissions do harm human health, but the research has major weaknesses—most studies looked at entire communities rather than tracking individuals—so better monitoring systems and stricter air quality controls around these plants are needed to protect public health.

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Researchers used baker's yeast as a model to understand how a cholera-causing bacterium called Vibrio cholerae attacks human cells using a protein called VopX. They found that VopX damages cells by triggering a stress response pathway that ultimately prevents cells from growing properly. Because this same stress-response pathway exists in human cells (where it controls cell death and survival), VopX likely causes disease by hijacking this critical cellular control system.

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Researchers studied a bacterial survival protein called VapC1 by deliberately breaking it in different ways to understand which parts make it work as a toxin that helps bacteria enter a dormant, hard-to-kill state during infections. They found that specific regions of the protein, especially around its active site where it does its damage, are critical for its toxic function, and that a partner protein called VapB1 can still bind to and disable even partially broken versions of the toxin. These discoveries reveal how bacteria build the molecular machinery that lets them hibernate and survive antibiotic treatment, which could eventually help doctors design better ways to fight stubborn infections.

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Researchers reviewed imaging scans to document how lymphoma (a blood cancer) appears when it spreads to organs and tissues in the belly and pelvis. They found that lymphoma most commonly affects the spleen and liver, but can show up almost anywhere in the abdomen—including the stomach, pancreas, and kidneys—and that these cancers look different depending on where they appear. Doctors need to recognize these different appearances on scans because imaging is how they diagnose lymphoma and track whether treatment is working, without needing to do surgery or biopsies.

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Researchers used brain scans to look for hidden damage in 34 young people who had been infected with a parasitic disease called schistosomiasis mansoni but had no obvious brain symptoms. They found that nearly 60% of these patients had abnormal patterns on their brain scans, including small spots of damage in the brain's white matter and changes in a deep brain region called the basal ganglia. This matters because it shows that this parasitic infection can cause brain damage even when patients feel fine, suggesting doctors should monitor the brains of infected people more carefully and that the disease may cause more widespread harm than previously thought.

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Researchers tested whether giving HIV-infected youth one or two doses of a meningitis vaccine produced better immune protection. They found that two doses—given six months apart—worked significantly better than one dose, with two to five times more youth developing protective antibodies against the disease. The vaccine worked well in youth with stronger immune systems, but performed poorly in those with very weak immune systems, even when given twice. **Why it matters:** This research shows doctors should give two doses of this meningitis vaccine to HIV-infected patients with adequate immune function to maximize protection, but also highlights that severely immunocompromised patients need additional strategies since the vaccine alone doesn't protect them adequately.

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Researchers tested whether a meningococcal vaccine was safe and effective in HIV-infected children ages 2-10, giving some children two doses and tracking their immune response over time. The vaccine was safe with only mild side effects, and most children developed protective immunity after vaccination—though protection against two of the four disease types (serogroups A and C) faded significantly within a year. These results show that HIV-infected children can safely receive this vaccine and benefit from it, but they may need booster shots more frequently than other children to maintain protection against all disease types.

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Surgeons sometimes accidentally leave cotton sponges or gauze inside patients' bodies during operations, creating a problem called a gossypiboma. These forgotten foreign objects can cause serious health issues and are hard to diagnose because they look like tumors or infections on medical imaging scans. This review teaches doctors how to recognize gossypibomas using different imaging techniques so they can identify and remove them before they cause harm.

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Doctors accidentally leave surgical materials like sponges and gauze inside patients during operations, and these left-behind items are called gossypibomas. This educational module teaches doctors how to recognize these objects on medical imaging scans so they can identify them in patients and remove them before they cause serious harm.

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Schistosomiasis is a parasitic worm infection that damages the liver by leaving eggs in blood vessels, which eventually causes scarring and cirrhosis. The two main types of this infection show different patterns on medical imaging: one creates thick bands around the central liver blood vessels, while the other creates a distinctive "turtle-back" pattern of scarring in the outer liver with calcified eggs. This infection commonly leads to serious complications like an enlarged liver and spleen, liver failure, high blood pressure in the liver's blood vessels, and bleeding from enlarged veins in the stomach and throat.

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Researchers tested whether a hormone called cerulein could improve a simple blood test that measures bile acids—substances the liver produces—to diagnose liver disease. They compared this hormone combined with eating a fatty meal against just eating the fatty meal alone, testing both healthy people and those with liver disease. The fatty meal alone was the most reliable way to diagnose liver disease, but adding cerulein made the test results change more dramatically in liver patients, which could be useful for people who had their gallbladders removed or have gallbladder problems.