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Objectives Diverticulitis is a common cause of hospitalization. The use of substances such as tobacco and alcohol can predispose patients to diverticulitis, and smoking is also associated with an increased risk of diverticulitis complications. Cannabis availability is growing in the United States, but there is a lack of data on the effects of cannabis use on the outcomes of diverticulitis. Thus, we investigated the effects of cannabis use on diverticulitis outcomes. Methods A retrospective analysis was conducted using 2014 data from the National Inpatient Sample. Patient demographics and outcomes of diverticulitis were compared between the groups with and without a history of cannabis use. The outcomes of interest were inpatient mortality, length of stay, total hospital charge, intestinal obstruction, shock/hypotension, colectomy, intestinal abscess, intestinal fistula, and intestinal perforation. Results Among 48,214 patients with diverticulitis, 447 patients had a history of cannabis use. Patients with a history of cannabis use were younger, more likely to be male, less likely to be White, had a lower Charlson Comorbidity Index, and had shorter hospital stays. There were no significant differences in inpatient mortality and total hospital charge. After adjusting for age, sex, race, and the Charlson Comorbidity Index, cannabis use was an independent risk factor for intestinal obstruction in patients hospitalized with diverticulitis. There were no statistically significant differences in other outcomes. Conclusions This study indicates that patients hospitalized with diverticulitis with a history of cannabis use are more likely to have an intestinal obstruction. Inhibition of gastrointestinal motility by cannabis in the setting of diverticular inflammation may explain this finding.
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BACKGROUND: Ever since orthopaedic surgery was cited as the specialty with the lowest percentage of women, research has geared toward better understanding where lapses occur and ensured that equitable opportunities exist within the field. PURPOSE/HYPOTHESIS: To analyze the 5-year trend in the academic leadership roles of female versus male orthopaedic surgeons at the AOSSM Annual Meeting. We hypothesized that a nationally representative proportion of female surgeons would hold academic leadership positions and that this figure would increase during the study period. STUDY DESIGN: Cross-sectional study. METHODS: Publicly available AOSSM Annual Meeting brochures from 2015 to 2019 were analyzed. Moderators and course instructors with doctor of medicine (MD) or doctor of osteopathic medicine (DO) degrees were included. Gender-neutral names were researched as needed for gender clarification. The gender composition of total moderators and total course instructors was calculated and trended over the 5-year period. Statistics from the Association of American Medical Colleges (AAMC) in 2017, the median of the study period, were used for comparison with total active sports medicine orthopaedic surgeons. RESULTS: Women represented 5.9% of moderators and course instructors at the AOSSM Annual Meeting from 2015 to 2019. The percentage of female moderators increased from 6.0% in 2015 to 8.6% in 2019, and the percentage of female course instructors increased from 3.4% in 2015 to 5.6% in 2019. After adjusting for dual contributions by a single woman to both roles, we found that 6.7% of total moderators and course instructors over the 5-year study period were women (6.3% in 2015, 7.7% in 2019). This was close to the 6.6% rate of female sports orthopaedic surgeons reported by the AAMC in 2017. CONCLUSION: Using moderator and instructor involvement at the AAOSM Annual Meetings as a proxy for involvement in academia, we found evidence to support gender parity in the orthopaedic subspecialty of sports medicine. This example of a culture of equity and inclusion may be an encouraging example to cite in recruitment efforts for prospective medical student applicants and endorsing current female surgeons to seek leadership roles in academia.
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BACKGROUND: Recent studies indicate that women are substantially underrepresented as orthopaedic surgeons and residents compared with other specialties in medicine and medical school. The reasons for this are multifactorial and not completely understood, but previous studies suggest that women may be attracted to fields in which they have female role models. Given that women interested in academia and research may use female editorship and authorship as a proxy for female representation in orthopaedic surgery, we wanted to examine the proportion of women represented in orthopaedic journals and determine if it reflects the distribution of women in orthopaedic surgery as a field. We further wanted to understand if this representation has changed over time in the setting of a slowly shifting gender landscape within orthopaedic surgery. QUESTIONS/PURPOSES: (1) How are women orthopaedic surgeons and residents represented in orthopaedic journals compared with men? (2) Have these proportions changed in the past two decades in light of relatively new efforts to recruit women to the field of orthopaedic surgery? METHODS: The gender composition of editorial boards and first and last authors were obtained from the 1997, 2007, and 2017 volumes of the following journals: The Journal of Bone & Joint Surgery (JBJS), the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), and Clinical Orthopaedics and Related Research® (CORR®). Gender neutral names were searched to obtain a picture to ensure proper tallies. RESULTS: The total combined amount of women first and last authors increased from 88 of 1450 (6%) in 1997 to 152 of 1912 (8%) in 2007 to 723 of 5391 (13%) in 2017. Similarly, three of 113 (3%) editorial board members were women in 1997, three of 105 (3%) were women in 2007 and 10 of 107 (9%) editors were women in 2017. Of note, 0 out of 9 editors-in-chief were women. CONCLUSIONS: Based on the current percentage of women orthopaedic surgeons and residents, women are represented equally or in greater numbers as editors and authors in JAAOS, JBJS, and CORR. This may be in part due to women orthopaedic surgeons entering academic medicine at a greater rate than males. CLINICAL RELEVANCE: Orthopaedic surgeons serving as mentors to prospective female applicants can cite female representation on editorial boards and as authors as an example of gender parity in the field. Additionally, active orthopaedic surgeons who are women interested in these leadership positions should be encouraged that these opportunities exist, regardless of gender.
