
Carlos E. Diaz-Castrillon, MD MSc retweeted
For 100+ years, Annals of Surgery has published research that changed how surgery is practiced. Starting tomorrow, #AnnalsTop100 highlights the most-cited articles in our history, with a new one every week. Follow along.
Carlos E. Diaz-Castrillon, MD MSc retweeted
Top 50 universities in the world for Clinical Medicine, based on the U.S. News Best Global Universities 2026-2027 rankings. *
Carlos E. Diaz-Castrillon, MD MSc retweeted
The football AC Milan are producing under Ruben Amorim is RIDICULOUS. ⚡️
Carlos E. Diaz-Castrillon, MD MSc retweeted
Robotic vs. Laparoscopic Cholecystectomy: What Our New Multihospital Study Reveals
At PittSurgery, we're always asking the same question before every operation: what's actually best for this patient? A new study led by @AmerZureikatMD
analyzing 1,828 patients across 8 hospitals (2020–2021), offers some of the clearest evidence yet on when robotic surgery adds real value in gallbladder removal — and when it doesn't.
Key findings:
-Robotic cholecystectomy (RC) showed lower rates of adverse outcomes overall (3.3% vs. 8.7% for laparoscopic) and shorter hospital stays.
-The advantage was concentrated in high-risk cases (Nassar score ≥7) and patients with elevated BMI — in these groups, laparoscopic surgery carried significantly higher odds of complications or conversion to open surgery.
-For low/intermediate-risk patients with lower BMI, both approaches performed comparably.
-The catch: RC cost roughly $2,200–$2,400 more per case than LC, regardless of risk level.
Dr. Zureikat's team also validated a preoperative risk calculator (AUC ~0.74–0.75) to help surgeons match the right approach to the right patient.
Robotic surgery isn't universally "better" — its clinical edge shows up specifically in technically complex or higher-risk cases. For most routine cholecystectomies, laparoscopic surgery remains equally safe and far more cost-effective. Smarter patient selection — not blanket adoption of new technology — may be the real path to better outcomes and resource stewardship.
What's your take: should risk-stratified guidelines like this shape hospital purchasing and OR scheduling decisions?
JAMA Surgery: Published today
Published Online: September 16, 2026. doi:10.1001/jamasurg.2026.4128
#PittSurgery #JAMASurgery #RoboticSurgery#LaparoscopicSurgery #Cholecystectomy#SurgicalInnovation #PatientSafety#ClinicalResearch #EvidenceBasedMedicine#SurgicalOutcomes
Carlos E. Diaz-Castrillon, MD MSc retweeted
How bad was life before modern science, technology, and economic growth? Awful.
The example I will use in class this Wednesday is Henry Clay (1777-1852). He was one of the most powerful men of his time in the U.S., not just among the elite but among the elite of the elite: Speaker of the House, Secretary of State, Senator, and three-time presidential candidate. He was also rich and a large slaveholder. The U.S. was among the richest countries in the world (perhaps only behind Great Britain) and among the most technologically advanced. And we are not talking about the early Middle Ages, but about the first half of the 19th century.
Given the constraints of his time, he had nearly everything within reach.
Clay and his wife, Lucretia (both in the photograph), had eleven children: six daughters and five sons. He buried all six daughters. By 1835, all were dead: two as infants, two as children, two as young mothers. He also buried a son in a war his father had opposed. Another son, Theodore, fractured his skull as a child, but since nobody could treat him, he spent decades in an asylum in Lexington.
Think about this for a second: seven children dead and one handicapped out of eleven, in the first half of the 19th century, among the elite of the elite, in one of the richest and most advanced places on the planet.
And I was angry yesterday because my cell phone coverage in Toddington (England) was poor.
Carlos E. Diaz-Castrillon, MD MSc retweeted
Let me make a few important qualifications:
1. First and foremost, the COIs: One of the authors is the CEO of Curai Health, which unsurprisingly is a AI physician startup. Another author is the investor in Curai Health.
2. "Published" is actually an overestimation of the qualitative threshold of this "review": This is, in fact and contrary to the paper's claim, NOT a "review" or "of all published articles on AI in medicine since Jan 1 2024." There is no review methodology, databases searched, search queries/strings, inclusion/exclusion criteria, PRISMA structure, risk-of-bias assessments, preregistered protocol, or really anything scientific.
3. Cherry-picked epistemology: When a paper showed physicians or physicians + AI > AI, they rationalize it as "old LLM model" or "sub-optimal prompting." Vice versa is, of course, evidence AI > physician. Its a unidirectional epistemic criteria.
4. Endpoints are proxies rather than real clinical outcomes: Correct diagnosis/appropriate test/guide-line concordant treatment/simulated cost/top-1 diagnosis vs. mortality rate/re-hospitalization rate/adverse drug events/morbidity/healthcare utilization rate
5. The review is misleading: they cite an RCT with their claim that "AI is better at chronic management for conditions including diabetes" but in that RCT before the AI was activated, each patient's diabetes clinician selected the protocol... So in other words, it was a human-based AI management
6. The review is again misleading, and possibly confused: They cite a meta-analysis with their claim that "When AI is better than humans, adding a human can actually make AI performance worse." This paper covered 106 experiments, of which only about 20 were medicine related. And here's the kicker... a human always signed off on the AI-generated medical plans.
tl;dr: Dad funds son's health startup and write an opinion piece. Embarrassingly low scientific comprehension by the authors but they're the equivalent of 'non-technical' in this domain, as they like to say in Silicon Valley, so we'll give them a pass. But, @JAMA_current do better? I get it's a perspective but like... at least make sure the studies cited say what the perspective cites them for?
@CuraiHQ if need some consulting before waging war against physicians, I am open for a curbside peer-review next time
A case for AI alone —autonomous medical care @JAMA_current, by @ZekeEmanuel @vkhosla @nealkhosla @AbeBakerButler
jamanetwork.com/journals/jam…
But this remains unproven; none of the studies were in real world medicine.
We've written about this potential, too. @pranavrajpurkar
gift link
nytimes.com/2025/02/02/opini…
Carlos E. Diaz-Castrillon, MD MSc retweeted
Among >1.8 million patients undergoing cardiac surgery with cardiopulmonary bypass, lower intraoperative temperature was not associated with reduced postoperative stroke, challenging the routine use of hypothermia for neuroprotection. ovid.com/10.1097/SLA.0000000…
Carlos E. Diaz-Castrillon, MD MSc retweeted
Mauricio Pochettino: “La conexión con el juego viene a través de las libertades que uno siente y con la felicidad de tomar decisiones dentro del campo sin pensar en consecuencias. Si la consecuencia es que si no hago un buen pase o si no marco un gol, la gente va a estar muy decepcionada... No se puede jugar así al fútbol. Cada mensaje de la gente que te quiere es para que demos lo que sabemos hacer con total libertad porque confían en nosotros, para que el equipo salga y disfrute, y juegue sin pensar, y cometa errores. Si estás pensando en la consecuencia de tus actos o de tus acciones, es muy difícil conectar con la naturaleza del fútbol”.
Carlos E. Diaz-Castrillon, MD MSc retweeted
Imagínese uno seguir diciendo que José Manuel Restrepo es un académico o un tipo serio con todas las boberías y absurdos que anda vendiendo por ahí.
Macrosystem Factors and Perioperative Outcomes in Adult Congenital Heart Surgery: An Analysis of the STS Databases evermed.short.gy/3bOB61 via @STS_OnDemand @STS_CTsurgery @UPMC_CTSurgery #ACHD
#HEART #medspace #someforsurgery @AATSHQ @ISACHD 163.… | The American Association for Thoracic Surgery | AATS aats.org/resources/age-relat…
Carlos E. Diaz-Castrillon, MD MSc retweeted
Drs. Kei Kobayashi, Irsa Hasan and Carlos Diaz-Castrillon represent UPMC CT Surgery at the 62nd STS Annual Meeting on Sat 1/31/26
New Orleans Ernest N. Morial Convention Center
@Irsa_Hasan @cediazc @STS_CTsurgery @UPMCPhysicianEd @HviUpmc #STS2026
Carlos E. Diaz-Castrillon, MD MSc retweeted
What are the implications of tracheostomy after acute type A aortic dissection repair? Learn about the longitudinal outcomes and factors associated with patients requiring it by reading this #JTCVS Open study published by researchers at @UPMC_CTSurgery: doi.org/10.1016/j.xjon.2025.…
Carlos E. Diaz-Castrillon, MD MSc retweeted
Nearly 3 in 4 academic surgeons believe corporatization is harming the mission of surgery. Education and research are sidelined, and burnout is rising. The tripartite model is at risk.
journals.lww.com/annalsofsur…
Carlos E. Diaz-Castrillon, MD MSc retweeted
National Readmissions Database study finds differential association between teaching hospital status and 90-day readmission mortality in patients who underwent #TAVR
🔗: pubmed.ncbi.nlm.nih.gov/4043…
@CJCJournals @cediazc @DSGMD @Irsa_Hasan @IbrahimSultanMD @HviUpmc @PittCardiology
Carlos E. Diaz-Castrillon, MD MSc retweeted
The May Issue of #JTCVS is now available. Read the newest #cardiothoracic surgery research to stay up to date. Topics include severe obstructive hypertrophic cardiomyopathy and gender, race, and ethnicity in lung cancer clinical trial participation: jtcvs.org/current
Join us at #AATS2025 congenital poster session!
Based on a national survey of pediatric cardiac surgery chiefs, we explore RV to PA conduit selection—its variability and key drivers.
@AATSHQ @UPMC_CTSurgery @ChildrensPgh @UPMCPhysicianEd
Honored to see our study featured as an Editor’s Choice in the May issue of #JTCVS
Read it free until 5/30
#AorticDissection @UPMC_CTSurgery @IbrahimSultanMD @DSGMD @M_Pompeu_Sa_MD @geoarnaoutakis #WilsonSzeto @STS_CTsurgery
Free until 5/30: The burden of major complications on failure to rescue after surgery for acute type A #aortic dissection. Researchers analyzed more than 19,000 patients to reach their conclusion. Read this Editor's Choice article now in #JTCVS: doi.org/10.1016/j.jtcvs.2024…
#AATS2025
Join us at the "Congenital Scientific Session: Adult Congenital Heart Disease"! We'll be discussing how age impacts outcomes and resource utilization in #ACHD undergoing valve replacement in the U.S.
@UPMC_CTSurgery @AATSHQ
Carlos E. Diaz-Castrillon, MD MSc retweeted
See you in Seattle @AATSHQ #AATS2025 where many firsts in the field are going to be presented. To list a few:
- 1st transcervical robotic AVR
-1st RCT of sternotomy vs MICS CABG
- Global real-world analysis of long-term outcomes of Ross vs bioprostheses
-ZEPIS-SAVR trial
👌🏻
"We are celebrating the 105th meeting!" - @FaisalBakaeen
Ready to join in on the celebration? TODAY is your last day to take advantage of lowered registration rates for #AATS2025. Join us in Seattle this May. Register: events.aats.org/am25/registr…



























