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American Surgeon

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https://www.readbyqxmd.com/read/28958284/standardized-interdepartmental-simulation-based-central-line-insertion-course-closes-an-educational-gap-and-improves-intern-comfort-with-the-procedure
#1
(no author information available yet)
No abstract text is available yet for this article.
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958283/guideline-driven-care-improves-outcomes-in-patients-with-traumatic-rib-fractures
#2
Kathleen Flarity, Whitney C Rhodes, Andrew J Berson, Brian E Leininger, Paul E Reckard, Keyan D Riley, Charles P Shahan, Thomas J Schroeppel
There is no established national standard for rib fracture management. A clinical practice guideline (CPG) for rib fractures, including monitoring of pulmonary function, early initiation of aggressive loco-regional analgesia, and early identification of deteriorating respiratory function, was implemented in 2013. The objective of the study was to evaluate the effect of the CPG on hospital length of stay. Hospital length of stay (LOS) was compared for adult patients admitted to the hospital with rib fracture(s) two years before and two years after CPG implementation...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958282/bicycle-helmets-save-more-than-heads-experience-from-a-pediatric-level-i-trauma-hospital
#3
Patrick D Michael, Daniel L Davenport, John M Draus
We studied pediatric bicycle accident victims (age ≤ 15 years) who were treated at our pediatric Level I trauma center during a 10-year period. Demographic data, injury severity, hospital course, and hospital cost data were collected. We compared the children who were helmeted to those who were unhelmeted. Our study cohort consisted of 516 patients. Patients were mostly male (70.2%) and white (84.7%); the median age was nine years. There were 101 children in the helmet group and 415 children in the unhelmeted group...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958281/an-innovative-way-to-separate-gastrointestinal-and-abdominal-wall-reconstruction-after-complex-abdominal-trauma
#4
David H Livingston, David V Feliciano
Despite advances in trauma care, a subset of patients surviving damage control cannot achieve fascial closure and require split-thickness skin grafting (STSG) of their open abdomen. Controversy exists as to whether reconstruction of the gastrointestine (GI) should be staged or performed at the time of abdominal wall reconstruction (AWR). Many surgeons do not believe that operations through the STSG can be completed safely or without loss of graft. This series reviews the outcomes of operations for GI reconstruction performed through the elevated healed STSG...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958280/differences-in-the-management-of-perforated-appendicitis-in-children-by-race-and-insurance-status
#5
Randi L Lassiter, Robyn M Hatley
This study was conducted to assess whether race and socioeconomic status influence the management method used to treat pediatric perforated appendicitis. Nonelective pediatric admissions with a primary diagnosis of appendicitis were analyzed using data from the 2001-2010 Nationwide Inpatient Sample. Bivariate and multivariate analyses were used to determine the association between race, insurance status, median household income, rural/metropolitan location, and the risk adjusted odds of undergoing surgery, laparoscopic appendectomy, percutaneous drainage, or neither surgery nor percutaneous drainage...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958279/an-analysis-of-factors-that-predict-hospital-readmission-after-surgery-for-perforated-appendicitis
#6
Jeffanne E Millien, Michael Townsend, Joshua Goldberg, George M Fuhrman
We performed this study to develop an understanding of why patients were readmitted after appendectomy for perforated appendicitis. Patients who required surgery for perforated appendicitis during a recent five-year period were identified. We recorded the demographic data, length of symptoms, length of stay, vital signs, laboratory findings, surgical approach, length of surgery, time to readmission, length of readmission, and intervention required after readmission. We divided the cohort into two groups depending on whether the patient was readmitted...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958278/what-are-the-costs-of-trauma-center-readiness-defining-and-standardizing-readiness-costs-for-trauma-centers-statewide
#7
Dennis W Ashley, Robert F Mullins, Christopher J Dente, Laura Garlow, Regina S Medeiros, Elizabeth V Atkins, Gina Solomon, Dena Abston, Colville H Ferdinand
Trauma center readiness costs are incurred to maintain essential infrastructure and capacity to provide emergent services on a 24/7 basis. These costs are not captured by traditional hospital cost accounting, and no national consensus exists on appropriate definitions for each cost. Therefore, in 2010, stakeholders from all Level I and II trauma centers developed a survey tool standardizing and defining trauma center readiness costs. The survey tool underwent minor revisions to provide further clarity, and the survey was repeated in 2013...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958277/tumor-mitotic-rate-and-association-with-recurrence-in-sentinel-lymph-node-negative-stage-ii-melanoma-patients
#8
Shachar Laks, Michael O Meyers, Allison M Deal, Jill S Frank, Karyn B Stitzenberg, Jen Jen Yeh, Nancy E Thomas, David W Ollila
Tumor mitotic rate (TMR) is a known prognostic variable in thin melanoma patients. Its significance in stage II melanoma patients is yet to be demonstrated. Retrospective analysis of a prospective melanoma database from 9/1997 to 7/2015 was performed. All stage II melanoma, with documented TMR, and six months of follow-up were included. We evaluated the association of clinicopathologic variables, TMR, as a continuous and categorical variable with recurrence-free survival (RFS) and overall survival (OS) using Cox proportional hazards modeling...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958276/successful-incorporation-of-performance-based-payments-for-trauma-center-readiness-costs-into-the-georgia-trauma-system
#9
Dennis W Ashley, Jeffrey M Nicholas, Christopher J Dente, Tracy J Johns, Laura E Garlow, Gina Solomon, Dena Abston, Colville H Ferdinand
As quality and outcomes have moved to the fore front of medicine in this era of healthcare reform, a state trauma system Performance Based Payments (PBP) program has been incorporated into trauma center readiness funding. The purpose of this study was to evaluate the impact of a PBP on trauma center revenue. From 2010 to 2016, a percentage of readiness costs funding to trauma centers was placed in a PBP and withheld until the PBP criteria were completed. To introduce the concept, only three performance criteria and 10 per cent of readiness costs funding were tied to PBP in 2010...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958275/heroin-related-compartment-syndrome-an-increasing-problem-for-acute-care-surgeons
#10
Matthew Benns, Keith Miller, Brian Harbrecht, Matthew Bozeman, Nicholas Nash
Heroin use has been increasing in the United States with the rate of heroin overdose nearly quadrupling in the last 10 years. Heroin overdose can occasionally lead to compartment syndrome (CS) because of extended periods of immobility and pressure tissue injury. Heroin-related compartment syndrome (HRCS) has previously been described, but has been limited to isolated case reports. We sought to examine our experience with HRCS in the climate of rising rates of heroin use among the general population. Medical records of all patients undergoing operative decompression for a CS at our academic medical center over a six-year period (2010-2015) were examined...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958274/age-and-achalasia-how-does-age-affect-patient-presentation-hospital-course-and-surgical-outcomes
#11
Darrell J Downs, Giavanna Jadick, Forat Swaid, Sharona B Ross, Alexander S Rosemurgy
Heller myotomy is the "gold-standard" therapy for achalasia, alleviating symptoms by defunctionalizing the lower esophageal sphincter mechanism. Observation has suggested many differences between young and old patients with achalasia, raising the question: is achalasia in younger patients a different disorder than it is in older patients? This study was undertaken to answer this question. With Institutional Review Board approval, 648 patients undergoing laparoscopic Heller myotomy from 1992-2016 were prospectively followed up...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958273/variation-in-clinical-characteristics-of-women-versus-men-preoperative-for-laparoscopic-roux-en-y-gastric-bypass-analysis-of-83-059-patients
#12
COMPARATIVE STUDY
Jandie Schwartz, Christopher Bashian, Leon Kushnir, Cristina Nituica, Gus J Slotman
Variation by sex in preoperative clinical characteristics of female and male laparoscopic Roux-en-Y gastric bypass (LRYGB) patients has not been evaluated comprehensively. The objective of our study was to identify clinical differences between morbidly obese women and men seeking LRYGB. Data from 83,059 patients in the Surgical Review Corporation's Bariatric Outcomes Longitudinal Database who were about to undergo LRYGB was analyzed in two groups: women (n = 65,325) and men (n = 17,734). Statistics were evaluated with analysis of variance and the χ2 equation...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958272/inclusion-of-the-acute-care-surgeon-in-the-difficult-airway-protocol-a-nine-year-experience
#13
Seong K Lee, Andrew A Rosenthal, Dafney L Davare, Chauniqua Kiffin, Rafael Sanchez, Michael Hurtado, Eddy H Carrillo
An emergency surgical airway is a lifesaving intervention required in the event of airway loss or respiratory failure when conventional endotracheal intubation cannot be performed. The Acute Care Surgery/Trauma Service is a critical component in the angioedema/difficult airway protocol at our institution. We conducted a retrospective review (2007-2016) to analyze the role our service has in managing patients requiring an emergency surgical airway. Cases were analyzed for preexisting conditions, hospital location of procedure, techniques, complications, and mortality...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958271/operative-outcomes-after-open-abdominal-wall-reconstruction-with-retromuscular-mesh-fixation-using-fibrin-glue-versus-transfascial-sutures
#14
COMPARATIVE STUDY
Adam S Weltz, Udai S Sibia, H Reza Zahiri, Alexa Schoeneborn, Adrian Park, Igor Belyansky
Ideal fixation techniques have not been fully elucidated at the time of complex open abdominal wall reconstruction (AWR). We compared operative outcomes and quality of life with retromuscular mesh fixation using fibrin glue (FG) versus transfascial sutures (TS). Retrospective review identified complex hernia patients who underwent open AWR with mesh from November 2012 through April 2016. Multivariate analysis examined postoperative outcomes between groups. Quality of life was assessed using the Carolinas Comfort Scale...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958270/prevention-of-implanted-central-venous-port-erosion-with-prophylactic-mesh-tissue-augmentation
#15
David Christopher Palange, Dare Ajibade, Stephanie Bonne, Anastasia Kunac
No abstract text is available yet for this article.
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958269/anaerobic-infections-of-autogenous-arteriovenous-fistulae
#16
Julia Coughlin, Charles Fredericks, Richard Keen, Erin Farlow, Neha Sheng
No abstract text is available yet for this article.
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958268/concurrent-laparoscopic-hernia-repair-and-cystoscopic-laser-cystolitholaxapy-for-urinary-bladder-calculus-contained-within-a-direct-inguinal-hernia
#17
Benjamin H Hancock, Jeremy A Warren, Charles Marguet, Alfredo M Carbonell, William S Cobb
No abstract text is available yet for this article.
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958267/metallic-surgical-clip-causing-cholangitis-after-cholecystectomy
#18
Philip A Erwin, Lucas R Beffa, Wesley B Jones, Allyson L Hale, John D Scott
No abstract text is available yet for this article.
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958266/embolization-of-the-inferior-vena-cava-filter-strut-to-the-right-ventricle-a-case-report
#19
Farzad Amiri, Ryan Landis, Paulina Skaff, David Denning, Constantinos Constantinou
No abstract text is available yet for this article.
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28958265/evaluation-of-a-trial-of-a-desufflation-technique-to-decrease-the-rate-of-postoperative-pneumoperitoneum-after-percutaneous-endoscopic-gastrostomy
#20
Ahkeel I Allen, Justin Vaughan, Allison Cauthen, Eric Long
No abstract text is available yet for this article.
September 1, 2017: American Surgeon
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