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https://www.readbyqxmd.com/read/28747618/comprehensive-approach-for-post-prostatectomy-incontinence-in-the-era-of-robot-assisted-radical-prostatectomy
#1
Nobuhiro Haga, Ruriko Takinami, Ryo Tanji, Akifumi Onagi, Kanako Matsuoka, Tomoyuki Koguchi, Hidenori Akaihata, Junya Hata, Soichiro Ogawa, Masao Kataoka, Yuichi Sato, Kei Ishibashi, Ken Aikawa, Yoshiyuki Kojima
Robot-assisted radical prostatectomy (RARP) has enabled steady and stable surgical procedures due to both meticulous maneuvers and magnified, clear, 3-dimensional vision. Therefore, better surgical outcomes have been expected with RARP than with other surgical modalities. However, even in the RARP era, post-prostatectomy incontinence has a relatively high incidence as a bothersome complication. To overcome post-prostatectomy incontinence, it goes without saying that meticulous surgical procedures and creative surgical procedures, i...
July 26, 2017: Fukushima Journal of Medical Science
https://www.readbyqxmd.com/read/28747255/adjuvant-gemcitabine-docetaxel-chemotherapy-for-stage-i-uterine-leiomyosarcoma-trends-and-survival-outcomes
#2
Ramey D Littell, Lue-Yen Tucker, Tina Raine-Bennett, Ted E Palen, Eve Zaritsky, Romain Neugebauer, Julia Embry-Schubert, Scott E Lentz
OBJECTIVE: To assess recent trends of administering adjuvant gemcitabine-docetaxel (GD) chemotherapy for Stage I uterine leiomyosarcoma, and to compare disease-free and overall survival between women who received and did not receive adjuvant GD chemotherapy. METHODS: All patients diagnosed with Stage I uterine leiomyosarcoma in a California-Colorado population-based health plan inclusive of 2006-2013 were included in a retrospective cohort. Adjuvant GD chemotherapy rates, clinico-pathologic characteristics and survival estimates were assessed...
July 24, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28746360/synergistic-effects-of-cognitive-impairment-on-physical-disability-in-all-cause-mortality-among-men-aged-80-years-and-over-results-from-longitudinal-older-veterans-study
#3
Wan-Chen Yu, Ming-Yueh Chou, Li-Ning Peng, Yu-Te Lin, Chih-Kuang Liang, Liang-Kung Chen
OBJECTIVE: We evaluated effects of the interrelationship between physical disability and cognitive impairment on long-term mortality of men aged 80 years and older living in a retirement community in Taiwan. METHODS: This prospective cohort study enrolled older men aged 80 and older living in a Veterans Care Home. Those with confirmed diagnosis of dementia were excluded. All participants received comprehensive geriatric assessment, including sociodemographic data, Charlson's Comorbidity Index (CCI), geriatric syndromes, activities of daily living (ADL) using the Barthel index and cognitive function using the Mini-Mental State Examination (MMSE)...
2017: PloS One
https://www.readbyqxmd.com/read/28746223/decreasing-incidence-and-mortality-among-hospitalized-patients-suffering-a-ventilator-associated-pneumonia-analysis-of-the-spanish-national-hospital-discharge-database-from-2010-to-2014
#4
Javier de Miguel-Díez, Ana López-de-Andrés, Valentín Hernández-Barrera, Isabel Jiménez-Trujillo, Manuel Méndez-Bailón, José M de Miguel-Yanes, Benito Del Rio-Lopez, Rodrigo Jiménez-García
The aim of this study was to describe trends in the incidence and outcomes of ventilator-associated pneumonia (VAP) among hospitalized patients in Spain (2010-2014).This is a retrospective study using the Spanish national hospital discharge database from year 2010 to 2014. We selected all hospital admissions that had an ICD-9-CM code: 997.31 for VAP in any diagnosis position. We analyzed incidence, sociodemographic and clinical characteristics, procedures, pathogen isolations, and hospital outcomes.We identified 9336 admissions with patients suffering a VAP...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28737988/patterns-of-care-for-biologic-dosing-outliers-and-nonoutliers-in-biologic-naive-patients-with-rheumatoid-arthritis
#5
Thomas Delate, Roxanne Meyer, Daniel Jenkins
BACKGROUND: Although most biologic medications for patients with rheumatoid arthritis (RA) have recommended fixed dosing, actual biologic dosing may vary among real-world patients, since some patients can receive higher (high-dose outliers) or lower (low-dose outliers) doses than what is recommended in medication package inserts. OBJECTIVE: To describe the patterns of care for biologic-dosing outliers and nonoutliers in biologic-naive patients with RA. METHODS: This was a retrospective, longitudinal cohort study of patients with RA who were not pregnant and were aged ≥ 18 and < 90 years from an integrated health care delivery system...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737986/real-world-adherence-and-persistence-to-oral-disease-modifying-therapies-in-multiple-sclerosis-patients-over-1-year
#6
Kristen M Johnson, Huanxue Zhou, Feng Lin, John J Ko, Vivian Herrera
BACKGROUND: Disease-modifying therapies (DMTs) are indicated to reduce relapse rates and slow disease progression for relapsing-remitting multiple sclerosis (MS) patients when taken as prescribed. Nonadherence or non-persistence in the real-world setting can lead to greater risk for negative clinical outcomes. Although previous research has demonstrated greater adherence and persistence to oral DMTs compared with injectable DMTs, comparisons among oral DMTs are lacking. OBJECTIVE: To compare adherence, persistence, and time to discontinuation among MS patients newly prescribed the oral DMTs fingolimod, dimethyl fumarate, or teriflunomide...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737985/evaluation-of-patient-migration-patterns-and-related-health-care-costs-within-a-national-medicare-advantage-prescription-drug-plan-after-implementation-of-an-oxycodone-hcl-extended-release-access-restriction
#7
Chi-Chang Chen, Ajita P De, Brian Sweet, Rolin L Wade
BACKGROUND: Health plans use formulary restrictions (e.g., prior authorization, step therapy, tier change, nonformulary status) in an effort to control cost and promote quality, safety, and appropriate prescription utilization. Some Medicare payers perceive that the inclusion of certain agents, such as branded oxycodone HCl extended-release tablets (OERs), on their formularies is associated with attracting high-cost members to the plan. OBJECTIVE: To evaluate disenrollment rates, patient migration, and subsequent health care costs among OER users who disenrolled from a national Medicare Advantage Prescription Drug plan (study-MAPD) in the plan year following OER nonformulary restriction...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28735459/diabetes-and-the-hospitalized-patient-a-cluster-analytic-framework-for-characterizing-the-role-of-sex-race-and-comorbidity-from-2006-to-2011
#8
Nisha Nataraj, Julie Simmons Ivy, Fay Cobb Payton, Joseph Norman
In the US, one in four adults has two or more chronic conditions; this population accounts for two thirds of healthcare spending. Comorbidity, the presence of multiple simultaneous health conditions in an individual, is increasing in prevalence and has been shown to impact patient outcomes negatively. Comorbidities associated with diabetes are correlated with increased incidence of preventable hospitalizations, longer lengths of stay (LOS), and higher costs. This study focuses on sex and race disparities in outcomes for hospitalized adult patients with and without diabetes...
July 22, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28735129/predictors-of-recurrence-and-complications-after-chronic-subdural-hematoma-surgery-a-population-based-study
#9
J Bartek, K Sjåvik, H Kristiansson, F Ståhl, I Fornebo, P Förander, A S Jakola
OBJECTIVE: To investigate predictors of recurrence and moderate to severe complications after burr-hole surgery for chronic subdural hematoma (cSDH). MATERIALS AND METHODS: A retrospective review was conducted in a Scandinavian single center population-based cohort of 759 adult cSDH patients operated with burr-hole surgery between January 1, 2005 and December 31, 2010. Possible predictors of recurrence and complications, assessed using a standardized reporting system of adverse events, were identified and analyzed in univariable analyses...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28733181/caring-for-a-person-with-dementia-on-the-margins-of-long-term-care-a-perspective-on-burden-from-8-european-countries
#10
Caroline Sutcliffe, Clarissa Giebel, Michel Bleijlevens, Connie Lethin, Minna Stolt, Kai Saks, Maria E Soto, Gabriele Meyer, Adelaida Zabalegui, Helen Chester, David Challis
OBJECTIVES: To explore associations between carer burden and characteristics of (1) the informal carer, (2) the person with dementia, and (3) the care support network in 8 European countries. DESIGN: Cross-sectional study. SETTING: People with dementia judged at risk of admission to long-term care (LTC) facilities in 8 European countries (Estonia, Finland, France, Germany, Netherlands, Spain, Sweden, United Kingdom). PARTICIPANTS: A total of 1223 people with dementia supported by community services at home or receiving day care or respite care and their informal carers...
July 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28732186/assessing-the-impact-of-surgeon-experience-on-urinary-continence-recovery-after-robot-assisted-radical-prostatectomy-results-of-four-high-volume-surgeons
#11
Nicola Fossati, Ettore Di Trapani, Giorgio Gandaglia, Paolo Dell'Oglio, Paolo Umari, Nicolò Maria Buffi, Giorgio Guazzoni, Alexander Mottrie, Franco Gaboardi, Francesco Montorsi, Alberto Briganti, Nazareno Suardi
PURPOSE: To test the impact of surgeon experience on urinary continence (UC) recovery after robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS: The study included 1477 consecutive patients treated with RARP by four surgeons between 2006 and 2014. UC recovery was defined as being completely dry over a 24-hour period at follow-up. Surgeon experience was coded as the total number of RARP performed by the surgeon before the patient's operation. Multivariable analysis tested the association between surgeon experience and UC recovery...
July 21, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28730775/charlson-comorbidity-index-for-evaluati%C3%AE-n-%C3%AE-f-the-outcomes-of-elderly-patients-undergoing-laparoscopic-surgery-for-colon-cancer
#12
Yun Huang, Yuxing Zhang, Jianjun Li, Gang Liu
PURPOSE: We investigated the effectiveness of the Charlson comorbidity index (CCI) for predicting postoperative 30-day complications and long-term survival outcomes of elderly patients who underwent laparoscopic surgery for colon cancer with radical intent. METHODS: We reviewed 178 patients aged ≥70 years who underwent laparoscopic surgery for colon cancer with radical intent between January 2008 and December 2015. Patients were divided into high CCI (CCI ≥ 3; n=71) and low CCI (CCI < 3; n=107) groups for comparative analyses of differences in their short- and long-term outcomes...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28729248/end-stage-renal-disease-versus-death-in-a-portuguese-cohort-of-elderly-patients-an-approach-using-competing-event-analysis
#13
Josefina Santos, Isabel Fonseca, Jorge Malheiro, Idalina Beirao, Luisa Lobato, Pedro Oliveira, Antonio Cabrita
Chronic kidney disease (CKD) is higher in elderly, but mortality outweighs the risk of end-stage renal disease (ESRD). Our aim was to identify prognostic markers for ESRD or death in elderly CKD, within a competing-risk analysis. This is a longitudinal study of consecutive newly referred patients with CKD ages 65 years, followed until the time of the first event (ESRD or death), using a competing-risk analysis. A modified Charlson Comorbidity Index (mCCI) was subdivided into subgroups (0-2, 3-4, ≥5). Patients were followed for hospitalizations that occurred prior to the outcomes...
July 19, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28727267/distinguishing-in-hospital-and-out-of-hospital-status-epilepticus-clinical-implications-from-a-10-year-cohort-study
#14
R Sutter, S Semmlack, R Spiegel, K Tisljar, S Rüegg, S Marsch
BACKGROUND AND PURPOSE: The aim was to determine differences of clinical, treatment and outcome characteristics between patients with in-hospital and out-of-hospital status epilepticus (SE). METHODS: From 2005 to 2014, clinical data were assessed in adults with SE treated in an academic medical care centre. Clinical characteristics, treatment and outcomes were compared between patients with in-hospital and out-of-hospital SE. RESULTS: Amongst 352 patients, 213 were admitted with SE and 139 developed in-hospital SE...
July 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28726018/association-of-vagotomy-and-decreased-risk-of-subsequent-ischemic-stroke-in-complicated-peptic-ulcer-patients-an-asian-population-study
#15
Chu-Wen Fang, Chun-Hung Tseng, Shih-Chi Wu, William Tzu-Liang Chen, Chih-Hsin Muo
OBJECTIVES: The primary management of peptic ulcers is medical treatment. Persistent exacerbation of a peptic ulcer may lead to complications (perforation and/or bleeding). There has been a trend toward the use of a less invasive surgical simple suture, simple local suture or non-operative (endoscopic/angiography) hemostasis rather than acid-reducing vagotomy (i.e., vagus nerve severance) for treating complicated peptic ulcers. Other studies have shown the relationship between high vagus nerve activity and survival in cancer patients via reduced levels of inflammation, indicating the essential role of the vagus nerve...
July 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28722609/differences-in-mortality-and-clinical-manifestations-of-dengue-hemorrhagic-fever-in-taiwan-in-different-years-a-comparison-for-cases-in-2014-and-2015-epidemics
#16
Ko Chang, Chung-Hao Huang, Ing-Kit Lee, Po-Liang Lu, Chun-Yu Lin, Tun-Chieh Chen, Ping-Chang Lai, Hsiao-Cheng Hsieh, Hsin-Liang Yu, Chih-Hsing Hung, Meng-Chieh Wu, Yi-Ying Chin, Chun-Chi Huang, Deng-Chyang Wu, Yen-Hsu Chen
People in southern Taiwan experienced two major dengue outbreaks in 2014 and 2015. The mortality and clinical features were very different between these 2 years. Dengue virus serotype 1 (DENV-1) caused epidemic outbreak in 2014 and DENV-2 was predominant in 2015. The characteristics of dengue hemorrhagic fever (DHF) cases in the 2 years was analyzed. We conducted a retrospective chart review to analyze the clinical and laboratory features of 206 adult patients with DHF in southern Taiwan in 2014 and 2015. The mortality rate of DHF cases in 2015 was higher than that of cases in 2014 (38...
June 12, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28719660/factors-associated-with-life-sustaining-treatment-restriction-in-a-general-intensive-care-unit
#17
Stein Arve Skjaker, Henrik Hoel, Vegard Dahl, Knut Stavem
PURPOSE: Few previous studies have investigated associations between clinical variables available after 24 hours in the intensive care unit (ICU), including the Charlson Comorbidity Index (CCI), and decisions to restrict life-sustaining treatment. The aim of this study was to identify factors associated with the life-sustaining treatment restriction and to explore if CCI contributes to explaining decisions to restrict life-sustaining treatment in the ICU at a university hospital in Norway from 2007 to 2009...
2017: PloS One
https://www.readbyqxmd.com/read/28719079/associations-between-drugs-and-small-bowel-mucosal-bleeding-a-multicenter-capsule-endoscopy-study
#18
Ryota Niikura, Atsuo Yamada, Koutarou Maki, Masanao Nakamura, Hirotsugu Watabe, Mitsuhiro Fujishiro, Shiro Oka, Motohiro Esaki, Shunji Fujimori, Atsushi Nakajima, Naoki Ohmiya, Takayuki Matsumoto, Shinji Tanaka, Kazuhiko Koike, Choitsu Sakamoto
OBJECTIVES: Although several drugs may induce small-bowel mucosal injuries, it is unclear whether these injuries contribute to overt small-bowel bleeding. This study was designed to evaluate the associations between drug use and small-bowel mucosal injury and between these mucosal injuries and overt bleeding in a disease-relevant population. METHODS: We retrospectively studied patients with suspected small-bowel diseases who underwent capsule endoscopy between 2010 and 2013...
July 18, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28717907/elevated-lactate-is-independently-associated-with-adverse-outcomes-following-hepatectomy
#19
Madeline Lemke, Paul J Karanicolas, Rogeh Habashi, Ramy Behman, Natalie G Coburn, Sherif S Hanna, Calvin H L Law, Julie Hallet
BACKGROUND: Arterial lactate is frequently monitored to indicate tissue hypoxia and direct therapy. We sought to determine whether early post-hepatectomy lactate (PHL) is associated with adverse outcomes and define factors associated with PHL. METHODS: Hepatectomy patients at a single institution from 2003 to 2012 with PHL available were included. Univariable and multivariable analyses examined factors associated with PHL and the relationship between PHL and 30-day major morbidity (Clavien grade III-V), 90-day mortality, and length of stay (LOS)...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28717843/septic-arthritis-associated-with-systemic-sepsis
#20
Sung-Weon Jung, Dong-Hee Kim, Sung-Jin Shin, Byoung-Youl Kang, Yil-Ju Eho, Seong-Wook Yang
PURPOSE: Septic arthritis presents with good joint function, but sometimes leads to poor outcomes. Concurrent systemic sepsis has been regarded as the poor outcome, and the exact cause remains unclear. This paper was performed to identify factors associated with concurrent systemic sepsis and to research results to predict poor outcomes in patients with septic arthritis. METHODS: Laboratory and medical data were reviewed for 137 adults with acute septic arthritis who underwent open or arthroscopic surgical debridement at our institution between January 2005 and December 2014...
July 17, 2017: International Orthopaedics
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