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High Volume Hospitals

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https://www.readbyqxmd.com/read/29218672/effect-of-academic-status-on-outcomes-of-surgery-for-rectal-cancer
#1
Kristen Cagino, Maria S Altieri, Jie Yang, Lizhou Nie, Mark Talamini, Konstantinos Spaniolas, Paula Denoya, Aurora Pryor
BACKGROUND: The purpose of our study was to investigate surgical outcomes following advanced colorectal procedures at academic versus community institutions. METHODS: The SPARCS database was used to identify patients undergoing Abdominoperineal resection (APR) and Low Anterior Resection between 2009 and 2014. Linear mixed models and generalized linear mixed models were used to compare outcomes. Laparoscopic versus open procedures, surgery type, volume status, and stoma formation between academic and community facilities were compared...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29217447/early-experience-with-fenestrated-endovascular-compared-to-open-repair-of-complex-abdominal-aortic-aneurysms-in-a-high-volume-open-aortic-center
#2
Sarah E Deery, Robert T Lancaster, Anna M Gubala, Thomas F X O'Donnell, Christopher J Kwolek, Mark F Conrad, Richard P Cambria, Virendra I Patel
OBJECTIVE: Early data suggest that FEVAR is feasible but may have higher morbidity and unclear durability compared to open surgical repair (OSR) of complex abdominal aortic aneurysms (CAAA). We compared the early experience following elective FEVAR to traditional OSR of CAAA in a high-volume open aortic center. METHODS: All patients undergoing FEVAR and OSR for elective CAAA from 1/2010-7/2015 were identified. Univariate, multivariable logistic, and Cox hazards modeling were used to compare perioperative and intermediate outcomes...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29217445/factors-that-predict-failure-to-meet-mips-quality-measures-for-asymptomatic-carotid-endarterectomy
#3
Anahita Dua, Steven Koprowski, Fadwa Ali, Sapan S Desai
INTRODUCTION: The Physician Quality Reporting System (PQRS) created by the Centers for Medicare and Medicaid Services (CMS) financially penalizes providers who fail to meet expected quality of care measures. The purpose of this study is to evaluate the factors that predict failure to meet PQRS measures for carotid endarterectomy (CEA). METHODS: PQRS measures 260 (discharge by postoperative day 2 following CEA in asymptomatic patients) and 346 (rate of postoperative stroke or death following CEA in asymptomatic patients) were evaluated using hospital records from the state of Florida from 2008-2012...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29215475/an-effective-bundled-approach-reduces-surgical-site-infections-in-a-high-outlier-colorectal-unit
#4
Emre Gorgun, Ahmet Rencuzogullari, Volkan Ozben, Luca Stocchi, Thomas Fraser, Cigdem Benlice, Tracy Hull
BACKGROUND: Surgical site infections are the most common hospital-acquired infection after colorectal surgery, increasing morbidity, mortality, and hospital costs. OBJECTIVE: The purpose of this study was to investigate the impact of preventive measures on colorectal surgical site infection rates in a high-volume institution that performs inherent high-risk procedures. DESIGN: This was a prospective cohort study. SETTINGS: The study was conducted at a high-volume, specialized colorectal surgery department...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29214321/hemithyroidectomy-for-low-risk-follicular-carcinoma-of-thyroid-results-from-a-regional-hospital
#5
Tam-Lin Chow, Susanna Wai-Yin Tam, Chi-Yee Choi, Wilson Wai-Yin Kwan
INTRODUCTION: Excellent outcome after conservative thyroid surgery for low-risk follicular thyroid carcinoma (FTC) has been reported from highly specialised centres. However, it is uncertain whether similar treatment results can be achieved in low-volume hospitals. METHODS: At our institution, 49 patients with FTC were treated during 1991-2014. Patients with minimally invasive FTC (MIFTC) were usually treated with hemithyroidectomy. The demographic data, pathology, treatment modality and oncological outcomes of these patients were retrospectively evaluated...
December 7, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/29213221/omalizumab-in-children-with-severe-allergic-asthma-the-italian-real-life-experience
#6
Amelia Licari, Riccardo Castagnoli, Chiara Denicolò, Linda Rossini, Manuela Seminara, Lucia Sacchi, Giorgia Testa, Mara De Amici, Gian Luigi Marseglia
Background: Anti-IgE treatment represents a major breakthrough in the therapeutic management of severe allergic asthma. To date, omalizumab is the only biological drug currently licensed as add-on therapy in children aged > 6 years with moderate-to-severe and severe allergic asthma uncontrolled after treatment with high dose of inhaled corticosteroids plus long-acting inhaled beta2-agonist. The clinical efficacy and safety of omalizumab treatment in the pediatric population has been extensively documented in specific trials and consistently expanded from real-life studies...
March 2017: Current Respiratory Medicine Reviews
https://www.readbyqxmd.com/read/29212684/do-higher-volume-hospitals-provide-better-value-in-revision-hip-and-knee-arthroplasty
#7
N B Frisch, P M Courtney, B Darrith, C J Della Valle
AIMS: The purpose of this study is to determine if higher volume hospitals have lower costs in revision hip and knee arthroplasty. MATERIALS AND METHODS: We questioned the Centres for Medicare and Medicaid Services (CMS) Inpatient Charge Data and identified 789 hospitals performing a total of 29 580 revision arthroplasties in 2014. Centres were dichotomised into high-volume (performing over 50 revision cases per year) and low-volume. Mean total hospital-specific charges and inpatient payments were obtained from the database and stratified based on Diagnosis Related Group (DRG) codes...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29212397/growth-and-neurodevelopment-in-very-preterm-infants-receiving-a-high-enteral-volume-feeding-regimen-a-population-based-cohort-study
#8
Claus Klingenberg, Fredrik Kragh Muraas, Catherine Elde Isaksen, Tina Nilsen, Marte Torgersen, Cecilie Melum-Hansen
AIM: To evaluate a feeding regimen routinely providing > 180 ml/kg/d fortified human milk to very preterm infants and impact on in-hospital growth, osteopenia and neurodevelopment. METHOD: Retrospective population-based descriptive study of infants < 30-week gestation admitted within 24 h of birth and discharged during the 6-year period 2005 to 2010. Growth and neurodevelopment was assessed until 2 years corrected age, and cerebral palsy up to 4 years corrected age Results: Ninety-nine infants below 30-week gestation were admitted within 24 h of birth during the 6-year period, of which 84 (85%) survived to discharge...
December 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29212084/perioperative-outcomes-and-early-survival-in-octogenarians-who-underwent-radical-cystectomy-for-bladder-cancer
#9
Fabio Zattoni, Vito Palumbo, Gianluca Giannarini, Alessandro Crestani, Afrovita Kungulli, Giacomo Novara, Filiberto Zattoni, Vincenzo Ficarra
OBJECTIVE: To evaluate perioperative outcomes and early survival in a series of octogenarians who underwent radical cystectomy (RC) and urinary diversion for bladder cancer. PATIENTS AND METHODS: We retrospectively evaluated the clinical records of 44 patients aged ≥80 years who underwent open RC and urinary diversion at 2 high-volume centers between July 2013 and December 2015. Estimated blood loss (EBL), transfusion rate, and length of hospital stay (LOS) were evaluated...
December 7, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/29211962/highly-sensitive-and-rapid-detection-of-salmonella-typhimurium-using-a-colorimetric-paper-based-analytical-device-coupled-with-immunomagnetic-separation
#10
Monpichar Srisa-Art, Katherine E Boehle, Brian J Geiss, Charles S Henry
Salmonella causes over a million foodborne illnesses per year in the United States resulting in more hospitalizations and deaths than any other foodborne bacteria pathogen. To help prevent outbreaks a rapid, portable, sensitive, and reliable method for onsite detection of bacteria that can be used in different sample matrices would be beneficial. Herein, we present a colorimetric paper-based analytical device (PAD) combined with immunomagnetic separation (IMS) for detecting Salmonella typhimurium. IMS anti-Salmonella coated magnetic beads was applied to capture and separate bacteria from the sample matrix and preconcentrated it into small volumes before testing on paper...
December 6, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/29209875/non-routine-discharge-disposition-is-associated-with-post-discharge-complications-and-30-day-readmissions-following-craniotomy-for-brain-tumor-resection
#11
Nikita Lakomkin, Constantinos G Hadjipanayis
Several studies have reported an association between high-volume brain tumor centers and greater rates of routine discharge disposition in the context of better outcomes. However, the relationship between in-hospital complications, discharge destination, and postoperative adverse events (AEs) remains unexplored. The purpose of this study was thus to use a large, prospectively collected database to examine the association between discharge destination, post-discharge complications, readmissions, and reoperations among patients undergoing craniotomy for brain tumor...
December 5, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29208530/analytical-performances-of-simultaneous-detection-of-hiv-1-hiv-2-and-hepatitis-c-specific-antibodies-and-hepatitis-b-surface-antigen-hbsag-by-multiplex-immunochromatographic-rapid-test-with-serum-samples-a-cross-sectional-study
#12
Leman Robin, Ralph-Sydney Mboumba Bouassa, Zita Ayelo, Laura Charmant, Mathieu Matta, Sylvie Simon, Mounir Filali, Souleymane Mboup, Laurent Bélec
BACKGROUND: The HIV/HCV/HBsAg Triplex [OEM: Biotest Biotech Inc, Hangzhou, China] consists in manually performed, visually interpreted, lateral flow, immunochromatographic rapid diagnostic test simultaneously detecting in 15minutes human immunodeficiency virus (HIV)-1 and HIV-2 and hepatitis C virus (HCV)- specific antibodies (Ab) (IgG and IgM) and hepatitis B virus (HBV) surface antigen (HBsAg) in serum, plasma and whole blood. METHODS: A hospital-based cross-sectional study was conducted on a prospective panel of serum samples from adult inpatients included from routine analysis irrespectively of age and sex, including 250 sera positive for HIV-1-specific Ab, 250 for HCV-specific Ab, 250 for HBsAg and 250 sera negative for HIV- and HCV- Ab and HBsAg, and from 110 HIV-2-infected patients living in Ivory Coast, according to the results obtained by the reference chemiluminiscent microparticle immunoassay (CMIA) Abbott Architect i2000SR analyzer (Abbott Diagnostic, Chicago, IL, USA)...
December 2, 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/29207366/differences-in-approaches-and-outcomes-of-defibrillator-lead-implants-between-high-volume-and-low-volume-operators-results-from-the-pacemaker-and-implantable-defibrillator-leads-survival-study-paidless
#13
Zohaib A Shaikh, Jessica A Chung, Daniel J Kersten, Alyssa M Feldman, Wilbur J Asheld, Joseph Germano, Shahidul Islam, Todd J Cohen
OBJECTIVES: The purpose of this study was to investigate the relationship between operator volume and implantable defibrillator lead failure and patient mortality at a single large implanting center. METHODS: This study analyzed the differences between high-volume and low-volume defibrillator implanters in the Pacemaker and Implantable Defibrillator Lead Survival Study ("PAIDLESS") between February 1, 1996 and December 31, 2011 at NYU Winthrop Hospital. "High-volume" was defined as performing ≥500 implants over the study period, while "low-volume" was defined as performing <500 implants...
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#14
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29204307/treatment-of-intracerebellar-haemorrhage-poor-outcome-and-high-long-term-mortality
#15
Jarno Satopää, Atte Meretoja, Riku J Koivunen, Satu Mustanoja, Jukka Putaala, Markku Kaste, Daniel Strbian, Turgut Tatlisumak, Mika R Niemelä
Background: Intracerebellar haemorrhage constitutes around 10% of all spontaneous, non-aneurysmal intracerebral haemorrhages (ICHs) and often carries a grim prognosis. In symptomatic patients, surgical evacuation is usually regarded the standard treatment. Our objective was to compare the in-hospital mortality and functional outcome at hospital discharge in either medically or surgically treated patients, and the impact of either treatment on long-term mortality after a cerebellar ICH...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29204170/locally-advanced-squamous-cell-cervical-cancer-in-a-patient-with-septate-uterus
#16
Guler Yavas, Cagdas Yavas, Gokcen Inan
A 33-year-old premenopausal multiparous woman with the history of septate uterus was referred to the hospital with menorrhagia and inter-menstrual bleeding occurring for the last 6 months. Work-up revealed a stage IIB cervical cancer. The patient underwent curative chemo/radiotherapy. The patient's septate uterus presented several difficulties during application. Brachytherapy was applied using standard computed tomography-compatible tandem and ovoids. The high-risk clinical target volume (HR-CTV), intermediate risk CTV, and organs at risk were contoured according to the Groupe Européen de Curiethérapie - European Society for Radiology and Oncology (GEC-ESTRO) guidelines...
October 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29203980/quality-of-life-after-total-mesorectal-excision-tme-for-rectal-carcinoma-a-study-from-a-tertiary-care-hospital-in-northern-india
#17
Rauf Ahmad Wani, Ikhlaq-Ul-Aziz Bhat, Fazl Qadir Parray, Nisar Ahmad Chowdri
Quality of life (QoL) is a key element in rectal cancer (RC) patients. There is not much data regarding this from North India. This study assesses QoL following low anterior resection (LAR) and abdominoperineal resection (APR), operated for low rectal tumors at a high-volume center in northern India. One-hundred-thirty patients of rectal carcinoma were prospectively assessed for quality of life using the European Organization for Cancer QLQ-30 and CR29 questionnaires and compared with reference data population...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29201841/the-combined-use-of-cardiac-output-and-intracranial-pressure-monitoring-to-maintain-optimal-cerebral-perfusion-pressure-and-minimize-complications-for-severe-traumatic-brain-injury
#18
Jin Shup So, Jung-Ho Yun
Objective: To show the effect of dual monitoring including cardiac output (CO) and intracranial pressure (ICP) monitoring for severe traumatic brain injury (TBI) patiens. We hypothesized that meticulous treatment using dual monitoring is effective to sustain maintain minimal intensive care unit (ICU) complications and maintain optimal ICP and cerebral perfusion pressure (CPP) for severe TBI patiens. Methods: We included severe TBI, below Glasgow Coma Scale (GCS) 8 and head abbreviation injury scale (AIS) >4 and performed decompressive craniectomy at trauma ICU of our hospital...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29201634/innovative-chest-physiotherapy-techniques-the-metaneb%C3%A2-system-in-the-intubated-child-with-extensive-burns
#19
Alexandra Ferguson, Sarah Wright
Introduction: The Metaneb® is a new generation Intrapulmonary Percussive Ventilation device utilised by the physiotherapist to assist airway clearance by providing calibrated oscillations during inspiration up to 3.8Hz. Predominantly used in the adult chronic respiratory patient, with anecdotal evidence in intubated patients, it was also proven to be safe in a paediatric lung model lab study. This case report outlines the first use of the Metaneb® with an intubated child in Australia...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29197407/low-tidal-volume-mechanical-ventilation-against-no-ventilation-during-cardiopulmonary-bypass-heart-surgery-mecano-study-protocol-for-a-randomized-controlled-trial
#20
Lee S Nguyen, Messaouda Merzoug, Philippe Estagnasie, Alain Brusset, Jean-Dominique Law Koune, Stephane Aubert, Thierry Waldmann, Jean-Michel Grinda, Hadrien Gibert, Pierre Squara
BACKGROUND: Postoperative pulmonary complications are a leading cause of morbidity and mortality after cardiac surgery. There are no recommendations on mechanical ventilation associated with cardiopulmonary bypass (CPB) during surgery and anesthesiologists perform either no ventilation (noV) at all during CPB or maintain low tidal volume (LTV) ventilation. Indirect evidence points towards better pulmonary outcomes when LTV is performed but no large-scale prospective trial has yet been published in cardiac surgery...
December 2, 2017: Trials
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