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https://www.readbyqxmd.com/read/28633157/epidemiology-practice-of-ventilation-and-outcome-for-patients-at-increased-risk-of-postoperative-pulmonary-complications-an-observational-study-in-29-countries
#1
(no author information available yet)
BACKGROUND: Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES: To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN: This was a prospective international 1-week observational study using the 'Assess Respiratory Risk in Surgical Patients in Catalonia risk score' (ARISCAT score) for PPC for risk stratification...
June 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#2
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#3
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631387/umeclidinium-bromide-versus-placebo-for-people-with-chronic-obstructive-pulmonary-disease-copd
#4
REVIEW
Han Ni, Aung Htet, Soe Moe
BACKGROUND: People with chronic obstructive pulmonary disease (COPD) have poor quality of life, reduced survival, and accelerated decline in lung function, especially associated with acute exacerbations, leading to high healthcare costs. Long-acting bronchodilators are the mainstay of treatment for symptomatic improvement, and umeclidinium is one of the new long-acting muscarinic antagonists approved for treatment of patients with stable COPD. OBJECTIVES: To assess the efficacy and safety of umeclidinium bromide versus placebo for people with stable COPD...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28630952/estimating-patient-s-health-state-using-latent-structure-inferred-from-clinical-time-series-and-text
#5
Aaron Zalewski, William Long, Alistair E W Johnson, Roger G Mark, Li-Wei H Lehman
Modern intensive care units (ICUs) collect large volumes of data in monitoring critically ill patients. Clinicians in the ICUs face the challenge of interpreting large volumes of high-dimensional data to diagnose and treat patients. In this work, we explore the use of Hierarchical Dirichlet Processes (HDP) as a Bayesian nonparametric framework to infer patients' states of health by combining multiple sources of data. In particular, we employ HDP to combine clinical time series and text from the nursing progress notes in a probabilistic topic modeling framework for patient risk stratification...
February 2017: IEEE-EMBS International Conference on Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28629904/perioperative-morbidity-of-same-day-and-staged-bilateral-total-hip-arthroplasty
#6
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Stavros G Memtsoudis, Huong T Do, Michael M Alexiades, Thomas P Sculco
BACKGROUND: Management strategies for bilateral hip degenerative disease include same-day or staged bilateral total hip arthroplasty (THA), but information on outcomes remains sparse. We sought to describe in-hospital complications and blood transfusion rates after same-day and staged bilateral THAs at different time intervals and to assess risk factors for these events. METHODS: We retrospectively reviewed administrative data for 3785 patients treated with same-day bilateral (n = 1946; group A) and staged bilateral THA within (1) 0-3 months apart (n = 328; group B); (2) 3-6 months apart (n = 703; group C); and (3) 6-12 months apart (n = 808; group D), between 1999 and 2014...
May 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629328/impact-of-systematic-capacity-building-on-cataract-surgical-service-development-in-25-hospitals
#7
Katherine Judson, Paul Courtright, Thulsiraj Ravilla, Rohit Khanna, Ken Bassett
BACKGROUND: This study measured the effectiveness and cost of a capacity building intervention in 25 eye hospitals in South Asia, East Africa and Latin America over 4 years. The intervention involved eye care non-governmental organizations or high-performing eye hospitals acting as "mentors" to underperforming eye hospitals- "mentees" in 10 countries. Intervention activities included systematic planning and support for training and key equipment purchases as well as hospital-specific mentoring which focused on strengthening leadership, increasing the volume and equity of community outreach, improving surgical quality and volume, strengthening organizational and financial management and streamlining operational processes...
June 19, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28628561/the-surgeon-volume-outcome-relationship-not-yet-ready-for-policy
#8
J Gregory Modrall, Rebecca M Minter, Abu Minhajuddin, Javier Eslava-Schmalbach, Girish P Joshi, Shivani Patel, Eric B Rosero
OBJECTIVE: Increasing surgeon volume may improve outcomes for index operations. We hypothesized that there may be surrogate operative experiences that yield similar outcomes for surgeons with a low-volume experience with a specific index operation, such as esophagectomy. BACKGROUND: The relationship between surgeon volume and outcomes has potential implications for credentialing of surgeons. Restrictions of privileges based on surgeon volume are only reasonable if there is no substitute for direct experience with the index operation...
June 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28625834/association-between-natural-killer-cell-activity-and-colorectal-cancer-in-high-risk-subjects-undergoing-colonoscopy
#9
G Jobin, R Rodriguez-Suarez, K Betito
BACKGROUND & AIMS: Low activity of natural killer (NK) cells has been associated with increased risk of cancer and has been reported in patients with colorectal cancer (CRC). Activity of NK cells can be measured in a small volume of whole blood by a commercially available test. We investigated whether this test could be used to identify patients with CRC, using findings from colonoscopy as a reference standard. METHODS: We performed an open-label, prospective, cross-sectional study of 872 high-risk subjects (more than 40 years old) screened for CRC by colonoscopy at a university hospital in Montreal, Canada from October 2014 through January 2016...
June 15, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28625246/-effects-of-high-flow-hemodialysis-on-the-biomarker-of-myocardium-injury-and-the-cardiac-function-related-records-in-uremia-patients
#10
Ling Tang, Xiaofeng Deng, Qing Dai, Hengfen Xiao, Yue Shu, Min Jiang, Ling Wei, Li Wang
OBJECTIVE: To investigate the effects of high flow hemodialysis (HFHD) on cardiac function in uremia patients. METHODS: A prospective randomized controlled study was conducted. Sixty patients who were diagnosed with uremia, taken maintenance hemodialysis (MHD) and 30 healthy controls admitted to the Second People's Hospital of Guiyang from December 2014 to June 2015 were enrolled. They were randomly divided into two groups: HFHD group (HFHD three times a week) and the routine hemodialysis group (HD group, HD three times a week), with 30 in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28624050/impact-of-hospital-volume-on-outcomes-for-laparoscopic-adhesiolysis-for-small-bowel-obstruction
#11
Raymond A Jean, Kathleen M O'Neill, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Volume-to-outcome data have been studied in several complex surgical procedures, demonstrating improved outcomes at higher volume centers. Laparoscopic lysis of adhesions (LLOA) for small bowel obstruction (SBO) may result in better outcomes, but there is no information on the learning curve for this potentially complex case. This study evaluates the effect of institutional procedural volume on length of stay (LOS), outcomes, and costs in LLOA for SBOs. MATERIALS AND METHODS: The Nationwide Inpatient Sample data set between 2000 and 2013 was queried for discharges for a diagnosis of SBO involving LLOA in adult patients...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623570/enhanced-recovery-protocols-in-total-joint-arthroplasty-a-review-of-the-literature-and-their-implementation
#12
REVIEW
A S Galbraith, E McGloughlin, J Cashman
BACKGROUND: During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey...
June 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28623057/clinical-outcomes-of-endoscopic-submucosal-dissection-for-colorectal-tumors-a-large-multicenter-retrospective-study-of-hiroshima-gi-endoscopy-research-group
#13
Kazuki Boda, Shiro Oka, Shinji Tanaka, Shinji Nagata, Masaki Kunihiro, Toshio Kuwai, Yuko Hiraga, Akira Furudoi, Motomi Terasaki, Koichi Nakadoi, Makoto Higashiyama, Hideharu Okanobu, Morihisa Akagi, Kazuaki Chayama
BACKGROUND AND AIMS: Although advanced high-volume centers have reported good outcomes of colorectal endoscopic submucosal dissection (ESD), a limited number of highly skilled experts in specialized institutions performed these procedures. We undertook a retrospective multicenter survey, which included non-specialized hospitals, to investigate the clinical outcomes of colorectal ESD. PATIENTS & METHODS: We recruited 1233 consecutive patients with 1259 colorectal tumors resected by ESD at 12 institutions...
June 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28622216/the-clinical-picture-of-severe-systemic-capillary-leak-syndrome-episodes-requiring-icu-admission
#14
Marc Pineton de Chambrun, Charles-Edouard Luyt, François Beloncle, Marie Gousseff, Wladimir Mauhin, Laurent Argaud, Stanislas Ledochowski, Anne-Sophie Moreau, Romain Sonneville, Bruno Verdière, Sybille Merceron, Nathalie Zappella, Mickael Landais, Damien Contou, Alexandre Demoule, Sylvie Paulus, Bertrand Souweine, Bernard Lecomte, Antoine Vieillard-Baron, Nicolas Terzi, Elie Azoulay, Raymond Friolet, Marc Puidupin, Jérôme Devaquet, Jean-Marc Mazou, Yannick Fedun, Jean-Paul Mira, Jean-Herlé Raphalen, Alain Combes, Zahir Amoura
OBJECTIVE: Systemic capillary-leak syndrome is a very rare cause of recurrent hypovolemic shock. Few data are available on its clinical manifestations, laboratory findings, and outcomes of those patients requiring ICU admission. This study was undertaken to describe the clinical pictures and ICU management of severe systemic capillary-leak syndrome episodes. DESIGN, SETTING, PATIENTS: This multicenter retrospective analysis concerned patients entered in the European Clarkson's disease (EurêClark) Registry and admitted to ICUs between May 1992 and February 2016...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28620642/early-intervention-with-live-donor-liver-transplantation-reduces-resource-utilization-in-nash-the-toronto-experience
#15
Andrew S Barbas, Nicolas Goldaracena, Martin J Dib, David P Al-Adra, Aloysious D Aravinthan, Leslie B Lilly, Eberhard L Renner, Nazia Selzner, Mamatha Bhat, Mark S Cattral, Anand Ghanekar, Ian D McGilvray, Gonzalo Sapisochin, Markus Selzner, Paul D Greig, David R Grant
BACKGROUND: In parallel with the obesity epidemic, liver transplantation for nonalcoholic steatohepatitis (NASH) is increasing dramatically in North America. Although survival outcomes are similar to other etiologies, liver transplantation in the NASH population has been associated with significantly increased resource utilization. We sought to compare outcomes between live donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) at a high volume North American transplant center, with a particular focus on resource utilization...
June 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28619191/outcomes-of-pci-in-relation-to-procedural%C3%A2-characteristics-and-operator%C3%A2-volumes-in%C3%A2-the-united-states
#16
Alexander C Fanaroff, Pearl Zakroysky, David Dai, Daniel Wojdyla, Matthew W Sherwood, Matthew T Roe, Tracy Y Wang, Eric D Peterson, Hitinder S Gurm, Mauricio G Cohen, John C Messenger, Sunil V Rao
BACKGROUND: Professional guidelines have reduced the recommended minimum number to an average of 50 percutaneous coronary intervention (PCI) procedures performed annually by each operator. Operator volume patterns and associated outcomes since this change are unknown. OBJECTIVES: The authors describe herein PCI operator procedure volumes; characteristics of low-, intermediate-, and high-volume operators; and the relationship between operator volume and clinical outcomes in a large, contemporary, nationwide sample...
June 20, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28617240/what-carcinoembryonic-antigen-level-should-trigger-further-investigation-during-colorectal-cancer-follow-up-a-systematic-review-and-secondary-analysis-of-a-randomised-controlled-trial
#17
Bethany Shinkins, Brian D Nicholson, Tim James, Indika Pathiraja, Sian Pugh, Rafael Perera, John Primrose, David Mant
BACKGROUND: Following primary surgical and adjuvant treatment for colorectal cancer, many patients are routinely followed up with blood carcinoembryonic antigen (CEA) testing. OBJECTIVE: To determine how the CEA test result should be interpreted to inform the decision to undertake further investigation to detect treatable recurrences. DESIGN: Two studies were conducted: (1) a Cochrane review of existing studies describing the diagnostic accuracy of blood CEA testing for detecting colorectal recurrence; and (2) a secondary analysis of data from the two arms of the FACS (Follow-up After Colorectal Surgery) trial in which CEA testing was carried out...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28616051/omega-3-supplementation-effects-on-polycystic-ovary-syndrome-symptoms-and-metabolic-syndrome
#18
Behnaz Khani, Farahnaz Mardanian, Sajadeh Jafari Fesharaki
BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder with unknown etiology and with different complications. The aim of this study was to evaluate the effect of omega-3 supplementation on PCOS symptoms and metabolic syndrome. MATERIALS AND METHODS: This double-blind clinical trial was performed in 2015 in Alzahra and Shahid Beheshti Hospitals, Isfahan, Iran, on 88 patients with PCOS. Intervention group took omega-3 supplements with dose of 2 g/day for 6 months (two capsules), but control group received two olive oil capsules...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28614127/a-hospital-is-not-just-a-factory-but-a-complex-adaptive-system-implications-for-perioperative-care
#19
Aman Mahajan, Salim D Islam, Michael J Schwartz, Maxime Cannesson
Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories. However, a hospital is not merely a factory but also a complex adaptive system (CAS). The hospital CAS has many subsystems, with perioperative care being an important one for which concepts of factory redesign are frequently advocated...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28613921/high-attenuation-areas-on-chest-ct-and-clinical-respiratory-outcomes-in-community-dwelling-adults
#20
Anna J Podolanczuk, Elizabeth C Oelsner, R Graham Barr, Elana J Bernstein, Eric A Hoffman, Imaani J Easthausen, Karen Hinckley Stukovsky, Arindam RoyChoudhury, Erin D Michos, Ganesh Raghu, Steven M Kawut, David J Lederer
RATIONALE: Areas of increased lung attenuation on computed tomography are associated with all-cause mortality in the general population. It is uncertain whether this association is attributable to interstitial lung disease (ILD). OBJECTIVES: To determine whether high attenuation areas are associated with the risk of ILD hospitalization and mortality in the general population. METHODS: We performed a cohort study of 6,808 adults aged 45-84 sampled from six communities in the United States...
June 14, 2017: American Journal of Respiratory and Critical Care Medicine
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