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P H Cashin, H Mahteme, I Syk, J E Frödin, B Glimelius, W Graf
BACKGROUND: The aim was to compare health-related quality-of-life (HRQOL) and cost-effectiveness between cytoreductive surgery with intraperitoneal chemotherapy (CRS + IPC) and systemic chemotherapy for patients with colorectal peritoneal metastases. METHODS: Patients included in the Swedish Peritoneal Trial comparing CRS + IPC and systemic chemotherapy completed the EORTC QLQ-C30 and SF-36 questionnaires at baseline, 2, 4, 6, 12, 18, and 24 months. HRQOL at 24 months was the primary endpoint...
February 21, 2018: European Journal of Surgical Oncology
Jean-Marc Classe, Frédéric Guyon, Claire Falandry, Mojgan Devouassoux-Shisheboran, Frédéric Selle, Florence Joly
Recommendations for the clinical practice of Nice-Saint-Paul de Vence The treatment of advanced epithelial ovarian cancer is multidisciplinary involving surgical teams and surgery and medical oncology, experienced in the management of this disease, following published quality criteria. The strategy must be validated in multidisciplinary consultation meeting (RCP) before any treatment. The pre-therapeutic assessment includes the histological diagnosis, evaluation of the tumor extension (biological assessment, markers, imaging, laparoscopy), assessment of the general state (operability), in order to answer the question of feasibility of an initial optimal surgery...
May 2017: Bulletin du Cancer
C Quah, E Bayley, N Bhamber, P Howard
BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) has issued guidelines on which thromboprophylaxis regimens are suitable following lower limb arthroplasty. Aspirin is not a recommended agent despite being accepted in orthopaedic guidelines elsewhere. We assessed the incidence of fatal pulmonary embolism (PE) and all-cause mortality following elective primary total knee replacement (TKR) with a standardised multi-modal prophylaxis regime in a large teaching district general hospital...
June 13, 2017: Knee
Jo Worthington, Hilary Taylor, Paul Abrams, Sara T Brookes, Nikki Cotterill, Sian M Noble, Tobias Page, K Satchi Swami, J Athene Lane, Hashim Hashim
BACKGROUND: Transurethral resection of the prostate (TURP) has been the standard operation for benign prostatic obstruction (BPO) for 40 years, with approximately 25,000 procedures performed annually, and has remained largely unchanged. It is generally a successful operation, but has well-documented risks for the patient. Thulium laser transurethral vaporesection of the prostate (ThuVARP) vaporises and resects the prostate using a surgical technique similar to TURP. The small amount of study data currently available suggests that ThuVARP may have certain advantages over TURP, including reduced blood loss and shorter hospital stay, earlier return to normal activities, and shorter duration of catheterisation...
April 17, 2017: Trials
D M McGoldrick, H P Redmond
BACKGROUND AND AIMS: Venous thromboembolism (VTE) is a potential source of morbidity and mortality in surgical in-patients. A number of guidelines exist that advise on prophylactic measures. We aimed to assess VTE prophylaxis prescribing practices and compliance with a kardex-based risk assessment tool in a general surgery population. METHODS: Data on general surgery in-patients were collected on two separate wards on two separate days. Drug kardexes were assessed for VTE prophylaxis measures and use of the risk assessment tool...
August 2017: Irish Journal of Medical Science
Richard D Holmes
Data sourcesAMED, CINAHL, Cochrane Library, Embase, Medline, PsycINFO, PsycARTICLES, ScienceDirect, SocINDEX, ASSIA, Social Policy and Practice, HMIC (Health Management Information Consortium), The Knowledge Network, Intute, MedNar, Copac, EPPI-Centre, EThOS, OpenGrey and TRIP databases. Searches were limited to publications in the English language published after 1994.Study selectionStudies set in general practice that investigated promoting good oral health in adult or child patients were considered. Study quality was assessed using NICE public health guidance checklists...
2016: Evidence-based Dentistry
A Fishlock, C Scarsbrook, R Marsh
Introduction In 2011 the National Institute for Health and Care Excellence (NICE) published guidelines suggesting that clinicians offer total hip replacement (THR) to patients with displaced intracapsular hip fractures who could walk independently outside with no aids or one stick, who are not cognitively impaired and are ASA (American Society of Anesthesiologists) grade ≤2. They also stated that best practice is operating within 36 hours of presentation. This audit aimed to determine whether Scarborough Hospital was following these guidelines and compared the results with the national average...
July 2016: Annals of the Royal College of Surgeons of England
Rhiannon Louise Worrall, Steven Jeffery
This study aims to build on the small body of evidence in previously published study exploring professional attitudes toward deliberate self-harm (DSH) patients from a predominantly burns and plastic surgery perspective. The authors distributed a short paper-based questionnaire within the burns and plastics department at the Queen Elizabeth Hospital, Birmingham, where the authors gathered a mixture of qualitative and quantitative data surrounding this issue. Professionals generally agree that DSH patients require input from multiple services and that surgery is not always the best option...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Jacob Koris, Catherine Hopkins
At Leicester General Hospital, England, patients are assessed by a team of junior doctors for elective colorectal and hepatobiliary procedures. After a number of same day cancellations, a large discrepancy was identified between the findings at the preoperative assessment clinic and the anaesthetic assessment on the day of surgery. After a multidisciplinary meeting was held, three interventions were decided on with an aim to bring the preoperative assessment in line with the anaesthetic assessment. Firstly, a set of guidelines was written and introduced for the junior doctors to use as a reference when assessing patients...
2015: BMJ Quality Improvement Reports
Helen Henfrey
AIMS AND METHODS: The IAPT scheme was introduced in 2007 to implement the recommendations from NICE guidelines regarding psychological therapy for depression. This retrospective audit carried out across two General Practice Surgeries evaluates the care being given in relation to the standards of NICE guidelines. RESULTS: Initial audit found variable concordance, however after discussion of this at a local audit meeting and the displaying of posters and leaflets detailing the IAPT scheme this was improved on re-audit...
September 2015: Psychiatria Danubina
Benjamin Bloch, Sue Brown, Darshan Angadi, Edward Crawfurd
We present the outcome of 270 cemented titanium alloy femoral stems. These patients were followed up annually both clinically and radiologically, and were included up until their last follow-up. 120 patients completed a 10-year follow-up. The 10-year survival of the Ultima Straight Stem cemented femoral component (defined by revision of the femoral stem) was 90.1% (95% CI=84.0-94.0%), with aseptic loosening being the major reason for failure. The preoperative Harris Hip Score improved from 35.3 to 79.3 at 10 years...
June 2015: Acta Orthopaedica Belgica
G A Fremlin, P Gomez, J Halpern
BACKGROUND: The incidence of basal cell carcinoma (BCC) is rising within the UK, and poses a significant workload on primary and secondary care services. Greater general practitioner (GP) involvement in the diagnosis and management of BCC has been suggested to reduce this burden. In 2010, the National Institute of Health and Care Excellence (NICE) produced guidelines on the management of low-risk BCCs by GP surgeons. AIM: To assess what proportion of BCCs are suitable for excision by GP surgeons, and to determine the potential demand for GP-led BCC surgery...
March 2016: Clinical and Experimental Dermatology
Ahsan Rao, Ian Tait, Afshin Alijani
BACKGROUND: Mental training is rehearsal of mental imagery without physically performing the task. The aim of the study was to perform systematic review and meta-analysis on all the available data to evaluate the role of mental training in the acquisition of surgical technical skills. METHODS: The following search databases were used: EMBASE, MEDLINE, Web of Science,, SIGN guidelines, NICE guidelines, and Cochrane review register. Meta-analysis was performed using Revman 5...
September 2015: American Journal of Surgery
Isabel Teo, D A Munnoch
INTRODUCTION: Liposuction for lymphoedematous limbs is an effective treatment for chronic lymphoedema, with excellent long-term results in well-selected patients. In 2008 NICE produced guidelines 'Liposuction for Chronic lymphoedema', acknowledging this treatment modality. However, there remain very few centers that provide this service in the United Kingdom. We aim to share our experience of our referral system at Ninewells Hospital, Dundee, Scotland. METHODS: A 10 year prospective database from 2005 to 2014 was analysed...
October 2015: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Carmen Pinto, Nadia Barrett
Background Looked after children and young people (LAC) have higher incidence of mental health problems than non-looked after children. Many mental health difficulties are missed in this group, in particular the effects of trauma and loss and the resulting depression. LAC often move between placements, which further disrupts their care and therapeutic interventions. NICE recommends that in most mental health disorders, children and adolescents should receive specific psychological therapies as first-line treatment, before medication...
July 2010: London Journal of Primary Care
Axel Maurice-Szamburski, Pascal Auquier, Véronique Viarre-Oreal, Philippe Cuvillon, Michel Carles, Jacques Ripart, Stéphane Honore, Thibaut Triglia, Anderson Loundou, Marc Leone, Nicolas Bruder
IMPORTANCE: Sedative premedication is widely administered before surgery, but little clinical evidence supports its use. OBJECTIVE: To assess the efficacy of sedative premedication on perioperative patient experience. DESIGN, SETTING, AND PARTICIPANTS: A randomized clinical trial, the PremedX study, enrolled 1062 adult patients who were younger than 70 years and had been scheduled for various elective surgeries under general anesthesia at 5 French teaching hospitals (in Marseille, Montpellier, Nimes, and Nice) between January 2013 and June 2014...
March 3, 2015: JAMA: the Journal of the American Medical Association
John Wilding
Diabetes risk increases exponentially with increasing BMI particularly if fat accumulates centrally and/or in the skeletal muscle, liver and other organs such as the pancreas. Those with diabetes and co-existing obesity, particularly if it is severe, are also at risk of other obesity-related conditions, such as cardiovascular disease, obstructive sleep apnoea, joint pain, many cancers and depression. In people with impaired glucose tolerance, modest weight loss can reduce the development of overt diabetes by 50% or more over four years...
January 2015: Practitioner
Dan W Parrish, Jeffrey H Haynes, Charles E Bagwell
Salzbergian\solz-bərgē-ən\ adjective of, relating to, or following the teachings of Arnold Salzberg. Noun one who embodies all that Arnold Salzberg taught about humanity. Noun one who has obtained his or her HB degree. Webster's dictionary would probably define "Salzbergian" as one who trained under Arnold Salzberg and exhibits the same great character traits, mentoring ability, and surgical skills. These might be the words that are used, but many times words cannot do justice to describing something so special...
January 2015: Journal of Pediatric Surgery
Bruce Campbell, Rebekah Morris, Lakshmi Mandava, Lakshmi Murthy, Helen Gallo, Koh Jun Ong, Ali Latif, Hannah Patrick
OBJECTIVES: The aim of this study was to analyze the experience of the National Institute for Health and Care Excellence (NICE) in identifying new procedures entering the United Kingdom (UK) healthcare system, for assessment and publication of recommendations on their use. This system is designed to provide guidance in an area where regulation is lacking worldwide. METHODS: Retrospective analysis of all procedures notified to the Interventional Procedures Programme (NICE) between 2002 and 2012...
October 2014: International Journal of Technology Assessment in Health Care
Mia Schmidt-Hansen, David R Baldwin, Elise Hasler, Javier Zamora, Víctor Abraira, Marta Roqué I Figuls
BACKGROUND: A major determinant of treatment offered to patients with non-small cell lung cancer (NSCLC) is their intrathoracic (mediastinal) nodal status. If the disease has not spread to the ipsilateral mediastinal nodes, subcarinal (N2) nodes, or both, and the patient is otherwise considered fit for surgery, resection is often the treatment of choice. Planning the optimal treatment is therefore critically dependent on accurate staging of the disease. PET-CT (positron emission tomography-computed tomography) is a non-invasive staging method of the mediastinum, which is increasingly available and used by lung cancer multidisciplinary teams...
November 13, 2014: Cochrane Database of Systematic Reviews
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