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https://www.readbyqxmd.com/read/28527552/postoperative-instructions-preoperatively-evaluating-the-effectiveness-of-a-teaching-model-on-patient-satisfaction-regarding-instructions-for-home-care
#1
Jennifer Hovsepian, Cheryl McGah, Claire O'Brien
Patients in the ambulatory setting often receive home care instructions, primarily in the postoperative phase. Patient's retention and understanding of these instructions is one determinant of postoperative outcomes. This article highlights how we designed and implemented a teaching strategy to better prepare patients for discharge from an ambulatory surgical setting. Our methods included developing a day of surgery plan for teaching patients their discharge instructions upon arrival, creating on-line teaching videos, and revising post discharge pain medication instructions...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28524384/patient-reported-dietetic-care-post-hospital-for-free-living-patients-a-canadian-malnutrition-task-force-study
#2
H Keller, H Payette, M Laporte, P Bernier, J Allard, D Duerksen, L Gramlich, K Jeejeebhoy
BACKGROUND: Transitions out of hospital can influence recovery. Ideally, malnourished patients should be followed by someone with nutrition expertise, specifically a dietitian, post discharge from hospital. Predictors of dietetic care post discharge are currently unknown. The present study aimed to determine the patient factors independently associated with 30-days post hospital discharge dietetic care for free-living patients who transitioned to the community. METHODOLOGY: Nine hundred and twenty-two medical or surgical adult patients were recruited in 16 acute care hospitals in eight Canadian provinces on admission...
May 19, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28521346/real-time-magnetic-resonance-imaging-guided-biopsy-using-smartframe%C3%A2-stereotaxis-in-the-setting-of-a-conventional-diagnostic-magnetic-resonance-imaging-suite
#3
Justin K Scheer, Thomas Hamelin, Leon Chang, Brian Lemkuil, Bob S Carter, Clark C Chen
BACKGROUND: Real-time magnetic resonance imaging (MRI) visualization during stereotactic needle biopsies affords several valuable benefits to the neurosurgeon, including the opportunity to visually confirm the biopsy site at the time of surgery. Until now, reported experiences with this technique have been limited to the setting of intraoperative MRI or dedicated procedural MRI suites with modified ventilation systems. OBJECTIVE: To describe our experience with 11 consecutive patients who underwent real-time MRI-guided biopsy performed using SmartFrame® stereotaxis (MRI Interventions, Irvine, California) in the setting of a conventional diagnostic MRI suite...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28521010/prospective-audit-of-a-pathway-for-in-patient-pain-management-of-chronic-abdominal-pain-a-novel-and-cost-effective-strategy
#4
Gopinath Niraj, Sanjay Chaudhri
Background.:  Unexplained abdominal pain is a common cause of hospital admission and utilizes significant resource. Current in-patient pain management of acute exacerbation of chronic abdominal pain is primarily directed at pharmacological and psychological management strategies in this group of complex patients. We adopted a novel approach that proved to be both clinically effective and cost-effective. Design.:  Adult patients admitted to a surgical ward with acute exacerbation of chronic abdominal pain referred to in-patient pain management were prospectively audited over a two-year period at a single tertiary centre...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28515414/mediastinal-solitary-fibrous-tumor-diagnosed-by-endobronchial-ultrasound-directed-biopsy
#5
Alaina J Webb, Ahmed S Yassin, Ali Saeed, Hemang Yadav, James P Utz
BACKGROUND Solitary fibrous tumors of the middle mediastinal space are uncommon and often not discovered until symptoms secondary to compression of adjacent structures occur. Diagnosis requires surgical biopsy and histological tissue analysis. We describe the ECHO appearance of the solitary fibrous tumor and successful non-invasive EBUS diagnosis. This method of diagnosis allowed for surgical planning for resection and allowed us to exclude non-surgical diseases, such as small cell carcinoma. CASE REPORT A 32-year-old man presented to his primary care physician with worsening intermittent chronic chest pain with recent progressive dysphagia, cough, and dyspnea...
May 18, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28514132/-assessing-the-short-and-long-term-effect-of-video-assisted-thoracic-surgery-lobectomy-in-octogenarian-patients
#6
Ofir Zalcberg, Dan Levy Faber, Moshe Lapidot, Lael Anson Best, Ran Kremer
BACKGROUND: Lung cancer is a leading deadly malignancy, both in men and women, with an increasing cancer diagnosis risk with age. Although thoracic surgery techniques have evolved and now include Video Assisted Thoracic Surgery (VATS), older operable lung cancer patients are still operated on less compared to the younger population. This study aimed at investigating the postoperative morbidity, mortality, and long-term quality of life in our pool of octogenarian patients. METHODS: Octogenarians with newly diagnosed lung cancer at a clinical operable stage undergoing VATS procedures were reviewed...
July 2016: Harefuah
https://www.readbyqxmd.com/read/28511972/a-matched-cohort-comparison-of-cervical-disc-arthroplasty-versus-anterior-cervical-discectomy-and-fusion-evaluating-perioperative-outcomes
#7
Pavan S Upadhyayula, John K Yue, Erik I Curtis, Reid Hoshide, Joseph D Ciacci
OBJECTIVE: Cervical disc arthroplasty (CDA) is a recent alternative to anterior cervical discectomy and fusion (ACDF) in patients suffering cervical disc herniation and degeneration. To date, a systematic analysis of their comparative advantages and risks following elective surgery remains elusive. METHODS: Adult patients undergoing elective CDA or ACDF were extracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database years 2011-2014...
May 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28506604/the-supraciliary-space-as-a-suitable-pathway-for-glaucoma-surgery-ho-hum-or-home-run
#8
REVIEW
Michele Figus, Chiara Posarelli, Andrea Passani, Timothy G Albert, Francesco Oddone, Angela Tindara Sframeli, Marco Nardi
The supraciliary space is a physiological route for aqueous humor outflow located anteriorly between the outer surface of the ciliary body and the internal surface of the sclera. Posteriorly, the suprachoroidal space is located between the choroid and the internal surface of the sclera. These spaces have been targeted as suitable and helpful pathways for glaucoma treatment, alternatives to the traditional subconjunctival space. The subconjunctival surgical pathway is affected by several limitations such as poor cosmesis, a lifetime risk for endophthalmitis, and an unpredictable wound healing response...
May 12, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28504359/changing-the-paradigm-for-diagnostic-mri-in-pediatrics-don-t-hold-your-breath
#9
Melissa M Masaracchia, Michael J Tsapakos, Nancy J McNulty, Michael L Beach
Increasingly complex pediatric patients and improvements in technology warrant reevaluation of the risk associated with anesthesia for diagnostic imaging. Although magnetic resonance imaging is the imaging modality of choice for children given the potentially harmful effects of computerized tomography-associated ionizing radiation, we dare to suggest that certain patients would benefit from the liberalization of our current standard. Incorporating the use of newer computerized tomography technology may improve safety for those that are already at higher risk for adverse events...
May 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28504355/home-high-flow-nasal-cannula-as-a-treatment-for-severe-tracheomalacia-a-pediatric-case-report
#10
Kevin Vézina, Sophie Laberge, The Thanh Diem Nguyen
Tracheomalacia refers to a softness of the tracheal cartilage that makes the airway more susceptible to collapse. In contrast to milder cases where conservative therapy is preferred, severe tracheomalacia is often a life threatening condition requiring more aggressive management. For children with this condition, a variety of treatment options are available. To our knowledge, this is the first report of home high-flow nasal cannula as an alternative therapy to continuous positive airway pressure (CPAP) and surgical procedures in a pediatric patient with severe extensive tracheomalacia...
May 15, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28501112/early-results-of-a-surgeon-led-perioperative-surgical-home
#11
Anathea C Powell, Marie S Thearle, Matthew Cusick, Dorothy Jensen Sanderson, Holly Van Lew, Candace Lee, Jennefer A Kieran
BACKGROUND: The Perioperative Surgical Home is a novel care model designed to provide patient-centered, high-quality surgical care. In 2013, we implemented POSH, a pilot Peri-Operative Surgical Home at Phoenix Indian Medical Center (PIMC), an Indian Health Service hospital, as a quality improvement project. After 2 y, we sought to quantify the impact of POSH on the quality of surgical care at PIMC. MATERIALS AND METHODS: We conducted a retrospective review of 33 surgical patients who underwent surgery at PIMC through the POSH process between 2013 and 2015 matched to 64 historical controls with similar operations...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28499084/psychological-assessment-of-emirati-patients-pursuing-bariatric-surgery-for-obesity
#12
Ossama T Osman, Essam Emam, Taoufik Zoubeidi, Fadwa Al-Mugaddam, Abdul-Kader Souid
Background: Obesity is currently a rapidly growing global problem of epidemic proportions and is especially prevalent in economically developed countries such as the United Arab Emirates. Obese individuals are increasingly considering bariatric surgery as their preferred means of choice for the reduction of excess body fat. This study explored the psychological characteristics that may potentially complicate the surgical management of obesity. Methods: This was a cross-sectional study of Emirati patients attending a bariatric clinic at Tawam Hospital, Al Ain, United Arab Emirates, between December 2010 and February 2012...
May 11, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28498068/predictors-of-extended-length-of-stay-discharge-to-inpatient-rehab-and-hospital-readmission-following-elective-lumbar-spine-surgery-introduction-of-the-carolina-semmes-grading-scale
#13
Matthew J McGirt, Scott L Parker, Silky Chotai, Deborah Pfortmiller, Jeffrey M Sorenson, Kevin Foley, Anthony L Asher
OBJECTIVE Extended hospital length of stay (LOS), unplanned hospital readmission, and need for inpatient rehabilitation after elective spine surgery contribute significantly to the variation in surgical health care costs. As novel payment models shift the risk of cost overruns from payers to providers, understanding patient-level risk of LOS, readmission, and inpatient rehabilitation is critical. The authors set out to develop a grading scale that effectively stratifies risk of these costly events after elective surgery for degenerative lumbar pathologies...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28497099/acetabular-fractures-in-the-senior-population-epidemiology-mortality-and-treatments
#14
Reza Firoozabadi, William W Cross, James C Krieg, Milton L Chip Routt
BACKGROUND: Management of acetabular fractures in the senior population can be one of the most challenging injuries to manage. Furthermore, treating surgeons have a paucity of information to guide the treatment in this patient population. THE PURPOSE OF THIS STUDY WAS TO DETERMINE: (1) demographic and epidemiologic data, (2) mortality rates for nonoperative compared to operative management at different time points, (3) common fracture configurations, and (4) fracture fixation strategies in senior patients treated with acetabular fractures...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28492996/patient-perspectives-on-barriers-to-surgical-care-and-the-impact-of-mobile-surgery-in-ecuador
#15
Matthew D Price, Haadi T Shalabi, Blasco Guzhñay, Saggah T Shalabi, Raymond R Price, Edgar B Rodas
BACKGROUND: An estimated 5 billion people worldwide lack access to timely safe surgical care (Gawande in Lancet 386(9993):523-525, 2015). A mere 6% of all surgical procedures occur in the poorest countries where over a third of the world's population lives (Meara et al. in Surgery 158(1):3-6, 2015). Mobile surgical units like the Cinterandes Foundation endeavor to bring surgical care directly to these communities who otherwise would lack access to safe surgery. This study examines the barriers patients encounter in seeking surgical care in rural communities of Ecuador and their impressions on how mobile surgery addresses such barriers...
May 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28492816/enhanced-recovery-after-surgery-program-implementation-in-2-surgical-populations-in-an-integrated-health-care-delivery-system
#16
Vincent X Liu, Efren Rosas, Judith Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Derrick C Lee, Alex Mustille, Patricia Kipnis, Stephen Parodi
Importance: Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. Objective: To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. Design, Setting, and Participants: A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery)...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28491303/self-evaluation-of-tobacco-exposure-by-allied-health-students-in-a-community-college-setting
#17
Fiona Geiser, Meredith Much, Karen Beyer
OBJECTIVE: Tobacco education is among the initiatives encouraged for health professionals to help them appreciate the significance of addressing tobacco use among their patients. In this pilot study, a nicotine biomarker (cotinine) study was introduced to an applied microbiology course required of all allied health students. Participants assessed their own smoking status in the previous 24 h using a two-dimensional experimental design of a questionnaire and rapid urinary cotinine immunoassay...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28486325/experiences-of-older-adult-trauma-patients-discharged-home-from-a-level-i-trauma-center
#18
Nathalie Rodrigue, Andréa Maria Laizner, Nancy Tze, Maida Sewitch
The number of patients 65 years and older has been rising steadily every year at our Level I trauma center. Our clinical experience demonstrated that once discharged, some of these patients were not managing well. Postdischarge portrait is difficult to ascertain because this information is not captured in the trauma registry database. The purpose of this study was to describe the experiences of hospitalized trauma patients 65 years and older who are discharged home. A descriptive cross-sectional study of hospitalized trauma patients was conducted 1 month postdischarge using PREPARED Patient and 36-item Short Form Health Survey questionnaires...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28486022/wound-concerns-and-healthcare-consumption-of-resources-after-colorectal-surgery-an-opportunity-for-innovation
#19
Puja M Shah, Heather L Evans, Amy Harrigan, Robert G Sawyer, Charles M Friel, Traci L Hedrick
BACKGROUND: Significant portions of patients undergoing colorectal surgical procedures have minor incision disturbances, yet very few meet definitions for surgical site infection (SSI). We sought to investigate the natural history of incision disturbances with a focus on the patient experience and resource utilization. We hypothesize that patients who have an incision disturbance consume frequent healthcare resources in the post-operative period despite the fact that most never receive a diagnosis of SSI...
May 9, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28486000/evolution-in-the-treatment-of-esophageal-disease-at-a-single-academic-institution-2004-2013
#20
James P Dolan, Patrick J McLaren, Brian S Diggs, Paul H Schipper, Brandon H Tieu, Brett C Sheppard, Erin W Gilbert, Molly A Conroy, John G Hunter
INTRODUCTION: Management of benign and malignant esophageal disease has changed rapidly over the past decade. The aim of this study was to analyze evolution in surgical management of esophageal disease at a single academic medical center during this period. MATERIALS AND METHODS: We reviewed a retrospective cohort of patients who underwent esophagectomy between 2004 and 2013. Patient, institutional, treatment, and outcomes variables were reviewed. RESULTS: 317 patients were analyzed...
May 9, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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