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https://www.readbyqxmd.com/read/28645288/a-cohort-study-of-a-general-surgery-electronic-consultation-system-safety-implications-and-impact-on-surgical-yield
#1
Jesus G Ulloa, Marika D Russell, Alice Hm Chen, Delphine S Tuot
BACKGROUND: Electronic consultation (eConsult) systems have enhanced access to specialty expertise and enhanced care coordination among primary care and specialty care providers, while maintaining high primary care provider (PCP), specialist and patient satisfaction. Little is known about their impact on the efficiency of specialty care delivery, in particular surgical yield (percent of ambulatory visits resulting in a scheduled surgical case). METHODS: Retrospective cohort of a random selection of 150 electronic consults from PCPs to a safety-net general surgery clinic for the three most common general surgery procedures (herniorrhaphy, cholecystectomy, anorectal procedures) in 2014...
June 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28639117/tubeless-outpatient-robotic-upper-urinary-tract-reconstruction-in-the-pediatric-population-short-term-assessment-of-safety
#2
Eric J Fichtenbaum, Andrew C Strine, Charles W Concodora, Marion Schulte, Paul H Noh
Robotic upper urinary tract reconstruction (UUTR) has been widely utilized for surgical management of congenital obstruction. To further reduce morbidity and simplify postoperative care, outpatient robotic pyeloplasty (RP) and robotic ureteroureterostomy (RUU) were performed without ureteral stents, drains, or urethral catheters. The aim of the study was to assess the safety of performing tubeless robotic UUTR as an outpatient procedure. A retrospective review was performed for patients who underwent outpatient tubeless RP and RUU between July 2015 and January 2017...
June 21, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28607755/access-and-barriers-to-ms-care-in-latin-america
#3
REVIEW
Víctor M Rivera, Miguel Angel Macias
Multiple sclerosis (MS), an epidemiologically emergent disorder in Latin America (LATAM), poses substantial socioeconomic challenges to a region where most countries remain as economies in development. MS is not health priority despite its economic and communitarian impact with a relatively low prevalence. MS treatments in LATAM have evolved from earlier long-term oral steroids and immunosuppression protocols, to platform disease modifying therapies (DMTs), to the current landscape with more advanced therapeutic molecules...
January 2017: Multiple Sclerosis Journal—Experimental, Translational and Clinical
https://www.readbyqxmd.com/read/28583023/safety-of-outpatient-total-ankle-arthroplasty-vs-traditional-inpatient-admission-or-overnight-observation
#4
Ryan P Mulligan, Selene G Parekh
BACKGROUND: Total joint surgeons have successfully performed hip, knee, and shoulder arthroplasty procedures in the outpatient setting without compromising safety, satisfaction, or results. The purpose of this study was to evaluate outpatient total ankle arthroplasty (TAA) as compared with overnight or extended inpatient stay, with regard to 90-day medical and operative complications, reoperations, readmissions or emergency room visits, and pain control. METHODS: The medical records of patients who underwent TAA with 1 fellowship-trained orthopedic foot and ankle surgeon were reviewed...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28562388/procedural-sedation-in-the-icu-and-emergency-department
#5
Nikhil Chawla, Adjoa Boateng, Ranjit Deshpande
PURPOSE OF REVIEW: Procedures are increasingly being performed in the acute care setting, outside of the operating rooms (OR). This article aims to review the current literature on out-of-OR procedural sedation with a focus on the ICU and emergency department, highlighting the following topics: multidisciplinary team approach, choice of pharmacologic agent, sedation scales, current safety guidelines, anticipating complications, appropriate monitoring and necessary resources. RECENT FINDINGS: Subjective assessment of sedation using sedation scales is controversial...
May 27, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28557640/workplace-violence-training-programs-for-health-care-workers-an-analysis-of-program-elements
#6
Sheila Arbury, Michael Hodgson, Donna Zankowski, Jane Lipscomb
Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies...
June 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/28481385/an-assessment-of-the-safety-of-an-orthopedic-specialty-hospital-a-5-year-experience
#7
Eric M Padegimas, Matthew L Ramsey, Matthew Austin, Javad Parvizi, Gerald R Williams, Kelly Doyle, Michael E West, Richard H Rothman, Alexander R Vaccaro, Surena Namdari
One of the goals of orthopedic specialty hospitals is to provide safe and efficient care to medically optimized patients. The authors' orthopedic specialty hospital is a physician-owned, 24-bed facility that accommodates a multispecialty orthopedic practice in the areas of spine, hip and knee arthroplasty, shoulder and elbow, sports, foot and ankle, and hand surgery. The purpose of this study was to examine the first 5 years of an institutional experience with an orthopedic specialty hospital and to determine if any procedures were at increased risk of postoperative transfer...
May 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#8
Hussnain S Mirza, Gregory Logsdon, Anoop Pulickal, Mark Stephens, Rajan Wadhawan
Point-of-care (POC) ultrasound refers to the use of portable imaging. Although POC ultrasound is widely available to the neonatologists in Australia and Europe, neonatologists in the United States report limited availability. Our objective was to seek the US neonatologists' perception of barriers and prerequisites in adopting POC ultrasound in neonatal intensive care units. An online survey link was sent via e-mail to 3000 neonatologists included in the database maintained by the American Academy of Pediatrics...
April 20, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28417890/fire-safety-for-the-oral-and-maxillofacial-surgeon-and-surgical-staff
#9
REVIEW
LisaMarie Di Pasquale, Elie M Ferneini
Fire in the operating room is a life-threatening emergency that demands quick, efficient intervention. Because the circumstances surrounding fires are generally well-understood, virtually every operating room fire is preventable. Before every operating room case, thorough preprocedure "time outs" should address each team members' awareness of specific fire risks and agreement regarding fire concerns and emergency actions. Fire prevention centers on 3 constituent parts of the fire triad necessary for fire formation...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#10
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28375472/enhanced-recovery-after-surgery-protocol-in-patients-undergoing-esophagectomy-for-cancer-a-single-center-experience
#11
S Giacopuzzi, J Weindelmayer, E Treppiedi, M Bencivenga, M Ceola, S Priolo, M Carlini, G de Manzoni
This article is about an emerging issue in esophageal surgery: enhanced recovery after surgery (ERAS) Few data are published in literature and its safety and feasibility is still debated. The focus of our paper is on the feasibility of an ERAS protocol for esophagectomy (including both the Ivor-Lewis and McKeown procedure) in a high volume center comparing to a standard perioperative protocol. We introduced a novelty item on this type of surgery: resume of oral feeding in the first postoperative day. We analyzed the dropout rate for each item and the postoperative morbidity...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28356887/pre-test-and-post-test-applications-to-shape-the-education-of-phlebotomists-in-a-quality-management-program-an-experience-in-a-training-hospital
#12
Güzin Aykal, Mustafa Keşapli, Özgür Aydin, Hatice Esen, Ayşenur Yeğin, Faruk Güngör, Necat Yilmaz
BACKGROUND: After the introduction of modern laboratory instruments and information systems, preanalytic phase is the new field of battle. Errors in preanalytical phase account for approximately half of total errors in clinical laboratory. The objective of this study was to share an experience of an education program that was believed to be successful in decreasing the number of rejected samples received from the Emergency Department (ED). METHODS: An education program about laboratory procedures, quality requirements in the laboratory, patient and health-care worker safety was planned by the quality team to be performed on 36 people who were responsible for sample collection in the ED...
September 2016: Journal of Medical Biochemistry
https://www.readbyqxmd.com/read/28340041/bleeding-complications-in-patients-undergoing-intrathecal-drug-delivery-system-implantation
#13
Nafisseh S Warner, Markus A Bendel, Matthew A Warner, Jacob J Strand, Halena M Gazelka, Bryan C Hoelzer, William D Mauck, Tim J Lamer, Daryl J Kor, Susan M Moeschler
Introduction.:  Intrathecal drug delivery systems (IDDSs) have dramatically improved analgesia and the functional status of cancer patients and those with chronic pain states. However, given the close proximity to the neuraxis and frequent concomitant use of antiplatelet or anticoagulant medications, this intervention is not without risk. The goal of this investigation was to determine the incidence of bleeding complications following IDDS placement. Methods.:  This is a retrospective review from 2005 through 2014 of adult patients undergoing IDDS implantation or revision at a tertiary care center...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28335637/reversing-the-anticoagulation-effects-of-dabigatran
#14
REVIEW
William E Dager, Linda Banares
The standard of care for oral anticoagulation therapy has primarily been warfarin, which is limited by its indirect mechanism-of-action, variable kinetics, tolerability, and routine monitoring concerns. The direct-acting oral anticoagulants (DOACs) have predictable pharmacokinetics and pharmacodynamics, and improved safety and efficacy compared to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation and prevention or management of venous thromboembolism. Consequential bleeding is a concern with all anticoagulants...
April 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28328569/mid-term-follow-up-of-minimally-invasive-multivessel-coronary-artery-bypass-grafting-is-the-early-learning-phase-detrimental
#15
Maria Lorena Rodriguez, Harry R Lapierre, Benjamin Sohmer, David Glineur, Marc Ruel
OBJECTIVE: Minimally invasive coronary artery bypass grafting (MICS CABG) through a small left thoracotomy is a novel technique for surgical coronary revascularization, which is increasingly being adopted around the world. This study aimed to describe the characteristics and mid-term outcomes of a series of MICS CABG to identify areas for improvement. METHODS: A prospective longitudinal study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015...
March 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28326800/safety-feasibility-and-efficacy-of-bilateral-synchronous-percutaneous-nephrolithotomy-for-bilateral-stone-disease-evidence-from-a-systematic-review
#16
REVIEW
Patrick Jones, Blessing Dhliwayo, Bhavan Prasad Rai, Moeketsi Mokete, Ramachandran Amitharaj, Omar M Aboumarzouk, Bhaskar K Somani
INTRODUCTION: With the evolution of endourologic technology, bilateral synchronous percutaneous nephrolithotomy (BS-PCNL) has emerged as a potentially practical intervention for patients with bilateral lithiasis. Although tradition has favored a staged approach, an increasing number of original studies have reported their experiences with the synchronous approach. MATERIALS AND METHODS: A Cochrane style search was performed after development of a sensitive and predefined search strategy...
April 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#17
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28286524/mesenchymal-stem-cells-for-the-treatment-of-spinal-arthrodesis-from-preclinical-research-to-clinical-scenario
#18
REVIEW
F Salamanna, M Sartori, G Barbanti Brodano, C Griffoni, L Martini, S Boriani, M Fini
The use of spinal fusion procedures has rapidly augmented over the last decades and although autogenous bone graft is the "gold standard" for these procedures, alternatives to its use have been investigated over many years. A number of emerging strategies as well as tissue engineering with mesenchymal stem cells (MSCs) have been planned to enhance spinal fusion rate. This descriptive systematic literature review summarizes the in vivo studies, dealing with the use of MSCs in spinal arthrodesis surgery and the state of the art in clinical applications...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28257612/health-care-in-high-school-athletics-in-west-virginia
#19
Kyle Schneider, Wesley Meeteer, Jill A Nolan, H David Campbell
INTRODUCTION: The purpose of this study was to determine the level of implementation of emergency preparedness procedures and administrative procedures to provide appropriate medical coverage to high school athletics in the predominantly rural US state of West Virginia. Particular attention was given to determine the extent to which the schools provided the recommendations for best practice in the National Athletic Trainers Association consensus statement outlining appropriate medical coverage for high school athletics...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28251880/choosing-wisely-canada%C3%A2-five-tests-procedures-and-treatments-to-question-in-emergency-medicine
#20
Amy H Y Cheng, Sam Campbell, Lucas B Chartier, Tom Goddard, Kirk Magee, Jill McEwen, Atul K Kapur, Brian R Holroyd, Suneel Upadhye, Stephanie Couperthwaite, Brian H Rowe
OBJECTIVES: Choosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians' (CAEP) top five list of recommendations, and the process undertaken to generate them. METHODS: The CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned...
March 2, 2017: CJEM
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