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https://www.readbyqxmd.com/read/28817348/palliative-care-consults-in-u-s-nursing-homes-not-just-for-the-dying
#1
Julie C Lima, Susan C Miller
BACKGROUND: Little is known about nursing home (NH) residents who receive palliative care (PC) consults in the United States. OBJECTIVE: Separately by short versus long (≥90 days) stays, to describe NH residents with PC consults compared to a prevalent NH sample. DESIGN: Descriptive longitudinal study. SETTING/SUBJECTS: NH residents in 2008-2010 in 54 NHs. MEASUREMENTS: Resident characteristics came from merged Medicare and NH data from the Centers for Medicare and Medicaid Services and consult information from two PC organizations that were the sole PC consult providers in the study NHs...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817298/radical-prostatectomy-innovation-and-outcomes-at-military-and-civilian-institutions
#2
Jeffrey J Leow, Joel S Weissman, Linda Kimsey, Andrew Hoburg, Lorens A Helmchen, Wei Jiang, Nathanael Hevelone, Stuart R Lipsitz, Louis L Nguyen, Steven L Chang
OBJECTIVES: Limited data are available regarding the impact of the type of healthcare delivery system on technology diffusion and associated clinical outcomes. We assessed the adoption of minimally invasive radical prostatectomy (MIRP), a recent clinical innovation, and whether this adoption altered surgical morbidity for prostate cancer surgery. STUDY DESIGN: Retrospective review of administrative data from TRICARE, the healthcare program of the United States Military Health System...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28817114/trauma-informed-care-in-the-newborn-intensive-care-unit-promoting-safety-security-and-connectedness
#3
M R Sanders, S L Hall
Both babies and their parents may experience a stay in the newborn intensive care unit (NICU) as a traumatic or a 'toxic stress,' which can lead to dysregulation of the hypothalamic-pituitary-adrenal axis and ultimately to poorly controlled cortisol secretion. Toxic stresses in childhood or adverse childhood experiences (ACEs) are strongly linked to poor health outcomes across the lifespan and trauma-informed care is an approach to caregiving based on the recognition of this relationship. Practitioners of trauma-informed care seek to understand clients' or patients' behaviors in light of previous traumas they have experienced, including ACEs...
August 17, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28816967/hand-assisted-laparoscopic-surgery-versus-conventional-open-surgery-in-intraoperative-and-postoperative-outcomes-for-colorectal-cancer-an-updated-systematic-review-and-meta-analysis
#4
Xubing Zhang, Qingbin Wu, Chaoyang Gu, Tao Hu, Liang Bi, Ziqiang Wang
AIM: This meta-analysis aims to compare hand-assisted laparoscopic surgery (HALS) and conventional open surgery (OS) for colorectal cancer (CRC) in terms of intraoperative and postoperative outcomes, and to explore the safety, feasibility of HALS for CRC surgery. METHODS: A systematic literature search with no limits was performed in PubMed, Embase, and Medline. The last search was performed on April 23, 2017. The outcomes of interests included intraoperative outcomes (operative time, blood loss, length of incision, transfusion, and lymph nodes harvested), postoperative outcomes (length of hospital stay, length of postoperative hospital stay, time to first flatus, time to first liquid diet, time to first soft diet, time to first bowel movement, postoperative complications, reoperation, ileus, anastomotic leakage, wound infection, urinary complication, pulmonary infection, and mortality)...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28816522/the-intertwined-relationship-between-patient-education-hospital-waiting-times-and-hospital-utilization
#5
Maike Schulz
Background Hospital waiting times are established instruments to ration healthcare when resources are scarce. However, higher educated patients may be better able to influence access to, and exit from, hospital care when waiting times are long. Methods Based on a representative sample of 11 European countries from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected in 2004/2005, this paper investigates whether the relationship between individual educational background and hospital utilization depends on the prevalent hospital waiting times in a country...
January 1, 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28816274/-retroperitoneal-laparoscopic-with-renal-pedicle-rotation-for-partial-nephrectomy-of-ventro-renal-tumor
#6
Y H Liang, X B Zu, X Cheng, L F Liu
OBJECTIVE: Retro-laparoscopic partial nephrectomy is a challenge for ventro-renal tumors, especially hilar tumors. The tumors are partial or entirely out of operative field and there is blind space for operation. To solve this problem, a set of techniques including renal pedicle rotation is developed. METHODS: A set of techniques including renal pedicle rotation, double-layer suture, early artery unclamping for retro-laparoscopic nephrectomy for ventro-renal tumors, especially hilar tumors were developed...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28816201/risk-factors-and-the-prognosis-of-sexual-dysfunction-in-male-patients-with-pituitary-adenomas-a-multivariate-analysis
#7
Wen-Jian-Long Zhou, Shun-Chang Ma, Min Zhao, Chang Liu, Xiu-Dong Guan, Zhao-Shi Bao, Gui-Jun Jia, Wang Jia
The impact of sexual dysfunction (SD) is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual function and the prognosis of male patients with pituitary adenomas. Two hundred and fifty-four male patients, who aged between 18 and 60 (mean ± s.d.: 44.16 ± 10.14) years and diagnosed with pituitary adenomas, were retrospectively analyzed. One hundred and fifty-nine patients (62.6%) complained of SD prior to surgery...
August 11, 2017: Asian Journal of Andrology
https://www.readbyqxmd.com/read/28815085/recurrent-laryngeal-nerve-injury-after-esophagectomy-for-esophageal-cancer-incidence-management-and-impact-on-short-and-long-term-outcomes
#8
Martijn G Scholtemeijer, Maarten F J Seesing, Hylke J F Brenkman, Luuk M Janssen, Richard van Hillegersberg, Jelle P Ruurda
BACKGROUND: Recurrent laryngeal nerve (RLN) injury caused by esophagectomy may lead to postoperative morbidity, however data on long-term recovery are scarce. The aim of this study was to evaluate the consequences of RLN palsy (RLNP) in terms of pulmonary morbidity and long-term functional recovery. METHODS: Patients who underwent a 3-stage transthoracic (McKeown) or a transhiatal esophagectomy for esophageal carcinoma in the University Medical Center Utrecht (UMCU) between January 2004 and March 2016 were included from a prospective database...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28815083/routine-jejunostomy-tube-feeding-following-esophagectomy
#9
Teus J Weijs, Hanneke W J van Eden, Jelle P Ruurda, Misha D P Luyer, Elles Steenhagen, Grard A P Nieuwenhuijzen, Richard van Hillegersberg
BACKGROUND: Malnutrition is an important problem following esophagectomy. A surgically placed jejunostomy secures an enteral feeding route, facilitating discharge with home-tube feeding and long-term nutritional support. However, specific complications occur, and data are lacking that support its use over other enteral feeding routes. Therefore routine jejunostomy tube feeding and discharge with home-tube feeding was evaluated, with emphasis on weight loss, length of stay and re-admissions...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28814260/neonatal-abstinence-syndrome-management-a-review-of-recent-evidence
#10
Matthew Grossman, Carl Seashore, Alison Volpe Holmes
BACKGROUND: The evaluation and management of infants with neonatal abstinence syndrome (NAS), the constellation of opioid withdrawal specific to newborns, has received renewed attention over the past decade during a new epidemic of opioid use, misuse, abuse, and dependence. Infants with NAS often endure long and costly hospital stays. OBJECTIVE: We aim to review recent literature on the management and outcomes of infants with, and at risk for, opioid withdrawal...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28812175/a-prospective-non-randomized-controlled-multicenter-trial-comparing-appendectomy-and-conservative-treatment-for-patients-with-uncomplicated-acute-appendicitis-the-actuaa-study
#11
Mauro Podda, Fernando Serventi, Lorenzo Mortola, Stefano Marini, Danilo Sirigu, Michela Piga, Marcello Pisano, Massimiliano Coppola, Ferdinando Agresta, Francesco Virdis, Salomone Di Saverio, Nicola Cillara
PURPOSE: Acute appendicitis (AA) is among the most common causes of lower abdominal pain and admissions to the emergency department. Over the past 20 years, there has been a renewed interest in the conservative management of uncomplicated AA, and several studies demonstrated that an antibiotic-first strategy is a viable treatment option for uncomplicated AA. The aim of this prospective non-randomized controlled, multicenter trial is to compare antibiotic therapy and emergency appendectomy as treatment for patients with uncomplicated AA confirmed by US and/or CT or MRI scan...
August 15, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28811985/incidence-impact-and-risk-factors-for-30-day-wound-complications-following-elective-adult-spinal-deformity-surgery
#12
Nathan J Lee, John I Shin, Parth Kothari, Jun S Kim, Dante M Leven, Jeremy Steinberger, Javier Z Guzman, Branko Skovrlj, John M Caridi, Samuel K Cho
STUDY DESIGN: Case-control study. OBJECTIVE: To determine the incidence, impact, and risk factors for wound complications within 30 days following elective adult spinal deformity surgery. METHODS: Current Procedural Terminology and International Classification of Diseases, Ninth Edition, diagnosis codes were used to query the database for adults who underwent spinal deformity surgery from 2010 to 2014. Patients were separated into groups of those with and without wound complications...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811766/prognostic-factors-determining-morbidity-and-mortality-in-organophosphate-poisoning
#13
Ayca Acikalin, Nezihat Rana Dişel, Selcuk Matyar, Ahmet Sebe, Zeynep Kekec, Yuksel Gokel, Emre Karakoc
OBJECTIVE: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature. METHODS: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28809096/pancreatico-jejunostomy-decreases-post-operative-pancreatic-fistula-incidence-and-severity-after-central-pancreatectomy
#14
Frédéric Borel, Mehdi Ouaissi, Aude Merdrignac, Aurelien Venara, Valéria De Franco, Laurent Sulpice, Antoine Hamy, Nicolas Regenet
BACKGROUNDS: Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreatico-gastrostomy (PG). METHODS: Fifty-eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed...
August 15, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28808675/acute-appendicitis-in-pregnancy-and-the-developing-world
#15
Tika Ram Bhandari, Sudha Shahi, Sarita Acharya
BACKGROUND: Acute appendicitis is the commonest nonobstetric surgical emergency during pregnancy. The aim of the study was to compare perioperative outcomes of acute appendicitis in pregnant and nonpregnant patients. METHODS: A retrospective review of medical records of 56 pregnant patients between 2011 and 2016 who were compared with 164 nonpregnant women of reproductive age who underwent open appendectomy between 2014 and 2016 for acute appendicitis. The patient's demographics and perioperative data were analyzed...
2017: International Scholarly Research Notices
https://www.readbyqxmd.com/read/28807254/minimally-invasive-gastrectomy-for-gastric-cancer-a-national-perspective-on-oncologic-outcomes-and-overall-survival
#16
Kenneth Leung, Zhifei Sun, Daniel P Nussbaum, Mohamed A Adam, Mathias Worni, Dan G Blazer
BACKGROUND: Minimally invasive (MI) gastrectomy has become increasingly common as a resection technique for gastric cancer; however, data are limited regarding peri-operative morbidity, oncologic outcomes and long-term survival, particularly in the Western patient population. STUDY DESIGN: The 2010-2012 National Cancer Data Base was queried for adult patients who underwent gastrectomy for localized, intestinal-type gastric adenocarcinoma. Patients were classified by surgical approach (MI vs...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28807252/role-of-hepatic-trisectionectomy-in-advanced-hepatocellular-carcinoma
#17
J S Tsang, K S H Chok, C M Lo
BACKGROUND: Advanced hepatocellular carcinoma (HCC) with underlying cirrhosis poses a major operative challenge. Patients have a dismal prognosis without curative resection. The role of hepatic trisectionectomy in these patients is not established. The aim of this study was to analyze and compare the perioperative outcome and prognosis of patients undergoing trisectionectomy with hepatic resection of a lesser extent. METHODS: From 2000 to 2014, 48 patients underwent hepatic trisectionectomy for HCC with background cirrhosis or chronic hepatitis (Group A)...
September 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28806366/african-american-veterans-storytelling-a-multisite-randomized-trial-to-improve-hypertension
#18
Thomas K Houston, Gemmae M Fix, Stephanie L Shimada, Judith A Long, Howard S Gordon, Charlene Pope, Julie Volkman, Jeroan J Allison, Kathryn DeLaughter, Michelle Orner, Barbara G Bokhour
BACKGROUND: Disparities in hypertension control persist for African American Veterans. OBJECTIVE: To enhance cultural relevance of hypertension control self-management education, in a multisite, stratified randomized trial, we tested an interactive Veteran-to-Veteran storytelling digital video disk (DVD) intervention created with Veteran partners, versus an education-only DVD comparison. METHODS: At 3 VA facilities, African American Veterans with uncontrolled hypertension were randomized to storytelling DVD intervention or didactic comparison DVD and followed for 6 months...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28805958/large-orbital-defect-reconstruction-in-the-setting-of-globe-sparing-maxillectomy-the-titanium-hammock-and-layered-fibula-technique
#19
Samuel J Trosman, Timothy M Haffey, Rafael A Couto, Michael A Fritz
INTRODUCTION: The purpose of our study was to describe a novel technique for reconstruction of orbital defects after maxillectomy using a non-anatomic titanium mesh suspension of orbital contents for both support and volume correction. This construct is then articulated with a layered fibula osteocutaneous free flap that restores orbital rim, zygoma, and maxillary alveolus. We herein present our application of this technique, including refinements over time and long-term outcomes. METHODS: A retrospective review was performed on 12 patients who underwent reconstruction of Brown class III orbitopalatomaxillary defects with extensive orbital involvement (at minimum complete orbital floor and rim absent) with titanium mesh sling and a layered fibula free flap...
August 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28802463/improving-long-term-driving-comfort-by-taking-breaks-how-break-activity-affects-effectiveness
#20
George M Sammonds, Neil J Mansfield, Mike Fray
During long duration journeys, drivers are encouraged to take regular breaks. The benefits of breaks have been documented for safety; breaks may also be beneficial for comfort. The activity undertaken during a break may influence its effectiveness. Volunteers completed 3 journeys on a driving simulator. Each 130 min journey included a 10 min break after the first hour. During the break volunteers either stayed seated, left the simulator and sat in an adjacent room, or took a walk on a treadmill. The results show a reduction in driver discomfort during the break for all 3 conditions, but the effectiveness of the break was dependent on activity undertaken...
November 2017: Applied Ergonomics
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