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procedures in primary care

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https://www.readbyqxmd.com/read/28432506/elective-colectomy-for-diverticulitis-in-transplant-patients-is-it-worth-the-risk
#1
Janet T Lee, Steve Skube, Genevieve B Melton, Mary R Kwaan, Christine C Jensen, Robert D Madoff, Wolfgang B Gaertner
BACKGROUND: The aim of this study was to determine morbidity and mortality for transplant patients undergoing elective colectomy for diverticulitis and determine the impact of recurrent diverticulitis on postoperative complications. METHODS: We identified transplant recipients that underwent elective colectomy for diverticulitis between 2000 and 2015 at a tertiary care institution. Patient and procedure variables, postoperative complications, length of stay, 30-day readmission, and mortality were identified through retrospective chart review...
April 21, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28431896/pressurized-intraperitoneal-aerosol-chemotherapy-%C3%A2-practical-aspects
#2
M Hübner, F Grass, H Teixeira-Farinha, B Pache, P Mathevet, N Demartines
INTRODUCTION: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) has been introduced as novel treatment for peritoneal carcinomatosis. Only proper patient selection, stringent safety protocol and careful surgery allow for a secure procedure. We hereby report the essentials for safe implementation. METHODS: All consecutive procedures within 20 months after PIPAC implementation were analyzed with regards to practical and surgical aspects. Special emphasis was laid on modifications of technique and safety measures during the implementation process with systematic use of a dedicated checklist...
April 8, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#3
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/28430557/utilization-management-of-high-cost-imaging-in-an-outpatient-setting-in-a-large-stable-patient-and-provider-cohort-over-7-years
#4
Jeffrey B Weilburg, Christopher L Sistrom, Daniel I Rosenthal, Markus B Stout, Keith J Dreyer, Helaine R Rockett, Jason M Baron, Timothy G Ferris, James H Thrall
Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28430534/chronobiological-factors-for-compassion-satisfaction-and-fatigue-among-ambulatory-oncology-caregivers
#5
Daniela Bellicoso, Maureen Trudeau, Margaret I Fitch, Martin R Ralph
Primary caregivers for victims of chronic illness and or trauma experience both positive and negative emotional consequences. These are broadly classified as compassion satisfaction (CS) and compassion fatigue (CF). Because one of the components of CF, burnout, varies with chronotype and sleep quality, we assessed the influence of chronobiological features on the broader constructs of CS and CF. Responses from primary ambulatory care oncology staff working dayshifts were assessed for potential relationships of chronotype and sleep quality with CS and CF using the professional quality of life scale...
April 21, 2017: Chronobiology International
https://www.readbyqxmd.com/read/28429473/surgery-for-limited-stage-small-cell-lung-cancer
#6
REVIEW
Hayley Barnes, Katharine See, Stephen Barnett, Renée Manser
BACKGROUND: Current treatment guidelines for limited-stage small-cell lung cancer (SCLC) recommend concomitant platinum-based chemo-radiotherapy plus prophylactic cranial irradiation, based on the premise that SCLC disseminates early, and is chemosensitive. However, although there is usually a favourable initial response, relapse is common and the cure rate for limited-stage SCLC remains relatively poor. Some recent clinical practice guidelines have recommended surgery for stage 1 (limited) SCLC followed by adjuvant chemotherapy, but this recommendation is largely based on the findings of observational studies...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#7
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#8
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28422273/a-survey-of-women-s-awareness-of-and-reasons-for-lack-of-postfracture-osteoporotic-care
#9
Denise M Boudreau, Onchee Yu, Akhila Balasubramanian, Heidi Wirtz, Andreas Grauer, Daria B Crittenden, Delia Scholes
OBJECTIVES: To identify women's beliefs and other factors associated with lack of osteoporosis (OP) pharmacotherapy (OP-RX) during the 6 months after a fragility fracture, including the woman's perspective on fracture risk, OP, and treatment. DESIGN: Cross-sectional. SETTING: Group Health Cooperative, a mixed-model delivery system. PARTICIPANTS: Female Group Health Cooperative enrollees aged 55 and older with an OP-related fracture according to diagnostic and procedure codes from January 1, 2013, to March 30, 2014 (N = 985)...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28416652/simplification-of-the-hospital-score-for-predicting-30-day-readmissions
#10
Carole E Aubert, Jeffrey L Schnipper, Mark V Williams, Edmondo J Robinson, Eyal Zimlichman, Eduard E Vasilevskis, Sunil Kripalani, Joshua P Metlay, Tamara Wallington, Grant S Fletcher, Andrew D Auerbach, Drahomir Aujesky, Jacques D Donzé
OBJECTIVE: The HOSPITAL score has been widely validated and accurately identifies high-risk patients who may mostly benefit from transition care interventions. Although this score is easy to use, it has the potential to be simplified without impacting its performance. We aimed to validate a simplified version of the HOSPITAL score for predicting patients likely to be readmitted. DESIGN AND SETTING: Retrospective study in 9 large hospitals across 4 countries, from January through December 2011...
April 17, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28416497/prognostication-in-critically-ill-patients-with-severe-traumatic-brain-injury-the-tbi-prognosis-multicentre-feasibility-study
#11
Alexis F Turgeon, François Lauzier, Ryan Zarychanski, Dean A Fergusson, Caroline Léger, Lauralyn A McIntyre, Francis Bernard, Andrea Rigamonti, Karen Burns, Donald E Griesdale, Robert Green, Damon C Scales, Maureen O Meade, Martin Savard, Michèle Shemilt, Jérôme Paquet, Jean-Luc Gariépy, André Lavoie, Kesh Reddy, Draga Jichici, Giuseppe Pagliarello, David Zygun, Lynne Moore
OBJECTIVE: Severe traumatic brain injury is a significant cause of morbidity and mortality in young adults. Assessing long-term neurological outcome after such injury is difficult and often characterised by uncertainty. The objective of this feasibility study was to establish the feasibility of conducting a large, multicentre prospective study to develop a prognostic model of long-term neurological outcome in critically ill patients with severe traumatic brain injury. DESIGN: A prospective cohort study...
April 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28416391/ultrasound-guided-out-of-plane-versus-in-plane-transpectoral-left-axillary-vein-cannulation
#12
Madan Mohan Maddali, Nishant Ram Arora, Nilay Chatterjee
OBJECTIVE: The primary objective was to compare the frequency of first-attempt successful axillary vein cannulation by the Seldinger technique using out-of-plane ultrasound guidance versus in-plane imaging. Between the two ultrasound imaging planes, this study also compared the number of attempts that were necessary for the cannulation of the left axillary vein along with the number of needle redirections that had to be done for final cannulation of the vein. Incidence of complications and the number of times the procedure was abandoned also were compared between the two imaging planes...
February 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28416221/ombitasvir-paritaprevir-and-ritonavir-plus-dasabuvir-for-8-weeks-in-previously-untreated-patients-with-hepatitis-c-virus-genotype-1b-infection-without-cirrhosis-garnet-a-single-arm-open-label-phase-3b-trial
#13
Tania M Welzel, Tarik Asselah, Emily O Dumas, Stefan Zeuzem, David Shaw, Rawi Hazzan, Xavier Forns, Tami Pilot-Matias, Wenjing Lu, Daniel E Cohen, Jordan J Feld
BACKGROUND: Clinical studies have shown high rates of sustained virological response (hepatitis C virus [HCV] RNA <15 IU/mL) at post-treatment week 12 (SVR12) in patients with genotype 1b infection with and without cirrhosis who received coformulated ombitasvir, paritaprevir, and ritonavir, plus dasabuvir, without ribavirin, for 12 weeks. In this study, we aimed to assess 8-week treatment with ombitasvir, paritaprevir, and ritonavir, plus dasabuvir, without ribavirin in patients infected with HCV genotype 1b without cirrhosis...
April 13, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28416042/earthquakes-fuel-crisis-power-outages-and-health-care-in-nepal-implications-for-the-future
#14
Bipin Adhikari, Shiva Raj Mishra, Sujan Babu Marahatta, Nils Kaehler, Kumar Paudel, Janak Adhikari, Shristi Raut
Earthquakes are a major natural calamity with pervasive effects on human life and nature. Similar effects are mimicked by man-made disasters such as fuel crises and power outages in developing countries. Natural and man-made disasters can cause intangible human suffering and often leave scars of lifelong psychosocial damage. Lessons from these disasters are frequently not implemented. The main objective of this study was to review the effects of the 2015 earthquakes, fuel crisis, and power outages on the health services of Nepal and formulate recommendations for the future...
April 18, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28414029/how-well-does-capture%C3%A2-translate-an-exploratory-analysis-of-a-copd-case-finding-method-for-spanish-speaking-patients
#15
Wilson A Quezada, Beth A Whippo, Patricia A Jellen, Nancy K Leidy, David Mannino, Katherine J Kim, MeiLan K Han, Julia F Houfek, Barry Make, Karen G Malley, Catherine A Meldrum, Stephen Rennard, Barbara P Yawn, Fernando Martinez, Byron M Thomashow
BACKGROUND: This study tested the properties of a Spanish translation of CAPTURE™ (COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk) with selective use of peak expiratory flow (PEF). METHODS: Analyses of data from the Spanish-speaking cohort of the cross-sectional, case-control study used to develop CAPTURE. Translation procedures included forward and backward translation, reconciliation, and cognitive interviewing to assure linguistic and cultural equivalence...
April 13, 2017: Chest
https://www.readbyqxmd.com/read/28413301/anorectal-malformations-in-males-pros-and-cons-of-neonatal-versus-staged-reconstruction-for-high-and-intermediate-varieties
#16
Prema Menon, Katragadda Lakshmi Narasimha Rao, Amit Kumar Sinha, K Lokesha, Ram Samujh, Jai Kumar Mahajan, Ravi Prakash Kanojia, Monika Bawa
BACKGROUND: High and intermediate types of anorectal malformations (ARMs) in male neonates may be managed either by primary neonatal reconstruction without colostomy cover or by traditional policy of staged reconstruction after neonatal colostomy. Posterior sagittal anorectoplasty (PSARP) is the current widely practiced reconstructive technique with varied results. AIM: To assess our functional results of PSARP without colostomy in male neonates with high and intermediate ARMs compared to 3-stage (neonatal colostomy - PSARP - colostomy closure) methodology in a high volume tertiary care institution of a developing country...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28410640/florida-sleeve-procedure-is-durable-and-improves-aortic-valve-function-in-marfan-syndrome-patients
#17
Seyed Hossein Aalaei-Andabili, Tomas Martin, Philip Hess, Charles Klodell, Ashkan Karimi, George Arnaoutakis, Teng Lee, Thomas Beaver
BACKGROUND: The Florida sleeve (FS) procedure was developed as a simplified approach for repair of functional type I aortic insufficiency secondary to aortic root aneurysm. We evaluated postoperative aortic valve function, long-term survival, and freedom from reoperation in Marfan syndrome patients who underwent the FS procedure at our center. METHODS: All Marfan syndrome patients undergoing FS procedure from May 2002 to December 2014 were included. Echocardiography assessment included left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), ejection fraction, and degree of aortic insufficiency (none = 0, minimal = 1, mild = 2, moderate = 3, severe = 4)...
April 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28408154/outcomes-for-critical-limb-ischemia-are-driven-by-lower-extremity-revascularization-volume-not-distance-to-hospital
#18
Ankit N Medhekar, Doran S Mix, Christopher T Aquina, Lauren E Trakimas, Katia Noyes, Fergal J Fleming, Roan J Glocker, Michael C Stoner
OBJECTIVE: The objective of this study was to identify relationships among geographic access to care, vascular procedure volume, limb preservation, and survival in patients diagnosed with critical limb ischemia (CLI). METHODS: Using New York State administrative data from 2000 to 2013, we identified a patient's first presentation with CLI defined by International Classification of Diseases, Ninth Revision diagnosis and procedure codes. Distance from the patient's home to the index hospital was calculated using the centroids of the respective ZIP codes...
April 10, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28407258/a-cardiovascular-prescreening-protocol-for-unmonitored-in-office-laryngology-procedures
#19
Lyndsay L Madden, John Ward, Anne Ward, VyVy N Young, Libby J Smith, David G Lott, Paul C Bryson, Matthew S Clary, Phillip A Weissbrod, Jonathan M Bock, Joel H Blumin, Clark A Rosen
OBJECTIVES: Currently, there are no cardiovascular (CV) preprocedure screening parameters for patients undergoing in-office laryngeal procedures (IOLP). Studies have shown significant changes in CV measures for IOLP. The aim was to develop and evaluate a pre-IOLP CV screening protocol. METHODS: Review of IOLP literature and consultation with an anesthesiologist and cardiologist led to the development of CV parameters and questions related to four metabolic equivalents (METS) of work as a patient-screening tool before IOLP...
April 13, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28407197/autologous-hematopoietic-stem-cell-transplantation-following-high-dose-chemotherapy-for-nonrhabdomyosarcoma-soft-tissue-sarcomas
#20
REVIEW
Frank Peinemann, Heike Enk, Lesley A Smith
BACKGROUND: Soft tissue sarcomas (STS) are a highly heterogeneous group of rare malignant solid tumors. Nonrhabdomyosarcoma soft tissue sarcomas (NRSTS) comprise all STS except rhabdomyosarcoma. In people with advanced local or metastatic disease, autologous hematopoietic stem cell transplantation (HSCT) applied after high-dose chemotherapy (HDCT) is a planned rescue therapy for HDCT-related severe hematologic toxicity. The rationale for this update is to determine whether any randomized controlled trials (RCTs) have been conducted and to clarify whether HDCT followed by autologous HSCT has a survival advantage...
April 13, 2017: Cochrane Database of Systematic Reviews
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