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procedures in primary care

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https://www.readbyqxmd.com/read/28637066/-surgery-for-pulmonary-metastases-in-patients-with-advanced-soft-tissue-and-osteosarcomas
#1
Sascha Macherey, Khosro Hekmat, Kourosh Zarghooni, Fabian Doerr, Matthias Heldwein, Thorsten Wahlers
Background Advanced soft tissue or osteosarcoma is often associated with lung metastases. Curative pulmonary metastasectomy is appropriate for patients with successfully resected primary cancer who show no evidence of extrapulmonary metastases, with proven functional operability and completely resectable metastases. Material and Methods Systematic literature research and qualitative analysis of studies on patients undergoing lung metastasectomy after resection of primary sarcoma published since 01.01.2010. We assessed operative findings, survival data and prognostic factors...
June 21, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28635566/stone-size-is-a-predictor-for-residual-stone-and-multiple-procedures-of-endoscopic-combined-intrarenal-surgery
#2
Shimpei Yamashita, Yasuo Kohjimoto, Akinori Iba, Kazuro Kikkawa, Isao Hara
OBJECTIVES: The aim of this study was to identify the predictors of treatment results after endoscopic combined intrarenal surgery (ECIRS). MATERIALS AND METHODS: A retrospective analysis was conducted of 75 patients with renal stones who underwent ECIRS and a preoperative non-contrast computed tomography (NCCT) examination. The stone-free rate (SFR), number of primary procedures and perioperative complications were investigated, and the predictors contributing to these three outcomes were analyzed...
February 13, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28634629/medical-malpractice-claims-in-laparoscopic-gynecologic-surgery-a-dutch-overview-of-20-years
#3
Evelien M Sandberg, Esmée M Bordewijk, Désirée Klemann, Sara R C Driessen, Andries R H Twijnstra, Frank Willem Jansen
BACKGROUND: The success of newly introduced surgical techniques is generally primarily assessed by surgical outcome measures. However, data on medical liability should concomitantly be used to evaluate provided care as they give a unique insight into substandard care from patient's point of view. The aim of this study was to analyze the number and type of medical claims after laparoscopic gynecologic procedures since the introduction of advanced laparoscopy two decades ago. Secondly, our objective was to identify trends and/or risk factors associated with these claims...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28634502/impact-of-neurological-follow-up-on-early-hospital-readmission-rates-for-acute-ischemic-stroke
#4
Alexander Allen, Todd Barron, Ashley Mo, Richard Tangel, Ruth Linde, Rodney Grim, John Mingle, Ellen Deibert
INTRODUCTION: Despite advances in stroke care, readmission rates for patients with ischemic stroke remain high. Although factors such as age, diabetes, and continuous use of antiplatelet agents have been found to predict readmission rates, the impact of after-hospital care has not been examined. METHODS: The present study reviewed the charts of 416 patients with acute ischemic stroke and recorded stroke-related comorbidities, neurology follow-up within 21 days, readmission at 0 to 30 days, readmission at 31 to 90 days, and any reasons for readmission...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28633169/untapped-potential-performance-of-procedural-skills-in-the-family-medicine-clerkship
#5
Martina Kelly, Kelly M Everard, Lara Nixon, Alexander Chessman
BACKGROUND AND OBJECTIVES: While family medicine residency directors have expressed concern about low procedural skills proficiency among incoming residents, curricular recommendations do not provide widely accepted guidance. This study was designed to describe requirements and experiences in procedural skill training during the family medicine clerkship and test the hypothesis that more rural placements may support this training. METHODS: The survey was conducted as part of the CAFM Educational Research Alliance (CERA) Family Medicine Clerkship Director (CD) 2013 survey...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#6
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28632559/counting-the-cost-of-failed-spinal-fusion-for-relief-of-low-back-pain-does-primary-fusion-with-bone-morphogenetic-protein-make-economic-sense-from-a-primary-payer-perspective
#7
Adam P Lloyd
STUDY DESIGN: A retrospective cohort study. OBJECTIVES: To investigate the unknown direct costs of failed instrumented lumbar fusion using iliac crest bone graft (ICBG) and subsequent reoperation utilizing recombinant human bone morphogenetic protein-2 (rhBMP-2) from a primary payer perspective. SUMMARY OF BACKGROUND DATA: Recent evidence has demonstrated increased rates of instrumented lumbar fusion and utilization of rhBMP-2 to treat a range of conditions causing lower back pain...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28630035/the-effects-of-preoperative-volume-replacement-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-surgery-protocol-for-a-randomized-controlled-trial-verdict-trial
#8
Madeleine Clout, Tracy Harris, Chris Rogers, Lucy Culliford, Jodi Taylor, Gianni Angelini, Pradeep Narayan, Barnaby Reeves, James Hillier, Kate Ashton, Kunal Sarkar, Raimondo Ascione
BACKGROUND: Diabetes mellitus is a major risk factor for prolonged hospital stays, renal failure, and mortality in patients having coronary artery bypass grafting (CABG). Complications pose a serious threat to patients and prolong intensive care and hospital stays. Low glomerular filtration rate (GFR) due to existing renal impairment or volume depletion may exacerbate acute renal impairment/failure in these patients. Preoperative volume replacement therapy (VRT) is reported to increase the GFR and we hypothesize that VRT will reduce renal impairment and related complications in diabetic patients...
June 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28626816/evaluation-of-topical-bevacizumab-as-an-adjunct-to-mitomycin-c-augmented-trabeculectomy
#9
Reza Zarei, Masoumeh Masoumpour, Sasan Moghimi, Ghasem Fakhraei, Yadollah Eslami, Masoud Mohammadi
PURPOSE: To investigate the safety and synergistic effect of topical bevacizumab after trabeculectomy surgery with mitomycin C (MMC). METHODS: In this prospective, non-randomized, comparative interventional study, 40 eyes from 40 patients with uncontrolled open-angle glaucoma were studied after they underwent primary trabeculectomy with mitomycin C (0.02% for 2 min). Following the procedure topical bevacizumab (4 mg/mL) was used for 2 weeks 4 times daily in group A...
June 2017: Journal of Current Ophthalmology
https://www.readbyqxmd.com/read/28625299/managing-major-obstetric-haemorrhage-pharmacotherapy-and-transfusion
#10
REVIEW
Rachel Collis, Emilia Guasch
Major obstetric haemorrhage is a leading cause of maternal mortality. A prescriptive approach to early recognition and management is critical to improving outcomes. Uterine atony is the primary cause of post-partum haemorrhage. First-line prevention and treatment include the administration of uterine tonic agents; other conservative measures include uterine cavity tamponade and uterine compression sutures. Interventional radiology procedures have been used for both prophylaxis and treatment, but a hysterectomy may be necessary if conservative measures fail...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28625021/antibiotic-prophylaxis-for-elective-hysterectomy
#11
REVIEW
Reuben Olugbenga Ayeleke, Selma Mourad, Jane Marjoribanks, Karim A Calis, Vanessa Jordan
BACKGROUND: Elective hysterectomy is commonly performed for benign gynaecological conditions. Hysterectomy can be performed abdominally, laparoscopically, or vaginally, with or without laparoscopic assistance. Antibiotic prophylaxis consists of administration of antibiotics to reduce the rate of postoperative infection, which otherwise affects 40%-50% of women after vaginal hysterectomy, and more than 20% after abdominal hysterectomy. No Cochrane review has systematically assessed evidence on this topic...
June 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28623995/rationale-design-and-methodology-of-the-observational-insights-svt-study-on-the-current-state-of-care-and-outcomes-of-patients-with-superficial-vein-thrombosis
#12
Rupert Bauersachs, Horst Eberhard Gerlach, Andreas Heinken, Ulrich Hoffmann, Florian Langer, Thomas Noppeney, David Pittrow, Jens Klotsche, Eberhard Rabe
OBJECTIVE: Superficial vein thrombosis (SVT) is a common disease in clinical practice. In terms of pathophysiology and outcomes, the condition is related to venous thromboembolism, bearing a potential for severe thromboembolic complications if it is not treated adequately. A wide range of treatment approaches (including oral and injectable anticoagulants, pain medication, nondrug therapy including compression therapy, and no treatment at all) are applied in clinical practice, but there is sparse information about selection of patients for therapies, current treatment pathways, and drug use as well as outcomes...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28623434/-cost-analysis-as-a%C3%A2-tool-for-assessing-the-efficacy-of-intensive-care-units
#13
T Maierhofer, F Pfisterer, A Bender, H Küchenhoff, O Moerer, H Burchardi, W H Hartl
BACKGROUND: The German "Hospital Structure Act" intends to align the state hospital planning on quality criteria. Within this process cost-utility analyses (CUAs) shall be used to assess the efficacy of medical care. To be objective, CUAs of intensive care units (ICUs) require standardization (adjustment) of costs. The present study analyzed the extent to which treatment costs are related to patient-specific baseline variables (such as type and severity of the primary disease). METHODS: From 2000-2004, a bottom-up procedure was used to quantify total costs on 14 ICUs in nine German university hospitals...
June 16, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28622186/a-90-day-bundled-payment-for-primary-single-level-lumbar-discectomy-decompression-what-does-big-data-say
#14
Nikhil Jain, Sohrab S Virk, Frank M Phillips, Elizabeth Yu, Safdar N Khan
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28621617/intrathoracic-meningocele-associated-with-neurofibromatosis-type-1-and-a-novel-technique-for-surgical-repair-case-report
#15
Paramita Das, Tarini Goyal, Matthew A Hunt
Neurofibromatosis Type 1 (NF1) is a neurocutaneous disorder that can have associated spinal abnormalities related to both bone and dural dysplasia. Thoracic meningoceles are one spine anomaly associated with NF1, although they are a fairly uncommon pathology. Surgical techniques to treat these meningoceles, usually undertaken only when the patient is symptomatic, are targeted at decreasing the size of the protrusion and improving lung capacity. Surgical interventions discussed in the literature include shunting the pseudomeningocele, primary repair with laminectomy, thoracoscopic plication, and reinforcement of the closure with cement, muscle, or fascia...
June 16, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28618130/benefits-of-an-individualized-perioperative-plan-for-children-with-autism-spectrum-disorder
#16
Jo S Swartz, Karen E Amos, Mirna Brindas, Linda G Girling, M Ruth Graham
BACKGROUND: Perioperative care for children with autism spectrum disorder may be challenging. Previous investigators recommend development of an individualized perioperative management plan with caregiver involvement. AIM: The primary goal was to determine the usefulness of an individualized plan based on the decision to provide preoperative sedation stratified by autism spectrum severity level. Secondary goals were to assess the effectiveness of the plan based on subjective assessment of patient behavior at induction of anesthesia and caregiver satisfaction...
June 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28617160/rising-need-for-health-education-among-renal-transplant-patients-and-caregiving-competence-in-care-providers
#17
Jianfei Xie, Yingzi Ming, Siqing Ding, Xiaoxia Wu, Jia Liu, Lifang Liu, Jianda Zhou
BACKGROUND: Health education positively affects the efficacy of self-management and should be carried out according to the status of patients' needs, knowledge, and the competence of the primary caregivers. OBJECTIVES: This study was to investigate the needs of health education knowledge in transplant patients and the competence of the primary caregivers. METHODS: This is a cross-sectional study using a convenient sampling approach. Self-report questionnaires were applied to 351 renal transplantation patients and their primary caregivers...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28615159/mobile-health-in-oncology-a-patient-survey-about-app-assisted-cancer-care
#18
Kerstin Anne Kessel, Marco Me Vogel, Carmen Kessel, Henning Bier, Tilo Biedermann, Helmut Friess, Peter Herschbach, Rüdiger von Eisenhart-Rothe, Bernhard Meyer, Marion Kiechle, Ulrich Keller, Christian Peschel, Roland M Schmid, Stephanie E Combs
BACKGROUND: In the last decade, the health care sector has been enriched by numerous innovations such as apps and connected devices that assist users in weight reduction and diabetes management. However, only a few native apps in the oncological context exist, which support patients during treatment and aftercare. OBJECTIVE: The objective of this study was to analyze patients' acceptance regarding app use and to investigate the functions of an oncological app that are most required, and the primary reasons for patients to refuse app-assisted cancer care...
June 14, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28614192/perioperative-antibiotic-prophylaxis-to-prevent-surgical-site-infections-in-solid-organ-transplantation
#19
Judith A Anesi, Emily A Blumberg, Lilian M Abbo
Antibiotic prophylaxis in the perioperative period is the standard of care for nearly all surgical procedures and routinely prescribed during solid organ transplantation (SOT). The primary goal of perioperative antibiotic prophylaxis is to minimize postoperative surgical site infections (SSIs). SSIs are a significant issue in SOT. Depending on the organ transplanted, SSIs occur in 3 to 53% of patients, with the highest rates observed in small bowel/multivisceral, liver, and pancreas transplant recipients. SOT recipients are also at increased risk of developing SSIs with antimicrobial-resistant organisms...
June 13, 2017: Transplantation
https://www.readbyqxmd.com/read/28613127/differences-in-medical-services-in-nordic-general-practice-a-comparative-survey-from-the-qualicopc-study
#20
Torunn Bjerve Eide, Jørund Straand, Cecilia Björkelund, Elise Kosunen, Ofeigur Thorgeirsson, Peter Vedsted, Elin Olaug Rosvold
OBJECTIVE: We aim to describe medical services provided by Nordic general practitioners (GPs), and to explore possible differences between the countries. DESIGN AND SETTING: We did a comparative analysis of selected data from the Nordic part of the study Quality and Costs of Primary Care in Europe (QUALICOPC). SUBJECTS: A total of 875 Nordic GPs (198 Norwegian, 80 Icelandic, 97 Swedish, 212 Danish and 288 Finnish) answered identical questionnaires regarding their practices...
June 2017: Scandinavian Journal of Primary Health Care
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