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https://www.readbyqxmd.com/read/28543108/complications-and-30-day-hospital-readmission-rates-of-patients-undergoing-tracheostomy-a-prospective-analysis
#1
Emily Spataro, Nedim Durakovic, Dorina Kallogjeri, Brian Nussenbaum
OBJECTIVE: To determine inpatient and outpatient tracheostomy complication rates and 30-day hospital readmission rates, and to assess patient and procedural risk factors associated with complications and readmissions. STUDY DESIGN: Prospective cohort study. METHODS: Adult patients undergoing tracheostomy at a single academic hospital performed by any service, for any indication, were enrolled in this study over the course of 1 year. All patients had complete 30-day follow-up after discharge to determine complication and hospital readmission rates...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28523092/management-of-a-life-threatening-bleeding-following-extraction-of-deciduous-second-molar-related-to-a-capillary-haemangioma
#2
REVIEW
Amr Amin Ghanem, Yasser Nabil El Hadidi
Various forms of vascular lesion affect the head and neck region. The head and neck vascular lesions are classified into neoplasms and malformations. Neoplasm presents either as hemangioma or lymphangioma; neoplasm usually presents in young age compared with vascular malformation. A 9-year-old female patient presented to the outpatient clinic referred from the department of pedodontics after extraction of a right mandibular second deciduous molar. Extraction was done by dental GP in outpatient clinic. Massive bleeding followed the extraction...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28518084/subcutaneous-trigeminal-nerve-field-stimulation-for-refractory-facial-pain
#3
Martin Jakobs, Sigrid Schuh-Hofer, Andreas Unterberg, Rezvan Ahmadi
Chronic or neuropathic trigeminal facial pain can be challenging to treat. Neurosurgical procedures should be applied when conservative treatment fails. Neuromodulation techniques for chronic facial pain include deep brain stimulation and motor cortex stimulation, which are complex to perform. Subcutaneous nerve field stimulation is certified for chronic back pain and is the least invasive form of neuromodulation. We applied this technique to treat chronic and neuropathic trigeminal pain as an individual therapy concept...
May 10, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28504322/racial-differences-in-the-pain-management-of-children-recovering-from-anesthesia
#4
Olubukola O Nafiu, Wilson T Chimbira, Margaret Stewart, Kathleen Gibbons, L Kareen Porter, Paul I Reynolds
BACKGROUND: When pain management has been studied in settings such as pediatric emergency departments, racial disparities have been clearly identified. To our knowledge, this has not been studied in the pediatric perioperative setting. We sought to determine whether there are differences based on race in the administration of analgesia to children suffering from pain in the postanesthesia care unit. METHODS: This is a prospective, observational, study of 771 children aged 4-17 years who underwent elective outpatient surgery...
May 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28494887/preoperative-risk-stratification-of-critically-ill-patients
#5
Curtis C Copeland, Andrew Young, Tristan Grogan, Eilon Gabel, Anahat Dhillon, Vadim Gudzenko
STUDY OBJECTIVE: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. DESIGN: Retrospective cohort analysis over a 21-month period...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28474273/outpatient-appendectomy-in-an-emergency-outpatient-surgery-unit-24%C3%A2-h-a-day-an-intention-to-treat-analysis-of-194-patients
#6
Adeline Aubry, Arnaud Saget, Gilles Manceau, Matthieu Faron, Mathilde Wagner, Christophe Tresallet, Bruno Riou, Olivier Lucidarme, Frédéric le Saché, Mehdi Karoui
OBJECTIVE: To evaluate the feasibility and outcomes of patients operated on for uncomplicated acute appendicitis (UAA) in our 24-h emergency outpatient surgery unit. METHODS: This was a prospective observational study with intention-to-treat (ITT) analysis. From 12/2013 to 03/2015, all consecutive patients admitted for acute appendicitis (AA) were prospectively screened. A computed tomography or abdominal ultrasound confirmed the diagnosis of AA. Eligibility criteria for outpatient appendectomy were: UAA, no comorbidity, no physical or mental condition preventing participation in the study, absence of pregnancy, age older than 15 years, an accompanying adult person available for the hospital discharge and place of residence within 1 h of our hospital...
May 4, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28472830/definitive-contraception-trends-in-a-ten-year-interval
#7
Cecília Maria Ventuzelo Marques, Magda Maria do Vale Pinto Magalhães, Maria João Leal da Silva Carvalho, Giselda Marisa Costa Carvalho, Francisco Augusto Falcão Santos Fonseca, Isabel Torgal
Objective To evaluate the trends in definitive contraception in a ten-year interval comprising the years 2002 and 2012. Method Retrospective analysis of the tubal sterilization performed in our service in 2002 and 2012, analyzing the demographic characteristics, personal history, previous contraceptive method, definite contraception technique, effectiveness and complications. Results Definitive contraception was performed in 112 women in 2002 (group 1) and in 60 women in 2012 (group 2). The groups were homogeneous regarding age, parity, educational level and personal history...
May 4, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28469122/pediatric-otorhinolaryngology-emergencies-at-the-jos-university-teaching-hospital-study-of-frequency-management-and-outcomes
#8
Adeyi A Adoga, Emoche T Okwori, John P Yaro, Andrew A Iduh
BACKGROUND: Studies from Nigeria on pediatric otorhinolaryngology (ORL) emergencies are rare in literature with most focusing on emergencies involving individual systems. OBJECTIVE: The aim of this study is to determine the prevalence of all ORL emergencies among children in our region to provide a baseline data for future health planning. PATIENTS AND METHODS: This is a 1-year retrospective cross-sectional study of patients aged 16 years and below presenting to the Accident and Emergency Department of the Jos University Teaching Hospital, Jos, Nigeria...
April 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/28461175/in-office-hysteroscopic-extraction-of-intrauterine-devices-in-pregnant-patients-who-underwent-prior-ultrasound-guided-extraction-failure
#9
Shlomo B Cohen, Jerome Bouaziz, Alexandra Bar On, Eyal Schiff, Motti Goldenberg, Roy Maschiach
STUDY OBJECTIVE: To determine an effective method of intrauterine device (IUD) retrieval from pregnant women who had previous unsuccessful ultrasound-guided IUD extraction failure. DESIGN: Retrospective cohort study (Canadian task force classification II-1) SETTING: Gynecology department of an outpatient clinic. PATIENTS: Pregnant patients in their first trimester with IUD in situ who underwent prior unsuccessful ultrasound-guided IUD extraction...
April 28, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28452817/measuring-and-improving-the-quality-of-preprocedural-assessments
#10
Farah Manji, Kelsey McCarty, Vanessa Kurzweil, Eden Mark, James P Rathmell, Aalok V Agarwala
BACKGROUND: Preprocedural assessments are used by anesthesia providers to optimize perioperative care for patients undergoing invasive procedures. When these assessments are performed in advance by providers who are not caring for the patient during the procedure, there is an additional layer of complexity in ensuring that the workup meets the needs of the primary anesthesia care team. In this study, anesthesia providers were asked to rate the quality of preprocedural assessments prepared by other providers to evaluate anesthesia care team satisfaction...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28451601/cost-comparison-of-outpatient-versus-inpatient-unicompartmental-knee-arthroplasty
#11
Dustin L Richter, David R Diduch
BACKGROUND: Outpatient unicompartmental knee arthroplasty (UKA) has been shown to be safe and feasible when compared with inpatient surgery; however, no studies have evaluated the cost-effectiveness and cost-benefit of performing outpatient versus inpatient UKA. HYPOTHESIS: Significant cost savings can be achieved by transitioning UKAs from an inpatient to an outpatient procedure in an outpatient surgical facility, with no appreciable difference in complication or readmission rates...
March 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28429926/the-efficacy-of-intraurethral-lidocaine-in-optical-internal-urethrotomy-for-anterior-urethral-stricture-a-multicenter-study
#12
Nedim Y Cem, Yıldız Yildiray, Cem Ö Berat, Melih S Mehmet, Gökhan D Ömer, Metin H Ahmet, Özyuvalı Ekrem, Ayyıldız Ali
BACKGROUND: Male anterior urethral strictures can be treated successfully with the help of optical internal urethrotomy (OIU) and is usually performed under general or regional anaesthesia. In this study, we determined the efficacy of intraurethral lidocaine in OIU for anterior urethral stricture in an outpatient setting. METHODS: 157 patients with anterior urethral strictures underwent OIU under local urethral anaesthesia with lidocaine. Optical urethrotomy was performed with a cold-cutting knife...
April 20, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28419032/formal-physical-therapy-after-total-hip-arthroplasty-is-not-required-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Matthew S Austin, Brian T Urbani, Andrew N Fleischman, Navin D Fernando, James J Purtill, William J Hozack, Javad Parvizi, Richard H Rothman
BACKGROUND: The value of formal physical therapy after total hip arthroplasty is unknown. With substantial changes that have occurred in surgical and anesthesia techniques, self-directed therapy may be efficacious in restoring function to patients undergoing total hip arthroplasty. METHODS: We conducted a single-center, randomized trial of 120 patients undergoing primary, unilateral total hip arthroplasty who were eligible for direct home discharge. The experimental group followed a self-directed home exercise program for 10 weeks...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28413736/targeted-intraspinal-radiofrequency-ablation-for-lumbar-spinal-stenosis
#14
Robert E Jacobson, Michelle Granville, Jesse Hatgis DO
INTRODUCTION: By using a combination of magnetic resonance imaging (MRI) and computed tomography (CT) of the lumbar spine, it is possible to distinguish between spinal stenosis caused by bone compression and specific soft tissue epidural intraspinal lesions that cause localized spinal canal stenosis and neural compression. Examples include facet cysts and yellow ligament hypertrophy. Many of these patients are elderly with medical comorbidities that make open surgery problematic. MATERIALS & METHODS: This is a study of patients with predominantly soft tissue stenosis being treated with targeted intraspinal radiofrequency (RF) heat ablation...
March 10, 2017: Curēus
https://www.readbyqxmd.com/read/28413268/novel-propofol-derivatives-and-implications-for-anesthesia-practice
#15
REVIEW
Aiden Y Feng, Alan D Kaye, Rachel J Kaye, Kumar Belani, Richard D Urman
Propofol (2,6-diisopropylphenol) is the most commonly used intravenous agent for induction of anesthesia. It is also used for maintenance of anesthesia and sedation in both Intensive Care Units and outpatient procedural settings. Its success in the clinical setting has been a result of its rapid onset, short duration of action, and minimal side effects despite disadvantages associated with its oil emulsion formulation. Early attempts to alter the standard emulsion or to develop new formulations with cyclodextrins and micelles to resolve issues with pain upon injection, the need for antimicrobial agents, and possible hyperlipidemia have mostly failed...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#16
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28390888/liposomal-bupivacaine-mixture-has-similar-pain-relief-and-significantly-fewer-complications-at-less-cost-compared-to-indwelling-interscalene-catheter-in-total-shoulder-arthroplasty
#17
William J Weller, Michael G Azzam, Richard A Smith, Frederick M Azar, Thomas W Throckmorton
BACKGROUND: The efficacy and costs of indwelling interscalene catheter (ISC) and liposomal bupivacaine (LBC), with and without adjunctive medications, in patients with primary shoulder arthroplasty are a source of current debate. METHODS: In 214 arthroplasties, 156 patients had ISC and 58 had LBC injections that were mixed with morphine, ketorolac, and 0.5% bupivacaine with epinephrine. Charts were reviewed for visual analog scale pain scores, oral morphine equivalent (OME) usage, major complications, and costs...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28346253/a-retrospective-case-matched-cost-comparison-of-surgical-treatment-of-melanoma-and-nonmelanoma-skin-cancer-in-the-outpatient-versus-operating-room-setting
#18
Ryan P Johnson, Niraj Butala, Murad Alam, Naomi Lawrence
BACKGROUND: To date, no study has used authentic billing data in a case-control matched fashion to examine the cost of treating skin cancer in different settings. OBJECTIVE: To compare the cost of surgical treatment of skin cancer in the outpatient versus operating room setting using matched cases based on patient and skin cancer characteristics. METHODS: ICD-9 diagnosis codes for skin cancers were used to find patients who had a malignant excision current procedural terminology code in the operating room setting during 2010 to 2014...
March 23, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28336421/percutaneous-planter-fasciitis-release-under-local-anesthesia-a-prospective-study
#19
Ramji Lal Sahu
PURPOSE: Plantar fasciitis is the most common cause of pain on the bottom of the heel. It occurs when the strong band of the tissue supporting the arch of foot becomes irritated and inflamed. The majority of patients can be treated conservatively but some resistant cases need surgery eventually. This study aims to evaluate the outcome results of percutaneous planter fascia release under local anesthesia for chronic planter fasciitis. METHODS: This prospective study was conducted in the Department of Orthopaedic Surgery in the School of Medical Science and Research, Sharda University, India from December 2010 to December 2013...
April 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#20
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
March 3, 2017: Aesthetic Surgery Journal
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