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ERAS program

David B Burkholder
Pearce Bailey (1902-1976) had an active career focused on the growth and development of neurology as a specialty in the post-World War II era. He was a founding member of the American Academy of Neurology (AAN) and its second president from 1951 to 1953. In 1951, he was also appointed as the first director of the National Institute for Neurological Diseases and Blindness (NINDB), which is now the National Institute of Neurological Disorders and Stroke. Known as an excellent politician, Bailey's role at the NINDB helped bolster the AAN in its early days...
July 2018: Journal of the History of the Neurosciences
Roxana M Grasu, Juan P Cata, Anh Q Dang, Claudio E Tatsui, Laurence D Rhines, Katherine B Hagan, Shreyas Bhavsar, Sally R Raty, Radha Arunkumar, Yury Potylchansky, Ian Lipski, Benjamin A Arnold, Thomas M McHugh, Justin E Bird, Andrea Rodriguez-Restrepo, Mike Hernandez, Keyuri U Popat
OBJECTIVE Enhanced Recovery After Surgery (ERAS) programs follow a multimodal, multidisciplinary perioperative care approach that combines evidence-based perioperative strategies to accelerate the functional recovery process and improve surgical outcomes. Despite increasing evidence that supports the use of ERAS programs in gastrointestinal and pelvic surgery, data regarding the development of ERAS programs in spine surgery are scarce. To evaluate the impact of an Enhanced Recovery After Spine Surgery (ERSS) program in a US academic cancer center, the authors introduced such a program and hypothesized that ERSS would have a significant influence on meaningful clinical measures of postoperative recovery, such as pain management, postoperative length of stay (LOS), and complications...
August 17, 2018: Journal of Neurosurgery. Spine
William C Newman, Yue-Fang Chang, L Dade Lunsford
OBJECTIVE Neurosurgery is often self-selecting. Concern has been raised that residents in the millennial era (born between 1982 and 2004) may have more serious professionalism and performance issues (PPIs) during training compared to prior trainees. Serious PPIs were defined as concerns that led to specific resident disciplinary actions ranging from initial warnings to termination. In order to evaluate this concern, the authors retrospectively reviewed a 50-year experience at a single training center. They then prospectively surveyed living graduates of the program to assess variations in practice patterns and job satisfaction over 5 decades...
August 17, 2018: Journal of Neurosurgery
Kevin M Elias, Alexander B Stone, Katharine McGinigle, Jo'An I Tankou, Michael J Scott, William J Fawcett, Nicolas Demartines, Dileep N Lobo, Olle Ljungqvist, Richard D Urman
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are multimodal care pathways designed to minimize the physiological and psychological impact of surgery for patients. Increased compliance with ERAS guidelines is associated with improved patient outcomes across surgical types. As ERAS programs have proliferated, an unintentional effect has been significant variation in how ERAS-related studies are reported in the literature. METHODS: To improve the quality of ERAS reporting, ERAS® USA and the ERAS® Society launched an effort to create an instrument to assist authors in manuscript preparation...
August 16, 2018: World Journal of Surgery
Ilias Gountas, Vana Sypsa, Sarah Blach, Homie Razavi, Angelos Hatzakis
BACKGROUND: Elimination of hepatitis C virus (HCV) among people who inject drugs (PWID) is a costly investment, so strategies should not only focus on eliminating the disease, but also on preventing disease resurgence. The aims of this study are to compute the minimum necessary antiviral therapies to achieve elimination with and without the additional expansion of harm reduction (HR) programs and to examine the sustainability of HCV elimination after 2030 if treatment is discontinued...
2018: PloS One
Kenneth H Mayer
Since the turn of the current century, syphilis incidence and prevalence have been increasing more rapidly among men who have sex with men (MSM) than any other US subpopulation, exceeding their previously high rates in the 1970s and 1980s, before the AIDS epidemic. The reasons for these trends are multifactorial and complex, involving individual behavioral, sociocultural, structural, and biological factors, which will be reviewed in this article. Men who have sex with men tend to have more sexual partners than heterosexuals, and engage in practices (e...
September 2018: Sexually Transmitted Diseases
Matthew R Golden, Julia C Dombrowski
No abstract text is available yet for this article.
September 2018: Sexually Transmitted Diseases
Ayse Deniz Elmali, Ruken Simsekoglu, Erdi Sahin, Canan Duman Ilki, Ozge Uygun, Oguzhan Coban, Candan Gurses
Subacute sclerosing panencephalitis (SSPE) is a well-known childhood disease; however, the adult onset of SSPE cases are also widely recognized where the oldest case reported is 52 years old. We report a 61-year-old woman patient presenting with atypical clinical and EEG features, diagnosed with SSPE. Measles and SSPE have decreased dramatically owing to worldwide immunization programs; however, there are still reasons to consider SSPE in differential diagnosis even in patients presenting with atypical clinical findings and older ages...
August 13, 2018: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
Gilbert Bigras, Simon Mairs, Paul E Swanson, Didier Morel, Raymond Lai, Iyare Izevbaye
Pembrolizumab is an FDA-approved immune-checkpoint (IC) inhibitor that targets programmed cell death protein PD-1, and recent phase III trials have demonstrated its superiority over chemotherapy in the treatment of patients with advanced non-small cell lung cancer (NSCLC). Eligibility for treatment with Pembrolizumab is based on demonstration of PD-L1 expression on tumoral cells using the approved companion test 22C3 PharmDx (Dako). Access to the drug depends on a tumor proportion score (TPS) expressing the PD-L1 protein above predetermined cutoffs...
August 8, 2018: Applied Immunohistochemistry & Molecular Morphology: AIMM
Taras Grosh, Nabil M Elkassabany
Enhanced recovery after surgery (ERAS) protocols depend on multidisciplinary care and should be peer-reviewed and data-driven. ERAS has reduced hospital length of stay and complications, simultaneously improving patient outcomes. ERAS protocol after shoulder arthroplasty features multidisciplinary collaboration among different perioperative services and multimodal analgesia with a focus on regional anesthesia. Despite success, adoption is not universal because ERAS protocols are resource intensive. They require clinicians invested in the success of these programs and patients who can take charge of their own health...
September 2018: Anesthesiology Clinics
Lisa Kumar, Amanda H Kumar, Stuart A Grant, Jeff Gadsden
Enhanced recovery after surgery (ERAS) programs for orthopedics involve a multidisciplinary approach to accelerating return to function, reducing pain, improving patient comfort and satisfaction, reducing complications from the surgical procedure, reducing hospital length of stay, and reducing costs. ERAS pathways for patients receiving total knee arthroplasty are different from those having intracavitary surgery; they are less focused on fluid homeostasis and gut motility than they are with optimizing systemic and local analgesics and providing a balance between the highest quality pain control and accelerated return to ambulation...
September 2018: Anesthesiology Clinics
Giulia Capodaglio, Manuel Zorzi, Sandro Tognazzo, Alessandra Greco, Federica Michieletto, Chiara Fedato, Adriana Montaguti, Anna Turrin, Antonio Ferro, Sandro Cinquetti, Francesca Russo, Maria Chiara Corti, Massimo Rugge, Ugo Fedeli
OBJECTIVE: The impact of organized screening programs on breast cancer (BC) mortality is unclear in an era of high spontaneous referral of women to mammography. The aim of this study was to analyze if the introduction of mammographic screening programs reduced BC mortality in the Veneto region, Italy, despite already widespread spontaneous access to mammography. METHODS: In Veneto, screening was introduced in different years between 1999 and 2009 across 21 local health units (LHUs), inviting asymptomatic women aged 50-69 years to undergo mammography biennially...
August 6, 2018: Tumori
Nigel M Bagnall, Edward T Pring, George Malietzis, Thanos Athanasiou, Omar D Faiz, Robin H Kennedy, John T Jenkins
PURPOSE: This study aims to determine whether traditional risk models can accurately predict morbidity and mortality in patients undergoing major surgery by colorectal surgeons within an enhanced recovery program. METHODS: One thousand three hundred eighty patients undergoing surgery performed by colorectal surgeons in a single UK hospital (2008-2013) were included. Six risk models were evaluated: (1) Physiology and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM), (2) Portsmouth POSSUM (P-POSSUM), (3) ColoRectal (CR-POSSUM), (4) Elderly POSSUM (E-POSSUM), (5) the Association of Great Britain and Ireland (ACPGBI) score, and (6) modified Estimation of Physiologic Ability and Surgical Stress Score (E-PASS)...
August 4, 2018: International Journal of Colorectal Disease
Boudewijn J J Smeets, Misha D P Luyer
PURPOSE OF REVIEW: Postoperative ileus (POI) is an important contributor to postoperative morbidity. However, postoperative outcomes have improved by enhanced recovery after surgery (ERAS) programs. Enteral nutrition is an essential part of ERAS and many studies suggest a therapeutic effect of nutrition on POI. RECENT FINDINGS: Early postoperative enteral nutrition has been shown to reduce various complications, including POI, although studies are heterogeneous...
September 2018: Current Opinion in Clinical Nutrition and Metabolic Care
L Mark Knab, Mazen S Zenati, Anton Khodakov, Maryjoe Rice, Amr Al-Abbas, David L Bartlett, Amer H Zureikat, Herbert J Zeh, Melissa E Hogg
BACKGROUND: Robotic surgery is increasingly being used for complex oncologic operations, although currently there is no standardized curriculum in place for surgical oncologists. We describe the evolution of a proficiency-based robotic training program implemented for surgical oncology fellows, and demonstrate the outcomes of the program. METHODS: A 5-step robotic curriculum began integration in July 2013. Fellows from July 2013 to August 2017 were included. An education portfolio was created for each fellow, including pre-fellowship experience, fellowship experience with data from robotic curriculum and operative experience, and post-fellowship practice information...
August 2, 2018: Annals of Surgical Oncology
Anthony Lopez, Lieven Pouillon, Laurent Beaugerie, Silvio Danese, Laurent Peyrin-Biroulet
Ulcerative colitis is characterized by chronic inflammation, which may lead to the accumulation of high levels of pro-inflammatory cytokines within the colonic mucosa, and thus to dysplastic lesions and cancer. Although the trend is decreasing, ulcerative colitis patients still have a 2.4 fold higher risk of colorectal cancer compared to the general population. The key task is to control colonic inflammation, and a rapid step-up approach while closely monitoring intestinal inflammation are recommented. Surveillance colonoscopy program demonstrated its efficacy for reducing the incidence of colorectal cancer in ulcerative colitis...
February 2018: Best Practice & Research. Clinical Gastroenterology
Lara Khalil, Rebecca B McNeil, Kellie J Sims, Kristina A Felder, Elizabeth R Hauser, Karen M Goldstein, Corrine I Voils, Nancy G Klimas, Mary T Brophy, Catherine M Thomas, Richard L Whitley, Erin K Dursa, Drew A Helmer, Dawn T Provenzale
The United States Department of Veterans Affairs Gulf War Era Cohort and Biorepository (GWECB) is a nationally representative longitudinal cohort of United States Veterans who served during the 1990-1991 Gulf War era. The GWECB combines survey data, such as demographic, health behavior, and environmental exposure data; medical records; and a linked biorepository of blood specimens that can support a broad range of future research regarding health concerns unique to Veterans of this era. To build this resource, the Veterans Affairs Cooperative Studies Program initiated a pilot study (2014-2016) to establish the GWECB and evaluate the processes required to build and maintain the resource...
July 30, 2018: American Journal of Epidemiology
Xan Sarah Chacko
In the early twentieth century, the United States Department of Agriculture (USDA) funded international expeditions with the aim of finding plant specimens for introduction into the agricultural landscape and the new experimental projects in hybridization. One such agricultural explorer, noted for his eponymous lemon, was Frank Nicholas Meyer, an immigrant from the Netherlands whose expeditions in Asia have brought to the United States celebrated fruit and toxic weeds. Neither professional botanists nor farmers, plant hunters like Meyer worked by taking advantage of historical allegiances to academic programs, while leaning on the authority of their newer national institutions...
July 29, 2018: History of Science; An Annual Review of Literature, Research and Teaching
A Claire Watkins, Mehrdad Ghoreishi, Nathan L Maassel, Brody Wehman, Filiz Demirci, Bartley P Griffith, James S Gammie, Bradley S Taylor
BACKGROUND: Throughout surgery, specialization in a procedure has been shown to improve outcomes. Currently, there is no evidence for or against subspecialization in coronary surgery. Tasked with the goal of improving outcomes after isolated coronary artery bypass grafting (CABG), our institution sought to determine whether the development of a subspecialized coronary surgery program would improve morbidity and mortality. METHODS: All isolated CABG operations at a single institution were retrospectively examined in two distinct periods, 2002 to 2013 and 2013 to 2016, before and after the implementation of a subspecialized coronary surgery program...
July 26, 2018: Annals of Thoracic Surgery
Tomoharu Sugie
The development of immune-check inhibitors has resulted in a paradigm shift for immune oncology therapeutics in the past few decades. Blocking antibodies against programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) leads to robust local tumor control and a durable response in patients with various tumors that are refractory to standard treatments. Breast cancer was traditionally thought to be poorly immunogenic and yield a relatively lower mutation burden compared to 'inflamed' tumors, including melanoma and non-small cell lung carcinoma...
June 2018: Chinese Clinical Oncology
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