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https://www.readbyqxmd.com/read/29221878/universal-insurance-and-an-equal-access-healthcare-system-eliminate-disparities-for-black-patients-after-traumatic-injury
#1
Muhammad Ali Chaudhary, Meesha Sharma, Rebecca E Scully, Daniel J Sturgeon, Tracey Koehlmoos, Adil H Haider, Andrew J Schoenfeld
BACKGROUND: Although inequities in trauma care are reported widely, some groups have theorized that universal health insurance would decrease disparities in care for disadvantaged minorities after a traumatic injury. We sought to examine the presence of racial disparities in outcomes and healthcare utilization at 30- and 90-days after discharge in this universally insured, racially diverse, American population treated for traumatic injuries. METHODS: This work studied adult beneficiaries of TRICARE treated at both military and civilian trauma centers 2006-2014...
December 5, 2017: Surgery
https://www.readbyqxmd.com/read/29220430/postoperative-outcomes-in-ustekinumab-treated-patients-undergoing-abdominal-operations-for-crohn-s-disease
#2
Amy L Lightner, Nicholas P McKenna, Chung Sang Tse, Neil Hyman, Radhika Smith, Gayane Ovsepyan, Phillip Fleshner, Kristen Crowell, Walter Koltun, Marc Ferrante, Andre D'Hoore, Nathalie Lauwers, Bram Verstockt, Antonino Spinelli, Francesca DiCandido, Laura E Raffals, Kellie L Mathis, Edward V Loftus
Introduction: Ustekinumab, a monoclonal antibody targeting interleukins-12 and -23 is used to treat adults with Crohn's disease (CD). We determined the 30-day postoperative infectious complication rate among CD patients who received ustekinumab within 12 weeks prior to an abdominal operation as compared to patients who received anti-tumor necrosis factor (TNF) agents. Methods: A retrospective chart review of adults with CD who underwent an abdominal operation between 1/1/2015 and 5/1/2017 was performed across six sites...
December 6, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29220082/benefits-of-multimodal-enhanced-recovery-pathway-in-patients-undergoing-kidney-transplantation
#3
Kevin A Espino, J Reinier F Narvaez, Michael C Ott, Liise K Kayler
BACKGROUND: Use of Enhanced recovery after surgery (ERAS) pathways to accelerate functional recovery and reduce length of stay (LOS) has rarely been investigated in kidney transplantation (KTX). MATERIALS AND METHODS: Consecutive adult isolated KTXs between 7/2015-7/2016 (ERAS, n=139) were compared with a historical cohort between 1/2014-7/2015 (HISTORIC, n=95). RESULTS: ERAS recipients were significantly more likely to receive kidneys that were non-local (56...
December 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29219945/vats-plication-of-the-diaphragm-a-descriptive-observational-10-year-southampton-experience
#4
Rhona J Taberham, Adnan Raza, Aiman Alzetani, Edwin B Woo, Martin H Chamberlain, George Koulaxouzidis, Khalid M Amer
OBJECTIVE: The aim of the study was to report the safety and efficacy of video-assisted thoracoscopic (VATS) plication of the diaphragm at our institution between 2006 and 2016. METHODS: Adult patients selected on etiology and combination of investigations including plain chest x-ray, computed tomography of chest and abdomen, lung functions in supine and sitting positions, radiological/ultrasonic screening for diaphragmatic movement, and phrenic nerve conduction studies...
December 6, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29218691/reliability-and-validity-assessment-of-administrative-databases-in-measuring-the-quality-of-rectal-cancer-management
#5
Carlo Corbellini, Bruno Andreoni, Luca Ansaloni, Giovanni Sgroi, Mario Martinotti, Ildo Scandroglio, Pierluigi Carzaniga, Mauro Longoni, Diego Foschi, Paolo Dionigi, Eugenio Morandi, Mauro Agnello
PURPOSE: Measurement and monitoring of the quality of care using a core set of quality measures are increasing in health service research. Although administrative databases include limited clinical data, they offer an attractive source for quality measurement. The purpose of this study, therefore, was to evaluate the completeness of different administrative data sources compared to a clinical survey in evaluating rectal cancer cases. METHODS: Between May 2012 and November 2014, a clinical survey was done on 498 Lombardy patients who had rectal cancer and underwent surgical resection...
December 5, 2017: Tumori
https://www.readbyqxmd.com/read/29218672/effect-of-academic-status-on-outcomes-of-surgery-for-rectal-cancer
#6
Kristen Cagino, Maria S Altieri, Jie Yang, Lizhou Nie, Mark Talamini, Konstantinos Spaniolas, Paula Denoya, Aurora Pryor
BACKGROUND: The purpose of our study was to investigate surgical outcomes following advanced colorectal procedures at academic versus community institutions. METHODS: The SPARCS database was used to identify patients undergoing Abdominoperineal resection (APR) and Low Anterior Resection between 2009 and 2014. Linear mixed models and generalized linear mixed models were used to compare outcomes. Laparoscopic versus open procedures, surgery type, volume status, and stoma formation between academic and community facilities were compared...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29216838/a-prediction-model-to-identify-hospitalised-older-adults-with-reduced-physical-performance
#7
Inge H Bruun, Thomas Maribo, Birgitte Nørgaard, Berit Schiøttz-Christensen, Christian B Mogensen
BACKGROUND: Identifying older adults with reduced physical performance at the time of hospital admission can significantly affect patient management and trajectory. For example, such patients could receive targeted hospital interventions such as routine mobilisation. Furthermore, at the time of discharge, health systems could offer these patients additional therapy to maintain or improve health and prevent institutionalisation or readmission. The principle aim of this study was to identify predictors for persisting, reduced physical performance in older adults following acute hospitalisation...
December 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29215657/-the-patient-and-the-crossing-between-primary-and-hospital-care-systematic-review-of-trials-for-the-implementation-of-tools-for-integration-in-spain
#8
REVIEW
L Corral Gudino, M Borao Cengotita-Bengoa, R J Jorge Sánchez, J García Aparicio
BACKGROUND: Health services are moving towards a complete integration to try and reduce fragmentation, increase efficiencies and improve health outcomes. Estimates the effectiveness in of different tools for integrated care in Spain. METHODS: We performed a systematic review of articles using MEDLINE (last search July31st, 2017). Randomized clinical trials reporting health outcomes of tools for integrated care used in Spain were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment...
December 7, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29215534/incidence-and-predictors-of-readmissions-in-acute-pancreatitis-a-nationwide-analysis
#9
Sushil Kumar Garg, James P Campbell, Chimaobi Anugwom, Vaibhav Wadhwa, Rajeshwar Singh, Nancy Gupta, Madhusudhan R Sanaka
OBJECTIVES: Acute pancreatitis (AP) is a common cause for hospitalization, and readmission is common, with variable associated risk factors for readmission. Here, we assessed the incidence and risk factors for readmission in AP in a large national database. METHODS: We analyzed data from the National Readmission Database during the year 2013. Index admissions with a primary discharge diagnosis of AP using the International Classification of Diseases, Ninth Revision, Clinical Modification were identified from January to November to identify 30-day readmission rates...
December 5, 2017: Pancreas
https://www.readbyqxmd.com/read/29215510/timing-and-risk-factors-of-postpartum-stroke
#10
Gloria Too, Timothy Wen, Amelia K Boehme, Eliza C Miller, Lisa R Leffert, Frank J Attenello, William J Mack, Mary E DʼAlton, Alexander M Friedman
OBJECTIVE: To characterize risk and timing of postpartum stroke readmission after delivery hospitalization discharge. METHODS: The Healthcare Cost and Utilization Project's Nationwide Readmissions Database for calendar years 2013 and 2014 was used to perform a retrospective cohort study evaluating risk of readmission for stroke within 60 days of discharge from a delivery hospitalization. Risk was characterized as odds ratios (ORs) with 95% CIs based on whether patients had hypertensive diseases of pregnancy (gestational hypertension or preeclampsia), or chronic hypertension, or neither disorder during the index hospitalization...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215499/post-operative-emergency-department-utilization-and-hospital-readmission-after-cervical-spine-arthrodesis-rates-trends-causes-and-risk-factors
#11
Peter B Derman, Lukas P Lampe, Ting Jung Pan, Stephan N Salzmann, Janina Kueper, Federico P Girardi, Stephen Lyman, Alexander P Hughes
STUDY DESIGN: Retrospective state database analysis. OBJECTIVE: To quantify the 30-day and 90-day emergency department (ED) utilization and inpatient readmission rates after primary cervical arthrodesis, to stratify these findings by surgical approach and to describe risk factors and conditions precipitating these events. SUMMARY OF BACKGROUND DATA: Limited data exist on ED utilization and hospital readmission rates after cervical spine arthrodesis...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29215492/postoperative-opioid-use-complications-and-costs-in-surgical-management-of-lumbar-spondylolisthesis
#12
Daniel Vail, Tej D Azad, Chloe O'Connell, Summer S Han, Anand Veeravagu, John K Ratliff
STUDY DESIGN: Retrospective analysis on a national longitudinal database (2007-2014). OBJECTIVE: To determine the association between arthrodesis and complication rates, costs, surgical revision, and postoperative opioid prescription. SUMMARY OF BACKGROUND DATA: Arthrodesis in patients receiving laminectomy for lumbar spondylolisthesis remains controversial. However, population-level evidence to support the use of arthrodesis remains limited...
December 5, 2017: Spine
https://www.readbyqxmd.com/read/29215478/tranexamic-acid-for-lower-gi-hemorrhage-a-randomized-placebo-controlled-clinical-trial
#13
Stephen R Smith, David Murray, Peter G Pockney, Cino Bendinelli, Brian D Draganic, Rosemary Carroll
BACKGROUND: Lower GI hemorrhage is a common source of morbidity and mortality. Tranexamic acid is an antifibrinolytic that has been shown to reduce blood loss in a variety of clinical conditions. Information regarding the use of tranexamic acid in treating lower GI hemorrhage is lacking. OBJECTIVE: The aim of this trial was to determine the clinical efficacy of tranexamic acid when used for lower GI hemorrhage. DESIGN: This was a prospective, double-blind, placebo-controlled, randomized clinical trial...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29215474/assessment-of-ileostomy-output-using-telemedicine-a-feasibility-trial
#14
Brian K Bednarski, Rebecca S Slack, Matthew Katz, Y Nancy You, John Papadopolous, Miguel A Rodriguez-Bigas, John M Skibber, Surena F Matin, George J Chang
BACKGROUND: Ileostomies are a routine part of the care of patients with rectal cancer, but are associated with significant risk for dehydration, readmission, and acute kidney injury. Telemedicine has proven beneficial in decreasing readmission in chronic medical illnesses, but its utility in patients with an ileostomy is not well studied. OBJECTIVE: The purpose of this study was to evaluate the feasibility of televideoconferencing in the assessment of ileostomy output...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29214454/impact-of-sarcopenia-on-unplanned-readmission-and-survival-after-esophagectomy-in-patients-with-esophageal-cancer
#15
Daisuke Makiura, Rei Ono, Junichiro Inoue, Akimasa Fukuta, Miyuki Kashiwa, Yasushi Miura, Taro Oshikiri, Tetsu Nakamura, Yoshihiro Kakeji, Yoshitada Sakai
BACKGROUND: Although sarcopenia increases postoperative complications following esophagectomy, its effects on prognosis remain unclear. This study was performed to identify the effect of sarcopenia on 90-day unplanned readmission and overall survival (OS) after esophagectomy. METHODS: Ninety-eight patients with esophageal cancer who underwent esophagectomy were enrolled in this study. Unplanned readmission was defined as any emergent hospitalization within 90 days after discharge...
December 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29214324/-benefits-of-medical-emergency-teams-mortality-on-normal-wards-and-readmission-to-intensive-care-wards
#16
REVIEW
Uwe Hamsen, Thomas A Schildhauer, Christian Waydhas
Medical emergency teams (MET) were implemented in many hospitals worldwide in order to identify patients at risk on normal wards and to initiate diagnostics and therapy without delay. Ideally, the implementation leads to prevention of cardiac arrests and unexpected deaths on normal wards, reduced rates of admissions to intensive care units and hospital mortality. Various track and trigger systems are available to identify such patients and for them to be assessed and treated within 30-45 min by the MET. The ideal personnel composition of METs has not yet been established...
December 6, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29212485/outcome-comparison-between-percutaneous-cholecystostomy-and-cholecystectomy-a-10-year-population-based-analysis
#17
Ping Lu, Chien-Lung Chan, Nan-Ping Yang, Nien-Tzu Chang, Kai-Biao Lin, K Robert Lai
BACKGROUND: Controversy surrounding the role of percutaneous cholecystostomy (PC) is fed by the absence of large amounts of data concerning its outcomes, and many authors have maintained that there is no evidence to support a recommendation for PC rather than cholecystectomy (CCS) in elderly or critically ill patients with acute cholecystitis (AC). METHODS: We conducted this study by tracking trends in the utilization and outcomes of PC and CCS using longitudinal health research data in Taiwan...
December 7, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29212367/assessment-of-patient-and-surgical-variables-including-residency-training-level-on-adverse-events-after-ureteroscopy-for-ureteral-stones-a-multivariate-analysis
#18
Carrie Johans, Woodson Smelser, Chelsea DeRoche, Jack Campbell, James Cummings
Purpose With advances in technology, ureteroscopy is increasingly utilized for the management of urolithiasis. Previous studies have attempted to characterize the post-operative complication and readmission rates relative to the technical difficulty of the procedure. There is limited data exploring resident level of training and its effect on adverse outcomes in these cases. We review our experience with ureteroscopy to create a model to predict factors, including resident experience,that affect rates of post-operative complications Materials and Methods We reviewed ureteroscopies performed at our academic facility from January 2009 to December 2013...
December 6, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29211218/impact-of-myocardial-revascularization-method-on-smoking-cessation-coronary-artery-bypass-grafting-versus-percutaneous-coronary-intervention
#19
Ricardo das Neves, Greicy Kelly Avila, Fernando de Barros Oliveira, João Augusto Ferraz de Sampaio
INTRODUCTION: Smoking is a serious public health issue, being a precursor of heart disease and a predictor of sudden death due to myocardial ischemia. Major events in the patient's health can lead to radical changes in habits and the choice for different myocardial revascularization methods might differently impact smoking cessation and relapse. OBJECTIVE: To study the rate and perpetuation of smoking cessation after myocardial revascularization comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29210926/hospital-readmissions-after-pediatric-trauma
#20
Aline B Maddux, Peter E DeWitt, Peter M Mourani, Tellen D Bennett
OBJECTIVES: To determine the rate, etiology, and timing of unplanned and planned hospital readmissions and to identify risk factors for unplanned readmission in children who survive a hospitalization for trauma. DESIGN: Multicenter retrospective cohort study of a probabilistically linked dataset from the National Trauma Data Bank and the Pediatric Health Information System database, 2007-2012. SETTING: Twenty-nine U.S. children's hospitals...
November 28, 2017: Pediatric Critical Care Medicine
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