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https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#1
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28321371/anatomic-variations-in-pituitary-endocrinopathies-implications-for-the-surgical-corridor
#2
Edward C Kuan, Frederick Yoo, Won Kim, Karam W Badran, Thomas E Heineman, Ali R Sepahdari, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses Functioning pituitary adenomas may produce endocrinopathies such as acromegaly and Cushing syndrome. Both conditions lead to characteristic anatomic variations as a result of hormonally induced abnormal soft tissue deposition. We evaluate the anatomic differences between acromegalics and Cushing disease patients and compare these dimensions to controls. Design Radiographic review of preoperative magnetic resonance images (MRI) of the pituitary gland. Setting Tertiary academic medical center...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28298026/prospective-comparison-of-long-term-pain-relief-rates-after-first-time-microvascular-decompression-and-stereotactic-radiosurgery-for-trigeminal-neuralgia
#3
Doris D Wang, Kunal P Raygor, Tene A Cage, Mariann M Ward, Sarah Westcott, Nicholas M Barbaro, Edward F Chang
OBJECTIVE Common surgical treatments for trigeminal neuralgia (TN) include microvascular decompression (MVD), stereotactic radiosurgery (SRS), and radiofrequency ablation (RFA). Although the efficacy of each procedure has been described, few studies have directly compared these treatment modalities on pain control for TN. Using a large prospective longitudinal database, the authors aimed to 1) directly compare long-term pain control rates for first-time surgical treatments for idiopathic TN, and 2) identify predictors of pain control...
February 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291408/clinical-outcomes-following-spinal-fusion-using-an-intraoperative-computed-tomographic-3d-imaging-system
#4
Roy Xiao, Jacob A Miller, Navin C Sabharwal, Daniel Lubelski, Vincent J Alentado, Andrew T Healy, Thomas E Mroz, Edward C Benzel
OBJECTIVE Improvements in imaging technology have steadily advanced surgical approaches. Within the field of spine surgery, assistance from the O-arm Multidimensional Surgical Imaging System has been established to yield superior accuracy of pedicle screw insertion compared with freehand and fluoroscopic approaches. Despite this evidence, no studies have investigated the clinical relevance associated with increased accuracy. Accordingly, the objective of this study was to investigate the clinical outcomes following thoracolumbar spinal fusion associated with O-arm-assisted navigation...
March 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28289059/what-is-wrong-with-pertussis-vaccine-immunity-why-immunological-memory-to-pertussis-is-failing
#5
Dimitri A Diavatopoulos, Kathryn Margaret Edwards
Memory responses seen after whole-cell pertussis (wP) and acellular pertussis (aP) vaccine priming are different and reflect better long-term protection against pertussis disease seen with the whole-cell vaccines. Although acellular vaccines generate higher levels of antigen-specific IgG to the antigens included in the aP vaccines, there are many more pertussis antigens included in whole-cell vaccines. Acellular vaccine priming is associated with skewing of the immune response to a more Th2-like response, whereas whole-cell priming is associated with a Th1/Th17 response...
March 13, 2017: Cold Spring Harbor Perspectives in Biology
https://www.readbyqxmd.com/read/28283840/locking-stand-alone-cages-versus-anterior-plate-constructs-in-single-level-fusion-for-degenerative-cervical-disease-a-systematic-review-and-meta-analysis
#6
REVIEW
Mithun Nambiar, Kevin Phan, John Edward Cunningham, Yi Yang, Peter Lawrence Turner, Ralph Mobbs
PURPOSE: To conduct a meta-analysis to compare the clinical and radiological outcomes in single-level anterior cervical discectomy and fusion (ACDF) surgery for degenerative cervical disease performed by either single-level locking stand-alone cage (LSC) or anterior plate construct (APC). METHODS: We performed a comprehensive database search of Medline, PubMed, EMBASE and Cochrane Database of Systematic Reviews according to PRISMA guidelines and identified six articles that satisfied our inclusion criteria...
March 10, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28264845/clinical-response-of-tedizolid-versus-linezolid-in-acute-bacterial-skin-and-skin-structure-infections-by-severity-measure-using-a-pooled-analysis-from-two-phase-3-double-blind-trials
#7
Taylor Sandison, Carisa De Anda, Edward Fang, Anita F Das, Philippe Prokocimer
Tedizolid phosphate is approved for the treatment of acute bacterial skin and skin structure infections (ABSSSI). In a pooled analysis of 1,333 ABSSSI patients from the ESTABLISH clinical trials, treatment with tedizolid or linezolid demonstrated similar early and posttherapy clinical responses in both non-severe and severe disease, irrespective of the parameters used to measure ABSSSI severity. Shorter 6-day treatment of ABSSSI, including severe infections, with tedizolid phosphate demonstrated comparable efficacy to 10-day treatment with linezolid...
March 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28258727/comparison-of-baseline-characteristics-and-inhospital-outcomes-of-patients-and-use-of-bare-metal-versus-drug-eluting-stents-during-percutaneous-coronary-intervention-2005-to-2015-at-a-single-tertiary-hospital
#8
Romain Didier, Michael A Gaglia, Michael J Lipinski, Edward Koifman, Sarkis Kiramijyan, Smita Negi, Jiaxiang Gai, Rebecca Torguson, Augusto D Pichard, Ron Waksman
With steady growth in the use of drug-eluting stents (DES), the indications for bare metal stents (BMS) have significantly changed over the last decade. This study aims to describe trends in the use of BMS and the evolution of the population receiving them over the past 10 years and determine patient characteristics associated with using BMS. Consecutive patients who underwent percutaneous coronary intervention (PCI) at the Washington Hospital Center from January 2005 through March 2015 were included. Baseline characteristics and inhospital outcomes of patients who underwent PCI with BMS versus DES were compared during 2 different time periods: from 2005 to 2010 and from 2011 to 2015...
February 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28253221/objective-short-sleep-duration-modifies-the-relationship-between-hypertension-and-all-cause-mortality
#9
Julio Fernandez-Mendoza, Fan He, Alexandros N Vgontzas, Duanping Liao, Edward O Bixler
OBJECTIVE: Short sleep duration has been associated with cardiovascular morbidity and mortality. However, previous studies were limited by using subjective sleep measures and treating sleep duration as a sole, independent predictor. Therefore, the role of sleep duration in predicting mortality is still not well understood. We posit that objective sleep duration is an effect modifier of the relationship between hypertension and all-cause mortality. METHODS: We addressed this question in the Penn State Adult Cohort, a random, general population sample of 1741 men and women (48...
April 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28196730/globe-axial-length-growth-at-age-5-years-in-the-infant-aphakia-treatment-study
#10
M Edward Wilson, Rupal H Trivedi, David R Weakley, George A Cotsonis, Scott R Lambert
PURPOSE: To report the longitudinal change in axial length (AL) from the time of unilateral cataract surgery at age 1 to 7 months to age 5 years, and to compare AL growth of operated eyes with that of fellow unoperated eyes. DESIGN: Comparative case series. PARTICIPANTS: Infants enrolled in the Infant Aphakia Treatment Study (IATS). METHODS: The AL at baseline and age 5 years and change in AL were analyzed relative to treated versus fellow eye, visual outcome, and treatment modality (contact lens [CL] vs...
February 10, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28192722/a-preliminary-longitudinal-study-of-white-matter-alteration-in-cocaine-use-disorder-subjects
#11
Liangsuo Ma, Joel L Steinberg, Qin Wang, Joy M Schmitz, Edward L Boone, Ponnada A Narayana, F Gerard Moeller
BACKGROUND: Previous diffusion tensor imaging (DTI) studies have consistently shown that subjects with cocaine use disorder (CocUD) had altered white matter microstructure in the corpus callosum. It is believed that these alterations are due to preexisting factors, chronic cocaine use, or both. However, there is no published longitudinal DTI study on human cocaine users yet which could shed light on the relationship between cocaine use and DTI findings. METHODS: This study used a longitudinal design and DTI to test if the white matter microstructure shows quicker alteration in CocUD subjects than controls...
January 30, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28184977/lateral-atrial-tunnel-fontan-operation-predisposes-to-the-junctional-rhythm
#12
Katarzyna Januszewska, Anna Schuh, Anja Lehner, Robert Dalla-Pozza, Edward Malec
The goal of the study was to compare the early postoperative course after fenestrated lateral atrial tunnel (LT) and non-fenestrated extracardiac conduit (EC) Fontan operation (FO) in a single center where both techniques were parallelly used. Between 2004 and 2012, 56(32.7%) children underwent LT and 113(66.1%) EC FO. The mean age was 3.7 ± 2.9 years and mean weight was 14.6 ± 7.3 kg. The most common malformation was hypoplastic left heart syndrome (50.9%). The general approach was to perform LT in children after hemi-Fontan operation and EC in patients after Glenn anastomosis...
February 10, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28177873/prognostic-mutations-in-myelodysplastic-syndrome-after-stem-cell-transplantation
#13
R Coleman Lindsley, Wael Saber, Brenton G Mar, Robert Redd, Tao Wang, Michael D Haagenson, Peter V Grauman, Zhen-Huan Hu, Stephen R Spellman, Stephanie J Lee, Michael R Verneris, Katharine Hsu, Katharina Fleischhauer, Corey Cutler, Joseph H Antin, Donna Neuberg, Benjamin L Ebert
Background Genetic mutations drive the pathogenesis of the myelodysplastic syndrome (MDS) and are closely associated with clinical phenotype. Therefore, genetic mutations may predict clinical outcomes after allogeneic hematopoietic stem-cell transplantation. Methods We performed targeted mutational analysis on samples obtained before transplantation from 1514 patients with MDS who were enrolled in the Center for International Blood and Marrow Transplant Research Repository between 2005 and 2014. We evaluated the association of mutations with transplantation outcomes, including overall survival, relapse, and death without relapse...
February 9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28156482/implementing-an-emergency-department-emr-trigger-tool-for-palliative-medicine-consultation-and-its-effect-on-length-of-stay-and-health-care-costs-a-retrospective-study
#14
Felix Rivera, Wendy Edwards
167 Background: Several studies have shown that palliative medicine consultation can improve multiple patient-centered outcomes, especially when provided early. Our goal is to show that our electronic health record (EHR) trigger tool is a cost-effective way for hospitals to identify patients who may benefit from early consultation, improving outcomes such as hospital length of stay and facilitating appropriate disposition for patients with metastatic cancer. METHODS: Retrospective chart review of 721 patients at an urban community hospital who were identified by a trigger system integrated into the Emergency Department (ED) EHR...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28130737/dexmedetomidine-versus-propofol-during-drug-induced-sleep-endoscopy-and-sedation-a-systematic-review
#15
REVIEW
Edward T Chang, Victor Certal, Sungjin A Song, Soroush Zaghi, Marina Carrasco-Llatas, Carlos Torre, Robson Capasso, Macario Camacho
BACKGROUND: The purpose of the present study is to review the international literature, using a systematic review, for studies comparing propofol and dexmedetomidine for drug-induced sleep endoscopy (DISE) or sedation in which there is a description of the effect of the agents on the upper airway and associated variables (e.g., vital signs, sedation scores). METHODS: This is a systematic review through October 4, 2016. PubMed/MEDLINE and four additional databases were accessed for this study...
January 27, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28114196/early-gains-in-renal-function-following-implantation-of-heartmate-ii-left-ventricular-assist-devices-may-not-persist-to-one-year
#16
Tal Hasin, Avishay Grupper, John J Dillon, Joseph J Maleszewski, Zhuo Li, Yan Topilsky, Robert P Frantz, Brooks S Edwards, Naveen L Pereira, Simon Maltais, John M Stulak, Lyle Joyce, Richard Daly, Soon J Park, Sudhir S Kushwaha
Renal function improves early after left ventricular assist device (LVAD) implantation but later decline has been observed. We sought to determine the occurrence and evaluate possible causes for this decline. In 62 consecutive patients with HeartMateII LVAD with available calculated glomerular filtration rate (GFR, ml/min/1.73m) one year after implant, GFR was assessed repeatedly and possible predictors for decline from 3 to 12 months were investigated. Post-mortem renal specimens for patients supported with an LVAD were evaluated...
January 19, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28107026/impact-of-mobile-intensive-care-unit-use-on-total-ischemic-time-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-real-world-data-from-the-acute-coronary-syndrome-israeli-survey
#17
Edward Koifman, Roy Beigel, Zaza Iakobishvili, Nir Shlomo, Yitschak Biton, Avi Sabbag, Elad Asher, Shaul Atar, Shmuel Gottlieb, Ronny Alcalai, Doron Zahger, Amit Segev, Ilan Goldenberg, Rafael Strugo, Shlomi Matetzky
BACKGROUND: Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. METHODS: Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. RESULTS: The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28097381/rotating-night-shift-work-sleep-and-colorectal-adenoma-in-women
#18
Elizabeth E Devore, Jennifer Massa, Kyriaki Papantoniou, Eva S Schernhammer, Kana Wu, Xuehong Zhang, Walter C Willett, Charles S Fuchs, Andrew T Chan, Shuji Ogino, Edward Giovannucci, Esther K Wei
PURPOSE: This study aims to investigate the associations of rotating night shift work history and sleep duration with risk of colorectal adenoma. METHODS: We evaluated 56,275 cancer-free participants of the Nurses' Health Study II, who had their first colonoscopy or sigmoidoscopy between 1991 and 2011; rotating night shift work and sleep duration were reported by mailed questionnaire. Multivariable-adjusted logistic regression was used to estimate relative risks (RR) of colorectal adenoma, with 95% confidence intervals (CI), across categories of rotating night shift work history (none, 1-4, 5-9, and ≥10 years) and sleep duration (≤5, 6, 7, 8, and ≥9 h/day)...
January 17, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28076288/transfer-rnas-with-novel-cloverleaf-structures
#19
Takahito Mukai, Oscar Vargas-Rodriguez, Markus Englert, H James Tripp, Natalia N Ivanova, Edward M Rubin, Nikos C Kyrpides, Dieter Söll
We report the identification of novel tRNA species with 12-base pair amino-acid acceptor branches composed of longer acceptor stem and shorter T-stem. While canonical tRNAs have a 7/5 configuration of the branch, the novel tRNAs have either 8/4 or 9/3 structure. They were found during the search for selenocysteine tRNAs in terabytes of genome, metagenome and metatranscriptome sequences. Certain bacteria and their phages employ the 8/4 structure for serine and histidine tRNAs, while minor cysteine and selenocysteine tRNA species may have a modified 8/4 structure with one bulge nucleotide...
October 5, 2016: Nucleic Acids Research
https://www.readbyqxmd.com/read/28073298/extraperitoneal-vs-transperitoneal-robot-assisted-radical-prostatectomy-in-the-setting-of-prior-abdominal-or-pelvic-surgery
#20
David Horovitz, Changyong Feng, Edward M Messing, Jean Volny Joseph
INTRODUCTION: During Robotic-Assisted Radical Prostatectomy (RARP), the prostate may be approached extraperiteoneally (eRARP) or transperitoneally (tRARP). The former avoids the abdominal cavity which might be of benefit in patients who have had prior abdominal or pelvic surgery (PAPS). Our objective was to compare the outcomes of patients with PAPS undergoing either technique. METHODS: A retrospective review of patients treated with RARP from July 1, 2003-Dec. 31, 2014 with a minimum follow-up of 3 months was undertaken...
January 10, 2017: Journal of Endourology
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