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https://www.readbyqxmd.com/read/28647838/preoperative-education-for-hip-and-knee-replacement-never-stop-learning
#1
REVIEW
Paul K Edwards, Simon C Mears, C Lowry Barnes
PURPOSE OF REVIEW: Participation in alternative payment models has focused efforts to improve outcomes and patient satisfaction while also lowering cost for elective hip and knee replacement. The purpose of this review is to determine if preoperative education classes for elective hip and knee replacement achieve these goals. RECENT FINDINGS: Recent literature demonstrates that patients who attend education classes prior to surgery have decreased anxiety, better post-operative pain control, more realistic expectations of surgery, and a better understanding of their surgery...
June 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28647069/oncologic-quality-indicators-in-thoracic-surgery
#2
REVIEW
Jessica Hudson, Tara Semenkovich, Varun Puri
This article outlines a structure for assessing thoracic surgical quality and provides an overview of evidence-based quality metrics for surgical care in both lung cancer and esophageal cancer, with a focus on process and outcome measures in the preoperative, intraoperative, and postoperative setting.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28647068/risk-adjustment-and-performance-measurement-for-esophageal-cancer-resection
#3
REVIEW
Stephanie G Worrell, Andrew C Chang
Achieving high-quality care for all patients undergoing esophageal cancer requires identifying and modifying risk factors associated with poor outcomes. These factors occur at different time points from the preoperative to the postoperative periods. A straightforward model for predicting outcomes has proved difficult to identify. This article reviews the current studies addressing risk adjustment and performance measurement for esophageal cancer resection.
August 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28644938/preoperative-epoxy-embolization-facilitates-the-safe-and-effective-resection-of-venous-malformations-in-the-hand-and-forearm
#4
Brian P Holly, Yuval A Patel, James Park, Laura M Fayad, E Gene Deune, Sally E Mitchell, Clifford R Weiss
BACKGROUND: The standard of care for treatment of low-flow venous malformations (VMs) is percutaneous sclerotherapy. These lesions are seldom surgically resected, especially if the malformation is in an anatomically difficult location. Percutaneous sclerotherapy is safe and effective. However, the drawbacks to sclerotherapy are the need for repeated treatments and risks of skin ulceration, deep venous thrombosis, scarring/contractures, and nerve damage. Surgical resection can be difficult because of intraoperative bleeding, intraoperative lesional decompression, and difficulty in localization...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28643843/perisylvian-including-insular-childhood-epilepsy-presurgical-workup-and-surgical-outcome
#5
Elena Freri, Sara Matricardi, Francesca Gozzo, Massimo Cossu, Tiziana Granata, Laura Tassi
OBJECTIVE: To report the presurgical workup, surgical procedures, and outcomes in a series of pediatric patients with drug-resistant epilepsy involving the perisylvian/insular regions. METHODS: We retrospectively assessed 16 pediatric patients affected by drug-resistant focal epilepsy involving perisylvian/insular regions, who consecutively underwent tailored resective surgery. All patients underwent a detailed presurgical workup, which included the analysis of the anatomoelectroclinical correlations with scalp electroencephalography (EEG) and/or with stereo-electroencephalography (SEEG), brain magnetic resonance imaging (MRI), and comprehensive cognitive and neuropsychological evaluations...
June 23, 2017: Epilepsia
https://www.readbyqxmd.com/read/28643711/glued-intraocular-lens-implantation-for-eyes-with-inadequate-capsular-support-analysis-of-the-postoperative-visual-outcome
#6
Sujatha Mohan, Bina John, Mohan Rajan, Harsha Malkani, S V Nagalekshmi, Siddhartha Singh
AIM: The aim of this study is to analyze the postoperative visual outcomes of fibrin glue-assisted, suture-less posterior chamber (PC) intraocular lens (IOL) implantation technique in eyes with inadequate capsule support at a tertiary eye care hospital in South India. SETTING AND DESIGN: This is a retrospective, nonrandomized case series. PATIENTS AND METHODS: This study analyzes 94 eyes which underwent PC-IOL implantation by fibrin glue-assisted, suture-less technique...
June 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28643062/loss-of-medicaid-insurance-after-successful-bariatric-surgery-an-unintended-outcome
#7
J Hunter Mehaffey, Eric J Charles, Irving L Kron, Bruce Schirmer, Peter T Hallowell
BACKGROUND: Bariatric surgery leads to dramatic weight loss and improved overall health, which may affect insurance status for certain patients. Traditional Medicaid provides coverage for children, pregnant women, and disabled adults, while expanded Medicaid provides insurance coverage to all adults with incomes up to 138% of the federal poverty level. We hypothesized that successful bariatric surgery would lead to improved health status but an unintended loss of Medicaid coverage. METHODS: All patients who underwent bariatric surgery at a single institution in a non-expansion state from 1985 through 2015 were identified using a prospectively collected database...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642653/clinical-application-of-a-drill-guide-template-for-pedicle-screw-placement-in-severe-scoliosis
#8
Xin Li, Yaoshen Zhang, Qiang Zhang, Changsong Zhao, Kun Liu
OBJECTIVE: To evaluate the accuracy and the effect of drill guide template for pedicle screw placement in severe scoliosis. METHOD: Eight patients with rigid scoliosis were enrolled, five males and three females, ranging from nine to 23 years old. A three-dimensional CT scan of the spine was performed and saved as a DICOM file type. The multi-level template was designed by Mimics software and manufactured according to the part of the most severe deformity. The drill template was placed on the corresponding vertebral surface...
March 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28640112/cement-leakage-in-osteoporotic-vertebral-compression-fractures-with-cortical-defect-using-high-viscosity-bone-cement-during-unilateral-percutaneous-kyphoplasty-surgery
#9
Tie Liu, Zhe Li, Qingjun Su, Yong Hai
The purpose of this study was to investigate cement leakage (CL) in osteoporotic vertebral compression fractures (OVCFs) with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty (PKP) surgery.This study included a series of 77 patients (23 males, 54 females) with single level osteoporotic vertebral body fracture (OVCF) who underwent unilateral PKP in our hospital. Preoperative x-ray, computed tomography (CT) scan, and 3-dimensional reconstructions were studied. During the PKP procedure, needle was carefully put to avoid too near to the cortical defect according to CT image...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28638240/perioperative-management-of-neurological-conditions
#10
REVIEW
Manjeet Singh Dhallu, Ahmed Baiomi, Madhavi Biyyam, Sridhar Chilimuri
Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. We have tried to address few commonly encountered neurological conditions in clinical practice, such as delirium, stroke, epilepsy, myasthenia gravis, and Parkinson disease...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28637567/the-impact-of-early-recurrence-on-quality-of-life-after-cytoreduction-with-hipec
#11
Nathan M Hinkle, Vandana Botta, John P Sharpe, Paxton Dickson, Jeremiah Deneve, Gitonga Munene
Improved oncological outcomes after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in highly selected patients have been well documented. The extensive nature of the procedure adversely affects quality of life (QoL). The aim of this study is to longitudinally evaluate QoL following CRS/HIPEC. This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC. Clinicopathological data, oncologic outcomes, and QoL were analyzed preoperatively and postoperatively at 2 weeks, and 1, 3, 6, and 12 months...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637558/travel-time-influences-readmission-risk-geospatial-mapping-of-surgical-readmissions
#12
Florence E Turrentine, Patrick J Buckley, Min-Woong Sohn, Michael D Williams
The University of Virginia (UVA) has recently become an Accountable Care Organization (ACO), intensifying efforts to provide better care for individuals. UVA's ACO population resides across the entire Commonwealth, with a large percentage of patients living in rural areas. To provide better health for this population, the central tenet of the ACO mission, we identified geographic risk factors influencing hospital readmission. We analyzed the relationship between the distance of patients' residence to the nearest hospital and 30-day readmission in general surgery patients...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637557/nomogram-derived-prediction-of-postoperative-ileus-after-colectomy-an-assessment-from-nationwide-procedure-targeted-cohort
#13
Ahmet Rencuzogullari, Cigdem Benlice, Meagan Costedio, Feza H Remzi, Emre Gorgun
Postoperative ileus (POI) is a clinical burden to health-care system. This study aims to evaluate the incidence and predictors of POI in patients undergoing colectomy and create a nomogram by using recently released procedure-targeted nationwide database. Patients who underwent elective colectomy in 2012 and 2013 were identified from American College of Surgeons National Surgical Quality Improvement Program using the new procedure-targeted database. Demographics, comorbidities, and 30-day postoperative outcomes were evaluated...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637179/is-delayed-surgical-revascularization-in-acute-myocardial-infarction-useful-or-dangerous-new-insights-into-an-old-problem
#14
Philippe Grieshaber, Peter Roth, Lukas Oster, Tobias M Schneider, Gerold Görlach, Bernd Nieman, Andreas Böning
OBJECTIVES: Haemodynamically stable patients admitted for coronary artery bypass grafting in acute myocardial infarction often undergo delayed surgery in order to avoid the risks of emergency surgery. However, initially stable patients undergoing delayed surgery may develop low cardiac output syndrome (LCOS) during the waiting period, which might be a major drawback of this strategy. We aim to define risk factors and clinical consequences of LCOS during the waiting period. METHODS: A total of 530 consecutive patients with acute myocardial infarction (33% non-ST-segment elevation myocardial infarction and 67% ST-segment-elevation myocardial infarction) underwent isolated coronary artery bypass grafting between 2008 and 2013...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28636474/lumbar-artery-perforators-an-anatomical-study-based-on-computed-tomographic-angiography-imaging
#15
Casper Emile Sommeling, Britt Colebunders, Heleen E Pardon, Filip B Stillaert, Phillip N Blondeel, Koenraad Van Landuyt
BACKGROUND: The free lumbar artery perforator flap has recently been introduced as a potentially valuable option for autologous breast reconstruction in a subset of patients. Up to date, few anatomical studies, exploring the lumbar region as a donor site for perforator- based flaps, have been conducted. METHODS: An anatomical study of the position of the dominant lumbar artery perforator was performed, using the preoperative computed tomographic angiography images of 24 autologous breast reconstruction patients...
February 28, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28635566/stone-size-is-a-predictor-for-residual-stone-and-multiple-procedures-of-endoscopic-combined-intrarenal-surgery
#16
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/28634785/-imaging-and-preoperative-planning-for-osteotomies-around-the-knee
#17
REVIEW
D Pape, A Hoffmann, R Seil
Physiologic alignment of the human lower leg is well defined. The etiology for malalignment comprises constitutional, degenerative and posttraumatic conditions. Osteotomies around the knee can correct the malalignment, provided that the origin of deviation is in proximity of the knee center. Crucial factors for the evaluation of axis deviation are the weight-bearing line, the mechanical axes of femur and tibia, the joint line angles and the center of the hip, knee and upper ankle joint. Careful preoperative planning is mandatory for reproducible clinical results...
June 20, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28634025/impaired-cerebral-autoregulation-in-preoperative-newborn-infants-with-congenital-heart-disease
#18
Jodie K Votava-Smith, Christopher J Statile, Michael D Taylor, Eileen C King, Jesse M Pratt, David P Nelson, Erik C Michelfelder
OBJECTIVES: To characterize cerebral autoregulation (CA) in preoperative newborn infants with congenital heart disease (CHD). METHODS: This was a prospective, pilot study of term newborns with CHD who required intensive care. Continuous mean arterial blood pressure (MAP), cerebral tissue oxygen saturation (SCTO2) via near-infrared spectroscopy, and arterial oxygen saturation (SaO2) were collected. Significant low-frequency coherence between MAP and SCTO2 was used to define impaired CA in 20-minute epochs...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#19
Jacob Deister, Brian G Cothern, Chad Williams, Andrew W Froehle, Richard T Laughlin
Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. We conducted a retrospective review of 198 cases treated during a 3-year period to identify the risk factors for an extended LOHS and ECF admission after ankle arthrodesis, triple arthrodesis, pantalar arthrodesis, and subtalar arthrodesis...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633411/surgeon-level-variability-in-outcomes-cost-and-comorbidity-adjusted-cost-for-elective-lumbar-decompression-and-fusion
#20
Silky Chotai, Ahilan Sivaganesan, John A Sielatycki, Kristin R Archer, Richard Call, Matthew J McGirt, Clinton J Devin
BACKGROUND: The costs and outcomes following degenerative spine surgery may vary from surgeon to surgeon. Patient factors such as comorbidities may increase the health care cost. These variations are not well studied. OBJECTIVE: To understand the variation in outcomes, costs, and comorbidity-adjusted cost for surgeons performing lumbar laminectomy and fusions surgery. METHODS: A total of 752 patients undergoing laminectomy and fusion, performed by 7 surgeons, were analyzed...
June 14, 2017: Neurosurgery
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