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https://www.readbyqxmd.com/read/28215039/impact-of-surgical-experience-on-management-and-outcome-of-pancreatic-surgery-performed-in-high-and-low-volume-centers
#1
Marco Stella, Massimiliano Bissolati, Daniele Gentile, Alessandro Arriciati
Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume...
February 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28214908/-integrated-patient-centered-care-in-community-health-centers-in-italy-performance-evaluation
#2
Piero Salvadori
In Italy, a "Casa della Salute" (or "House of Health"), translated for the purposes of this article as Community Health Center (CHC), is a public center (of the national public healthcare system), where one can find allocated all primary community healthcare services centered on prevention, treatment and rehabilitation of the citizen in the same physical space, including general practitioner offices, outpatient specialist clinics, and social services. CHCs assure patient-centered primary care services and are the ideal place for applying the Chronic Care Model...
November 2016: Igiene e Sanità Pubblica
https://www.readbyqxmd.com/read/28214795/pre-implantation-balloon-aortic-valvuloplasty-and-clinical-outcomes-following-transcatheter-aortic-valve-implantation-a-propensity-score-analysis-of-the-uk-registry
#3
Glen P Martin, Matthew Sperrin, Rodrigo Bagur, Mark A de Belder, Iain Buchan, Mark Gunning, Peter F Ludman, Mamas A Mamas
BACKGROUND: Aortic valve predilation with balloon aortic valvuloplasty (BAV) is recommended before transcatheter aortic valve implantation (TAVI), despite limited data around the requirement of this preprocedural step and the potential risks of embolization. This study aimed to investigate the trends in practice and associations of BAV on short-term outcomes in the UK TAVI registry. METHODS AND RESULTS: Eleven clinical endpoints were investigated, including 30-day mortality, myocardial infarction, aortic regurgitation, valve dysfunction, and composite early safety...
February 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28214786/cost-effectiveness-of-risk-reducing-surgeries-in-preventing-hereditary-breast-and-ovarian-cancer
#4
Michael G Schrauder, Lisa Brunel-Geuder, Lothar Häberle, Marius Wunderle, Juliane Hoyer, André Reis, Rüdiger Schulz-Wendtland, Matthias W Beckmann, Michael P Lux
OBJECTIVES: Risk-reducing surgeries are a feasible option for mitigating the risk in individuals with inherited susceptibility to cancer, but are the procedures cost-effective in the current health-care system in Germany? This study compared the health-care costs for bilateral risk-reducing mastectomy (BRRM) and risk-reducing (bilateral) salpingo-oophorectomy (RRSO) with cancer treatment costs that could potentially be prevented. PATIENTS AND METHODS: The analysis is based on interdisciplinary consultations with individuals with a high familial risk for breast and ovarian cancer at the University Breast Center for Franconia (Germany) between 2009 and 2013 (370 consultations; 44 patients with BRCA1 mutations and 26 with BRCA2 mutations)...
February 16, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28214722/when-high-pressure-system-constraints-and-a-social-justice-mission-collide-a-socio-structural-analysis-of-emergency-department-social-work-services
#5
Megan Moore, Margaret Cristofalo, Danae Dotolo, Nicole Torres, Alexandra Lahdya, Leyna Ho, Mia Vogel, Mollie Forrester, Bonnie Conley, Susan Fouts
The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. This paper reports a qualitative content analysis of social work medical record notes (N = 1509) of services provided to trauma patients in an urban, public, level 1 trauma center and an in-depth analysis of semi-structured interviews with ED social workers (N = 10)...
February 11, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28214642/short-term-results-of-carotid-endarterectomy-and-stenting-after-the-introduction-of-carotid-magnetic-resonance-imaging-a-single-institutional-retrospective-study
#6
Ryu Fukumitsu, Kazumichi Yoshida, Yoshitaka Kurosaki, Koichi Torihashi, Nobutake Sadamasa, Masaomi Koyanagi, Osamu Narumi, Tsukasa Sato, Masaki Chin, Akira Handa, Sen Yamagata, Susumu Miyamoto
OBJECTIVE: While carotid artery stenting (CAS) has been gaining popularity as an alternative to carotid endarterectomy (CEA), the perioperative stroke rate following contemporary CAS remains significantly higher than that in CEA. The purpose of this study was to assess perioperative (within 30-day) therapeutic results in patients with carotid stenosis (CS) after the introduction of preoperative carotid magnetic resonance plaque evaluation in a single center offering both CEA and CAS. METHODS: Based on prospectively collected data for patients with CS who were scheduled for carotid revascularization, retrospective analysis was conducted of 295 consecutive CS patients...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28214615/the-effect-on-patient-outcomes-of-a-nursing-care-and-follow-up-program-for-patients-with-heart-failure-a-randomized-controlled-trial
#7
Dilek Sezgin, Hatice Mert, Ebru Özpelit, Bahri Akdeniz
BACKGROUND: Heart failure is associated with exacerbated symptoms such as dyspnea and edema and results in frequent hospitalization and a poor quality of life. With the adoption of a comprehensive nursing care and follow-up program, patients with heart failure may exhibit improvements in their self-care capabilities and their hospitalizations may be reduced. OBJECTIVE: The purpose of this study was to examine the effect of a nursing care and follow-up program for patients with heart failure on self-care, quality of life, and rehospitalization...
February 14, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28214574/minimally-invasive-versus-open-approach-for-cystectomy-trends-in-the-utilization-and-demographic-or-clinical-predictors-using-the-national-cancer-database-ncdb
#8
Andrew G Bachman, Alexander A Parker, Marshall D Shaw, Brian W Cross, Kelly L Stratton, Michael S Cookson, Sanjay G Patel
OBJECTIVES: To examine temporal national trends of operative approach for cystectomy and identify demographic or clinical predictive factors that influence choice of approach. METHODS: We performed a retrospective cohort study of patients who underwent cystectomy for bladder cancer between 2010 and 2013 using the National Cancer Database (NCDB). Approach was stratified by open vs. minimally invasive (robotic or laparoscopic). Univariate Pearson chi-square and multivariate logistic regression analysis was used to assess relationships between demographic and hospital factors and the receipt of minimally invasive or open surgical approach...
February 15, 2017: Urology
https://www.readbyqxmd.com/read/28214183/-misuse-and-dependence-on-prescription-opioids-prevention-identification-and-treatment
#9
B Rolland, D Bouhassira, N Authier, M Auriacombe, V Martinez, P Polomeni, G Brousse, R Schwan, P Lack, J Bachellier, S Rostaing, P Bendimerad, P Vergne-Salle, M Dematteis, S Perrot
Since the 1990s, the use of prescription opioids has largely spread, which has brought a real progress in the treatment of pain. The long-term use of prescription opioid is sometimes required, and may lead to pharmacological tolerance and withdrawal symptoms, i.e. pharmacological dependence on prescription opioids. Occasionally, this may also lead to misuse of prescription opioids (MPO). MPO preferentially occurs in vulnerable individuals, i.e., those with a young age, history of other addictive or psychiatric disorders, especially anxious and depressive disorders...
February 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28214173/pyrocarbon-interposition-shoulder-arthroplasty-preliminary-results-from-a-prospective-multicenter-study-at-2-years-of-follow-up
#10
Jérôme Garret, Arnaud Godeneche, Pascal Boileau, Daniel Molé, Mikael Etzner, Luc Favard, Christophe Levigne, François Sirveaux, Marc-Olivier Gauci, Charles Dezaly, Gilles Walch
BACKGROUND: The concept of free interposition arthroplasty proved successful for small joints of the hand, wrist, and foot, particularly after the use of implants coated with pyrocarbon, which enhanced their tribologic and elastic properties. The present study reports preliminary outcomes of a pyrocarbon-coated interposition shoulder arthroplasty (PISA) implant. METHODS: This was a prospective study of 67 consecutive patients who underwent shoulder PISA at 9 centers...
February 14, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28214167/psychometric-evaluation-and-design-of-patient-centered-communication-measures-for-cancer-care-settings
#11
Bryce B Reeve, David M Thissen, Carla M Bann, Nicole Mack, Katherine Treiman, Hanna K Sanoff, Nancy Roach, Brooke E Magnus, Jason He, Laura K Wagner, Rebecca Moultrie, Kathryn D Jackson, Courtney Mann, Lauren A McCormack
OBJECTIVE: To evaluate the psychometric properties of questions that assess patient perceptions of patient-provider communication and design measures of patient-centered communication (PCC). METHODS: Participants (adults with colon or rectal cancer living in North Carolina) completed a survey at 2 to 3 months post-diagnosis. The survey included 87 questions in six PCC Functions: Exchanging Information, Fostering Health Relationships, Making Decisions, Responding to Emotions, Enabling Patient Self-Management, and Managing Uncertainty...
February 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28214162/knowledge-attitude-and-practice-of-blood-culture-contamination-a-multicenter-study
#12
Archana Nair, Sean P Elliott, Mayar Al Mohajer
We developed a questionnaire to assess the knowledge and practice of nursing staff, patient care assistants, phlebotomists, and laboratory technicians regarding blood culture collection and contamination at 2 tertiary care academic centers. Our study showed there were several gaps in knowledge and practice regarding obtaining blood cultures.
February 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28214006/-conduct-of-epidemiologic-studies-in-french-cancer-survivors-methods-difficulties-encountered-and-solutions-provided-lessons-learned-from-the-simonal-study-on-long-term-toxicities-after-non-hodgkin-lymphoma-treatment
#13
Sabine Anthony, Pierre Hebel, André Garrel, Vanina Oliveri, Catherine Thieblemont, Vincent Ribrag, Hervé Tilly, Corinne Haioun, René-Olivier Casasnovas, Franck Morschhauser, Pierre Feugier, Richard Delarue, Loic Ysebaert, Catherine Sebban, Florence Broussais, Gandhi Damaj, Virginie Nerich, Jean-Philippe Jais, Gilles Salles, Michel Henry-Amar, Nicolas Mounier
INTRODUCTION: Since the introduction of targeted therapies, specific lymphoma mortality has decreased. Possible long-term toxicities, however, are not known yet. This article describes the implementation of the SIMONAL study that investigates the hypothesis of an overconsumption of care after lymphoma treatment with a 10-year follow-up. METHODS: After the mandatory regulatory steps (CCTIRS and CNIL) the vital status and address of 5247 patients treated in 131 French centers were retrieved using a secure web portal, in order to send a quality of life after lymphoma questionnaire...
February 14, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28213997/echocardiographic-correlates-are-associated-with-in-hospital-mortality-in-trauma-and-burn-patients
#14
Duraid Younan, Russell Griffin, Donald Reiff, Jeffrey Richey, Eric Schinnerer, Jean-Francois Pittet, Ahmed Zaky
BACKGROUND: The role of echocardiographic indices of preload and contractility in predicting outcomes is unknown. We report the association of end diastolic area (EDA) and fractional area of change (FAC) with mortality in a cohort of trauma and burn patients. METHODS: Data on 86 patients admitted to a tertiary care center between July 2013 and July 2015 were reviewed. The association between abnormal EDA and FAC and adverse clinical outcomes was tested using exact logistic regression analysis...
February 9, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28213988/-contribution-of-mindfulness-meditation-in-cognitive-behavioral-therapy-for-insomnia
#15
H Vanhuffel, M Rey, I Lambert, D Da Fonseca, F Bat-Pitault
INTRODUCTION: Insomnia is considered to be a serious public health issue affecting approximately 10% of adults. Chronic insomnia may increase the risk of health problem, psychological vulnerability and proneness to accidents. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first line of treatment. Even though CBT-I is widely considered as an effective therapy, 20 to 30% of patients do not respond to this treatment. Mindfulness therapy, known to reduce rumination and stress, could be an interesting complement to enhance CBT-I...
February 14, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28213902/professional-identity-of-korean-nurse-practitioners-in-the-united-states
#16
Kumsook Seo, Miyoung Kim
BACKGROUND: Despite nurse practitioners' (NPs) professional identity having important implications for the confirmation of nursing practice characteristics, few studies have examined the professional identity of NPs overlaid with the immigrant experience. PURPOSE: The aim of this study was to explore the career characteristics of Korean nurse immigrants who became NPs in the United States. METHODS: Seven Korean NPs in the United States underwent in-depth interviews from August 2013 to May 2015...
February 17, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28213854/bilateral-simultaneous-ureteroscopic-bs-urs-approach-in-the-management-of-bilateral-urolithiasis-is-a-safe-and-effective-strategy-in-the-contemporary-era-evidence-from-a-systematic-review
#17
REVIEW
Robert M Geraghty, Bhavan P Rai, Patrick Jones, Bhaskar K Somani
PURPOSE OF REVIEW: Ureteroscopic treatment of urolithiasis has become safer and more effective in the modern era. With a rise in the incidence of bilateral urolithiasis, management dilemma of staged single-side ureteroscopy versus bilateral simultaneous ureteroscopy (BS-URS) is often debatable. This review evaluates the current evidence base for bilateral simultaneous ureteroscopic approach in the modern era. RECENT FINDINGS: A systematic review was conducted from 1990 to June 2016 including all English language articles reporting on outcomes of BS-URS for urolithiasis...
February 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28213848/intraoperative-blood-pressure-changes-during-cemented-versus-uncemented-bipolar-hemiarthroplasty-for-displaced-femoral-neck-fracture-a-multi-center-cohort-study-the-effect-of-bone-cement-for-bipolar-hemiarthroplasty-in-elderly-patients
#18
Shuichi Miyamoto, Junichi Nakamura, Satoshi Iida, Tomonori Shigemura, Shunji Kishida, Isao Abe, Munenori Takeshita, Yoshitada Harada, Sumihisa Orita, Seiji Ohtori
INTRODUCTION: The purpose of this study was to compare the cemented bipolar hemiarthroplasty with uncemented about the change of intraoperative blood pressure and the incidence of major complications in elderly patients with femoral neck fracture. MATERIALS AND METHODS: This multiple center prospective cohort study included only patients with acute displaced femoral neck fracture (Garden stage III or IV). All patients were treated with cemented or uncemented bipolar hemiarthroplasty using modified Hardinge or Watson-Jones approach in the lateral decubitus position...
February 17, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28213829/onabotulinumtoxina-effectiveness-on-chronic-migraine-negative-emotional-states-and-sleep-quality-a-single-center-prospective-cohort-study
#19
Elif Ilgaz Aydinlar, Pinar Yalinay Dikmen, Seda Kosak, Ayse Sagduyu Kocaman
BACKGROUND: OnabotulinumtoxinA (OnabotA) is considered effective in in patients with chronic migraine (CM) who failed on traditional therapies. This study was designed to evaluate the effect of OnabotA injection series on migraine outcome, negative emotional states and sleep quality in patients with CM. METHODS: A total of 190 patients with CM (mean (SD) age: 39.3 (10.2) years; 87.9% were female) were included. Data on Pittsburgh sleep quality index (PSQI), headache frequency and severity, number of analgesics used, Migraine Disability Assessment Scale...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28213801/efficacy-of-a-neoadjuvant-gonadotropin-releasing-hormone-antagonist-plus-low-dose-estramustine-phosphate-in-high-risk-prostate-cancer-a-single-center-study
#20
Kazuhisa Hagiwara, Takuya Koie, Chikara Ohyama, Hayato Yamamoto, Atsushi Imai, Shingo Hatakeyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Yuki Tobisawa, Tohru Yoneyama
PURPOSE: The optimal treatment for high-risk prostate cancer (Pca) remains to be established. We previously reported favorable biochemical recurrence-free survival (BRFS) for high-risk Pca patients treated with neoadjuvant therapy comprising a luteinizing hormone-releasing hormone agonist plus low-dose estramustine (LHRH + EMP) prior to radical prostatectomy (RP). In the present study, we evaluated the efficacy of neoadjuvant therapy comprising a gonadotropin-releasing hormone antagonist plus low-dose estramustine phosphate (GnRH + EMP) in patients with high-risk Pca...
February 17, 2017: International Urology and Nephrology
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