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https://www.readbyqxmd.com/read/29690755/perioperative-surgical-home-a-new-scope-for-future-anesthesiology
#1
Min A Kwon
The health care system is changing from 'pay for volume' to 'pay for value.' These changes are turning health care delivery into a more cost-effective and coordinated care setup that drives hospitals to lower costs and greater quality gains. The present perioperative care service in Korea has proven to be costly, fragmented, and neither evidence-based nor patient- centered. Recently, a new concept of a perioperative care model termed perioperative surgical home (PSH) has been proposed. The PSH is a patient-centered, team-based, and coordinated perioperative care setup, composed of the head anesthesiologist-perioperativist in tandem with dedicated nurse practitioners and other PSH team doctors...
April 25, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29685712/no-difference-in-major-complication-and-readmission-rates-following-simultaneous-bilateral-vs-unilateral-total-hip-arthroplasty
#2
Mina W Morcos, Adam Hart, John Antoniou, Olga L Huk, David J Zukor, Stephane G Bergeron
BACKGROUND: Simultaneous bilateral total hip arthroplasty (THA) is an attractive option for patients with osteoarthritis as it requires a single anesthetic and hospitalization. Nonetheless, serious concerns remain over the perioperative safety and rate of hospital readmission. The purpose of the present study was to compare the rate of 30-day major complications and hospital readmissions between patients undergoing simultaneous bilateral vs unilateral THA using the National Surgical Quality Improvement Program database...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29682848/the-stop-bang-questionnaire-shows-an-insufficient-specificity-for-detecting-obstructive-sleep-apnea-in-patients-with-atrial-fibrillation
#3
Asmaa M Abumuamar, Paul Dorian, David Newman, Colin M Shapiro
Obstructive sleep apnea (OSA) is a sleep disorder associated with significant cardiovascular comorbidities, including cardiac arrhythmia. The STOP-BANG questionnaire is an eight-item self-report questionnaire designed to screen patients for OSA and was validated in preoperative surgical patients. The STOP items are snoring, daytime tiredness, observed apneas and high blood pressure. The BANG items are body mass index >35 kg/m2 , age >50 years, neck circumference >40 cm and male gender. We aimed to determine the screening properties of the STOP-BANG questionnaire in patients with arrhythmia...
April 22, 2018: Journal of Sleep Research
https://www.readbyqxmd.com/read/29682719/-evolution-and-prospect-of-colorectal-anastomosis
#4
Qi Liu, Xinxiang Li
Colorectal cancer is the third most common malignant tumor among men, and the second most common malignant tumor among women worldwide. As one of the most common malignant tumor, colorectal cancer has a great threat to the health of people. Although the development of radiotherapy and chemotherapy could improve the prognosis of colorectal cancer, surgery, the complete resection of the tumor, remains the only chance for the cure of this disease. Over the past hundred years, surgical oncology went in the direction of protecting organ function and improving quality of life...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29681109/safety-and-efficacy-of-noncardiac-surgical-procedures-in-the-management-of-patients-with-trisomy-13-a-single-institution-based-detailed-clinical-observation
#5
Soichi Shibuya, Yuichiro Miyake, Shigeru Takamizawa, Eriko Nishi, Katsumi Yoshizawa, Tomoko Hatata, Kazuki Yoshizawa, Kenya Fujita, Masahiko Noguchi, Jun Ohata, Takehiko Hiroma, Tomohiko Nakamura, Tomoki Kosho
Intensive treatment including surgery for patients with trisomy 13 (T13) remains controversial. This study aimed to evaluate the safety and efficacy of noncardiac surgical intervention for T13 patients. Medical records of patients with karyotypically confirmed T13 treated in the neonatal intensive care unit in Nagano Children's Hospital from January 2000 to October 2016 were retrospectively reviewed, and data from patients who underwent noncardiac surgery were analyzed. Of the 20 patients with T13, 15 (75%) underwent a total of 31 surgical procedures comprising 15 types, including tracheostomy in 10 patients and gastrostomy in 4...
May 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29680415/home-antibiotics-at-discharge-for-pediatric-complicated-appendicitis-friend-or-foe
#6
Kathryn Tinsley Anderson, Marisa A Bartz-Kurycki, Akemi L Kawaguchi, Mary T Austin, Galit Holzmann-Pazgal, Lillian S Kao, Kevin P Lally, Kuojen Tsao
BACKGROUND: The role of home discharge antibiotics in children after perforated appendicitis is unclear. This study evaluates the outcomes of complicated appendicitis patients being discharged with or without home antibiotics after initial surgery and in-patient treatment. STUDY DESIGN: The 2015 and 2016 National Surgical Quality Improvement-Pediatric (NSQIP-P) database was queried for patients <18 years of age with complicated appendicitis. Home antibiotics (HA) were prescribed or not (No Home Antibiotics- NHA)...
April 19, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29674852/long-term-prospective-outcomes-after-minimally-invasive-trans-iliac-sacroiliac-joint-fusion-using-triangular-titanium-implants
#7
Emily Darr, S Craig Meyer, Peter G Whang, Don Kovalsky, Clay Frank, Harry Lockstadt, Robert Limoni, Andy Redmond, Philip Ploska, Michael Y Oh, Daniel Cher, Abhineet Chowdhary
Background: Minimally invasive sacroiliac joint fusion (SIJF) has become an increasingly accepted surgical option for chronic sacroiliac (SI) joint dysfunction, a prevalent cause of unremitting low back/buttock pain. Objective: The objective of this study was to report clinical and functional outcomes of SIJF using triangular titanium implants (TTI) in the treatment of chronic SI joint dysfunction due to degenerative sacroiliitis or sacroiliac joint (SIJ) disruption at 3 years postoperatively...
2018: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29672387/perioperative-surgical-home-evaluation-of-a-new-protocol-focused-on-a-multidisciplinary-approach-to-manage-children-undergoing-posterior-spinal-fusion-operation-erratum
#8
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29669697/the-prevalence-of-sarcopaenia-in-a-vascular-surgical-patient-cohort-and-its-impact-on-outcome
#9
Rachel Heard, Douglas Black, George Ramsay, Neil Scott, Diane Hildebrand
BACKGROUND: Sarcopaenia, loss of lean muscle mass and quality, has prognostic significance and can be used to guide the management of oncology patients.1 However, there is limited research into the prevalence and effect of sarcopaenia in vascular populations. We aim to investigate the prevalence of this measure of physiological reserve in a vascular patient group. METHODS: All patients admitted to a tertiary vascular unit in a single year were considered for the study...
April 16, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29665978/outpatient-intravenous-multimodal-elastomeric-pump-with-methadone-in-ambulatory-surgery
#10
L Gómez-López, X Sala-Blanch, P L Gambús Cerrillo, A López Gutiérrez, M Agustí Lasús, M T Anglada Casas
BACKGROUND AND OBJECTIVE: Analgesia in Ambulatory Surgery (AS) needs to evolve in parallel with surgical complexity. We designed a study to try to improve analgesia in painful surgery using an intravenous elastomeric pump. As a novelty, methadone was included. PATIENTS AND METHODS: An observational study, physical status ASA I-II, underwent ambulatory surgeries with moderate-severe postoperative pain. Analgesia was administered for 48h by an intravenous multimodal elastomeric pump (methadone, tramadol, dexketoprofen and ondansetron at low doses)...
April 14, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29664889/transfer-status-a-significant-risk-factor-for-mortality-in-emergency-general-surgery-patients-requiring-colon-resection
#11
Michael P DeWane, Kimberly A Davis, Kevin M Schuster, Scott P Erwin, Adrian A Maung, Robert D Becher
BACKGROUND: Patients requiring emergency surgery have increased rates of morbidity and mortality. Transfer from outside institution delays effective control of ongoing infection and has been linked with worse outcomes. Previous research suggests transfer status negatively impacts survival but hasn't examined the effect of location and type of institution prior to transfer. This study aims to characterize the effect of type of transferring institution on postoperative outcomes after emergency colon surgery...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29662816/mitral-valve-replacement-with-a-pulmonary-autograft-in-an-infant
#12
Yong Ho Jeong, Tae-Jin Yun
A 76-day-old infant weighing 3.4 kg was referred for surgical intervention for severe mitral valve stenoinsufficiency caused by leaflet fibrosis and calcification. He had experienced a cerebral infarction in the left middle cerebral artery territory, which was deemed attributable to an embolism of a calcified particle from the dysmorphic mitral valve. Because mitral valve replacement using a prosthetic valve was not feasible in this small baby, mitral valve replacement with a pulmonary autograft was performed...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29662703/aortic-dissection-presenting-as-acute-pancreatitis-suspecting-the-unexpected
#13
Adam Hafeez, Dillon Karmo, Adrian Mercado-Alamo, Alexandra Halalau
Aortic dissection is a life-threatening condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). It is considered a medical emergency. We report a case of a healthy 56-year-old male who presented to the emergency room with sudden onset of epigastric pain radiating to his back. His blood pressure was 167/91 mmHg, equal in both arms. His lipase was elevated at 1258 U/L, and he was clinically diagnosed with acute pancreatitis (AP)...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29658218/-burden-of-healthcare-associated-infections-in-outpatient-care
#14
Walter Zingg, Aliki Metsini, Qiao Fu, Diana Neves, Didier Pittet
There is little evidence on healthcare-associated infections in outpatient care. The Swiss Federal Office for Public Health commissioned a systematic review to estimate the incidence of healthcare-associated infections in non-institutional settings. A total of 126 papers were eligible for data abstraction. The identified reports and studies were heterogeneous and generally of low quality. The main outcomes were surgical site infections, central venous catheter-related bloodstream infections, and urinary tract infections...
April 11, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29657087/the-pediatric-aerodigestive-center-as-a-tertiary-care-based-medical-home-a-proposed-model
#15
Meghan M Galligan, Tara W Bamat, Annique K Hogan, Joseph Piccione
Children with special healthcare needs have been identified nationally as a population whose health care is associated with unmet needs; increased morbidity; fragmentation of care and medical errors; caregiver dissatisfaction; and disproportionately high costs. A subset of these children are medically fragile, with medical complexity that requires a reliance on tertiary care-based services-including subspecialty appointments, surgical procedures, and care coordination resources. For medically complex patients affected by upper and lower respiratory tract and gastrointestinal disorders, multidisciplinary aerodigestive centers have emerged at tertiary care centers across the United States to facilitate coordinated, high-quality, and high value care...
April 12, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29652531/adult-narratives-of-the-psychosocial-impact-of-cleft-in-a-western-australian-cohort
#16
Wendy Nicholls, Martin Persson, Suzanne Robinson, Linda Selvey
BACKGROUND: Living with a cleft condition involves many years of multidisciplinary therapy, treatment, and surgical intervention. This complex process may have both physical and psychosocial long-term impacts. There is limited evidence of the psychosocial impact of cleft on individuals in Australia. AIM: To obtain an understanding of the adult patient perception of having a cleft and explore the impact of the condition on their lives. DESIGN: Qualitative methodologies at one case study site in Western Australia...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29650429/-emergency-department-consultations-associated-with-unintentional-injuries-a-cases-series
#17
Cristina Arribas Sánchez, Eduardo J Bardón Cancho, Arístides Rivas García, Santiago Mintegi, Rafael Marañón Pardillo
OBJECTIVE: To analyse the clinical and epidemiological characteristics of children who are attended in Emergency Departments (EDs) for an unintentional injury in Spain. METHODS: Multicentre case series with prospective data collection conducted during 12 months in the ED of 11 hospitals belonging to the Spanish Paediatric Emergency Research Group. Data were collected between September 2014 and January 2015, continuing for one year in all paediatric EDs, and included children between 0 and 16 years old seen for an unintentional injury...
April 9, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29649611/predictors-of-adverse-discharge-disposition-in-adult-spinal-deformity-and-associated-costs
#18
Peter G Passias, Gregory W Poorman, Cole A Bortz, Rabia Qureshi, Bassel G Diebo, Justin C Paul, Samantha R Horn, Frank A Segreto, Alexandra Pyne, Cyrus M Jalai, Virginie Lafage, Shay Bess, Frank J Schwab, Hamid Hassanzadeh
BACKGROUND CONTEXT: With advances in the understanding of adult spinal deformity (ASD), more complex osteotomy and fusion techniques are being implemented with increasing frequency. Patients undergoing ASD corrections infrequently require extended acute care, longer inpatient stays, and are discharged to supervised care. Given the necessity of value-based health care, identification of clinical indicators for adverse discharge disposition in ASD surgeries is paramount. PURPOSE: On nationwide and surgeon-created databases, identify predictors of adverse discharge disposition after ASD surgeries and view corresponding differences in charges...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29644298/use-of-idarucizumab-for-dabigatran-reversal-emergency-department-experience-in-two-cases-with-subdural-haematoma
#19
Gail Edwards, Cristina Roman, Rondhir Jithoo, Biswadev Mitra
Introduction: Idarucizumab is the first effective humanized monoclonal antibody fragment developed specifically as a reversal agent for dabigatran, a Direct Oral Anticoagulant. Despite recent trials demonstrating reversal of clinically relevant bleeding, there is a paucity of data on use outside the trial setting. This manuscript describes the use of Idarucizumab to reverse dabigatran in two patients presenting to the emergency department of a major tertiary hospital with acute traumatic subdural haematomas (SDH)...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29644153/acute-fatty-liver-of-pregnancy-a-thorough-examination-of-a-harmful-obstetrical-syndrome-and-its-counterparts
#20
Joshua Ronen, Shahzeb Shaheen, David Steinberg, Kevin R Justus
Diagnosed in one of every 20,000 deliveries, acute fatty liver of pregnancy (AFLP) was considered to be a deadly disease for many years. However, advancements in the clinical and surgical management of pregnant mothers have lead to a drastic decrease in maternal morbidity and mortality. The corresponding case recounts a 23-year-old gravida 2 para 1 (G2P1) at 38 weeks gestational age (GA) with no relevant past medical or family medical history that presented to the emergency department (ED) with a five-day history of nausea, protracted vomiting, hypertension, and new-onset headache...
February 6, 2018: Curēus
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