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https://www.readbyqxmd.com/read/28096306/national-multicentre-audit-of-pregnancy-status-in-general-surgery-admissions-in-scotland
#1
Michael S J Wilson, Matilda Powell-Bowns, Andrew G Robertson, Andreas Luhmann, Colin H Richards
BACKGROUND: Documentation of pregnancy status (PS) is an integral component of the assessment of women of reproductive age when admitted to hospital. Our aim was to determine how accurately PS was documented in a multicentre audit of female admissions to general surgery. METHODS: A prospective multicentre audit of elective and emergency admissions was performed in 18 Scottish centres between 08:00 on 11 May 2015 and 07:59 on 25 May 2015. The lower age limit was the minimum age for admission to the adult surgical ward and the upper age limit was 55 years...
January 17, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28072795/treatment-outcomes-for-patients-with-failed-back-surgery
#2
Jae Hwan Cho, Jae Hyup Lee, Kwang Sup Song, Jae-Young Hong, Yoon-Suk Joo, Dong-Ho Lee, Chang Ju Hwang, Choon Sung Lee
BACKGROUND: Failed back surgery syndrome (FBSS) is a frequently encountered disease entity following lumbar spinal surgery. Although many plausible reasons have been investigated, the exact pathophysiology remains unknown. Various medications, reoperations, interventions such as spinal cord stimulation, epidural adhesiolysis or epidural injection, exercise therapy, and psychotherapy have been suggested treatment options. However, the evidence of the clinical outcome for each treatment has not been clearly determined...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28062349/-best-case-worst-case-training-surgeons-to-use-a-novel-communication-tool-for-high-risk-acute-surgical-problems
#3
Jacqueline M Kruser, Lauren J Taylor, Toby C Campbell, Amy Zelenski, Sara K Johnson, Michael J Nabozny, Nicole M Steffens, Jennifer L Tucholka, Kris L Kwekkeboom, Margaret L Schwarze
CONTEXT: Older adults often have surgery in the months preceding death, which can initiate post-operative treatments inconsistent with end-of-life values. "Best Case/Worst Case" (BC/WC) is a communication tool designed to promote goal-concordant care during discussions about high-risk surgery. OBJECTIVE: To evaluate a structured training program designed to teach surgeons how to use BC/WC. METHODS: Twenty-five surgeons from one tertiary-care hospital completed a two-hour training session followed by individual coaching...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28036112/protocol-of-glucose-control-safety-and-efficacy-in-type-2-diabetes-a-network-meta-analysis-glucose-dinet-protocol-rational-and-design
#4
REVIEW
Guillaume Grenet, Audrey Lajoinie, Shams Ribault, Gia Bao Nguyen, Thomas Linet, Augustin Metge, Catherine Cornu, Michel Cucherat, Philippe Moulin, François Gueyffier
The aim of this study is to propose a ranking of the currently available antidiabetic drugs, regarding vascular clinical outcomes, in type 2 diabetic patients, through a network meta-analysis approach. Randomized clinical trials, regardless of the blinding design, testing contemporary antidiabetic drugs and considering clinically relevant outcomes in patients with type 2 diabetes mellitus will be included. The primary outcomes of this analysis will be overall mortality, cardiovascular mortality, and major cardiovascular events...
December 30, 2016: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28009731/combining-systems-and-teamwork-approaches-to-enhance-the-effectiveness-of-safety-improvement-interventions-in-surgery-the-safer-delivery-of-surgical-services-s3-program
#5
Peter McCulloch, Lauren Morgan, Steve New, Ken Catchpole, Eleanor Roberston, Mohammed Hadi, Sharon Pickering, Gary Collins, Damian Griffin
IMPORTANCE: Patient safety improvement interventions usually address either work systems or team culture. We do not know which is more effective, or whether combining approaches is beneficial. OBJECTIVE: To compare improvement in surgical team performance after interventions addressing teamwork culture, work systems, or both. DESIGN: Suite of 5 identical controlled before-after intervention studies, with preplanned analysis of pooled data for indirect comparisons of strategies...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28007224/efficacy-of-surgical-safety-checklist-assessing-orthopaedic-surgical-implant-readiness
#6
Benjamin G Thomasson, David Fuller, John Mansour, Robert Marburger, Erin Pukenas
INTRODUCTION: Our institution employs a Surgical Universal Protocol Preoperative Checklist in accordance with World Health Organization guidelines to promote patient safety. It is used in part to evaluate orthopaedic surgical equipment and implant readiness prior to the initiation of each surgical case. Our goal is to measure the preoperative checklist's efficacy in assessing orthopaedic equipment readiness preoperatively and its ability to prevent orthopaedic equipment failures (OEF)...
December 2016: Healthcare
https://www.readbyqxmd.com/read/27998548/do-errors-and-critical-events-relate-to-hernia-repair-outcomes
#7
Katherine Law Forsyth, Shannon M DiMarco, Caitlin G Jenewein, Rebecca D Ray, Anne-Lise D D'Angelo, Elaine R Cohen, Douglas A Wiegmann, Carla M Pugh
BACKGROUND: The study aimed to validate an error checklist for simulated laparoscopic ventral hernia (LVH) repair procedures. We hypothesize that residents' errors can be assessed with a structured checklist and the results will correlate significantly with procedural outcomes. METHODS: Senior residents' (N = 7) performance on a LVH simulator were video-recorded and analyzed using a human error checklist. Junior residents (N = 38) performed two steps of the same simulated LVH procedure...
November 17, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27987308/a-systematic-review-on-the-role-of-imiquimod-in-lentigo-maligna-and-lentigo-maligna-melanoma-need-for-standardization-of-treatment-schedule-and-outcome-measures
#8
REVIEW
D Tio, J van der Woude, C A C Prinsen, E P Jansma, R Hoekzema, C van Montfrans
BACKGROUND: Lentigo maligna (LM) is an in situ variant of melanoma. Our objective was to systematically review clinical and histological clearance and recurrence rates of imiquimod treatment of LM with emphasis on progression to lentigo maligna melanoma (LMM). METHODS: PubMed, EMBASE and the Cochrane library were searched from inception to May 2015. Articles were included if they described histologically proven LM treated with imiquimod 5% monotherapy or combined with another topical therapy...
December 17, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/27986227/global-surgical-ecosystems-a-need-for-systems-strengthening
#9
Catherine R deVries, Jenna S Rosenberg
BACKGROUND: As surgery is gaining recognition as a critical component of universal health care worldwide, surgical communities have come together with unprecedented unity to advocate for systems to support surgical care. This community has long believed that much care could be performed in a cost-effective manner even in low resource settings, despite skepticism voiced by many in public health. To do so will require the development of new systems and re-vamping of old systems that are not effective...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27926559/preoperative-immunonutrition-and-elective-colorectal-resection-outcomes
#10
Lucas W Thornblade, Thomas K Varghese, Xu Shi, Eric K Johnson, Amir Bastawrous, Richard P Billingham, Richard Thirlby, Alessandro Fichera, David R Flum
BACKGROUND: Randomized controlled trials demonstrate the efficacy of arginine-enriched nutritional supplements (immunonutrition) in reducing complications after surgery. The effectiveness of preoperative immunonutrition has not been evaluated in a community setting. OBJECTIVE: This study aims to determine whether immunonutrition before elective colorectal surgery improves outcomes in the community at large. DESIGN: This is a prospective cohort study with a propensity score-matched comparative effectiveness evaluation...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27918334/challenges-of-anesthesia-in-low-and-middle-income-countries-a-cross-sectional-survey-of-access-to-safe-obstetric-anesthesia-in-east-africa
#11
Isabella Epiu, Jossy Verel Bahe Tindimwebwa, Cephas Mijumbi, Thomas M Chokwe, Edwin Lugazia, Francois Ndarugirire, Theogene Twagirumugabe, Gerald Dubowitz
BACKGROUND: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27913082/efficacy-and-feasibility-of-objective-structured-clinical-examination-in-the-internal-assessment-for-surgery-postgraduates
#12
Anitha Muthusami, Subair Mohsina, Sathasivam Sureshkumar, Amaranathan Anandhi, Thirthar Palanivelu Elamurugan, Krishnamachari Srinivasan, Thulasingam Mahalakshmy, Vikram Kate
INTRODUCTION: Traditionally assessment in medical training programs has been through subjective faculty evaluations or multiple choice questions. Conventional examinations provide assessment of the global performance rather than individual competencies thus making the final feedback less meaningful. The objective structured clinical examination (OSCE) is a relatively new multidimensional tool for evaluating training. This study was carried out to determine the efficacy and feasibility of OSCE as a tool for the internal assessment of surgery residents...
November 29, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27886969/a-pilot-study-to-gauge-effectiveness-of-standardized-patient-scenarios-in-assessing-general-surgery-milestones
#13
REVIEW
Denise W Gee, Roy Phitayakorn, Avni Khatri, Kathryn Butler, John T Mullen, Emil R Petrusa
PURPOSE: Some General Surgery Milestones can be difficult to assess in traditional clinical settings and especially difficult to assess in junior residents. The purpose of this pilot study was to METHODS: A total of 9 categorical interns participated in a comprehensive, 4-module, SP scenario designed to evaluate and manage right upper quadrant pain. SP checklist scores (SP%) were converted to Milestone-equivalent scores for direct comparison (SP-C). Milestone scores were analyzed from 3 different sources: SP, faculty (FAC), and CCC...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27882413/double-bundle-anterior-cruciate-ligament-reconstruction-is-superior-to-single-bundle-reconstruction-in-terms-of-revision-frequency-a-study-of-22-460-patients-from-the-swedish-national-knee-ligament-register
#14
Eleonor Svantesson, David Sundemo, Eric Hamrin Senorski, Eduard Alentorn-Geli, Volker Musahl, Freddie H Fu, Neel Desai, Anders Stålman, Kristian Samuelsson
PURPOSE: Studies comparing single- and double-bundle anterior cruciate ligament (ACL) reconstructions often include a combined analysis of anatomic and non-anatomic techniques. The purpose of this study was to compare the revision rates between single- and double-bundle ACL reconstructions in the Swedish National Knee Ligament Register with regard to surgical variables as determined by the anatomic ACL reconstruction scoring checklist (AARSC). METHODS: Patients from the Swedish National Knee Ligament Register who underwent either single- or double-bundle ACL reconstruction with hamstring tendon autograft during the period 2007-2014 were included...
November 23, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27879522/a-systematic-review-of-completeness-of-reporting-in-randomized-controlled-trials-in-dermatologic-surgery-adherence-to-consort-2010-recommendations
#15
Murad Alam, Mutahir Rauf, Sana Ali, Parth Patel, Daniel I Schlessinger, Matthew R Schaeffer, Simon S Yoo, Kira Minkis, Shang I Brian Jiang, Ian A Maher, Joseph F Sobanko, Todd V Cartee, Emily Poon
BACKGROUND: Randomized controlled trials are the gold standard for comparing safety and effectiveness of surgical interventions. Reporting guidelines are available for conveying the results of such trials. OBJECTIVE: To assess adherence to standard reporting guidelines among randomized controlled trials in dermatologic surgery. MATERIALS AND METHODS: Systematic review. Data source was randomized controlled trials in the journal Dermatologic Surgery, per PubMed search, 1995 to 2014...
December 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/27864253/macquarie-surgical-innovation-identification-tool-msiit-a-study-protocol-for-a-usability-and-pilot-test
#16
Brette Blakely, Amanda Selwood, Wendy A Rogers, Robyn Clay-Williams
INTRODUCTION: Medicine relies on innovation to continually improve. However, innovation is potentially risky, and not all innovations are successful. Therefore, it is important to identify innovations prospectively and provide support, to make innovation as safe and effective as possible. The Macquarie Surgical Innovation Identification Tool (MSIIT) is a simple checklist designed as a practical tool for hospitals to identify planned surgical innovations. This project aims to test the usability and pilot the use of the MSIIT in a surgical setting...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27829730/are-we-all-guilty-of-under-estimating-intra-operative-blood-loss-during-hip-fracture-surgery
#17
Basil Budair, Usman Ahmed, James Hodson, Michael David, Mujeeb Ashraf, Tim McBride
AIM: To assess how accurately orthopaedic surgeons and anaesthesiologists estimate intraoperative blood loss during hip fracture surgery as part of the Surgical Safety Checklist (SCC). METHODS: A prospective study of 55 operations over 9 months. Pre- and post-operative estimations of blood loss were documented. Actual blood loss was determined by subtracting total amount of lavage fluid used from overall volumes in the suction bag and by weighing used swabs. RESULTS: Both, surgeons and anaesthesiologists, significantly underestimated intraoperative blood loss (p < 0...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27800588/identification-of-risk-factors-in-minimally-invasive-surgery-a-prospective-multicenter-study
#18
Sara R C Driessen, Evelien M Sandberg, Sharon P Rodrigues, Erik W van Zwet, Frank Willem Jansen
BACKGROUND: Since the introduction of minimally invasive surgery (MIS), concerns for patient safety are more often brought to the attention. Knowledge about and awareness of patient safety risk factors are crucial in order to improve and enhance the surgical team, the environment, and finally surgical performance. The aim of this study was to identify and quantify patient safety risk factors in laparoscopic hysterectomy and to determine their influence on surgical outcomes. METHODS: A prospective multicenter study was conducted from April 2014 to January 2016, participating gynecologists registered their performed laparoscopic hysterectomies (LHs)...
October 31, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27792792/economic-analysis-of-children-s-surgical-care-in-low-and-middle-income-countries-a-systematic-review-and-analysis
#19
Anthony T Saxton, Dan Poenaru, Doruk Ozgediz, Emmanuel A Ameh, Diana Farmer, Emily R Smith, Henry E Rice
BACKGROUND: Understanding the economic value of health interventions is essential for policy makers to make informed resource allocation decisions. The objective of this systematic review was to summarize available information on the economic impact of children's surgical care in low- and middle-income countries (LMICs). METHODS: We searched MEDLINE (Pubmed), Embase, and Web of Science for relevant articles published between Jan. 1996 and Jan. 2015. We summarized reported cost information for individual interventions by country, including all costs, disability weights, health outcome measurements (most commonly disability-adjusted life years [DALYs] averted) and cost-effectiveness ratios (CERs)...
2016: PloS One
https://www.readbyqxmd.com/read/27779998/examining-the-quality-of-rectal-cancer-operative-reports-in-teaching-institutions-is-there-an-opportunity-for-resident-education
#20
Aaron B Parrish, Yas Sanaiha, Beverley A Petrie, Marcia M Russell, Formosa Chen
The American Society of Colon and Rectal Surgeons rectal cancer checklist describes a set of best practices for rectal cancer surgery. The objective of this study was to assess the quality of operative reports for rectal cancer surgery based on the intraoperative American Society of Colon and Rectal Surgeons checklist items. Patients undergoing rectal cancer surgery at two public teaching hospitals from 2009 to 2015 were included. A total of 12 intraoperative checklist items were assessed. One hundred and fifty-eight operative reports were reviewed...
October 2016: American Surgeon
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