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https://www.readbyqxmd.com/read/28646936/surgical-flow-disruptions-during-robotic-assisted-radical-prostatectomy
#1
Christopher J Dru, Jennifer T Anger, Colby P Souders, Catherine Bresee, Matthias Weigl, Elyse Hallett, Ken Catchpole
INTRODUCTION: We sought to apply the principles of human factors research to robotic-assisted radical prostatectomy to understand where training and integration challenges lead to suboptimal and inefficient care. MATERIALS AND METHODS: Thirty-four robotic-assisted radical prostatectomy and bilateral pelvic lymph node dissections over a 20 week period were observed for flow disruptions (FD) - deviations from optimal care that can compromise safety or efficiency. Other variables - physician experience, trainee involvement, robot model (S versus Si), age, body mass index (BMI), and American Society of Anesthesiologists (ASA) physical status - were used to stratify the data and understand the effect of context...
June 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28644054/the-thermoexpandable-nitinol-stent-a-long-term-alternative-in-patients-without-nephropathy-or-malignancy
#2
Simone Bier, Bastian Amend, Elena Wagner, Steffen Rausch, Johannes Mischinger, Eva Neumann, Viktoria Stühler, Joerg Hennenlotter, Tilman Todenhoefer, Arnulf Stenzl, Jens Bedke, Stephan Kruck
OBJECTIVE: The aim of this study was to investigate the long-term outcome of a thermoexpandable nickel-titanium nitinol ureteral stent (Memokath 051™) and to identify individual risk factors for failure. MATERIALS AND METHODS: This retrospective single-centre study included 125 patients who underwent implantation of the self-expandable Memokath 051 stent. Complications, indwelling time and reason for explantation were recorded. Analyses were stratified by gender, age, body mass index, American Society of Anesthesiologists score, estimated glomerular filtration rate (eGFR), side, localization and cause of the stricture...
June 23, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28643079/similar-clinical-outcomes-with-preoperative-and-postoperative-start-of-thromboprophylaxis-in-tha-a-register-based-study
#3
Pål O Borgen, Are H Pripp, Eva Dybvik, Lilian Leistad, Ola E Dahl, Olav Reikerås
BACKGROUND: Elective THA is associated with a high risk of thromboembolic events. Although these events may be less common now than they were in the past, they can be serious, and most patients undergoing the procedure therefore still receive thromboprophylaxis. However, controversy remains regarding whether to begin thromboprophylaxis before THA or after to best balance the risks of clotting and bleeding. QUESTIONS/PURPOSES: We asked the following questions: (1) Is there a difference in bleeding events with pre- versus postoperative thromboprophylaxis? (2) Is there a difference in thromboembolic episodes after THA between the two regimens? (3) How do the two approaches of thromboprophylaxis influence mortality, readmissions, and other complications? METHODS: We used a population-based followup design with predefined data based on international health codification to assess clinical effects of LMWH prophylaxis initiated before or after THA...
June 22, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28643011/prevalence-and-risk-factors-for-cardiac-arrest-and-myocardial-infarction-after-pelvic-reconstructive-surgery-a-national-multi-institutional-surgical-database-study
#4
David Sheyn, Sangeeta Mahajan, Sherif El-Nashar, Adonis Hijaz, Xiao-Yu Wang, Jeff Mangel
INTRODUCTION AND HYPOTHESIS: There is limited data available regarding the risk for perioperative cardiac morbidity following pelvic reconstructive surgery (PRS). We sought to determine the incidence of cardiac arrest and myocardial infarction within 30 days of pelvic organ prolapse (POP) surgery and determine which factors may contribute to an increased risk of these complications. METHODS: Using the American College of Surgeons National Quality Improvement Program (NSQIP) database, we identified patients who underwent PRS procedures between 2010 to 2015 using Current Procedural Terminology (CPT) codes...
June 22, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28641825/-yours-sincerely-barney-ralph-waters-barindra-sircar-and-the-training-of-an-international-anesthesiologist
#5
Aaron S Hess, Mark E Schroeder
In 1936, Ralph Milton Waters accepted a proposal to train an Indian physician who could return home and become the first native anesthesiologist in the subcontinent. Waters founded the United States' first anesthesiology residency in 1927 and in 1937 welcomed Barindra Sircar, MBBS, to the University of Wisconsin in Madison. Sircar trained with Waters for two years and did further training with Robert Macintosh and Ivan Magill. He became one of the first specialty-trained anesthesiologists in India and founded the Indian Society of Anaesthesiologists...
April 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/28640971/enhanced-recovery-programme-following-laparoscopic-colorectal-resection-for-elderly-patients
#6
Wei Gen Zeng, Meng Jia Liu, Zhi Xiang Zhou, Zhen Jun Wang
BACKGROUND: The aim of this study was to investigate the feasibility and safety of an enhanced recovery programme (ERP) in patients aged ≥75 years who undergo laparoscopic surgery for colorectal cancer. METHODS: Patients were divided into two groups according to perioperative management: the ERP group (Group A, n = 94) and the conventional perioperative care group (Group B, n = 157). The postoperative outcomes were compared between two groups. RESULTS: There were no differences in terms of age, gender, American Society of Anesthesiologists score, operative time or blood loss between two groups...
June 22, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28640785/physiologic-considerations-in-trauma-patients-undergoing-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#7
Zaffer A Qasim, Robert A Sikorski
Resuscitative endovascular balloon occlusion of the aorta is a new procedure for adjunctive management of critically injured patients with noncompressible torso or pelvic hemorrhage who are in refractory hemorrhagic shock, ie, bleeding to death. The anesthesiologist plays a critical role in management of these patients, from initial evaluation in the trauma bay to definitive care in the operating room and the critical care unit. A comprehensive understanding of the effects of resuscitative endovascular balloon occlusion of the aorta is essential to making it an effective component of hemostatic resuscitation...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28640783/the-implementation-of-a-preoperative-transthoracic-echocardiography-consult-service-by-anesthesiologists
#8
Sasha K Shillcutt, Daniel P Walsh, Walker R Thomas, Elizabeth Lyden, Tara R Brakke, Sheila J Ellis, Steven J Lisco, Nicholas W Markin
We describe a preoperative transthoracic echocardiography consult service led by anesthesiologists. The implementation process and the patient cohort are described. Preoperative transthoracic echocardiographic examinations were mostly performed in patients undergoing intermediate- or high-risk noncardiac surgery and in patients with a higher calculated mortality risk. All transthoracic echocardiographic examinations were interpreted by anesthesiologists.
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28640171/changes-in-electroconvulsive-therapy-practice-in-the-last-12-years-in-hungary
#9
Márton Asztalos, Gabor S Ungvari, Gábor Gazdag
BACKGROUND: Electroconvulsive therapy (ECT) was rarely used in Hungary in 2002, and the majority of patients receiving ECT were diagnosed with schizophrenia. This study aimed to explore the use of ECT in Hungary in 2014. METHODS: Two semi-structured questionnaires were sent to all acute adult psychiatric units in Hungary. The first questionnaire contained items concerning ECT use, and the second explored the reasons for not using ECT. RESULTS: Fifty-eight acute psychiatric inpatient units were identified, and 54 replied...
June 15, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28640104/the-easytube-during-general-anesthesia-for-minor-surgery-a-randomized-controlled-trial
#10
Oliver Robak, Sonia Vaida, Luis Gaitini, Andreas Thierbach, Ricardo Urtubia, Peter Krafft, Michael Frass
BACKGROUND: The EasyTube (EzT) is a supraglottic airway device that is used for emergency airway situations. Ventilation during general anesthesia should also be feasible, but literature on the EzT is scarce. We evaluated the EzT in comparison with the endotracheal tube (ETT) in its use during general anesthesia in a comparative study. METHODS: A total of 400 patients with American Society of Anesthesiologists (ASA) physical status I to II scheduled for minor surgery in 4 centers were randomized for ventilation via the ETT or EzT...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#11
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28639701/insurance-status-as-a-predictor-of-mortality-in-patients-undergoing-head-and-neck-cancer-surgery
#12
Matthew L Rohlfing, Ashley C Mays, Scott Isom, Joshua D Waltonen
OBJECTIVE: Explore relationship between insurance status and survival, determine outcomes that vary based on insurance status, and identify potential areas of intervention. STUDY DESIGN: Retrospective cohort analysis of patients who underwent resection of an upper aerodigestive tract malignancy at a single tertiary care hospital during a 5-year period. METHODS: Patients were categorized into four groups by insurance status: Medicaid or uninsured, Medicare and under 65 years of age, Medicare and 65 years or older, and private insurance...
June 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28639253/ultrasonography-in-trauma-a-nation-wide-cross-sectional-investigation
#13
Jesper Weile, Klaus Nielsen, Stine C Primdahl, Christian A Frederiksen, Christian B Laursen, Erik Sloth, Hans Kirkegaard
BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark. METHODS: We conducted a nation-wide cross-sectional investigation of ultrasonography usage in trauma care...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28639240/approach-to-thyroid-carcinoma-in-pregnancy
#14
Cristina Modesti, Paola Aceto, Lucia Masini, Celestino Pio Lombardi, Rocco Bellantone, Liliana Sollazzi
Thyroid carcinoma is the first cancer found in general population and the second diagnosed during pregnancy following the breast one. Diagnostic and therapeutic approaches to thyroid malignancy in pregnant women pose several and serious issues to the physicians. Even if there is no consensus about the surgical treatment of thyroid carcinomas during pregnancy, a large number of women undergo surgery over the world. The best surgical and anesthesiological treatment should be chosen after reaching a consensus between surgeons, anesthesiologists, obstetrics, and the patients...
June 22, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28637557/nomogram-derived-prediction-of-postoperative-ileus-after-colectomy-an-assessment-from-nationwide-procedure-targeted-cohort
#15
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/28636738/impact-of-a-pediatric-anesthesiologist-on-operating-room-efficiency-during-pediatric-tonsillectomies-and-adenotonsillectomies
#16
Nicholas A Dewyer, Yoseph A Kram, Stephen Long, Marika D Russell
We conducted a retrospective case review to determine if the presence of an Accreditation Council for Graduate Medical Education (ACGME) fellowship-trained pediatric anesthesiologist improves efficiency during pediatric tonsillectomies and adenotonsillectomies in hospitals that do not have dedicated pediatric operating rooms and, if so, to determine which specific anesthesia practices might account for such a difference. We reviewed the charts of all patients aged 12 years and younger who had undergone a tonsillectomy or adenotonsillectomy from Jan...
June 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#17
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/28632608/science-medicine-and-the-anesthesiologist
#18
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Anesthesiology
https://www.readbyqxmd.com/read/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#19
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632535/perioperative-surgical-home-evaluation-of-a-new-protocol-focused-on-a-multidisciplinary-approach-to-manage-children-undergoing-posterior-spinal-fusion-operation
#20
Eugene Kim, Brian Lee, Giovanni Cucchiaro
BACKGROUND: The concept of Perioperative Surgical Home has been gaining significant attention in surgical centers. This model is delivering and improving coordinated care in a cost-effective manner to patients undergoing surgical procedures. It starts with the decision for surgical intervention, continues to the intraoperative and postoperative periods, and follows into long-term recovery. Constant re-evaluation of outcomes and modifications of delivery provides a feedback loop for improvement...
June 17, 2017: Anesthesia and Analgesia
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