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https://www.readbyqxmd.com/read/29340817/adenoma-detection-rate-metrics-in-colorectal-cancer-surveillance-colonoscopy
#1
Jamie M Tjaden, Jessica A Hause, Daniel Berger, Samantha K Duveneck, Shriram M Jakate, Bruce A Orkin, Elizabeth L Hubbard, Joshua E Melson
BACKGROUND: A target goal for screening adenoma detection rate (S-ADR) of ≥ 25% has been set to define high-quality colonoscopy performance. However, there is no current accepted target goal for ADR in colorectal cancer (CRC) surveillance. This makes quality assessment challenging when physicians perform cancer surveillance colonoscopy but minimal screening procedures. METHODS: In this cohort study, consecutive colonoscopies performed at either Rush University Medical Center or Rush Oak Park Hospital by a gastroenterologist or colorectal surgeon in average risk screening population and CRC surveillance population were reviewed retrospectively from 2006 to 2012 and prospectively from 2013 to 2016...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340680/association-of-bariatric-surgery-vs-medical-obesity-treatment-with-long-term-medical-complications-and-obesity-related-comorbidities
#2
Gunn Signe Jakobsen, Milada Cvancarova Småstuen, Rune Sandbu, Njord Nordstrand, Dag Hofsø, Morten Lindberg, Jens Kristoffer Hertel, Jøran Hjelmesæth
Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29340678/lifestyle-intervention-and-medical-management-with-vs-without-roux-en-y-gastric-bypass-and-control-of-hemoglobin-a1c-ldl-cholesterol-and-systolic-blood-pressure-at-5-years-in-the-diabetes-surgery-study
#3
COMMENT
Sayeed Ikramuddin, Judith Korner, Wei-Jei Lee, Avis J Thomas, John E Connett, John P Bantle, Daniel B Leslie, Qi Wang, William B Inabnet, Robert W Jeffery, Keong Chong, Lee-Ming Chuang, Michael D Jensen, Adrian Vella, Leaque Ahmed, Kumar Belani, Charles J Billington
Importance: The Roux-en-Y gastric bypass is effective in achieving established diabetes treatment targets, but durability is unknown. Objective: To compare durability of Roux-en-Y gastric bypass added to intensive lifestyle and medical management in achieving diabetes control targets. Design, Setting, and Participants: Observational follow-up of a randomized clinical trial at 4 sites in the United States and Taiwan, involving 120 participants who had a hemoglobin A1c (HbA1c) level of 8...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29338688/transurethral-resection-of-the-prostate-provides-more-favorable-clinical-outcomes-compared-with-conservative-medical-treatment-in-patients-with-urinary-retention-caused-by-benign-prostatic-obstruction
#4
Yu-Hsiang Lin, Chen-Pang Hou, Tien-Hsing Chen, Horng-Heng Juang, Phei-Lang Chang, Pei-Shan Yang, Chien-Lun Chen, Ke-Hung Tsui
BACKGROUND: To evaluate the long-term surgical outcomes of patients with urinary retention (UR) caused by a benign prostatic obstruction (BPO) who underwent transurethral resection of the prostate (TURP), and compare their outcomes with those of patients who received medication without surgical intervention. METHODS: This retrospective cohort study analyzed claims data collected during the period of 1997-2012 from Taiwan's National Health Insurance Research Database...
January 16, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29338090/influence-of-provider-factors-and-race-on-uptake-of-breast-cancer-gene-expression-profiling
#5
Katherine E Reeder-Hayes, Stephanie B Wheeler, Christopher D Baggett, Xi Zhou, Ke Meng, Megan C Roberts, Lisa A Carey, Anne-Marie Meyer
BACKGROUND: Gene expression profiling (GEP) has been rapidly adopted for early breast cancer and can aid in chemotherapy decision making. Study results regarding racial disparities in testing are conflicting, and may reflect different care settings. To the authors' knowledge, data regarding the influence of provider factors on testing are scarce. METHODS: The authors used a statewide, multipayer, insurance claims database linked to cancer registry records to examine the impact of race and provider characteristics on GEP uptake in a cohort of patients newly diagnosed with breast cancer between 2005 and 2012...
January 16, 2018: Cancer
https://www.readbyqxmd.com/read/29337776/l%C3%A3-mann-index-at-diagnosis-predicts-the-risk-of-early-surgery-in-crohn-s-disease
#6
Wei Liu, Wei Zhou, Jianjian Xiang, Qian Cao, Jinzhou Zhu, Weilin Qi, Pengpeng Chen, Qingwen Xie
BACKGROUND: Identifying patients with Crohn's disease with rapid disease progress or high risk of early surgery is crucial to clinical decision making. OBJECTIVE: The aim was to evaluate the correlation between the Lémann index at diagnosis and abdominal surgery in the first year after Crohn's disease diagnosis and to find the risk factors for early surgery. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at a single tertiary hospital...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29336903/one-year-experience-of-a-regional-service-model-of-teleconsultation-for-planning-and-treatment-of-complex-thoracoabdominal-aortic-disease
#7
Emiliano Chisci, Gianmarco de Donato, Aaron Fargion, Giorgio Ventoruzzo, Gianbattista Parlani, Carlo Setacci, Leonardo Ercolini, Stefano Michelagnoli
OBJECTIVE: The objective of this study was to report the methodology and 1-year experience of a regional service model of teleconsultation for planning and treatment of complex thoracoabdominal aortic disease (TAAD). METHODS: Complex TAADs without a feasible conventional surgical repair were prospectively evaluated by vascular surgeons of the same public health service (National Health System) located in a huge area of 22,994 km2 with 3.7 million inhabitants and 11 tertiary hospitals...
January 11, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29334564/validating-the-electronic-cardiac-arrest-risk-triage-ecart-score-for-risk-stratification-of-surgical-inpatients-in-the-postoperative-setting-retrospective-cohort-study
#8
Bartlomiej Bartkowiak, Ashley M Snyder, Andrew Benjamin, Andrew Schneider, Nicole M Twu, Matthew M Churpek, Kevin K Roggin, Dana P Edelson
OBJECTIVE: Assess the accuracy of 3 early warning scores for predicting severe adverse events in postoperative inpatients. SUMMARY OF BACKGROUND DATA: Postoperative clinical deterioration on inpatient hospital services is associated with increased morbidity, mortality, and cost. Early warning scores have been developed to detect inpatient clinical deterioration and trigger rapid response activation, but knowledge regarding the application of early warning scores to postoperative inpatients is limited...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29331347/empowering-post-surgical-patients-to-improve-opioid-disposal-a-before-and-after-quality-improvement-study
#9
Jessica M Hasak, Carrie L Roth Bettlach, Katherine B Santosa, Ellen L Larson, Jean Stroud, Susan E Mackinnon
BACKGROUND: Our country is in the midst of an opioid epidemic. Although the problem is multifactorial, one issue is the presence of excess prescription opioid medications circulating in our communities. Our objective was to determine whether dissemination of an educational brochure would improve the disposal of unused opioids after surgery. STUDY DESIGN: Eligible surgery patients from an upper extremity/peripheral nerve clinic were enrolled into this prospective before and after study between February 2017 and September 2017...
January 5, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29328496/hypotension-risk-based-on-vasoactive-agent-discontinuation-order-in-patients-in-the-recovery-phase-of-septic-shock
#10
Gretchen L Sacha, Simon W Lam, Abhijit Duggal, Heather Torbic, Anita J Reddy, Seth R Bauer
STUDY OBJECTIVES: Patients with septic shock often require vasoactive agents for hemodynamic support; however, the optimal approach to discontinuing these agents once patients reach the recovery phase is currently unknown. The objective of this evaluation was to compare the incidence of hypotension within 24 hours based on the discontinuation order of norepinephrine (NE) and vasopressin (AVP) in patients in the recovery phase of septic shock. DESIGN: Retrospective cohort study...
January 12, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29328004/thoracolumbar-injury-classification-and-severity-score-in-children-a-reliability-study
#11
Ross L Dawkins, Joseph H Miller, Omar I Ramadan, Michael C Lysek, Elizabeth N Kuhn, Brandon G Rocque, Michael J Conklin, R Shane Tubbs, Beverly C Walters, Bonita S Agee, Curtis J Rozzelle
OBJECTIVE There are many classification systems for injuries of the thoracolumbar spine. The recent Thoracolumbar Injury Classification and Severity Score (TLICS) has been shown to be a reliable tool for adult patients. The aim of this study was to assess the reliability of the TLICS system in pediatric patients. The validity of the TLICS system is assessed in a companion paper. METHODS The medical records of pediatric patients with acute, traumatic thoracolumbar fractures at a single Level 1 trauma center were retrospectively reviewed...
January 12, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29325789/long-term-outcomes-following-ileal-pouch-anal-anastomosis-in-patients-with-indeterminate-colitis
#12
Uri Netz, Norman J Galbraith, Stephen O'Brien, Jane Carter, Stephen Manek, Robert E Petras, Susan Galandiuk
BACKGROUND: The advisability of performing ileal pouch-anal anastomosis for patients with indeterminate colitis is debated. Indeterminate colitis is found in up to 15% of inflammatory bowel disease colectomy specimens. We determined long-term outcomes in patients diagnosed with indeterminate colitis undergoing ileal pouch-anal anastomosis. METHODS: Fifty-six patients were included with a mean follow-up of 14 ± 7 years. Long-term behavior was defined based on surgeon assessment as "Crohn disease-like" in patients who subsequently developed clear signs of Crohn disease and as "non-Crohn disease-like...
January 8, 2018: Surgery
https://www.readbyqxmd.com/read/29325697/early-stable-sinus-rhythm-associated-with-greater-success-five-years-following-surgical-ablation
#13
Niv Ad, Sari D Holmes
BACKGROUND: An important challenge in surgical ablation for atrial fibrillation (AF) is the scarcity of publications on credible predictors of long-term success in procedures performed with ablation tools that produce consistently reliable transmural lesions. We examined factors associated with 1-year success and no atrial arrhythmia (AA) recurrence during 1-5 years after surgical ablation for AF. METHODS: Surgical ablation patients with complete rhythm follow-up at 12 months after surgery were followed prospectively (N=743)...
January 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29324541/intrauterine-manipulator-use-during-minimally-invasive-hysterectomy-and-risk-of-lymphovascular-space-invasion-in-endometrial-cancer
#14
Hiroko Machida, Marianne S Hom, Crystal L Adams, Sarah E Eckhardt, Jocelyn Garcia-Sayre, Mikio Mikami, Koji Matsuo
OBJECTIVE: This study aimed to examine an association between intrauterine manipulator (IUM) use and frequency of lymphovascular space invasion (LVSI) in women with endometrial cancer undergoing minimally invasive hysterectomy. METHODS: A retrospective case-control study was conducted among stage I-IV endometrial cancer patients who underwent hysterectomy between 2008 and 2015. Medical records were reviewed for patient demographics, surgical details, and tumor characteristics...
January 10, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29323807/impact-of-obesity-on-cesarean-delivery-outcomes
#15
Andrew J Vegel, Dana M Benden, Andrew J Borgert, Kara J Kallies, Shanu N Kothari
BACKGROUND: The rate of cesarean delivery has increased over the last 2 decades. Obesity is a risk factor for complications during pregnancy and cesarean procedures. The objective of this study was to evaluate cesarean delivery outcomes in patients with vs without obesity, and determine the impact of obesity on complications. METHODS: The medical records of patients who underwent a cesarean delivery from 2010 to 2014 were reviewed. Patients were grouped by body mass index (BMI) into obese (≥30kg/m²) and non-obese (<30kg/m²) cohorts for comparison...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29323794/skills-transfer-to-sinus-surgery-via-a-low-cost-simulation-based-curriculum
#16
R Alex Harbison, Jennifer Dunlap, Ian M Humphreys, Greg E Davis
BACKGROUND: Surgical skill development outside the operating room aims to improve technique and subsequent patient safety. The purpose of this study was to evaluate the correlation between technical and cognitive skills with cadaveric endoscopic sinus surgery (ESS) performance and change in ESS performance before and after implementation of a dedicated ESS simulation-based and knowledge-based curriculum. METHODS: A before-after study design was implemented among 10 medical students and 10 junior otolaryngology residents...
January 11, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29322646/comparison-of-hook-wire-versus-coil-localization-for-video-assisted-thoracoscopic-surgery
#17
Sangwon Hwang, Tae Gyu Kim, Yun Gyu Song
BACKGROUND: A hook wire has been most widely used for computed tomography (CT)-guided localization before video-assisted thoracoscopic surgery (VATS). However, microcoils have been suggested to replace wires. The purpose of this study was to compare the efficacy, VATS procedure time, and excised volume of specimens of CT-guided localization using a hook wire and microcoil. METHODS: The medical records of 106 patients with 110 pulmonary nodules who underwent CT-guided localization using a hook wire (group A) or microcoil (group B) before VATS performed between March 2013 and January 2017 were retrospectively reviewed...
January 11, 2018: Thoracic Cancer
https://www.readbyqxmd.com/read/29322173/association-of-surgical-practice-patterns-and-clinical-outcomes-with-surgeon-training-in-university-or-nonuniversity-based-residency-program
#18
Morgan M Sellers, Luke J Keele, Catherine E Sharoky, Christopher Wirtalla, Elizabeth A Bailey, Rachel R Kelz
Importance: Important metrics of residency program success include the clinical outcomes achieved by trainees after transitioning to practice. Previous studies have shown significant differences in reported training experiences of general surgery residents at nonuniversity-based residency (NUBR) and university-based residency (UBR) programs. Objective: To examine the differences in practice patterns and clinical outcomes between surgeons trained in NUBR and those trained in UBR programs...
January 10, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29319635/low-dose-epinephrine-boluses-for-acute-hypotension-in-the-picu
#19
Pamela D Reiter, Jennifer Roth, Beth Wathen, Jaime LaVelle, Leslie A Ridall
OBJECTIVES: To describe the use of low-dose bolus epinephrine in critically ill children during an acute hypotensive episode or prearrest condition. DESIGN: Institutional Review Board approved, single-center, retrospective medical chart review. SETTING: Large medical-surgical PICU within a freestanding, tertiary care children's hospital. PATIENTS: Patients admitted to the PICU between June 1, 2015, and June 1, 2016, who received low-dose (≤ 5 µg/kg) IV bolus epinephrine...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29318177/injury-recurrence-among-high-school-athletes-in-the-united-states-a-decade-of-patterns-and-trends-2005-2006-through-2015-2016
#20
K Linnea Welton, Matthew J Kraeutler, Lauren A Pierpoint, Justin H Bartley, Eric C McCarty, R Dawn Comstock
Background: As participation in high school athletics increases, so does the number of adolescents experiencing sports-related injury. Understanding injury patterns is an important component to developing and evaluating prevention and rehabilitation programs. Purpose: To analyze recurrent injury rates and patterns among high school athletes, to compare recurrent injuries with new injuries, and to evaluate injury trends over time. Study Design: Descriptive epidemiology study...
January 2018: Orthopaedic Journal of Sports Medicine
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