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https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#1
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#2
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28316314/choosing-surgery-identifying-factors-leading-to-increased-general-surgery-matriculation-rate
#3
David T Pointer, Matthew D Freeman, James R Korndorffer, Peter C Meade, Bernard M Jaffe, Douglas P Slakey
Tulane graduates have, over the past six years, chosen general surgical residency at a rate above the national average (mean 9.6% vs 6.6%). With much of the recent career choice research focusing on disincentives and declining general surgery applicants, we sought to identify factors that positively influenced our students' decision to pursue general surgery. A 50-question survey was developed and distributed to graduates who matched into a general surgery between the years 2006 and 2014. The survey evaluated demographics, exposure to surgery, and factors affecting interest in a surgical career...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28301925/retrospective-molecular-epidemiology-study-of-pd-l1-expression-in-patients-with-egfr-mutant-non-small-cell-lung-cancer
#4
Jong Ho Cho, Wei Zhou, Yoon-La Choi, Jong-Mu Sun, Hyejoo Choi, Tae-Eun Kim, Marisa Dolled-Filhart, Kenneth Emancipator, Mary Anne Rutkowski, Jhingook Kim
Purpose: Data are limited on PD-L1 expression in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). Materials and Methods: We retrospectively evaluated the relationship between PD-L1 expression and recurrence-free (RFS) and overall survival in 319 patients with EGFR-mutant NSCLC who were treated at Samsung Medical Center from 2006 to 2014. Membranous PD-L1 expression on tumor cells was measured using the PD-L1 IHC 22C3 pharmDx antibody and reported as tumor proportion score (TPS)...
March 17, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28299720/ketamine-infusion-as-a-counter-measure-for-opioid-tolerance-in-mechanically-ventilated-children-a-pilot-study
#5
Felix Neunhoeffer, Anja Hanser, Martin Esslinger, Vanja Icheva, Matthias Kumpf, Ines Gerbig, Michael Hofbeck, Jörg Michel
BACKGROUND: Drug rotation to prevent opioid tolerance is well recognized in chronic pain management. However, ketamine infusion as a counter measure for opioid tolerance is rarely described in mechanically ventilated children developing tolerance from prolonged opioid infusion. PATIENTS AND METHODS: We performed a retrospective study in a 14-bed medical-surgical-cardiac pediatric intensive care unit. Thirty-two mechanically ventilated children who had developed tolerance from prolonged intravenous infusion of opioids received a continuous intravenous infusion of ketamine as an opioid substitute for more than 2 days, scheduled in a drug rotation protocol...
March 15, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28296829/ovarian-torsion-in-the-normal-ovary-a-diagnostic-challenge-in-postmenarchal-adolescent-girls-in-the-emergency-department
#6
Erbil Karaman, Burhan Beger, Orkun Çetin, Mehmet Melek, Yasemin Karaman
BACKGROUND Ovarian torsion can be seen in the otherwise-normal ovary and is a challenging issue in the emergency department. The aims were (1) to evaluate and compare the surgically verified ovarian torsion cases in otherwise-normal ovaries and ovaries including a mass or cyst and (2) to investigate whether the normal-appearing ovaries on ultrasound examination affected the diagnosis of ovarian torsion or not. MATERIAL AND METHODS A retrospective cohort study design was used. The medical records of all postmenarchal adolescent girls with surgically verified ovarian torsion treated in a university hospital from 2010 to 2016 were reviewed...
March 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28293685/healthcare-team-perceptions-of-a-portal-for-parents-of-hospitalized-children-before-and-after-implementation
#7
Michelle M Kelly, Shannon M Dean, Pascale Carayon, Tosha B Wetterneck, Peter L T Hoonakker
BACKGROUND: Patient electronic health record (EHR) portals can enhance patient and family engagement by providing information and a way to communicate with their healthcare team (HCT). However, portal implementation has been limited to ambulatory settings and met with resistance from HCTs. OBJECTIVE: We evaluated HCT perceptions before and 6-months after implementation of an inpatient EHR portal application on a tablet computer given to parents of hospitalized children...
March 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28288792/disparities-in-the-management-of-ectopic-pregnancy
#8
Jennifer Y Hsu, Ling Chen, Arielle R Gumer, Ana I Tergas, June Y Hou, William M Burke, Cande V Ananth, Dawn L Hershman, Jason D Wright
BACKGROUND: Ectopic pregnancy is common among young women. Treatment can consist of either surgery with salpingectomy or salpingostomy or medical management with methotrexate. In addition to acute complications, treatment of ectopic pregnancy can result in long term sequelae including decreased fertility. Little is known about the patterns of care and predictors of treatment in women with ectopic pregnancy. Similarly, data on outcomes for various treatments are limited. OBJECTIVE: We examined the patterns of care and outcomes for women with ectopic pregnancy...
March 10, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28287011/follow-up-after-initial-surgical-treatment-of-soft-tissue-sarcomas-in-the-extremities-and-trunk-wall
#9
Thea Bechmann Hovgaard, Tine Nymark, Ole Skov, Michael Mørk Petersen
BACKGROUND/OBJECTIVES: Evaluation of our surveillance program for soft tissue sarcomas (STS) and borderline tumors (BT) for identification of local recurrence and lung metastases the first 2 years postoperatively. METHODS: We retrospectively assessed the medical files of all patients (n = 232) with STS and BT of the extremities and trunk wall who underwent surgery from 2010 to 2013. Two-hundred-and-thirty-two patients were included in the local recurrence study and 116 patients in the lung metastasis study...
March 13, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28285365/postoperative-ileus-in-an-enhanced-recovery-pathway-a-retrospective-cohort-study
#10
Fabian Grass, Juliette Slieker, Jonas Jurt, Anne Kummer, Josep Solà, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
PURPOSE: Enhanced recovery after surgery (ERAS) protocols advocate no nasogastric tubes after colorectal surgery, but postoperative ileus (POI) remains a challenging clinical reality. The aim of this study was to assess incidence and risk factors of POI. METHODS: This retrospective analysis included all consecutive colorectal surgical procedures since May 2011 until November 2014. Uni- and multivariate risk factors for POI were identified by multiple logistic regression and functional and surgical outcomes assessed...
March 11, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28282305/ce-original-research-identifying-hospitalized-patients-at-risk-for-harm-a-comparison-of-nurse-perceptions-vs-electronic-risk-assessment-tool-scores
#11
Andrea Stafos, Susan Stark, Kathryn Barbay, Kristen Frost, David Jackel, Lindsey Peters, Elizabeth Riggs, Susan Schedler, Shalan Stroud
Study findings indicate that bedside nurses and data mining software identify risk of harm differently. ABSTRACT: Objective: In many hospitals, nurse-led "safety huddles" are used to relay patient safety information, although whether this effectively identifies patients at risk for harm has not been determined. New electronic risk assessment tools are designed to identify patients at risk for harm during hospitalization, based on specific markers in the electronic health record. This study sought to compare the results of both methods...
March 9, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28281117/game-based-training-improves-the-surgeon-s-situational-awareness-in-the-operation-room-a-randomized-controlled-trial
#12
Maurits Graafland, Willem A Bemelman, Marlies P Schijven
BACKGROUND: Equipment-related malfunctions directly relate to one-fourth of the adverse events in the surgical theater. A serious game trains residents to recognize and respond to equipment problems in minimally invasive surgery (MIS). These include disturbed vision, gas transport, electrocautery, and pathophysiological disturbances. This randomized controlled trial explores whether game-based training improves surgical residents' response to equipment-related problems during surgery...
March 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28274964/predicting-aki-in-emergency-admissions-an-external-validation-study-of-the-acute-kidney-injury-prediction-score-aps
#13
L E Hodgson, B D Dimitrov, P J Roderick, R Venn, L G Forni
OBJECTIVES: Hospital-acquired acute kidney injury (HA-AKI) is associated with a high risk of mortality. Prediction models or rules may identify those most at risk of HA-AKI. This study externally validated one of the few clinical prediction rules (CPRs) derived in a general medicine cohort using clinical information and data from an acute hospitals electronic system on admission: the acute kidney injury prediction score (APS). DESIGN, SETTING AND PARTICIPANTS: External validation in a single UK non-specialist acute hospital (2013-2015, 12 554 episodes); four cohorts: adult medical and general surgical populations, with and without a known preadmission baseline serum creatinine (SCr)...
March 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28273299/association-between-ratio-of-fresh-frozen-plasma-to-red-blood-cells-during-massive-transfusion-and-survival-among-patients-without-traumatic-injury
#14
Tomaz Mesar, Andreas Larentzakis, Walter Dzik, Yuchiao Chang, George Velmahos, Daniel Dante Yeh
Importance: Hemostatic resuscitation has been shown to be beneficial for patients with trauma, but there is little evidence that it is equally beneficial for bleeding patients without trauma. The practice of a high transfusion ratio of fresh frozen plasma (FFP) to red blood cells (RBCs) has spread to other surgical and medical fields. Objective: To identify whether ratio-based resuscitation in patients without trauma is associated with improved survival. Design, Setting, and Participants: This study is a retrospective review of all massive transfusions provided in an urban academic hospital from January 1, 2009, through December 31, 2012...
March 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28272815/clinically-healthy-overweight-and-obese-dogs-differ-from-lean-controls-in-select-cbc-and-serum-biochemistry-values
#15
Lauren B Radakovich, Matthew P Truelove, Stephen C Pannone, Christine S Olver, Kelly S Santangelo
BACKGROUND: Obesity is a global disease, affecting nearly half a billion people. Unfortunately, this trend is mirrored in our canine population. OBJECTIVES: As obesity is a complex inflammatory disease, there is a need to determine whether routine medical screening tests may indicate, or be influenced by, its presence. The objective of the current study was to determine if significant differences exist between CBC and biochemical profile values from control vs overweight/obese, client-owned dogs considered clinically healthy...
March 8, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28270023/comparison-of-economic-and-clinical-outcomes-between-patients-undergoing-laparoscopic-bariatric-surgery-with-powered-versus-manual-endoscopic-surgical-staplers
#16
Sanjoy Roy, Andrew Yoo, Sashi Yadalam, Elliott J Fegelman, Iftekhar Kalsekar, Stephen S Johnston
AIMS: To compare economic and clinical outcomes between patients undergoing laparoscopic Roux-en-Y gastric bypass (LRY) or laparoscopic sleeve gastrectomy (LSG) with use of powered vs manual endoscopic surgical staplers. MATERIALS AND METHODS: Patients (aged ≥21 years) who underwent LRY or LSG during a hospital admission (January 1, 2012-September 30, 2015) were identified from the Premier Perspective Hospital Database. Use of powered vs manual staplers was identified from hospital administrative billing records...
April 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28267606/no-differences-in-population-based-readmissions-after-open-and-robotic-assisted-cystectomy-implications-for-post-discharge-care
#17
Tudor Borza, Bruce L Jacobs, Jeffrey S Montgomery, Alon Z Weizer, Todd M Morgan, Khaled S Hafez, Cheryl T Lee, Benjamin Y, Hye Sung Min, Chang He, Scott M Gilbert, Jonathan E Helm, Mariel S Lavieri, Brent K Hollenbeck, Ted A Skolarus
OBJECTIVE: To inform whether readmission reduction strategies should consider surgical approach, we examined readmission differences between open and robotic-assisted radical cystectomy (RARC) using population-based data. METHODS: We identified patients who underwent cystectomy between January 2010 and September 2013 based on ICD-9 codes and administrative claims from a large, national US health insurer (Clinformatics(TM) Data Mart Database, OptumInsight, Eden Prairie, MN)...
March 3, 2017: Urology
https://www.readbyqxmd.com/read/28267208/progression-free-survival-of-children-with-localized-ependymoma-treated-with-intensity-modulated-radiation-therapy-or-proton-beam-radiation-therapy
#18
Mariko Sato, Jillian R Gunther, Anita Mahajan, Eunji Jo, Arnold C Paulino, Adekunle M Adesina, Jeremy Y Jones, Leena M Ketonen, Jack M Su, M Fatih Okcu, Soumen Khatua, Robert C Dauser, William E Whitehead, Jeffrey Weinberg, Murali M Chintagumpala
BACKGROUND: The treatment for childhood intracranial ependymoma includes maximal surgical resection followed by involved-field radiotherapy, commonly in the form of intensity-modulated radiation therapy (IMRT). Proton-beam radiation therapy (PRT) is used at some centers in an effort to decrease long-term toxicity. Although protons have the theoretical advantage of a minimal exit dose to the surrounding uninvolved brain tissue, it is unknown whether they have the same efficacy as photons in preventing local recurrence...
March 7, 2017: Cancer
https://www.readbyqxmd.com/read/28264594/chronic-subdural-haematomas-a-single-centre-experience-developing-an-integrated-care-pathway
#19
Smita Bapat, Jonathan Shapey, Ahmed Toma, Louise Platt, Astri Maria Valpuri Luoma
OBJECTIVE: To improve quality of care for patients presenting with chronic subdural haematoma (CSDH) by introducing a multi-disciplinary integrated care pathway. SUMMARY BACKGROUND: CSDH is a common neurological condition. Incidence rises with age and currently affects around 58/100 000 people over 70 years. Six-month mortality is high (26%), however integrated care pathways have been shown to improve patient outcomes in other surgical subspecialties. MATERIALS AND METHODS: A baseline retrospective audit completed in 2012 identified areas for improvement in patient management...
March 6, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28264088/association-of-patent-ductus-arteriosus-ligation-with-death-or-neurodevelopmental-impairment-among-extremely-preterm-infants
#20
Dany E Weisz, Lucia Mirea, Erin Rosenberg, Maximus Jang, Linh Ly, Paige T Church, Edmond Kelly, S Joseph Kim, Amish Jain, Patrick J McNamara, Prakesh S Shah
Importance: Observational studies have associated patent ductus arteriosus (PDA) ligation among preterm infants with adverse neonatal outcomes and neurodevelopmental impairment in early childhood, with a resultant secular trend away from surgical treatment. However, to our knowledge, studies have inadequately addressed sources of residual bias, including survival bias and major neonatal morbidities arising before exposure to ligation. Objective: Evaluate the association between PDA ligation vs medical management and neonatal and neurodevelopmental outcomes...
March 6, 2017: JAMA Pediatrics
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