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https://www.readbyqxmd.com/read/28906360/plastic-wound-protectors-decreased-surgical-site-infections-following-laparoscopic-assisted-colectomy-for-colorectal-cancer-a-retrospective-cohort-study
#1
Yang Luo, Yi-Er Qiu, Yi-Fei Mu, Shao-Lan Qin, Yang Qi, Ming Zhong, Min-Hao Yu, Li-Ying Ma
Laparoscopic surgery is widespread and safe for the management of patients with colorectal cancer (CRC). Although the use of standard surgical techniques can prevent perioperative wound infections, surgical site infections (SSIs) remain an unresolved complication in laparoscopic-assisted colectomy. The present study investigated the ability of plastic wound protectors applied to the extraction incision during the externalized portion of the procedure to reduce the rate of infection in laparoscopic-assisted colectomy...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905202/drug-interactions-in-users-of-tablet-vs-oral-liquid-levothyroxine-formulations-a-real-world-evidence-study-in-primary-care
#2
Valeria Guglielmi, Alfonso Bellia, Elisa Bianchini, Gerardo Medea, Iacopo Cricelli, Paolo Sbraccia, Davide Lauro, Claudio Cricelli, Francesco Lapi
PURPOSE: Several medications may interact with levothyroxine (LT4) intestinal absorption or metabolism, thus reducing its bioavailability. We investigated the variability of thyroid stimulating hormone (TSH) levels and prescribed daily dosages (PDDs) of LT4 before and during potential drug-drug interactions (DDIs) in users of tablets vs. oral liquid LT4 formulations. METHODS: By using the Italian general practice Health Search Database (HSD), we retrospectively selected adult patients with at least one LT4 prescription from 2012 to 2015 and at least 1 year of clinical history recorded...
September 14, 2017: Endocrine
https://www.readbyqxmd.com/read/28900481/routine-pre-treatment-mri-for-breast-cancer-in-a-single-payer-medical-center-effects-on-surgical-choices-timing-and-outcomes
#3
Timothy J Vreeland, John S Berry Iv, Erika Schneble, Doreen O Jackson, Garth S Herbert, Diane F Hale, Jonathon M Martin, Madeline Flores, Adam R Pattyn, Kai Hata, Guy T Clifton, Aaron D Kirkpatrick, George E Peoples
Introduction: Pre-operative MRI is being used with increasing frequency to evaluate breast cancer patients, but the debate surrounding risks and benefits of this use continues. At our institution, we instituted a standardized protocol for pre-operative MRI. Here, we compare patients seen prior to routine use of MRI to those seen after and examine effects on surgical choices, timing and outcomes. Methods: This is a retrospective review of a prospectively collected database of all new invasive breast cancers seen from January 2007 to December 2012...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28891854/racial-and-socioeconomic-differences-manifest-in-process-measure-adherence-for-enhanced-recovery-after-surgery-pathway
#4
Ira L Leeds, Yewande Alimi, Deborah R Hobson, Jonathan E Efron, Elizabeth C Wick, Elliott R Haut, Fabian M Johnston
BACKGROUND: Adherence to care processes and surgical outcomes varies by population subgroups for the same procedure. Enhanced recovery after surgery pathways are intended to standardize care, but their effect on process adherence and outcomes for population subgroups is unknown. OBJECTIVE: This study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup. DESIGN: This study is a pre- and post-quality improvement implementation cohort study...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28891828/poor-performance-on-a-preoperative-cognitive-screening-test-predicts-postoperative-complications-in-older-orthopedic-surgical-patients
#5
Deborah J Culley, Devon Flaherty, Margaret C Fahey, James L Rudolph, Houman Javedan, Chuan-Chin Huang, John Wright, Angela M Bader, Bradley T Hyman, Deborah Blacker, Gregory Crosby
BACKGROUND: The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. METHODS: We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement...
September 8, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28888379/video-assisted-thoracoscopic-lobectomy-is-associated-with-greater-recurrence-free-survival-than-stereotactic-body-radiotherapy-for-clinical-stage-i-lung-cancer
#6
Lorraine D Cornwell, Alfredo E Echeverria, Jason Samuelian, Jessica Mayor, Roberto F Casal, Faisal G Bakaeen, Shuab Omer, Ourania Preventza, Weiyuan Mai, George Chen, Katherine H Simpson, Drew Moghanaki, Angela W Zhu
OBJECTIVE: Stereotactic body radiotherapy is the standard treatment for medically inoperable early-stage non-small cell lung cancer. Recent data suggest that in operable patients, stereotactic body radiotherapy produces outcomes comparable to those of surgical resection. In veterans with early non-small cell lung cancer, we compared the outcomes of stereotactic body radiotherapy and video-assisted thoracoscopic lobectomy. METHODS: We retrospectively reviewed data from 183 patients (94...
August 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28887251/metabolic-syndrome-but-not-obesity-adversely-affects-outcomes-after-open-aortoiliac-bypass-surgery
#7
Akiko Tanaka, Alexa Perlick, Charles C Miller, Harleen K Sandhu, Shaikh Afaq, Hazim J Safi, Ali Azizzadeh, Kristofer M Charlton-Ouw
OBJECTIVE: Although the incident risk of peripheral artery disease increases in patients with metabolic syndrome, several authors report favorable outcomes in obese patients after arterial bypass surgery. We examine the effect of the so-called "obesity paradox" and metabolic syndrome on outcomes after open aortoiliac bypass surgery. METHODS: We identified patients between 2004 and 2015 who had open surgical bypass for aortoiliac occlusive disease. We excluded patients with endovascular repair and those treated primarily for aneurysmal disease...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885936/vancomycin-vs-vancomycin-piperacillin-tazobactam-associated-acute-kidney-injury-in-noncritically-ill-patients-at-a-tertiary-care-military-treatment-facility
#8
Caleb W Anderson, Kathy S Cazares, Michael B Lustik, Shivam M Patel, Troy M Denunzio
BACKGROUND: Broad-spectrum antibiotics are often used as initial empiric therapy in patients at risk for infections by multidrug-resistant organisms. Emerging literature and anecdotal reports within Tripler Army Medical Center indicate an increased incidence of vancomycin-associated acute kidney injury when used in combination with piperacillin-tazobactam. This is a retrospective, single-center study comparing the incidence of acute kidney injury in noncritically ill patients receiving either vancomycin or vancomycin in combination with piperacillin-tazobactam in a 206-bed tertiary care military training facility...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28882740/effect-of-sleep-deprivation-after-a-night-shift-duty-on-simulated-crisis-management-by-residents-in-anaesthesia-a-randomised-crossover-study
#9
Ségolène Arzalier-Daret, Clément Buléon, Marie-Laure Bocca, Pierre Denise, Jean-Louis Gérard, Jean-Luc Hanouz
BACKGROUND: Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients' safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. METHODS: A randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator...
September 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28882524/activities-performed-and-treatments-conducted-prior-to-consultation-with-a-spine-surgeon-are-patients-and-clinicians-following-evidence-based-clinical-practice-guidelines
#10
Elliot I Layne, Darren M Roffey, Matthew J Coyle, Philippe Phan, Stephen P Kingwell, Eugene K Wai
BACKGROUND CONTEXT: Clinical practice guidelines (CPGs) are designed to ensure that evidence-based treatment is easily put into action. Whether patients and clinicians follow these guidelines is equivocal. PURPOSE: To examine how many patients complaining of low back pain (LBP) underwent evidence-based non-operative treatment in line with CPG recommendations prior to consultation with a spine surgeon, and to evaluate any associations between adherence to CPG recommendations and baseline factors...
September 4, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28881071/quantity-over-quality-findings-from-a-systematic-review-and-environmental-scan-of-patient-decision-aids-on-early-abortion-methods
#11
Kyla Z Donnelly, Glyn Elwyn, Rachel Thompson
BACKGROUND: The availability and effectiveness of decision aids (DAs) on early abortion methods remain unknown, despite their potential for supporting women's decision making. OBJECTIVE: To describe the availability, impact and quality of DAs on surgical and medical early abortion methods for women seeking induced abortion. SEARCH STRATEGY: For the systematic review, we searched MEDLINE, Cochrane Library, CINAHL, EMBASE and PsycINFO. For the environmental scan, we searched Google and App Stores and consulted key informants...
September 7, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28879511/risk-factors-for-unresectable-recurrence-after-up-front-surgery-for-colorectal-liver-metastasis
#12
Daisuke Hokuto, Takeo Nomi, Satoshi Yasuda, Takahiro Yoshikawa, Kohei Ishioka, Takatsugu Yamada, Takahiro Akahori, Kenji Nakagawa, Minako Nagai, Kota Nakamura, Shinsaku Obara, Hiromichi Kanehiro, Masayuki Sho
BACKGROUND: There is no clear evidence that preoperative chemotherapy for resectable colorectal liver metastasis (CRLM) is superior to up-front surgery (UFS). The aim of this study was to identify the risk factors associated with poor prognosis after UFS for CRLM. METHODS: Data about consecutive patients with CRLM who underwent liver resection at Nara Medical University Hospital between January 2000 and December 2015 were retrieved from a prospective database. Recurrence that developed within 2 years after liver resection and could not be surgically resected was defined as unresectable recurrence (UR)...
September 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28877800/disparities-in-mangement-of-patients-with-benign-colorectal-disease-impact-of-urbanization-and-specialized-care
#13
Viraj Pandit, Mazhar Khalil, Bellal Joseph, Jana Jandova, Tahereh Orouji Jokar, Ansab Abbas Haider, Bardiya Zangbar, Asad Azim, Ahmed Hassan, Valentine Nfonsam
Disparities in the management of patients with various medical conditions are well established. Colorectal diseases continue to remain one of the most common causes for surgical intervention. The aim of this study was to assess disparities (rural versus urban) in the surgical management of patients with noncancerous benign colorectal diseases. We hypothesized that there is no difference among rural versus urban centers (UC) in the surgical management for noncancerous benign colorectal diseases. The national estimates of surgical procedures for benign colorectal diseases from the National Inpatient Sample database 2011 representing 20 per cent of all in-patient admissions were abstracted...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28877303/association-of-guideline-adherence-for-serial-evaluations-with-survival-and-adverse-clinical-events-in-patients-with-asymptomatic-severe-aortic-stenosis
#14
Aisha Ahmed, Paul Sorajja, Ross F Garberich, R Saeid Farivar, Kevin M Harris, Mario Gössl
Importance: For patients with asymptomatic severe aortic stenosis and normal left ventricular function, current practice guidelines empirically recommend serial evaluations every 6 to 12 months. The benefit of this clinical monitoring is unknown. Objective: To determine the association of guideline adherence with clinical outcomes in patients with asymptomatic severe aortic stenosis. Design, Setting, and Participants: This retrospective cohort study involved 300 patients with asymptomatic severe aortic stenosis who were seen in the ambulatory Minneapolis Heart Institute at Abbott Northwestern Hospital...
September 6, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28877108/prevention-of-heel-pressure-injuries-and-plantar-flexion-contractures-with-use-of-a-heel-protector-in-high-risk-neurotrauma-medical-and-surgical-intensive-care-units-a-randomized-controlled-trial
#15
Tina Meyers
PURPOSE: The purpose of this study was to compare the use of a heel protector to standard of care (pillows) in the prevention of hospital-acquired pressure injuries (HAPI) of the heels and prevention of plantar flexion contractures. DESIGN: Randomized controlled trial. SUBJECTS AND SETTING: The study took place on a surgical intensive care unit, medical intensive care unit, and neurotrauma intensive care unit. Inclusion criteria were a minimum of 5 days of sedation related to care for a critical illness, immobility for 6 to 8 hours before study initiation, a Braden Scale for Pressure Sore Risk score 18 or less, and a mobility subscale score 2 or less...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28874187/prolonged-preoperative-treatment-of-acromegaly-with-somatostatin-analogs-may-improve-surgical-outcome-in-patients-with-invasive-pituitary-macroadenoma-knosp-grades-1-3-a-retrospective-cohort-study-conducted-at-a-single-center
#16
Lian Duan, Huijuan Zhu, Bing Xing, Feng Gu
BACKGROUND: This study aimed to investigate preoperative somatostatin analogs (SSAs) treatment on the surgical outcome in patients with acromegaly. METHODS: An analysis of 358 patients with acromegaly was conducted. The preoperative medical therapy group (81 patients) received SSA treatment for at least 3 months prior to surgery, while the primary surgery group (277 patients) underwent transsphenoidal surgery directly. Follow-up duration was ≥3 months. Tumor invasion was evaluated by magnetic resonance imaging (MRI) and classified according to the Knosp grading system...
September 6, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28870840/surgical-outcomes-in-the-elderly-with-degenerative-spondylolisthesis-comparative-study-between-patients-over-80-years-of-age-and-under-80-years-a-gender-diagnosis-and-surgical-method-matched-two-cohort-analyses
#17
Jen-Chung Liao, Wen-Jer Chen
BACKGROUND: In my country, the current life expectancy of an 80-year-old man is 88.4 years and that of an 80-year-old is woman is 89.8 years. Surgical candidates older than 80 years usually ask surgeons whether it would be safe for them to undergo surgery. PURPOSE: To report the surgical outcomes of patients with degenerative spondylolisthesis who were older than 80 years and underwent instrumented surgeries and to compare these data with the outcomes of patients aged 65-79 years...
September 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28870742/the-effect-of-smoking-on-thirty-day-postoperative-complications-after-total-joint-arthroplasty-a-propensity-score-matched-analysis
#18
Shawn Sahota, Francis Lovecchio, Ryan E Harold, Matthew D Beal, David W Manning
BACKGROUND: Total joint arthroplasty (TJA) is a highly successful treatment, but is burdensome to the national healthcare budget. National quality initiatives seek to reduce costly complications. Smoking's role in perioperative complication after TJA is less well known. This study aims to identify smoking's independent contribution to the risk of short-term complication after TJA. METHODS: All patients undergoing primary TJA between 2011 and 2012 were selected from the American College of Surgeon's National Surgical Quality Improvement Program's database...
August 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28869159/a-comparison-of-objective-assessment-data-for-the-united-states-and-international-medical-graduates-in-a-general-surgery-residency
#19
Francisco Cardenas Lara, Nimesh D Naik, T K Pandian, Becca L Gas, Suzanne Strubel, Rachel Cadeliña, Stephanie F Heller, David R Farley
OBJECTIVE: To compare objective assessment scores between international medical graduates (IMGs) and United States Medical Graduates. Scores of residents who completed a preliminary year, who later matched into a categorical position, were compared to those who matched directly into a categorical position at the Mayo Clinic, Rochester. DESIGN: Postgraduate year (PGY) 1 to 5 residents participate in a biannual multistation, OSCE-style assessment event as part of our surgical training program...
August 28, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28866139/impact-of-caloric-intake-in-critically-ill-patients-with-and-without-refeeding-syndrome-a-retrospective-study
#20
Laura E Olthof, W A C Kristine Koekkoek, Coralien van Setten, Johannes C N Kars, Dick van Blokland, Arthur R H van Zanten
BACKGROUND & AIMS: Refeeding syndrome comprises metabolic disturbances that occur after the reintroduction of feeding after prolonged fasting. Standard care consists of correcting fluid and electrolytes imbalances. Energy intake during refeeding syndrome is heavily debated. This study addresses the effect of caloric intake on outcome during the management of refeeding syndrome. METHODS: A retrospective study among critically ill invasive mechanically ventilated patients admitted for >7 days to a medical-surgical ICU...
August 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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