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Surgery in the United Kingdom

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https://www.readbyqxmd.com/read/28098417/delivery-of-anesthesia-for-children-with-mucopolysaccharidosis-type-iii-sanfilippo-syndrome-a-review-of-86-anesthetics
#1
Marc A Cohen, Grant M Stuart
BACKGROUND: Sanfilippo syndrome (MPS III) is rare, with 97 cases in the United Kingdom between 1988 and 1998. Mucopolysaccharide infiltration of tissues in mucopolysaccharidosis (MPS) causes multi-systemic pathology including difficult airways and cardiac disease. Published anesthesia case reviews of Sanfilippo syndrome have included limited numbers of patients to date. AIM: To identify the perioperative management and complications of anesthesia in children with mucopolysaccharidosis Type III at Great Ormond Street Hospital...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28055065/effect-of-fish-oil-supplementation-and-aspirin-use-on-arteriovenous-fistula-failure-in-patients-requiring-hemodialysis-a-randomized-clinical-trial
#2
Ashley B Irish, Andrea K Viecelli, Carmel M Hawley, Lai-Seong Hooi, Elaine M Pascoe, Peta-Anne Paul-Brent, Sunil V Badve, Trevor A Mori, Alan Cass, Peter G Kerr, David Voss, Loke-Meng Ong, Kevan R Polkinghorne
Importance: Vascular access dysfunction is a leading cause of morbidity and mortality in patients requiring hemodialysis. Arteriovenous fistulae are preferred over synthetic grafts and central venous catheters due to superior long-term outcomes and lower health care costs, but increasing their use is limited by early thrombosis and maturation failure. ω-3 Polyunsaturated fatty acids (fish oils) have pleiotropic effects on vascular biology and inflammation and aspirin impairs platelet aggregation, which may reduce access failure...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28053265/effectiveness-of-open-and-arthroscopic-rotator-cuff-repair-ukuff-a-randomised-controlled-trial
#3
A Carr, C Cooper, M K Campbell, J Rees, J Moser, D J Beard, R Fitzpatrick, A Gray, J Dawson, J Murphy, H Bruhn, D Cooper, C Ramsay
AIMS: The appropriate management for patients with a degenerative tear of the rotator cuff remains controversial, but operative treatment, particularly arthroscopic surgery, is increasingly being used. Our aim in this paper was to compare the effectiveness of arthroscopic with open repair of the rotator cuff. PATIENTS AND METHODS: A total of 273 patients were recruited to a randomised comparison trial (136 to arthroscopic surgery and 137 to open surgery) from 19 teaching and general hospitals in the United Kingdom...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28051892/what-is-the-role-of-bariatric-surgery-in-the-management-of-obesity
#4
E Panteliou, A D Miras
Diet, exercise, cognitive behavioral therapy and pharmacotherapy are some of the means of assisting patients to lose weight, with bariatric surgery being the most effective. Over the last two decades, the increased awareness of the systemic benefits of bariatric surgery, as well as the improved safety and the wider use of the laparoscopic approach, has made bariatric surgery flourish. In the United Kingdom, the adjustable gastric band (10%), vertical sleeve gastrectomy (37%) and Roux-en-Y gastric bypass (45%) are the three most common procedures...
January 4, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28035898/mycobacterium-chimaera-in-heater-cooler-units-in-denmark-related-to-isolates-from-the-united-states-and-united-kingdom
#5
Erik Svensson, Elsebeth Tvenstrup Jensen, Erik Michael Rasmussen, Dorte Bek Folkvardsen, Anders Norman, Troels Lillebaek
Mycobacterium chimaera was present at high rates (>80%) in heater-cooler units (HCUs) from all 5 thoracic surgery departments in Denmark. Isolates were clonal to HCU-associated isolates from the United States (including some from patients) and United Kingdom. However, M. chimaera from 2 brands of HCU were genetically distinct.
March 15, 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28032571/readmissions-after-general-surgery-a-prospective-multicenter-audit
#6
Matthew J Lee, Sarah L Daniels, Jonathan R L Wild, Timothy R Wilson
BACKGROUND: Readmission rates after surgical procedures are viewed as a marker of quality of care and as a driver to improve outcomes in the United Kingdom, they are not remunerated. However, readmissions are not wholly avoidable. The aim of this study was to develop a regional overview of readmissions to determine the proportion that might be avoidable and to examine predictors of readmissions at a unit level. METHODS: We undertook a prospective multicenter audit of readmissions following National Health Service funded general surgical procedures in five National Health Service hospitals and three independent sector providers over a 2-wk period...
September 19, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28007107/patient-reported-outcome-measuring-tools-in-cataract-surgery-clinical-comparison-at%C3%A2-a-tertiary-hospital
#7
Simon S M Fung, Joshua Luis, Badrul Hussain, Catey Bunce, Melanie Hingorani, Joanne Hancox
PURPOSE: To assess the performance of patient-reported outcome measure questionnaires and determine their appropriateness for routine use in cataract patients. SETTING: Moorfields Eye Hospital, London, United Kingdom. DESIGN: Prospective cohort study. METHODS: Patients having cataract surgery between February and March 2013 were recruited. The following 4 questionnaires-Catquest-9SF, EuroQol 5-dimensions questionnaire (EQ-5D) and visual analog scale (EQ-VAS), National Eye Institute Socioemotional Scale (NEI-SES), and short-form Visual Function Index (VF-8R)-were completed preoperatively and 3 weeks and 3 months postoperatively...
December 2016: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28007105/outcomes-and-complications-of-excimer-laser-surgery-in-patients-with-collagen-vascular-and-other-immune-mediated-inflammatory-diseases
#8
Julie M Schallhorn, Steven C Schallhorn, Keith A Hettinger, Jan A Venter, Martina Pelouskova, David Teenan, Stephen J Hannan
PURPOSE: To assess refractive and visual outcomes and postoperative complications in a large number of patients with well-controlled collagen vascular and other immune-mediated inflammatory diseases. SETTING: Optical Express, Glasgow, United Kingdom. DESIGN: Retrospective case series. METHODS: The files were reviewed of patients who had collagen vascular and other immune-mediated inflammatory diseases and who had excimer laser surgery between 2008 and 2015...
December 2016: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/27995370/the-impact-of-ultra-radical-surgery-in-the-management-of-patients-with-stage-iiic-and-iv-epithelial-ovarian-fallopian-tube-and-peritoneal-cancer
#9
Hilary L Turnbull, Nikolaos Akrivos, Simon Wemyss-Holden, Balachandra Maiya, Timothy J Duncan, Joaquin J Nieto, Nikolaos Burbos
OBJECTIVE: The aim of this study is to estimate the percentage of patients with metastatic ovarian, fallopian tube, and primary peritoneal cancer requiring ultra-radical surgery to achieve cytoreduction to less than 1 cm (optimal) or no macroscopic residual disease (complete). METHODS: Perioperative data were collected prospectively on consecutive patients undergoing elective cytoreductive surgery for metastatic epithelial ovarian, fallopian tube, or primary peritoneal cancer at the Norfolk and Norwich University Hospital, a tertiary referral cancer centre in the United Kingdom from November 2012 to June 2016...
December 19, 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27971698/economic-impact-of-fentanyl-hcl-iontophoretic-transdermal-system-versus-iv-pca-in-acute-pain-management-following-surgery-in-the-united-kingdom-germany-and-sweden
#10
J Abraham, C Edwards, L Feeney, M Gavaghan, R Beaton
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27970456/the-cost-effectiveness-of-bariatric-surgery-in-germany-france-italy-and-the-united-kingdom
#11
S Belarbi, J Kusel, M G Thomas
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27956674/patient-reported-outcome-of-adult-perioperative-anaesthesia-in-the-united-kingdom-a-cross-sectional-observational-study
#12
E M K Walker, M Bell, T M Cook, M P W Grocott, S R Moonesinghe
BACKGROUND: Understanding the patient perspective on healthcare is central to the evaluation of quality. This study measured selected patient-reported outcomes after anaesthesia in order to identify targets for research and quality improvement. METHODS: This cross-sectional observational study in UK National Health Service hospitals, recruited adults undergoing non-obstetric surgery requiring anaesthesia care over a 48 h period. Within 24 h of surgery, patients completed the Bauer questionnaire (measuring postoperative discomfort and satisfaction with anaesthesia care), and a modified Brice questionnaire to elicit symptoms suggestive of accidental awareness during general anaesthesia (AAGA)...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27926555/avoiding-radical-surgery-in-elderly-patients-with-rectal-cancer-is-cost-effective
#13
Christopher Rao, Arthur Sun Myint, Thanos Athanasiou, Omar Faiz, Antony Paul Martin, Brendan Collins, Fraser McLean Smith
BACKGROUND: Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27909127/costs-quality-of-life-and-cost-effectiveness-of-arthroscopic-and-open-repair-for-rotator-cuff-tears-an-economic-evaluation-alongside-the-ukuff-trial
#14
J Murphy, A Gray, C Cooper, D Cooper, C Ramsay, A Carr
AIMS: A trial-based comparison of the use of resources, costs and quality of life outcomes of arthroscopic and open surgical management for rotator cuff tears in the United Kingdom NHS was performed using data from the United Kingdom Rotator Cuff Study (UKUFF) randomised controlled trial. PATIENTS AND METHODS: Using data from 273 patients, healthcare-related use of resources, costs and quality-adjusted life years (QALYs) were estimated at 12 months and 24 months after surgery on an intention-to-treat basis with adjustment for covariates...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27898680/a-core-outcome-set-for-the-benefits-and-adverse-events-of-bariatric-and-metabolic-surgery-the-bariact-project
#15
Karen D Coulman, James Hopkins, Sara T Brookes, Katy Chalmers, Barry Main, Amanda Owen-Smith, Robert C Andrews, James Byrne, Jenny L Donovan, Graziella Mazza, Barnaby C Reeves, Chris A Rogers, Janice L Thompson, Richard Welbourn, Sarah Wordsworth, Jane M Blazeby
BACKGROUND: Bariatric and metabolic surgery is used as a treatment for patients with severe and complex obesity. However, there is a need to improve outcome selection and reporting in bariatric surgery trials. A Core Outcome Set (COS), an agreed minimum set of outcomes reported in all studies of a specific condition, may achieve this. Here, we present the development of a COS for BARIAtric and metabolic surgery Clinical Trials-the BARIACT Study. METHODS AND FINDINGS: Outcomes identified from systematic reviews and patient interviews informed a questionnaire survey...
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27893582/basic-burns-management-e-learning-a-new-teaching-tool
#16
Francesco M Egro
Burns teaching is organized only in a few medical schools in the United Kingdom. An e-learning tutorial was developed with the objective of incorporating burns teaching within the medical school curriculum. A 33-webpage e-learning was created, covering topics such as local and general response to burns, assessment of burns, first aid, primary and secondary survey, and referral guidelines. Medical student satisfaction was then evaluated using a 12-question feedback survey rated based on a Likert scale from 1 (very poor) to 5 (very good)...
November 11, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27834599/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#17
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
November 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27833483/acquired-hypernatremia-in-a-general-surgical-intensive-care-unit-incidence-and-prognosis
#18
Mariam A Alansari, Ahmed Abdulmomen, Mohammed Hussein, Ahmad Mohmmad Zubaidi, Jalal T Alswaiti
PURPOSE: Intensive Care Unit (ICU)-acquired hypernatremia (IAH) is a serious electrolyte disturbance that recently was shown to present an independent risk factor for mortality in critically ill patients. IAH has not been widely investigated in Surgical ICU (SICU) patients. No study has specifically investigated IAH epidemiology in the Kingdome of Saudi Arabia (KSA) in general SICU. The objectives of this study are to assess the epidemiological characteristics and prognostic impact of IAH on SICU mortality and outcome in KSA and compare it with international figures...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27820610/national-registry-data-and-record-linkage-to-inform-postmarket-surveillance-of-prosthetic-aortic-valve-models-over-15-years
#19
Graeme L Hickey, Ben Bridgewater, Stuart W Grant, John Deanfield, John Parkinson, Alan J Bryan, Malcolm Dalrymple-Hay, Neil Moat, Iain Buchan, Joel Dunning
Importance: Postmarket evidence generation for medical devices is important yet limited for prosthetic aortic valve devices in the United Kingdom. Objective: To identify prosthetic aortic valve models that display unexpected patterns of mortality or reintervention using routinely collected national registry data and record linkage. Design, Setting, and Participants: This observational study used data from all National Health Service and private hospitals in England and Wales that submit data to the National Adult Cardiac Surgery Audit (NACSA)...
January 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27803215/the-three-legged-stool-a-system-for-spinal-informed-consent
#20
EDITORIAL
J M Powell, A Rai, M Foy, A Casey, H Dabke, A Gibson, M Hutton
Many hospitals do not have a structured process of consent, the attainment of which can often be rather 'last-minute' and somewhat chaotic. This is a surprising state of affairs as spinal surgery is a high-risk surgical specialty with potential for expensive litigation claims. More recently, the Montgomery ruling by the United Kingdom Supreme Court has placed the subject of informed consent into the spotlight. There is a paucity of practical guidance on how a consent process can be achieved in a busy clinical setting...
November 2016: Bone & Joint Journal
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