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Evidence based surgery

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https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#1
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742680/individualized-metabolic-surgery-score-procedure-selection-based-on-diabetes-severity
#2
Ali Aminian, Stacy A Brethauer, Amin Andalib, Amy S Nowacki, Amanda Jimenez, Ricard Corcelles, Zubaidah Nor Hanipah, Suriya Punchai, Deepak L Bhatt, Sangeeta R Kashyap, Bartolome Burguera, Antonio M Lacy, Josep Vidal, Philip R Schauer
OBJECTIVE: To construct and validate a scoring system for evidence-based selection of bariatric and metabolic surgery procedures according to severity of type 2 diabetes (T2DM). BACKGROUND: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) account for >95% of bariatric procedures in United States in patients with T2DM. To date, there is no validated model to guide procedure selection based on long-term glucose control in patients with T2DM. METHODS: A total of 659 patients with T2DM who underwent RYGB and SG at an academic center in the United States and had a minimum 5-year follow-up (2005-2011) were analyzed to generate the model...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742606/functional-movement-screening-and-injury-rates-in-high-school-and-collegiate-runners-a-retrospective-analysis-of-3-prospective-observational-studies
#3
Benjamin V Bring, Miriam Chan, Robin C Devine, Christy L Collins, Jason Diehl, Benjamin Burkam
OBJECTIVE: Determine if the Functional Movement Screening (FMS) can be used to predict injury in high school and collegiate cross-country and track runners. DESIGN: Prospective Observational, Cohort Study, Level of Evidence, 2. SETTING: High schools and colleges in the Central Ohio area. PATIENTS: Inclusion: (1) cross-country or track runners at participating schools; (2) full participation without restrictions; and (3) signed informed assent or consent...
July 21, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28742580/surgery-and-endometriosis
#4
Austin Zanelotti, Alan H Decherney
Care of the endometriosis patient today can be complex and difficult. Once medical management has been exhausted and symptoms persist patients desire further treatment options. This chapter takes an evidence-based approach at discussion of patient surgcical options for treatment of endometriosis symptoms. Surgical techniques, success rates, patient satisfaction, and risks must be discussed and understood at depth before planning patient surgical intervention. This chapter provides reference to current surgical management options and symptom relief following those interventions...
September 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742255/weight-management-strategies-for-those-with-chronic-kidney-disease-a-consensus-report-from-the-asia-pacific-society-of-nephrology-and-australia-and-new-zealand-society-of-nephrology-2016-renal-dietitians-meeting
#5
Kelly Lambert, Jo Beer, Ruth Dumont, Katie Hewitt, Karen Manley, Anthony Meade, Karen Salamon, Katrina Campbell
AIM: Develop a consensus report to guide dietetic management of overweight or obese individuals with Chronic Kidney Disease (CKD). METHODS: Six statements relating weight management in CKD guided a comprehensive review of the literature. A summary of the evidence was then presented at the renal nutrition meeting of the 2016 Asia Pacific Society of Nephrology and Australia and New Zealand Society of Nephrology. Majority agreement was defined as group agreement on a statement of between 50-74%, and consensus was considered ≥ 75% agreement...
July 25, 2017: Nephrology
https://www.readbyqxmd.com/read/28741745/venous-thromboembolism-prophylaxis-in-urology-a-review
#6
REVIEW
Manmeet Saluja, Peter Gilling
Venous thromboembolism is potentially a lethal problem, and is associated with chronic morbidity. Venous thromboembolism is frequently diagnosed after urological surgery, yet the role of perioperative venous thromboembolism prophylaxis is not clearly defined. Any current recommendations are largely based on evidence derived from other surgical specialties. Even within different guidelines, there remains significant variation, suggesting a consensus is required. The present review aims to define the problem of venous thromboembolism within the urological population, and identifies patients at risk...
July 25, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28741202/a-user-centred-approach-to-developing-bwell-a-mobile-app-for-arm-and-shoulder-exercises-after-breast-cancer-treatment
#7
Helena Harder, Patrick Holroyd, Lynn Burkinshaw, Phil Watten, Charles Zammit, Peter R Harris, Anna Good, Val Jenkins
PURPOSE: The study aim was to develop a mobile application (app) supported by user preferences to optimise self-management of arm and shoulder exercises for upper-limb dysfunction (ULD) after breast cancer treatment. METHODS: Focus groups with breast cancer patients were held to identify user needs and requirements. Behaviour change techniques were explored by researchers and discussed during the focus groups. Concepts for content were identified by thematic analysis...
July 24, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/28741059/postoperative-follow-up-programs-improve-survival-in-curatively-resected-gastric-and-junctional-cancer-patients-a-propensity-score-matched-analysis
#8
Leila Sisic, Moritz J Strowitzki, Susanne Blank, Henrik Nienhueser, Sara Dorr, Georg Martin Haag, Dirk Jäger, Katja Ott, Markus W Büchler, Alexis Ulrich, Thomas Schmidt
BACKGROUND: To date there is no evidence that more intensive follow-up after surgery for esophagogastric adenocarcinoma translates into improved survival. This study aimed to evaluate the impact of standardized surveillance by a specialized center after resection on survival. METHODS: Data of 587 patients were analyzed who underwent curative surgery for esophagogastric adenocarcinoma in our institution. Based on their postoperative surveillance, patients were assigned to either standardized follow-up (SFU) by the National Center for Tumor Diseases (SFU group) or individual follow-up by other physicians (non-SFU group)...
July 24, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28740974/wound-closure-and-wound-healing-suture-techniques-in-contemporary-periodontal-and-implant-surgery-interactions-requirements-and-practical-considerations
#9
Otto Zuhr, Dodji Lukas Akakpo, Markus Hürzeler
In contemporary reconstructive periodontal and implant surgery, attaining uncomplicated wound healing in the early postoperative healing phase is the key to achieving a successful treatment outcome and is of central interest, from the clinical as well as the scientific perspective. The realization of primary wound healing is the central challenge in most cases. Two of the evidence-based factors that affect postoperative wound healing can be influenced by the surgeon: the blood supply to the surgical site and postoperative wound stability...
July 20, 2017: Quintessence International
https://www.readbyqxmd.com/read/28740431/what-we-know-about-surgical-therapy-in-early-stage-non-small-cell-lung-cancer-a-guide-for-the-medical-oncologist
#10
REVIEW
Sassine Ghanem, Sandy El Bitar, Sami Hossri, Chanudi Weerasinghe, Jean Paul Atallah
Lung cancer remains the leading cause of death in cancer patients. The gold standard for the treatment of early-stage non-small-cell lung cancer is lobectomy with mediastinal lymph-node dissection or systematic lymph-node sampling. The evidence behind this recommendation is based on the sole randomized controlled trial conducted to date, done by the Lung Cancer Study Group and published in 1995, which found a superiority for lobectomy over sublobar resection with regard to local recurrence rate and improved survival...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28739464/prophylactic-groin-wound-vacuum-assisted-therapy-in-vascular-surgery-patients-at-enhanced-risk-for-postoperative-wound-infection
#11
Luke O Pesonen, Brian G Halloran, Abdulhameed Aziz
OBJECTIVE: Vascular groin wounds have higher than expected surgical site infection (SSI) rates and some patients are at enhanced risk. The Wiseman et al. paper suggests an objective scoring system that identifies patients at enhanced risk of postdischarge SSI. We hypothesize that prophylactic groin wound vacuum-assisted closure (VAC) therapy in enhanced risk patients will decrease SSI and readmission and the Wiseman model provides potential evidence that enhanced risk patients can be objectively identified...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28738443/urethral-injection-therapy-for-urinary-incontinence-in-women
#12
REVIEW
Vivienne Kirchin, Tobias Page, Phil E Keegan, Kofi Om Atiemo, June D Cody, Samuel McClinton, Patricia Aluko
BACKGROUND: Urinary incontinence imposes a significant health and economic burden to society. Periurethral or transurethral injection of bulking agents is a minimally invasive surgical procedure used as one the surgical treatments of stress urinary incontinence (SUI) in adult women. OBJECTIVES: To assess the effects of periurethral or transurethral injection therapy on the cure or improvement of urinary incontinence in women. SEARCH METHODS: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 8 November 2010) and the reference lists of relevant articles...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28738352/future-perspectives-in-sleep-surgery
#13
Michael Friedman, Anna M Salapatas, Lauren B Bonzelaar
Over the past few decades there has been a significant increase in research focusing on the pathophysiology, diagnosis, and treatment of sleep apnea. However, there is still a long way to go in creating standard evidence-based medical practice for the diagnosis, evaluation, and treatment of sleep apnea patients. Current and future directions of sleep surgery and other treatments are discussed here.
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738031/perioperative-care-implementation-evidence-based-practice-for-patients-with-pancreaticoduodenectomy-using-the-enhanced-recovery-after-surgery-guidelines-%C3%A2
#14
Cesar Aviles, Marilyn Hockenberry, Dionisios Vrochides, David Iannitti, Allyson Cochran, Kendra Tezber, Misty Eller, Janet Desamero
BACKGROUND: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.
. OBJECTIVES: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28737949/effects-of-autogenous-bone-marrow-aspirate-concentrate-on-radiographic-integration-of-femoral-condylar-osteochondral-allografts
#15
Lasun O Oladeji, James P Stannard, Cristi R Cook, Mauricio Kfuri, Brett D Crist, Matthew J Smith, James L Cook
BACKGROUND: Transplantation of fresh osteochondral allografts (OCAs) is an attractive treatment option for symptomatic articular cartilage lesions in young, healthy patients. Because the lack of OCA bone integration can be a cause of treatment failure, methods for speeding and enhancing OCA bone integration to mitigate this potential complication are highly desirable. PURPOSE: To determine if autogenous bone marrow aspirate concentrate (BMC) treatment of large femoral condylar OCAs would be associated with superior radiographic OCA bone integration compared with nontreated allografts during the critical first 6 months after surgery...
July 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28734971/robotic-assistance-confers-ambidexterity-to-laparoscopic-surgeons
#16
Souzana Choussein, Serene S Srouji, Leslie V Farland, Ashley Wietsma, Stacey A Missmer, Michael Hollis, Richard N Yu, Charles N Pozner, Antonio R Gargiulo
STUDY OBJECTIVE: To examine whether a robotic surgical platform can complement the fine motor skills of the non-dominant hand, compensating for the innate difference in dexterity between the surgeon's hands, thereby conferring virtual ambidexterity. DESIGN: Crossover intervention study. DESIGN CLASSIFICATION: Level II-1 evidence. SETTING: Centers for medical simulation of two tertiary care hospitals of Harvard Medical School...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#17
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28732371/the-impacts-of-surgery-of-the-primary-cancer-and-radiotherapy-on-the-survival-of-patients-with-metastatic-rectal-cancer
#18
Duo Tong, Fei Liu, Wenhua Li, Wen Zhang
The role of surgery of the primary cancer and radiation in metastatic colorectal cancer (mCRC) is still controversial currently, and evidence implied that colon cancer (CC) and rectal cancer (RC) should be treated with difference. Hence we focused on metastatic rectal cancer (mRC) solely to compare the cancer cause-specific survival (CSS) of patients receiving varied treatments of the primary cancer: no treatment, surgery only, radiation only, and surgery plus radiation, based on the records of the Surveillance, Epidemiology, and End Results (SEER) database...
July 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28731875/management-of-complex-spine-surgery
#19
Massimo Lamperti, Boris Tufegdzic, Rafi Avitsian
PURPOSE OF REVIEW: The main objective of this article is to present the updated data regarding the perioperative management of patients undergoing major spine surgery in an era where the surgical techniques are changing and there is a high demand for these surgeries in older and high-risk patients. RECENT FINDINGS: Preoperative assessment and stabilization is now more structured protocol and it is based on a multidisciplinary approach to the patient. The Enhanced Recovery After Surgery (ERAS) programs and the Perioperative Surgical Home on major spine surgery are not yet fully evidence based but it seems that the use of a perioperative optimization of patients and use of a drugs' bundle is more effective than using single drugs or interventions on the postoperative pain reduction and faster recovery from surgery...
July 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28731779/arthroscopic-labral-base-repair-in-the-hip-5-year-minimum-clinical-outcomes
#20
Benjamin G Domb, Leslie C Yuen, Victor Ortiz-Declet, Jody Litrenta, Itay Perets, Austin W Chen
BACKGROUND: Arthroscopic labral base repair (LBR) in the hip is a previously described technique designed to restore the native functional anatomy of the labrum by reproducing its seal against the femoral head. LBR has been shown to have good short-term outcomes. Hypothesis/Purpose: The purpose was to evaluate clinical outcomes of an LBR cohort with a minimum 5-year follow-up. It was hypothesized that patients who underwent LBR would continue to have significant improvement from their preoperative scores and maintain scores similar to their 2-year outcomes...
July 1, 2017: American Journal of Sports Medicine
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