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Effect of specialization on surgery safety

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https://www.readbyqxmd.com/read/29926168/effectiveness-and-safety-of-sulcus-fixation-of-baerveldt-glaucoma-implants-in-glaucomatous-eyes-in-patients-who-underwent-multiple-intraocular-surgeries
#1
Sotaro Mori, Mari Sakamoto, Takuji Kurimoto, Akiyasu Kanamori, Kaori Ueda, Yukako Inoue, Yuko Yamada, Makoto Nakamura
PURPOSE: The purpose of this study was to evaluate the surgical success of sulcus fixation of Baerveldt glaucoma implant (BGIs) in special reference to corneal damage. METHODS: This observational prospective cohort study included 24 patients who underwent a median of 3.0 previous intraocular surgeries and sulcus fixation of BGIs for the first time. The intraocular pressure (IOP), the number of ocular hypotensives used, corneal endothelial cell density (ECD), and logMAR-converted best-corrected visual acuity (VA) of each patient were measured preoperatively and postoperatively until 12 months after surgery...
June 20, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29914842/ablative-stereotactic-neurosurgery-for-irreducible-neuroaggressive-disorder-in-pediatric-patients
#2
Manuel Hernández Salazar, Antonio Zarate Méndez, Oscar Meneses Luna, Lucía Ledesma Torres, Ramón Paniagua Sierra, Mary Carmen Sánchez Moreno, Juan Leonardo Serrato Avila
INTRODUCTION AND OBJECTIVES: The irreducible neuroaggressive disorder (IND) is a well-described entity known to be associated with impulsive and aggressive behavior. While various studies have assessed available pharmacological and non-pharmacological treatment regimens, patients with IND continue to pose a major threat to themselves and society. While targeted stereotactic therapy for IND has gained traction in recent years, there is a paucity of information describing comparative effectiveness of different validated anatomic regions...
June 15, 2018: Neurocirugía
https://www.readbyqxmd.com/read/29869089/pressurized-intraperitoneal-aerosol-chemotherapy-pipac-for-peritoneal-carcinomatosis-systematic-review-of-clinical-and-experimental-evidence-with-special-emphasis-on-ovarian-cancer
#3
REVIEW
Clemens Tempfer, Urs Giger-Pabst, Ziad Hilal, Askin Dogan, Günther A Rezniczek
BACKGROUND: Systemic chemotherapy is not effective in patients with peritoneal carcinomatosis (PC) and only a minority of affected patients is eligible for cytoreductive surgery. Intraperitoneal chemotherapy may provide a therapy alternative for these patients. METHODS: We performed a systematic review of clinical and experimental evidence on the safety and efficacy of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with PC and provide clinical recommendations based on the available evidence...
June 4, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29795070/endoscopic-treatment-of-early-esophageal-adenocarcinoma
#4
Reza V Milano, Jacques J Bergman, Roos E Pouw
The incidence of esophageal adenocarcinoma is on the rise. With advances in endoscopic techniques and imaging technology, early neoplastic lesions are being increasingly detected and treated. Managing early esophageal adenocarcinoma with endoscopic techniques is now considered the cornerstone of therapy, offering an alternative to surgery. The available endoscopic techniques can be broadly categorized into resection and ablation techniques that may be combined to increase the effectiveness of therapy. However, endoscopic treatments are highly specialized and patients with early adenocarcinoma should be referred to centers with expertise in advanced endoscopy of the esophagus...
May 24, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29791030/antiepileptic-drugs-as-prophylaxis-for-postcraniotomy-seizures
#5
REVIEW
Janette Greenhalgh, Jennifer Weston, Yenal Dundar, Sarah J Nevitt, Anthony G Marson
BACKGROUND: This is an updated version of the Cochrane Review previously published in Issue 3, 2015.The incidence of seizures following supratentorial craniotomy for non-traumatic pathology has been estimated to be between 15% to 20%; however, the risk of experiencing a seizure appears to vary from 3% to 92% over a five-year period. Postoperative seizures can precipitate the development of epilepsy; seizures are most likely to occur within the first month of cranial surgery. The use of antiepileptic drugs (AEDs) administered pre- or postoperatively to prevent seizures following cranial surgery has been investigated in a number of randomised controlled trials (RCTs)...
May 23, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29756637/withdrawal-of-immunosuppressant-or-biologic-therapy-for-patients-with-quiescent-crohn-s-disease
#6
REVIEW
Ray K Boyapati, Joana Torres, Carolina Palmela, Claire E Parker, Orli M Silverberg, Sonam D Upadhyaya, Tran M Nguyen, Jean-Frédéric Colombel
BACKGROUND: Crohn's disease (CD) is a chronic, relapsing and remitting disease of the gastrointestinal tract that can cause significant morbidity and disability. Current treatment guidelines recommend early intervention with immunosuppressant or biological therapy in high-risk patients with a severe disease phenotype at presentation. The feasibility of therapeutic de-escalation once remission is achieved is a commonly encountered question in clinical practice, driven by patient and clinician concerns regarding safety, adverse events, cost and national regulations...
May 12, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29662789/pie-crusting-technique-is-effective-and-safe-to-release-superficial-medial-collateral-ligament-for-total-knee-arthroplasty
#7
Xuan He, Hong Cai, Ke Zhang
Background: Pie-crusting technique is a damage-control soft tissue balance skill of total knee arthroplasty (TKA). The outcome of this technique to release lateral soft tissue is reasonable. A limited number of studies have focused on medial collateral ligament release with pie-crusting technique in the past years because of concerns about its efficacy and safety. Method: All cases underwent superficial medial collateral ligament (SMCL) release with either pie-crusting technique or traditional technique (39 knees in each group) between January 1, 2014 and August 31, 2015...
April 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29610988/operating-force-information-on-line-acquisition-of-a-novel-slave-manipulator-for-vascular-interventional-surgery
#8
Yan Zhao, Shuxiang Guo, Nan Xiao, Yuxin Wang, Youxiang Li, Yuhua Jiang
Vascular interventional surgery has its advantages compared to traditional operation. Master-slave robotic technology can further improve the operation accuracy, efficiency and safety of this complicated and high risk surgery. However, on-line acquisition of operating force information of catheter and guidewire remains to be a significant obstacle on the path to enhancing robotic surgery safety. Thus, a novel slave manipulator is proposed in this paper to realize on-line sensing of guidewire torsional operating torque and axial operation force during robotic assisted operations...
April 2, 2018: Biomedical Microdevices
https://www.readbyqxmd.com/read/29564687/prothrombin-complex-concentrate-for-reversal-of-direct-factor-xa-inhibitors-prior-to-emergency-surgery-or-invasive-procedure-a-retrospective-study
#9
Siavash Piran, Caroline Gabriel, Sam Schulman
Direct oral factor Xa (FXa) inhibitors are widely used for anticoagulation but a targeted antidote is not available. Four-factor prothrombin complex concentrate (4FPCC) has been shown in observational studies to support hemostasis in most patients with major bleeding related to FXa inhibitors with an acceptable rate of thromboembolic events. However, the effectiveness of 4FPCC for reversal of FXa inhibitors prior to emergency surgery or invasive procedures is unclear. A retrospective chart review was performed in patients that received 4FPCC at Hamilton General Hospital from 2015 to 2017...
May 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29479668/a-critical-appraisal-of-the-evidence-for-the-role-of-splenectomy-in-adults-and-children-with-itp
#10
REVIEW
Francesco Rodeghiero
In primary chronic immune thrombocytopenia, long-term response to splenectomy, with 60% of patients enjoying a treatment-free life, is higher when compared with rituximab and similar to that with continuous thrombopoietin-receptor agonists (TPO-RA) administration. Splenectomy should continue to be offered to patients failing initial treatments in the absence of increased surgery-related risks. The higher lifelong safety concerns with splenectomy (increased risk of infection, shared in part with rituximab, and of thrombosis, in common with TPO-RA) and a mortality <1-2%, justify postponing surgery to the chronic phase, when spontaneous remissions are rarer...
April 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29464292/-display-technologies-for-augmented-reality-in-medical-applications
#11
REVIEW
Ulrich Eck, Alexander Winkler
BACKGROUND: One of the main challenges for modern surgery is the effective use of the many available imaging modalities and diagnostic methods. Augmented reality systems can be used in the future to blend patient and planning information into the view of surgeons, which can improve the efficiency and safety of interventions. OBJECTIVE: In this article we present five visualization methods to integrate augmented reality displays into medical procedures and the advantages and disadvantages are explained...
April 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29456960/evaluation-and-customization-of-who-safety-checklist-for-patient-safety-in-otorhinolaryngology
#12
Yogesh Dabholkar, Haritosh Velankar, Sneha Suryanarayan, Twinkle Y Dabholkar, Akanksha A Saberwal, Bhavika Verma
The WHO has designed a safe surgery checklist to enhance communication and awareness of patient safety during surgery and to minimise complications. WHO recommends that the check-list be evaluated and customised by end users as a tool to promote safe surgery. The aim of present study was to evaluate the impact of WHO safety checklist on patient safety awareness in otorhinolaryngology and to customise it for the speciality. A prospective structured questionnaire based study was done in ENT operating room for duration of 1 month each for cases, before and after implementation of safe surgery checklist...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29438816/the-effect-of-tranexamic-acid-in-unilateral-and-bilateral-total-knee-arthroplasty-in-the-south-asian-population-a-retrospective-cohort-study
#13
Syed Hamza Mufarrih, Azeem Tariq Malik, Nada Qaisar Qureshi, Riaz Hussain Lakdawala, Muhammad Umar Rabbani, Arif Ali, Shahryar Noordin
INTRODUCTION: Together with evidence of higher bleeding tendencies, the vulnerability of the South-Asian population to anemia secondary to a higher prevalence of hemoglobinopathies and micronutrient deficiencies merits further exploration of the effects of tranexamic acid on this population. Additionally, limited access to self-care facilities and certain sociocultural beliefs and practices may not be conducive to a speedy recovery from surgical complications. The aim of this study is to investigate the effects of intraoperative administration of tranexamic acid during total knee arthroplasty when considering the South-Asian population...
April 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29306976/deep-brain-stimulation-of-the-anterior-nucleus-of-the-thalamus-for-drug-resistant-epilepsy
#14
REVIEW
Tim A M Bouwens van der Vlis, Olaf E M G Schijns, Frédéric L W V J Schaper, Govert Hoogland, Pieter Kubben, Louis Wagner, Rob Rouhl, Yasin Temel, Linda Ackermans
Despite the use of first-choice anti-epileptic drugs and satisfactory seizure outcome rates after resective epilepsy surgery, a considerable percentage of patients do not become seizure free. ANT-DBS may provide for an alternative treatment option in these patients. This literature review discusses the rationale, mechanism of action, clinical efficacy, safety, and tolerability of ANT-DBS in drug-resistant epilepsy patients. A review using systematic methods of the available literature was performed using relevant databases including Medline, Embase, and the Cochrane Library pertaining to the different aspects ANT-DBS...
January 6, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#15
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29179761/efficacy-and-safety-of-the-xingnao-kaiqiao-acupuncture-technique-via-intradermal-needling-to-treat-postoperative-gastrointestinal-dysfunction-of-laparoscopic-surgery-study-protocol-for-a-randomized-controlled-trial
#16
Wenli Zhao, Jinting Li, Yuling Wang, Jing Liu, Ying Chen, Guang Zhao, Ye Zhao, Huaien Bu, Yiider Tseng, Xuemin Shi
BACKGROUND: Xingnao Kaiqiao acupuncture involves needling of the Neiguan (PC6), Renzhong (DU26), and Sanyinjiao (SP6) acupoints. The technique has a significant clinical effect in many neurological diseases. In the present report, we have developed a protocol for a scientific trial to analyze whether Xingnao Kaiqiao can be used to treat gastrointestinal dysfunction after laparoscopic surgery. In this context, we intend to execute a double-blind, randomized controlled trial to assess the efficacy and safety of Xingnao Kaiqiao acupuncture via intradermal needling...
November 28, 2017: Trials
https://www.readbyqxmd.com/read/29178185/case-series-of-outcomes-of-a-standardized-surgical-approach-for-placenta-percreta-for-prevention-of-ureteral-lesions
#17
David Atallah, Malak Moubarak, Malek Nassar, Bernard Kassab, Michel Ghossain, Nadine El Kassis
OBJECTIVE: To report the outcomes of women with placenta percreta who were surgically treated by a specialized technique based on gynecologic oncology experience, and to demonstrate its safety in preventing ureteral lesions and reducing blood loss. METHODS: In the present retrospective study, data from patients with placenta percreta radically treated at Hôtel-Dieu de France, Beirut, Lebanon, between December 2012 and January 2017 were reviewed. Demographic, pathology, and delivery data, medical history, per-operative and postoperative information, and neonatal data were assessed...
March 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29115962/bridging-the-human-resource-gap-in-surgical-and-anesthesia-care-in-low-resource-countries-a-review-of-the-task-sharing-literature
#18
REVIEW
Tigistu Ashengo, Alena Skeels, Elizabeth J H Hurwitz, Eric Thuo, Harshad Sanghvi
Task sharing, the involvement of non-specialists (non-physician clinicians or non-specialist physicians) in performing tasks originally reserved for surgeons and anesthesiologists, can be a potent strategy in bridging the vast human resource gap in surgery and anesthesia and bringing needed surgical care to the district level especially in low-resource countries. Although a common practice, the idea of assigning advanced tasks to less-specialized workers remains a subject of controversy. In order to optimize its benefits, it is helpful to understand the current task sharing landscape, its challenges, and its promise...
November 7, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/29073928/safety-of-tubal-ligation-by-minilaparotomy-provided-by-clinical-officers-versus-assistant-medical-officers-study-protocol-for-a-noninferiority-randomized-controlled-trial-in-tanzanian-women
#19
Mark A Barone, Zuhura Mbuguni, Japhet Ominde Achola, Carmela Cordero, Joseph Kanama, Projestine S Muganyizi, Jamilla Mwanga, Caitlin Shannon, Leopold Tibyehabwa
BACKGROUND: Female sterilization by tubal ligation is a safe, extremely effective, and permanent way to limit childbearing. It is the most popular modern contraceptive method worldwide. The simplest way to provide tubal ligation is by a procedure called minilaparotomy, generally performed with the client under local anesthesia with systemic sedation and analgesia. In Tanzania, unmet need for family planning is high and has declined little in the past decade. Access to tubal ligation is limited throughout the country, in large part because of a lack of trained providers...
October 26, 2017: Trials
https://www.readbyqxmd.com/read/28827901/applied-research-on-laparoscopic-simulator-in-the-resident-surgical-laparoscopic-operation-technical-training
#20
Shangxi Fu, Xiao Liu, Li Zhou, Meisheng Zhou, Liming Wang
The purpose of this study was to estimate the effects of surgical laparoscopic operation course on laparoscopic operation skills after the simulated training for medical students with relatively objective results via data gained before and after the practice course of laparoscopic simulator of the resident standardized trainees. Experiment 1: 20 resident standardized trainees with no experience in laparoscopic surgery were included in the inexperienced group and finished simulated cholecystectomy according to simulator videos...
August 2017: Indian Journal of Surgery
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