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Effect of specialization on surgery Quality

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https://www.readbyqxmd.com/read/28213799/the-hybrid-technique-of-pelvic-organ-prolapse-treatment-apical-sling-and-subfascial-colporrhaphy
#1
Dmitry Shkarupa, Nikita Kubin, Alexey Pisarev, Anastasiya Zaytseva, Ekaterina Shapovalova
INTRODUCTION AND HYPOTHESIS: The majority of patients with cystocele undergoing reconstructive surgery have combined defects of pubocervical fascia and uterosacral/cardinal ligament complex. In this regard, the simultaneous correction of both defects is rational. Furthermore, decreasing the use of synthetic materials in pelvic floor surgery is an important goal. The aim was to evaluate the objective and subjective cure rate of a hybrid technique: bilateral sacrospinous fixation using modern monofilament synthetic tape (apical sling) combined with the original technique of subfascial colporrhaphy...
February 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28132086/incidence-and-prognostic-factors-for-postoperative-frozen-shoulder-after-shoulder-surgery-a-prospective-cohort-study
#2
Rinco C T Koorevaar, Esther Van't Riet, Marcel Ipskamp, Sjoerd K Bulstra
PURPOSE: Frozen shoulder is a potential complication after shoulder surgery. It is a clinical condition that is often associated with marked disability and can have a profound effect on the patient's quality of life. The incidence, etiology, pathology and prognostic factors of postoperative frozen shoulder after shoulder surgery are not known. The purpose of this explorative study was to determine the incidence of postoperative frozen shoulder after various operative shoulder procedures...
January 28, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28097111/fucntional-and-radiological-outcome-of-surgical-management-of-acetabular-fractures-in-tertiary-care-hospital
#3
Faizan Iqbal, Intikhab Taufiq, Muhammad Kazim Raheem Najjad, Naveed Khan, Osama Bin Zia
PURPOSE: Acetabular fractures are mainly caused by trauma and the incidence is rising in developing countries. Initially these fractures were managed conservatively, due to lack of specialized and dedicated acetabulum surgery centres. Our aim is to study the radiological and functional outcomes of surgical management of acetabular fractures in tertiary care hospital. MATERIALS AND METHODS: Total 50 patients were enrolled. The patients with acetabular fractures were enrolled between the years 2012 to 2014...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28079809/a-comparison-of-the-surgical-mortality-due-to-colorectal-perforation-at-different-hospitals-with-data-from-10-090-cases-in-the-japanese-national-clinical-database
#4
COMPARATIVE STUDY
Takeshi Ohki, Masakazu Yamamoto, Hiroaki Miyata, Yasuto Sato, Yoshihisa Saida, Tsuyoshi Morimoto, Hiroyuki Konno, Yasuyuki Seto, Koichi Hirata
Colorectal perforation has a high rate of mortality. We compared the incidence and fatality rates of colorectal perforation among different hospitals in Japan using data from the nationwide surgical database.Patients were registered in the National Clinical Database (NCD) between January 1st, 2011 and December 31st, 2013. Patients with colorectal perforation were identified from surgery records by examining if acute diffuse peritonitis (ADP) and diseases associated with a high probability of colorectal perforation were noted...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28057402/consultation-with-a-specialized-pain-clinic-reduces-pain-after-oral-and-maxillofacial-surgery
#5
Eva-Maria Dietrich, Norbert Griessinger, Friedrich Wilhelm Neukam, Tilo Schlittenbauer
PURPOSE: Postoperative pain management is important for improved patient care. Our primary objective was to investigate the effect of analgesic treatment adaptation by the pain clinic on postoperative pain relief at an oral and maxillofacial surgery department. Additionally, we aimed to present patients' pain characteristics and the administered analgesic treatment. MATERIALS AND METHODS: A total of 128 patients treated at our clinic in the period 2012-2015 who required analgesic treatment adaptation by our pain clinic were included...
February 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28049604/evaluating-tumour-after-care-in-oral-squamous-cell-carcinoma-insights-into-patients-health-related-quality-of-life
#6
Oliver Bissinger, Andrea Rau, Steffen Koerdt, Klaus-Dietrich Wolff, Marco Rainer Kesting, Carolin Götz
INTRODUCTION: Tumour aftercare (tac) is an essential tool in oncology. The main aim of these follow ups is to diagnose recurrence and second tumours from the beginning. Tac appointments can create a special environment for patients' further concerns. The purpose of the current study was to evaluate tac of patients diagnosed with OSCC and to investigate their health related quality of life (hrql). MATERIAL AND METHODS: A German questionnaire was created by two maxillo-facial surgeons with several years of tac experience...
December 9, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27928825/patient-involvement-in-own-rehabilitation-after-early-discharge
#7
Britta Hørdam, Merete Watt Boolsen
BACKGROUND: A European Union Commission report in 2015 concluded that the concept of patient involvement refers specially to the right of patients to have a central position in the healthcare process (EU Commission 2012, http://ec.europa.eu/public_opinion/archives/quali/ql_5937_patient_en.pdf). Recent research suggests that patient involvement after hip replacement is a very effective strategy in older adults with regard to improving walking ability and reducing pain and thereby lessening loss of physical, mental and social aspects of the quality of life...
December 8, 2016: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/27913266/cost-utility-of-video-electroencephalography-monitoring-followed-by-surgery-in-adults-with-drug-resistant-focal-epilepsy-in-thailand
#8
Pimprapa Kitwitee, Kanjana Unnwongse, Teeradej Srikijvilaikul, Tinonkorn Yadee, Chulaporn Limwattananon
OBJECTIVES: This study assessed whether video-electroencephalography (VEEG) monitoring followed by surgery was cost-effective in adult patients with drug-resistant focal epilepsy under Thai health care context, as compared with continued medical treatment without VEEG. METHODS: The total cost (in Thai Baht, THB) and effectiveness (in quality-adjusted life years, QALYs) were estimated over a lifetime horizon, using a decision tree and a Markov model. Data on short-term surgical outcomes, direct health care costs, and utilities were collected from Thai patients in a specialized hospital...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27901247/anabolic-steroids-for-rehabilitation-after-hip-fracture-in-older-people
#9
Vaqas Farooqi, Maayken E L van den Berg, Ian D Cameron, Maria Crotty
BACKGROUND: Hip fracture occurs predominantly in older people, many of whom are frail and undernourished. After hip fracture surgery and rehabilitation, most patients experience a decline in mobility and function. Anabolic steroids, the synthetic derivatives of the male hormone testosterone, have been used in combination with exercise to improve muscle mass and strength in athletes. They may have similar effects in older people who are recovering from hip fracture. OBJECTIVES: To examine the effects (primarily in terms of functional outcome and adverse events) of anabolic steroids after surgical treatment of hip fracture in older people...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27797116/methods-to-decrease-blood-loss-during-liver-resection-a-network-meta-analysis
#10
REVIEW
Elisabetta Moggia, Benjamin Rouse, Constantinos Simillis, Tianjing Li, Jessica Vaughan, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Liver resection is a major surgery with significant mortality and morbidity. Specialists have tested various methods in attempts to limit blood loss, transfusion requirements, and morbidity during elective liver resection. These methods include different approaches (anterior versus conventional approach), use of autologous blood donation, cardiopulmonary interventions such as hypoventilation, low central venous pressure, different methods of parenchymal transection, different methods of management of the raw surface of the liver, different methods of vascular occlusion, and different pharmacological interventions...
October 31, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27731885/transfusion-thresholds-and-other-strategies-for-guiding-allogeneic-red-blood-cell-transfusion
#11
REVIEW
Jeffrey L Carson, Simon J Stanworth, Nareg Roubinian, Dean A Fergusson, Darrell Triulzi, Carolyn Doree, Paul C Hebert
BACKGROUND: There is considerable uncertainty regarding the optimal haemoglobin threshold for the use of red blood cell (RBC) transfusions in anaemic patients. Blood is a scarce resource, and in some countries, transfusions are less safe than others because of a lack of testing for viral pathogens. Therefore, reducing the number and volume of transfusions would benefit patients. OBJECTIVES: The aim of this review was to compare 30-day mortality and other clinical outcomes in participants randomized to restrictive versus liberal red blood cell (RBC) transfusion thresholds (triggers) for all conditions...
October 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27689965/maxillary-distraction-osteogenesis-versus-orthognathic-surgery-for-cleft-lip-and-palate-patients
#12
Dimitrios Kloukos, Piotr Fudalej, Patrick Sequeira-Byron, Christos Katsaros
BACKGROUND: Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia...
September 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27637832/espen-guidelines-on-nutrition-in-cancer-patients
#13
Jann Arends, Patrick Bachmann, Vickie Baracos, Nicole Barthelemy, Hartmut Bertz, Federico Bozzetti, Ken Fearon, Elisabeth Hütterer, Elizabeth Isenring, Stein Kaasa, Zeljko Krznaric, Barry Laird, Maria Larsson, Alessandro Laviano, Stefan Mühlebach, Maurizio Muscaritoli, Line Oldervoll, Paula Ravasco, Tora Solheim, Florian Strasser, Marian de van der Schueren, Jean-Charles Preiser
Cancers are among the leading causes of morbidity and mortality worldwide, and the number of new cases is expected to rise significantly over the next decades. At the same time, all types of cancer treatment, such as surgery, radiation therapy, and pharmacological therapies are improving in sophistication, precision and in the power to target specific characteristics of individual cancers. Thus, while many cancers may still not be cured they may be converted to chronic diseases. All of these treatments, however, are impeded or precluded by the frequent development of malnutrition and metabolic derangements in cancer patients, induced by the tumor or by its treatment...
August 6, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27566706/role-of-imaging-in-transcatheter-aortic-valve-replacement
#14
REVIEW
Corinna Storz, Tobias Geisler, Mike Notohamiprodjo, Konstantin Nikolaou, Fabian Bamberg
Transcatheter aortic valve replacement (TAVR) has emerged as an effective treatment alternative in patients with severe aortic stenosis (AS) who are deemed surgically high-risk or ineligible for surgery. Pre-procedural imaging, in particular computed tomography (CT), plays an integral part in the planning and performance of TAVR and is crucial for a successful treatment. Novel technological advances in CT include high-pitch, low kV acquisitions, and iterative reconstruction resulting in high image quality at substantially reduced scan duration, contrast volume, and radiation exposure...
October 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27551554/surgeon-has-a-major-impact-on-long-term-recurrence-risk-in-patients-with-non-muscle-invasive-bladder-cancer
#15
Alexander Rolevich, Alexander Minich, Tatiana Nabebina, Sergey Polyakov, Sergey Krasny, Oleg Sukonko
INTRODUCTION: One of the factors responsible for the risk of recurrence after complete transurethral resection of the bladder tumor (TURBT) in patients with non-muscle invasive bladder cancer (NMIBC) is the quality of surgery that may vary between individual surgeons. The aim of the study was to evaluate the impact of the surgeon on recurrence-free survival in patients with NMIBC. MATERIAL AND METHODS: The long-term results of a series of consecutive TURBTs performed by five staff urologists at a single institution were retrospectively analyzed...
2016: Central European Journal of Urology
https://www.readbyqxmd.com/read/27495053/the-interplay-between-hospital-and-surgeon-factors-and-the-use-of-sentinel-lymph-node-biopsy-for-breast-cancer
#16
Tina W F Yen, Jianing Li, Rodney A Sparapani, Purushuttom W Laud, Ann B Nattinger
BACKGROUND: Several surgeon characteristics are associated with the use of sentinel lymph node biopsy (SLNB) for breast cancer. No studies have systematically examined the relative contribution of both surgeon and hospital factors on receipt of SLNB. OBJECTIVE: To evaluate the relationship between surgeon and hospital characteristics, including a novel claims-based classification of hospital commitment to cancer care (HC), and receipt of SLNB for breast cancer, a marker of quality care...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27422391/gender-differences-in-pediatric-orthopaedics-what-are-the-implications-for-the-future-workforce
#17
COMPARATIVE STUDY
Marielle A Amoli, John M Flynn, Eric W Edmonds, Michael P Glotzbecker, Derek M Kelly, Jeffrey R Sawyer
BACKGROUND: Although the number of women in surgical specialties has increased dramatically over the past two decades, little research exists regarding how a surgeon's gender impacts job selection and practice models. Because the number of women specializing in pediatric orthopaedics continues to increase, it is important to understand how one's gender affects practice choices and how this may affect the future workforce. QUESTIONS/PURPOSES: (1) Among pediatric orthopaedic surgeons, is gender associated with choice of practice type (academic, private practice, hospital-based, solo)? (2) For men and women, what are the most common reasons for choosing a job? (3) For new graduates, do men and women have equal starting salaries? (4) Do men have a higher chance of getting job offers? (5) Is there a difference in workload (call frequency and surgical case volume) for men and women? (6) Finally, is there a difference in imminent retirement plans for men and women? METHODS: The 2015 Pediatric Orthopaedic Society of North American (POSNA) Needs Assessment Survey was sent to POSNA members and a special 36-question survey was sent to recent pediatric orthopaedic fellowship graduates...
September 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27411316/rationale-design-and-protocol-of-a-longitudinal-study-assessing-the-effect-of-total-knee-arthroplasty-on-habitual-physical-activity-and-sedentary-behavior-in-adults-with-osteoarthritis
#18
Rebecca M Meiring, Emmanuel Frimpong, Lipalo Mokete, Jurek Pietrzak, Dick Van Der Jagt, Mohammed Tikly, Joanne A McVeigh
BACKGROUND: Physical activity levels are decreased and sedentary behaviour levels are increased in patients with knee osteoarthritis (OA). However, previous studies have shown that following total knee arthroplasty (TKA), objectively measured physical activity levels do not change compared to before the surgery. Very few studies have objectively assessed sedentary behaviour following TKA. This study aims to assess patterns of objective habitual physical activity and sedentary behaviour in patients with knee OA and to determine whether these change following TKA...
July 13, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27363329/increased-pediatric-sub-specialization-is-associated-with-decreased-surgical-complication-rates-for-inpatient-pediatric-urology-procedures
#19
R Tejwani, H-H S Wang, B J Young, N H Greene, S Wolf, J S Wiener, J C Routh
INTRODUCTION: Increased case volumes and training are associated with better surgical outcomes. However, the impact of pediatric urology sub-specialization on perioperative complication rates is unknown. OBJECTIVES: To determine the presence and magnitude of difference in rates of common postoperative complications for elective pediatric urology procedures between specialization levels of urologic surgeons. The Nationwide Inpatient Sample (NIS), a nationally representative administrative database, was used...
December 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27339104/implementation-of-a-respiratory-rehabilitation-protocol-weaning-from-the-ventilator-and-tracheostomy-in-difficult-to-wean-patients-with-spinal-cord-injury
#20
Ibrahim Gundogdu, Erhan Arif Ozturk, Ebru Umay, Ozgur Zeliha Karaahmet, Ece Unlu, Aytul Cakci
PURPOSE: Following repeated weaning failures in acute care services, spinal cord injury (SCI) patients who require prolonged mechanical ventilation and tracheostomy are discharged to their homes or skilled nursing facilities, with a portable mechanical ventilator (MV) and/or tracheostomy tube (TT) with excess risk of complications, high cost and low quality of life. We hypothesized that many difficult-to-wean patients with cervical SCI can be successfully managed in a rehabilitation clinic...
June 23, 2016: Disability and Rehabilitation
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