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https://www.readbyqxmd.com/read/28525490/surgeon-procedure-volume-and-complication-rates-in-anterior-cervical-discectomy-and-fusions-analysis-of-a-national-longitudinal-database
#1
Tyler Cole, Anand Veeravagu, Michael Zhang, John K Ratliff
STUDY DESIGN: Retrospective study using the MarketScan longitudinal database (2006-2010). OBJECTIVE: Compare complication rates between groups of patients undergoing anterior cervical discectomy and fusion (ACDF) procedures performed by surgeons with high versus low mean annual ACDF volume. SUMMARY OF BACKGROUND DATA: Over the past decade the volume of ACDFs performed has increased, concurrent with greater appreciation of potential for associated complications...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28524763/emergency-department-visits-for-postpartum-hypertension
#2
E Christine Brousseau, Valery Danilack, Fei Cai, Kristen Matteson
OBJECTIVE: To describe the characteristics of women diagnosed with postpartum hypertension in an emergency department (ED) to better inform postpartum care. METHODS: Women with an ED diagnosis of hypertension were compared to women with all other ED diagnoses. RESULTS: Among 252 postpartum women who presented for ED care, 52 were given a diagnosis of hypertension. Women with hypertension had some recognizable risk factors and presented on average within one week of delivery...
May 19, 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28523732/long-term-respiratory-outcomes-after-primary-total-correction-for-tetralogy-of-fallot-and-absent-pulmonary-valve-in-patient-with-respiratory-symptoms
#3
Takaya Hoashi, Toru Iwasa, Koji Kagisaki, Masatoshi Shimada, Kenichi Kurosaki, Isao Shiraishi, Hajime Ichikawa
OBJECTIVE: To review long-term respiratory outcomes for tetralogy of Fallot and absent pulmonary valve (TOF/APV) in respiratory symptomatic populations. METHODS: Of 25 consecutive patients undergoing primary total correction for TOF/APV between 1987 and 2016, Sixteen patients (64%) with a preoperative respiratory disturbance were enrolled. The median age at operation was 1.9 months old, including 4 neonates and 12 infants. Ten patients (62.5%) preoperatively necessitated mechanical ventilator support...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28523370/use-of-tolvaptan-vs-furosemide-in-older-patients-with-heart-failure-meta-analysis-of-randomized-controlled-trials
#4
W-L Huang, Y Yang, J Yang, J Yang, H-B Wang, X-L Xiong, Y-F Zhang
BACKGROUND: It is not known whether older patients with acute heart failure (HF) receiving tolvaptan have decreased mortality rates and a better long-term prognosis than patients who receive furosemide. We conducted a systematic review of randomized controlled trials (RCTs) to address this issue. METHODS: The Medline, Embase, and Cochrane Library databases were searched for English-language RCTs published before September 2016 comparing tolvaptan with furosemide treatment in older patients (>65 years old) after acute HF...
May 18, 2017: Herz
https://www.readbyqxmd.com/read/28522915/ninety-day-readmissions-after-inpatient-cholecystectomy-a-5-year-analysis
#5
Alba Manuel-Vázquez, Raquel Latorre-Fragua, Carmen Ramiro-Pérez, Aylhin López-Marcano, Farah Al-Shwely, Roberto De la Plaza-Llamas, José Manuel Ramia
AIM: To determine the incidence of readmission after cholecystectomy using 90 d as a time limit. METHODS: We retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomy-related complications...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28522604/hospital-level-variation-in-practice-patterns-and-patient-outcomes-for-pediatric-patients-hospitalized-with-functional-constipation
#6
Jamie Librizzi, Samuel Flores, Keith Morse, Kelly Kelleher, Jodi Carter, Ryan Bode
BACKGROUND AND OBJECTIVE: Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children's hospitals. METHODS: We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System...
May 18, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28522108/hospital-readmission-after-ovarian-cancer-surgery-are-we-measuring-surgical-quality
#7
Emma L Barber, Kemi M Doll, Paola A Gehrig
OBJECTIVES: Readmission after surgery is a quality metric hypothesized to reflect the quality of care in the index hospitalization. We examined the link between readmissions and a surrogate of surgical quality - major postoperative complication - among ovarian cancer patients. METHODS: Patients who underwent surgery for ovarian cancer between 2012 and 2013 were identified from the National Surgical Quality Improvement Project (NSQIP). Major complications were defined as grade 3 or ≥complications on the validated Claviden-Dindo scale and included both NSQIP and non-NSQIP defined complications based on readmission ICD-9 code...
May 15, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28521010/prospective-audit-of-a-pathway-for-in-patient-pain-management-of-chronic-abdominal-pain-a-novel-and-cost-effective-strategy
#8
Gopinath Niraj, Sanjay Chaudhri
Background.:  Unexplained abdominal pain is a common cause of hospital admission and utilizes significant resource. Current in-patient pain management of acute exacerbation of chronic abdominal pain is primarily directed at pharmacological and psychological management strategies in this group of complex patients. We adopted a novel approach that proved to be both clinically effective and cost-effective. Design.:  Adult patients admitted to a surgical ward with acute exacerbation of chronic abdominal pain referred to in-patient pain management were prospectively audited over a two-year period at a single tertiary centre...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28516505/associations-between-nursing-home-performance-and-hospital-30-day-readmissions-for-acute-myocardial-infarction-heart-failure-and-pneumonia-at-the-healthcare-community-level-in-the-united-states
#9
Michelle M Pandolfi, Yun Wang, Ann Spenard, Florence Johnson, Alice Bonner, Shih-Yieh Ho, Timothy Elwell, Anila Bakullari, Deron Galusha, Erica Leifheit-Limson, Judith H Lichtman, Harlan M Krumholz
OBJECTIVES: To evaluate community-specific nursing home performance with community-specific hospital 30-day readmissions for Medicare patients discharged with acute myocardial infarction, heart failure or pneumonia. DESIGN: Cross-sectional study using 2009-2012 hospital risk-standardised 30-day readmission data for Medicare fee-for-service patients hospitalised for all three conditions and nursing home performance data from the Centers for Medicare & Medicaid Services Five-Star Quality Rating System...
May 17, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28516154/wbc-associates-with-readmission-following-cystectomy
#10
Andrew G McIntosh, Tianyu Li, Timothy Ito, Jason Mannion, Mark Dziemianowicz, Nikhil Waingankar, Mohammed Haseebuddin, David Y T Chen, Richard E Greenberg, Rosalia Viterbo, Alexander Kutikov, Robert G Uzzo, Marc C Smaldone, Philip H Abbosh
Background: Radical cystectomy is associated with perioperative complication rates exceeding 50% in some series. Readmission rates are increasingly used as a surgical quality metric. White blood cell count is a crude surrogate for physiologic processes which may reflect postoperative complications leading to readmission. Objective: We assessed the association between final white blood cell count at discharge and risk of readmission following radical cystectomy. Methods: Records on 477 patients undergoing radical cystectomy from 2006-2013 were reviewed...
April 27, 2017: Bladder Cancer
https://www.readbyqxmd.com/read/28516129/enhanced-recovery-after-colorectal-surgery-eras-in-elderly-patients-is-feasible-and-achieves-similar-results-as-in-younger-patients
#11
Håvard Mjørud Forsmo, Christian Erichsen, Anne Rasdal, Hartwig Körner, Frank Pfeffer
Aim: Enhanced recovery after surgery (ERAS) is a multimodal approach that aims to optimize perioperative treatment. Whether elderly patients receiving colorectal surgery can adhere to and benefit from an ERAS approach is uncertain. The aim of this study was to compare patients in different age groups participating in an ERAS program. Method: In this substudy of a randomized controlled trial, we analyzed the interventional ERAS arm of adult patients eligible for laparoscopic or open colorectal resection with regard to the importance of age...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28515940/nivolumab-induced-autoimmune-diabetes-mellitus-presenting-as-diabetic-ketoacidosis-in-a-patient-with-metastatic-lung-cancer
#12
James Luke Godwin, Shuchie Jaggi, Imali Sirisena, Pankaj Sharda, Ajay D Rao, Ranee Mehra, Colleen Veloski
BACKGROUND: Advances in cancer immunotherapy have generated encouraging results in multiple malignancies refractory to standard chemotherapies. As the use of immune checkpoint inhibitors (ICI) proliferates, the incidence of autoimmune side effects associated with these agents, termed immune related adverse events (irAE), is expected to increase. The frequency of significant irAE in ICI treated patients is about 10-20% and early recognition is critical to prevent serious morbidity and even mortality...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28512772/subspecialty-approach-for-the-management-of-acute-cholecystitis-an-alternative-to-acute-surgical-unit-model-of-care
#13
Sonia Tran, Vincent Choi, Kirsten Hepburn, Nathan Hewitt, Joel Zhou, Daniel L Chan, Michael L Talbot
BACKGROUND: Acute cholecystitis is a common condition. Recent studies have shown an association between creation of an acute surgical unit (ASU) and improved outcomes. This study aimed to evaluate the outcomes of a subspecialty based approach to the management of acute cholecystitis as an alternative to the traditional 'generalist' general surgery approach or the ASU model. METHOD: A 6-year retrospective analysis of outcomes in patients admitted under a dedicated upper gastrointestinal service for acute cholecystitis undergoing emergency laparoscopic cholecystectomy...
May 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28512089/physician-age-and-outcomes-in-elderly-patients-in-hospital-in-the-us-observational-study
#14
Yusuke Tsugawa, Joseph P Newhouse, Alan M Zaslavsky, Daniel M Blumenthal, Anupam B Jena
Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians.Design Observational study.Setting US acute care hospitals.Participants 20% random sample of Medicare fee-for-service beneficiaries aged ≥65 admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians to whom they were assigned based on scheduled work shifts. To assess the generalizability of findings, analyses also included patients treated by general internists including both hospitalists and non-hospitalists...
May 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28511702/what-is-the-evidence-for-the-management-of-patients-along-the-pathway-from-the-emergency-department-to-acute-admission-to-reduce-unplanned-attendance-and-admission-an-evidence-synthesis
#15
Sarah H Credé, Colin O'Keeffe, Suzanne Mason, Anthea Sutton, Emma Howe, Susan J Croft, Mike Whiteside
BACKGROUND: Globally, the rate of emergency hospital admissions is increasing. However, little evidence exists to inform the development of interventions to reduce unplanned Emergency Department (ED) attendances and hospital admissions. The objective of this evidence synthesis was to review the evidence for interventions, conducted during the patient's journey through the ED or acute care setting, to manage people with an exacerbation of a medical condition to reduce unplanned emergency hospital attendance and admissions...
May 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28508012/rehabilitation-of-discharged-patients-with-chronic-obstructive-pulmonary-disease-are-new-strategies-needed
#16
Lars Morsø, Morten Sall Jensen, Christian von Plessen, Peter Qvist
BACKGROUND: Rehabilitation after hospital stay implies several benefits for patients with chronic obstructive pulmonary disease (COPD); still few patients are referred and participate in rehabilitation programs. We conducted a case study to investigate the effects of interventions targeting the referral, uptake, and completion for a program of early rehabilitation in the primary health-care sector. METHODS: We undertook targeted initiatives to make patients participate in an individualized rehabilitation program with gradual increased intensity...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/28507993/enhanced-recovery-after-emergency-surgery-a-systematic-review
#17
REVIEW
Mihai Paduraru, Luca Ponchietti, Isidro Martinez Casas, Peter Svenningsen, Mauro Zago
OBJECTIVE: To evaluate the current scientific evidence for the applicability, safety and effectiveness of pathways of enhanced recovery after emergency surgery (ERAS). METHODS: We undertook a search using PubMed and Cochrane databases for ERAS protocols in emergency cases. The search generated 65 titles; after eliminating the papers not meeting search criteria, we selected 4 cohort studies and 1 randomized clinical trial (RCT). Data extracted for analysis consisted of: patient age, type of surgery performed, ERAS elements implemented, surgical outcomes in terms of postoperative complications, mortality, length of stay (LOS) and readmission rate...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28507565/laparoscopic-and-open-liver-resection-a-literature-review-with-meta-analysis
#18
REVIEW
Andrzej L Komorowski, Jerzy W Mituś, Wojciech M Wysocki, Małgorzata M Bała
INTRODUCTION: In recent years laparoscopic approach to liver resections has gained important attention from surgeons worldwide. The aim of this review was to compare the results of laparoscopic and open liver resections. MATERIAL AND METHODS: We have performed a search in Medline, Embase and the Cochrane Library databases. Studies comparing laparoscopic and open liver resections were included. RESULTS: No randomized clinical trial were identified...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28506980/sex-differences-in-trajectories-of-risk-after-rehospitalization-for-heart-failure-acute-myocardial-infarction-or-pneumonia
#19
Rachel P Dreyer, Kumar Dharmarajan, Angela F Hsieh, John Welsh, Li Qin, Harlan M Krumholz
BACKGROUND: Women have an increased risk of rehospitalization in the immediate postdischarge period; however, few studies have determined how readmission risk dynamically changes on a day-to-day basis over the full year after hospitalization by sex and how these differences compare with the risk for mortality. METHODS AND RESULTS: We identified >3 000 000 hospitalizations of patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia and estimated sex differences in the daily risk of rehospitalization/death 1 year after discharge from a population of Medicare fee-for-service beneficiaries aged 65 years and older...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28506976/implementation-of-postdischarge-follow-up-telephone-calls-at-a-comprehensive-cancer-center
#20
Shrina D Patel, Phuoc Anh Anne Nguyen, Melissa Bachler, Bradley Atkinson
PURPOSE: The development and implementation of a pharmacy-driven, postdischarge follow-up telephone call program to assess medication adherence, provide education, and address medication-related concerns are discussed. SUMMARY: Many readmissions are avoidable through effective discharge planning and patient follow-up after hospitalization. However, there is limited information on how to effectuate this process. To address this barrier, a team consisting of a clinical pharmacy specialist, a clinical pharmacy manager, a postgraduate year 1 pharmacy resident, and an education specialist at The University of Texas MD Anderson Cancer Center collaborated to create a postdischarge telephone call program within a transitions-of-care (TOC) pilot program...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
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