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S Renshaw, I L Silva, A Hotouras, S D Wexner, J Murphy, C Bhan
The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulcerative Colitis"). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis...
March 15, 2018: Techniques in Coloproctology
Işıl Kasapoğlu, Pınar Türk, Aylin Dayan, Gürkan Uncu
OBJECTIVE: The aim of the study was to compare patients with endometriosis to those without endometriosis regarding performance rates, difficulties and complications associated with transvaginal oocyte retrieval (TVOR) procedures. MATERIAL AND METHODS: A prospective cohort study was conducted at the IVF Unit of the Division of Reproductive Endocrinology and Infertility Department of an University Hospital. Fifty-eight patients with endometriosis and 61 patients without endometriosis underwent a TVOR procedure consecutively...
March 16, 2018: Journal of the Turkish German Gynecological Association
John A Brockman, Joel Vetter, Vicky Peck, Seth A Strope
OBJECTIVES: To determine whether an enhance recovery protocol for radical cystectomy patient affected the length of stay or the number and type of readmissions that occurred after hospital discharge. METHODS: We prospectively assessed 152 cystectomy patients after initiation of the pathway. These patients were compared to the previous 147 patient operated on prior to the pathway initiation. Eligible patients were those undergoing radical cystectomy with any diversion at our institution...
March 12, 2018: Urology
Giorgio Gandaglia, Carlo Andrea Bravi, Paolo Dell'Oglio, Elio Mazzone, Nicola Fossati, Simone Scuderi, Daniele Robesti, Francesco Barletta, Luca Grillo, Steven Maclennan, James N'Dow, Francesco Montorsi, Alberto Briganti
The rate of postoperative complications might vary according to the method used to collect perioperative data. We aimed at assessing the impact of the prospective implementation of the European Association of Urology (EAU) guidelines on reporting and grading of complications in prostate cancer patients undergoing robot-assisted radical prostatectomy (RARP). From September 2016, an integrated method for reporting surgical morbidity based on the EAU guidelines was implemented at a single, tertiary center. Perioperative data were prospectively and systematically collected during a patient interview at 30 d after surgery as recommended by the EAU Guidelines Panel Recommendations on Reporting and Grading Complications...
March 12, 2018: European Urology
S-M Lee, K Gordon, R McMillan, F Crystal, P Acher
Introduction Transurethral resection of the prostate has remained the most common operation for bladder outlet obstruction in the UK, but it is associated with potential morbidity and median two-day length of hospital stay. Holmium laser enucleation of the prostate (HoLEP) provides an alternative procedure. Provision of day-case HoLEP would improve patient care through increased efficiency. We assessed the feasibility and safety of day-case HoLEP and examined predictive factors for increased length of hospital stay...
March 15, 2018: Annals of the Royal College of Surgeons of England
Msj Wilson, P Maniam, A Ibrahim, N Makaram, S R Knight, P Patil
Introduction The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis. Materials and methods Operative records were retrospectively analysed to identify patients undergoing laparoscopic appendicectomy between January 2014 and June 2015...
March 15, 2018: Annals of the Royal College of Surgeons of England
L G J Leijssen, A M Dinaux, H Kunitake, L G Bordeianou, D L Berger
PURPOSE: Proximal and distal colon cancers differ in terms of epidemiology, clinical presentation, and pathologic features. The aim of our study was to evaluate the impact of right-sided (RC), transverse (TC), and left-sided (LC) colon cancer on morbidity rates and oncological outcomes. METHODS: A retrospective analysis of patients with resected colon cancer between 2004 and 2014 was conducted. Cox proportional hazard models were used to assess predictors of overall (OS), and disease-specific survival (DSS), as well as disease-free survival (DFS)...
March 14, 2018: International Journal of Colorectal Disease
Dale N Gerding, Ciaran P Kelly, Galia Rahav, Christine Lee, Erik R Dubberke, Princy N Kumar, Bruce Yacyshyn, Dina Kao, Karen Eves, Misoo C Ellison, Mary E Hanson, Dalya Guris, Mary Beth Dorr
Background: Bezlotoxumab is a human monoclonal antibody against C. difficile toxin B indicated to prevent CDI recurrence (rCDI) in adults at high risk for rCDI. This post-hoc analysis of pooled MODIFY I/II data assessed bezlotoxumab efficacy in participants with characteristics associated with increased risk for rCDI. Methods: The analysis population was the modified Intent-to-Treat population who received bezlotoxumab or placebo (n=1554) by risk factors for rCDI that were prespecified in the statistical analysis plan: age ≥65 years, history of CDI, compromised immunity, severe CDI, and ribotype 027/078/244...
March 10, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Arjun K Venkatesh, Changqin Wang, Yongfei Wang, Faseeha Altaf, Susannah M Bernheim, Leora Horwitz
BACKGROUND: Hospital readmission rates are publicly reported by the Centers for Medicare & Medicaid Services (CMS); however, the implications of emergency department (ED) visits following hospital discharge on readmissions are uncertain. We describe the frequency, diagnoses, and hospital-level variation in ED visitation following hospital discharge, including the relationship between risk-standardized ED visitation and readmission rates. METHODS: This is a cross-sectional analysis of Medicare beneficiaries hospitalized for acute myocardial infarction (AMI), heart failure, and pneumonia between July 2011 and June 2012...
March 15, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
David M Tehrani, Daniel Rodgers, Sirtaz Adatya, Nitasha Sarswat, Jayant Raikhelkar, Gene H Kim, Gabriel Sayer, Nir Uriel
We aim to evaluate the echocardiographic/hemodynamic effects of left ventricular assist devices in African American (AA) versus non-AA patients undergoing ramp speed optimization and its subsequent effect on readmissions. In 65 patients (26 AA), no differences in baseline echocardiographic/hemodynamic parameters were noted. During ramp testing, there was a significantly greater increase in cardiac output (slope: 0.29 ± 0.24 vs. 0.15 ± 0.12, p < 0.01) with more rapid decrease in left ventricular end-diastolic diameter (slope: -0...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Wei Gong, Aobo Li, Hui Ai, Han Shi, Xiao Wang, Shaoping Nie
Background Early discharge after successful primary angioplasty is common, but the evidence supporting the practice is still lacking. We therefore performed a meta-analysis assessing the safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction (STEMI). Methods Randomised controlled trials were identified and extracted from PubMed, Embase, Cochrane Library databases and reference lists of relevant papers. Heterogeneity was analysed using the I2 test...
January 1, 2018: European Journal of Preventive Cardiology
Balázs Bánky, Miklós Lakatos, Krisztina Varga, Edit Hansági, Éva Horváth, Géza Járay
INTRODUCTION: Enhanced recovery after surgery (ERAS) programme has been described and practiced for twenty years in the perioperative management of colorectal patients. ERAS is a complex, evidence based strategy which proved to be extremely effective when linked to laparoscopy in reducing morbidity, length of hospital stay, as well as reducing cost of colorectal service. AIMS: We gradually adapted elements of ERAS protocol along with laparoscopy in the colorectal surgical treatment at a county hospital from 2013...
March 2018: Magyar Sebészet
Ashequl M Islam, Gaurav Alreja, Jaya Mallidi, Mohammed Ziaul Hoque, Jennifer Friderici
OBJECTIVE: To assess feasibility, safety, and patient satisfaction of same-day discharge (SD) following peripheral arterial interventions. BACKGROUND: Although diagnostic angiography is routinely performed as a same-day procedure, same-day percutaneous trans-luminal angioplasty is less common. Because there is very low incidence of peri-procedural complications after 4 hr, discharge after this window is possible provided the patient is able to ambulate and has necessary social support...
March 14, 2018: Catheterization and Cardiovascular Interventions
Dennis T Ko, Harlan M Krumholz, Jack V Tu, Peter C Austin, Therese A Stukel, Maria Koh, Alice Chong, Jose Francisco de Melo, Cynthia A Jackevicius
BACKGROUND: Clopidogrel is one of the most commonly prescribed medications because of its ability to improve clinical outcomes for a broad range of cardiovascular conditions. After patent protection expired for Plavix in 2012, many healthcare systems adopted generic clopidogrel as a strategy to reduce healthcare costs. METHODS AND RESULTS: We conducted a population-based observational study to determine whether generic clopidogrel was noninferior to Plavix. Patients who were hospitalized with an acute coronary syndrome (ACS) from 2009 to 2014 in Ontario, Canada, >65 years, survived ≥7 days after discharge, were eligible for inclusion...
March 2018: Circulation. Cardiovascular Quality and Outcomes
Ronald E Delanois, Chukwuweike U Gwam, Jeffrey J Cherian, Jennifer I Etcheson, Nicole E George, Kathleen A Schneider, Michael A Mont
BACKGROUND: The state of Maryland was granted a waiver by the Center for Medicare and Medicaid Services to implement a Global Budget Revenue (GBR) reimbursement model. This study aims to compare (1) costs of inpatient hospital stays; (2) postacute care costs; (3) lengths of stay (LOS); and (4) discharge disposition who underwent primary total hip arthroplasty at a single Maryland-based orthopedic institution before and after the implementation of GBR. METHODS: The Maryland Center for Medicare and Medicaid Services database was queried to obtain all Medicare patients who underwent total hip arthroplasty at a single institution before and after the implementation of GBR...
February 15, 2018: Journal of Arthroplasty
J Liu, Y Li, Y Cai, Z C Jin
Objective: To investigate the predictive value of elevated serum S100B level in patients with multiple traumas combined delirium for the clinical prognosis prior to intensive care unit (ICU) discharge. Methods: One hundred seventy-nine patients with multiple traumas diagnosed as delirium after admission over 48 hours to the Department of Critical Care Medicine, People's Hospital Affiliated to Jiangsu University from January 2013 to December 2016 were divided into two groups according to the level of serum S100B measured prior to the ICU discharge: high S100B group (≥0...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Zachary Hodosevich, Krista K Wheeler, Junxin Shi, Rebecca Coffey, J Kevin Bailey, Larry M Jones, Rajan K Thakkar, Renata B Fabia, Jonathan I Groner, Henry Xiang
Introduction: This study characterizes adult burn readmissions in the United States using a nationally representative hospital inpatient sample. Readmission rates, diagnoses, and risk factors are discussed. Methods: We analyzed the 2013 and 2014 Nationwide Readmission Database (NRD) for adult burn patients. The data were weighted to estimate national 30-day readmission rates. Principal readmission diagnoses were sorted into burn-specific or other readmission categories...
March 9, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Raza M Alvi, Noor Tariq, Atul Malhotra, Magid Awadalla, Virginia Triant, Markella V Zanni, Tomas G Neilan
Background: Sleep apnea (SA) is common and has prognostic significance among broad groups of patients with heart failure (HF). Among persons living with HIV (PLHIV), both SA and HF are reported. However, there are no data characterizing the presence, associations and prognostic significance of SA among PLHIV with HF. Methods: We conducted a single center study of PLHIV admitted with HFrEF (LVEF of <50%) and analyzed the relationship of SA with 30-day HF hospital readmission rate, cardiovascular (CV) and all-cause mortality...
March 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Jason R Falvey, Robert E Burke, Kyle J Ridgeway, Daniel J Malone, Jeri E Forster, Jennifer E Stevens-Lapsley
BACKGROUND AND PURPOSE: Recent evidence has suggested physical therapist involvement in care transitions after hospitalization is associated with reduced rates of hospital readmissions. However, little is known about how physical therapists participate in care transitions for older adults, the content of care communications, and the facilitators and barriers of implementing evidence-based care transition strategies into practice. Thus, the purpose of this article is to evaluate participation in care transition activities known to influence readmission risk among older adults, and understand perceptions of and barriers to participation in these activities...
March 12, 2018: Journal of Geriatric Physical Therapy
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