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https://www.readbyqxmd.com/read/28107594/weighing-the-evidence-from-surgical-trials
#1
Quoc-Dien Trinh, Alexander P Cole, Prokar Dasgupta
With growing calls to improve value in health care, the assessment of surgical outcomes has moved to the spotlight. Public awareness of medical errors has spurred initiatives like the ProPublica "Surgeon Scorecard" to measure and report complications (h t t p s : //projects. propublica. org/surgeons/). High-tech and expensive innovations such as robot-assisted surgery must be measured against traditional approaches. This article is protected by copyright. All rights reserved.
January 20, 2017: BJU International
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#2
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107239/management-of-pharyngeal-fistulas-after-anterior-cervical-spine-surgery-a-treatment-algorithm-for-severe-complications
#3
Christian Simon, Carl H Fürstenberg, Markus Eichler, Stefan Rohde, Cem Bulut, Bernd Wiedenhöfer
STUDY DESIGN: This study is a retrospective database query to identify all anterior spinal approaches. OBJECTIVES: The objectives were to assess all patients with pharyngocutaneous fistulas (PCFs) after anterior cervical spine surgery. SUMMARY OF BACKGROUND DATA: Patients with the diagnosis of PCFs were treated at the University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28106717/air-embolism-diagnosis-clinical-management-and-outcomes
#4
Colin J McCarthy, Sasan Behravesh, Sailendra G Naidu, Rahmi Oklu
Air embolism is a rare but potentially fatal complication of surgical procedures. Rapid recognition and intervention is critical for reducing morbidity and mortality. We retrospectively characterized our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical records were searched for all cases of air embolism over a 25-year period; relevant medical and imaging records were reviewed. Sixty-seven air embolism cases were identified; the mean age was 59 years (range, 3-89 years)...
January 17, 2017: Diagnostics
https://www.readbyqxmd.com/read/28106675/treatment-of-slipped-capital-femoral-epiphysis-with-the-modified-dunn-procedure-a-multicenter-study
#5
Masquijo J Javier, Allende Victoria, D'Elia Martín, Miranda Gabriela, Fernández Claudio A
INTRODUCTION: Treatment of moderate to severe slipped capital femoral epiphysis (SCFE) is controversial. Over the last years, 3 institutions in Argentina adopted the modified Dunn procedure for capital realignment in selected cases of SCFE. Our aim in this study was to evaluate the clinical outcome and the rate of complications of patients who had undergone surgical hip dislocation and capital realignment. METHODS: A multicenter retrospective cohort study of patients who received the modified Dunn procedure from January 2009 to 2013 was performed...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28106647/estimation-of-uterine-size-how-accurate-are-we
#6
Tanya P Hoke, Babak Vakili
OBJECTIVE: To evaluate the accuracy of gynecologic surgeons at estimating uterine dimensions and weight. METHODS: Six model uteri of various sizes were created to simulate the size and consistency of a uterus and displayed at 3 stations. The visual station (VS) comprised 2 specimens placed on an unmarked table. The laparoscopic station (LS) consisted of 2 model uteri, each placed in a separate simulated abdomen with a 0 degree laparoscope and 2 operative trocars with standard instruments...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106291/ocular-effects-of-sulfur-mustard-and-therapeutic-approaches-a-review
#7
Yunes Panahi, Seyyed Mahdi Rajaee, Amirhossein Sahebkar
Sulfur mustard (SM) is a strong blistering, highly reactive, lipophilic chemical war agent that causes injury in different organs including the skin, eyes and respiratory tract. The Eyes are especially susceptible to the consequences of SM poisoning because of the aqueous and mucosal nature of conjunctiva and cornea. DNA alkylation and depletion of glutathione, are the most important mechanisms of SM action in the eye injuries. Acute clinical symptoms are including decrease in visual acuity, dryness, photophobia, blepharospasm, conjunctivitis and complaints of foreign body sensation and soreness that gradually progress to severe ocular pain...
January 20, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28105882/quality-improvement-in-hospitals-barriers-and-facilitators
#8
Dick E Zoutman, B Douglas Ford
Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives. Findings The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28105622/-association-of-peripheral-nerve-invasion-with-clinicopathological-factors-and-prognosis-of-colorectal-cancer
#9
Dong Han, Ying Wei, Xidi Wang, Geng Wang, Yinggang Chen
OBJECTIVE: To investigate the association of peripheral nerve invasion (PNI) with clinicopathological factors and prognosis of colorectal cancer. METHODS: Clinicopathological data and Surgical specimens of 372 colorectal cancer patients who underwent radical resection from January 2011 to June 2012 in The Second Affiliated Hospital of Harbin Medical University were collected. Histopathological evaluation of tissue samples was conducted with hematoxylin and eosin-stained sections...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28105620/-effect-of-a-clinical-pathway-in-patients-with-crohn-s-disease-complicated-with-intestinal-obstruction
#10
Zhen Guo, Lei Cao, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction. METHODS: CD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28105614/-effect-of-surgeons-on-palliative-treatment-for-malignant-tumors
#11
Jin Gu
For advanced stage tumor patients who can not receive radical treatment, quite a part of them require surgical intervention. Surgeons play a important role and are still the main force in palliative treatment for tumors. But in present medical education system, training contents for surgeon involving palliative treatment are few. In fact, surgeons have responsibilities for improving the quality of life, ameliorating pain, preserving the dignity and relieving symptoms of patients in the palliative treatment of tumors...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28105590/case-report-on-managing-incomplete-bone-formation-after-bilateral-sinus-augmentation-using-a-palatal-approach-and-a-dilating-balloon-technique
#12
Tobias K Boehm
BACKGROUND: Patients with resorbed edentulous alveolar ridges in the posterior maxilla often require lateral window sinus augmentation procedures prior to implant placement. Lateral window sinus augmentation procedures can produce incomplete bone augmentation as consequence of surgical and healing complications producing unusual and complex sinus anatomy. Although incomplete bone formation after sinus augmentation has been described in a previous case reports, this is the first case report that describes grafting these compromised sites prior to implant placement...
December 2017: International Journal of Implant Dentistry
https://www.readbyqxmd.com/read/28105531/-big-eye-surgery-the-ethics-of-medicalizing-asian-features
#13
Yves Saint James Aquino
The popularity of surgical modifications of race-typical features among Asian women has generated debates on the ethical implications of the practice. Focusing on blepharoplasty as a representative racial surgery, this article frames the ethical discussion by viewing Asian cosmetic surgery as an example of medicalization, which can be interpreted in two forms: treatment versus enhancement. In the treatment form, medicalization occurs by considering cosmetic surgery as remedy for pathologized Asian features; the pathologization usually occurs in reference to western features as the norm...
January 19, 2017: Theoretical Medicine and Bioethics
https://www.readbyqxmd.com/read/28105502/transfracture-medial-transposition-of-the-radial-nerve-associated-with-plate-fixation-of-the-humerus
#14
Ali Hassan Chamseddine, Amer Abdallah, Hadi Zein, Assad Taha
PURPOSE: The aim of this study was to illustrate safety, feasibility and advantages of transfracture medial transposition of the radial nerve during the lateral approach and lateral plating of humeral fractures located in the mid and distal shaft. METHODS: This was a retrospective review and analysis of medical records and radiographs of 19 patients who underwent a transfracture medial transposition of the radial nerve. Fifteen patients were treated for fresh fracture and four for nonunion...
January 19, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28105497/comparison-of-traditional-and-emerging-surgical-therapies-for-lower-urinary-tract-symptoms-in-men-a-review
#15
Christopher Smith, Paul Craig, Shayandokht Taleb, Shamar Young, Jafar Golzarian
Lower urinary tract symptoms (LUTS) are one of the most common health issues in men and pose a significant economic challenge in healthcare. Transurethral resection of the prostate (TURP) remains the gold standard surgical treatment for medically refractive LUTS secondary to benign prostatic hyperplasia. The institution of medical therapy and the development of several minimally invasive surgical therapies (MISTs) began in the 1980's and 1990's. Together, these therapies brought about a change in the natural course of the disease, stimulating investigation into the economic consequences of various management approaches...
January 19, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28105299/geographic-variation-in-selected-hospital-procedures-and-services-in-the-israeli-health-care-system
#16
Joseph Mendlovic, Ethel-Sherry Gordon, Ziona Haklai, Jill Meron, Arnon Afek
BACKGROUND: Medical practice variation refers to differences in health service utilization among regions in the same country. It is used as a tool for studying health inequities. In 2011, the OECD launched a Medical Practice Variation Project which examines regional differences within countries and explores the sources of the inter-regional differences. The aim of this study is to examine the patterns and trends in geographic variation for selected health services in Israel. METHODS: The analysis is based on data from the National Hospital Discharges Database (NHDD) of the Israeli Ministry of Health...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28104807/transcatheter-aortic-valve-implantation-new-hope-in-the-management-of-valvular-heart-disease
#17
REVIEW
Sofia Metaxa, Adam Ioannou, Constantinos G Missouris
Severe calcific aortic stenosis is relatively common, and unless treated with valve replacement it carries an adverse prognosis. A large number of patients, however, are denied surgery due to their advanced age or coexistent medical conditions that increase perioperative cardiovascular risks. Transcatheter aortic valve implantation (TAVI), a technique in which a bioprosthetic valve is inserted via a catheter and implanted within the diseased native aortic valve, is a new therapeutic modality for treatment of older patients with severe symptomatic aortic stenosis and other comorbidities, who have an inherently high surgical risk...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28104496/risk-factors-clinical-presentation-and-outcomes-for-abdominal-wall-endometriosis
#18
Zaraq Khan, Valentina Zanfagnin, Sherif A El-Nashar, Bimbola O Famuyide, Gaurang S Daftary, Matthew R Hopkins
STUDY OBJECTIVE: To evaluate risk factors, presentation and outcomes in cases of abdominal wall endometriosis. DESIGN: This is a case control study. DESIGN CLASSIFICATION: Canadian Task Force classification II-2 SETTING: Academic medical center PATIENTS: Total of 102 (34 cases and 68 controls) were included. INTERVENTION(S): Surgical resection of abdominal wall endometriosis. MAIN OUTCOME MEASURE(S): Cases underwent surgical excision for abdominal wall endometriosis at Mayo Clinic from January 1, 2000 through December 31, 2013...
January 16, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28104438/safety-of-externally-stimulated-intracranial-electrodes-during-functional-mri-at-1-5t
#19
Pallab K Bhattacharyya, Jeffery Mullin, Bryan S Lee, Jorge A Gonzalez-Martinez, Stephen E Jones
Surgical resection of the epileptogenic zone (EZ) is a potential cure for medically refractory focal epilepsy. Proper identification of the EZ is essential for such resection. Synergistic application of functional magnetic resonance imaging (fMRI) simultaneously with stimulation of a single externalized intracranial stereotactic EEG (SEEG) electrode has the potential to improve identification of the EZ. While most EEG-fMRI studies use the electrodes passively to record electrical activity, it is possible to stimulate the brain using the electrodes by connecting them with conducting cables to the stimulation hardware...
January 16, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28104135/renal-allograft-aspergillus-infection-presenting-with-obstructive-uropathy-a-case-report
#20
L Sadagah, M Alharbi, M Alshomrani, A Almalki
BACKGROUND: Isolated renal allograft aspergillosis is rare and usually presents with fever and decreased glomerular filtration rate. Presentation with obstructive uropathy caused by aspergillus fungal balls is much less common. We report a young male patient who presented with obstructive uropathy secondary to isolated renal allograft aspergillus infection 6 weeks after transplant. He was treated with nephrectomy and antifungal medications. CASE PRESENTATION: A 29-year-old Saudi male patient had a recent living non-related kidney transplantation in Pakistan...
January 2017: Transplantation Proceedings
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