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https://www.readbyqxmd.com/read/28742955/bayesian-one-step-ipd-network-meta-analysis-of-time-to-event-data-using-royston-parmar-models
#1
Suzanne C Freeman, James R Carpenter
Network meta-analysis (NMA) combines direct and indirect evidence from trials to calculate and rank treatment estimates. While modelling approaches for continuous and binary outcomes are relatively well developed, less work has been done with time-to-event outcomes. Such outcomes are usually analysed using Cox proportional hazard (PH) models. However, in oncology with longer follow-up time, and time-dependent effects of targeted treatments, this may no longer be appropriate. Network meta-analysis conducted in the Bayesian setting has been increasing in popularity...
July 25, 2017: Research Synthesis Methods
https://www.readbyqxmd.com/read/28742949/strategies-to-increase-the-efficacy-of-using-gut-microbiota-for-the-modulation-of-obesity
#2
REVIEW
J Li, M S Riaz Rajoka, D Shao, C Jiang, M Jin, Q Huang, H Yang, J Shi
Obesity is one of the most serious global public health challenges of the 21st century. The adjustment of gut microbiota is often recommended as an efficient strategy to treat obesity. This modulation of gut microbiota can be performed by many methods, including dietary intervention, antibiotic application, the use of prebiotics and probiotics, bariatric surgery and faecal microbiota transplantation. In most cases, positive effects have been observed in response to treatment, but invalid and even contrary effects have also been observed in some cases due to factors that are unrelated to intervention methods, such as genetic factors, patient age or gender, environmental microbiota, climate, geography and lifestyle...
July 25, 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28742545/reductions-in-readmission-rates-are-associated-with-modest-improvements-in-patient-reported-health-gains-following-hip-and-knee-replacement-in-england
#3
Rocco Friebel, Kumar Dharmarajan, Harlan M Krumholz, Adam Steventon
BACKGROUND: Although many hospital readmission reduction initiatives have been introduced globally, health care systems ultimately aim to improve patients' health and well-being. We examined whether the hospitals that report greater success in reducing readmissions also see greater improvements in patient-reported outcomes. RESEARCH DESIGN: We examined hospital groups (Trusts) that provided hip replacement or knee replacement surgery in England between April 2010 and February 2013...
July 24, 2017: Medical Care
https://www.readbyqxmd.com/read/28741278/italian-intersociety-consensus-on-prevention-diagnosis-and-treatment-of-delirium-in-hospitalized-older-persons
#4
Giuseppe Bellelli, Alessandro Morandi, Marco Trabucchi, Guido Caironi, Daniele Coen, Carlo Fraticelli, Ciro Paolillo, Carolina Prevaldi, Angela Riccardi, Gianfranco Cervellin, Corrado Carabellese, Salvatore Putignano, Stefania Maggi, Antonio Cherubini, Paola Gnerre, Andrea Fontanella, Nicola Latronico, Concezione Tommasino, Antonio Corcione, Giovanni Ricevuti, Nicola Ferrara, Francesco De Filippi, Alberto Ferrari, Mario Guarino, Maria Pia Ruggieri, Pietro Amedeo Modesti, Carlo Locatelli, Patrizia Hrelia, Marco Otto Toscano, Emi Bondi, Antonio Tarasconi, Luca Ansaloni, Francesco Perticone
Delirium is a severe neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction in the setting of an acute medical illness, medical complication, drug intoxication, or drug withdrawal. The most important risk factors are advanced age and dementia, whereas pain, dehydration, infections, stroke, metabolic disturbances, and surgery are the most common triggering factors. Although delirium is a common clinical syndrome in different settings of care (acute care hospitals, inpatient rehabilitation facilities, nursing homes, and hospices), it often remains under-recognized, poorly understood, and inadequately managed...
July 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28741200/short-and-long-term-outcomes-in-malnourished-patients-after-laparoscopic-or-open-radical-gastrectomy
#5
Hua-Long Zheng, Jun Lu, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Mi Lin, Ru-Hong Tu, Chang-Ming Huang
OBJECTIVE: The aim of this study was to compare the short- and long-term outcomes of malnourished gastric cancer patients who underwent laparoscopic or open radical gastrectomy. BACKGROUND: Preoperative malnutrition is an independent risk factor for postoperative mortality and morbidity in major gastrointestinal surgery. However, whether laparoscopic surgery can improve the short- and long-term outcomes of malnourished gastric cancer patients has not been determined...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28741196/how-safe-is-performing-cholecystectomy-in-the-oldest-old-a-15-year-retrospective-study-from-a-single-institution
#6
Matteo Novello, Davide Gori, Salomone Di Saverio, Matteo Bianchin, Lorenzo Maestri, Francesco Vito Mandarino, Giuseppe Cavallari, Bruno Nardo
BACKGROUND: Globally, the number of people aged 80 years or over, the "oldest old," is the fastest growing population group. Because of the strong association between age and gallstone disease, both prevalence and incidence of this disease are increasing. The feasibility of the cholecystectomy in octogenarians has been evaluated in several studies that confirmed the safety of the operation. However, the safety of this procedure in nonagenarians is still controversial. The aim of this study was to evaluate the safety of cholecystectomies in nonagenarians and identify related predictors for postoperative hospital length of stay (LOS) and in-hospital mortality up to 30 days postoperatively...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28740414/the-role-of-endoscopic-therapy-in-obesity-management-intragastric-balloons-and-aspiration-therapy
#7
REVIEW
Nitin Kumar, Shelby Sullivan, Christopher C Thompson
Weight management is increasingly incorporating endoscopic bariatric therapy (EBT). As the global burden of obesity and its comorbidities has increased, it is evident that novel therapeutic approaches will be necessary to address the obesity epidemic. EBTs offer greater efficacy than diet and lifestyle modification and lower invasiveness than bariatric surgery. The US Food and Drug Administration has approved two intragastric balloons and aspiration therapy for the treatment of obesity: Apollo Orbera is indicated for the treatment of Class I and Class II obesity, Re Shape Integrated Dual Balloon system is indicated for the same range with a comorbidity, and Aspire Bariatrics AspireAssist is approved for patients with a body mass index of 35-55 kg/m(2)...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28739479/emergency-department-visits-after-lumbar-spine-surgery-are-associated-with-lower-hcahps-scores
#8
Jay M Levin, Robert D Winkelman, Gabriel A Smith, Joseph E Tanenbaum, Roy Xiao, Thomas E Mroz, Michael P Steinmetz
BACKGROUND: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys are used to assess the quality of the patient experience following an inpatient stay. HCAHPS scores are used to determine reimbursement for hospital systems and incentivize spine surgeons nationwide. There are conflicting data detailing whether early readmission or other post-discharge complications are associated with patient responses on the HCAHPS survey. Currently, the association between post-discharge ED visits and HCAHPS scores following lumbar spine surgery is unknown...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28739308/risk-of-surgical-site-infection-in-elective-hip-and-knee-replacements-after-confirmed-eradication-of-mrsa-in-chronic-carriers
#9
Tarang Tandon, Baha J Tadros, Harold Akehurst, Adhish Avasthi, Richard Hill, Madhu Rao
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is globally endemic and is a leading cause of surgical site infection (SSI). The purpose of this study was to evaluate the incidence of SSI in MRSA carriers undergoing elective hip or knee arthroplasty, who had confirmed eradication and to compare it with incidence of SSI in non-MRSA carriers. METHODS: This is a retrospective analysis of 6613 patients who underwent elective total hip arthroplasty (THA; n = 3347) and total knee arthroplasty (TKA; n = 3266) at our institution...
June 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735374/changes-in-global-transcriptional-profiling-of-women-following-obesity-surgery-bypass
#10
Marcela Augusta de Souza Pinhel, Natalia Yumi Noronha, Carolina Ferreira Nicoletti, Bruno Affonso Parente de Oliveira, Cristiana Cortes-Oliveira, Vitor Caressato Pinhanelli, Wilson Salgado Junior, Ana Julia Machry, Wilson Araújo da Silva Junior, Dorotéia Rossi Silva Souza, Júlio Sérgio Marchini, Carla Barbosa Nonino
BACKGROUND: Differential gene expression in peripheral blood mononuclear cells (PBMCs) after Roux-en-Y gastric bypass (RYGB) is poorly characterized. Markers of these processes may provide a deeper understanding of the mechanisms that underlie these events. The main goal of this study was to identify changes in PBMC gene expression in women with obesity before and 6 months after RYGB-induced weight loss. METHODS: The ribonucleic acid (RNA) of PBMCs from 13 obese women was analyzed before and 6 months after RYGB; the RNA of PBMCs from nine healthy women served as control...
July 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28734705/a-proficiency-based-stepwise-endovascular-curricular-training-prospect-program-enhances-operative-performance-in-real-life-a-randomised-controlled-trial
#11
H Maertens, R Aggarwal, N Moreels, F Vermassen, I Van Herzeele
OBJECTIVES: Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. DESIGN: A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions...
July 19, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28733905/glp-1-glucagon-receptor-co-agonism-for-treatment-of-obesity
#12
REVIEW
Miguel A Sánchez-Garrido, Sara J Brandt, Christoffer Clemmensen, Timo D Müller, Richard D DiMarchi, Matthias H Tschöp
Over a relatively short period, obesity and type 2 diabetes have come to represent a large medical and economic burden to global societies. The epidemic rise in the prevalence of obesity has metabolic consequences and is paralleled by an increased occurrence of other diseases, such as diabetes, cancer and cardiovascular complications. Together, obesity and type 2 diabetes constitute one of the more preventable causes of premature death and the identification of novel, safe and effective anti-obesity drugs is of utmost importance...
July 21, 2017: Diabetologia
https://www.readbyqxmd.com/read/28733294/determining-the-worldwide-epidemiology-of-surgical-site-infections-after-gastrointestinal-resection-surgery-protocol-for-a-multicentre-international-prospective-cohort-study-globalsurg-2
#13
GlobalSurg Collaborative
INTRODUCTION: Surgical site infection (SSI) is the most common complication following major gastrointestinal surgery, affecting between 25% and 40% of patients. The rate of SSI doubles from low-income to high-income settings, persisting after risk adjustment. The relative impact of antibiotic-resistant organisms and the effectiveness of antibiotic prophylaxis globally are unknown. This study aims to determine SSI rates following gastrointestinal surgery across worldwide hospital settings...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28730984/bariatric-surgery-tourism-hidden-costs-how-canada-is-not-doing-its-part-in-covering-bariatric-surgery-under-the-canada-health-act
#14
Michel Gagner
Many Canadians seek medical treatment outside our borders. Waiting times, rather than lack of expertise, are the number one culprit, and with globalization of health care, the number of patients who travel to obtain medical care will continue to rise. Though the provinces have covered the costs of complications from surgeries performed abroad for many years, complications from bariatric surgery performed abroad have been receiving negative attention. This commentary discusses associated costs and questions how the Canada Health Act should be covering bariatric procedures...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28729908/aki-after-pediatric-cardiac-surgery-for-congenital-heart-diseases-recent-developments-in-diagnostic-criteria-and-early-diagnosis-by-biomarkers
#15
REVIEW
Yuichiro Toda, Kentaro Sugimoto
BACKGROUND: Acute kidney injury (AKI) after cardiac surgery in children with congenital heart disease is a common complication. AKI is also associated with high morbidity and mortality. The Kidney Diseases Improving Global Outcomes (KDIGO) criteria for AKI classification are now widely used for the definition of AKI. It is noteworthy that a statement about children was added to the criteria. Many studies aimed at finding useful biomarkers are now being performed by using these criteria...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28729417/mathematical-modeling-of-tumor-tumor-distant-interactions%C3%A2-supports-a-systemic-control-of-tumor-growth
#16
Sebastien Benzekry, Clare Lamont, Dominique Barbolosi, Lynn Hlatky, Philip Hahnfeldt
Interactions between different tumors within the same organism have major clinical implications, especially in the context of surgery and metastatic disease. Three main explanatory theories (competition, angiogenesis inhibition and proliferation inhibition) have been proposed but precise determinants of the phenomenon remain poorly understood. Here we formalized these theories into mathematical models and performed biological experiments to test them with empirical data. In syngeneic mice bearing two simultaneously implanted tumors, growth of only one of the tumors was significantly suppressed (61% size reduction at day 15, p<0...
July 20, 2017: Cancer Research
https://www.readbyqxmd.com/read/28729188/assessing-interest-and-barriers-for-resident-and-faculty-involvement-in-global-surgery
#17
Maija Cheung, James M Healy, Michael R Hall, Doruk Ozgediz
BACKGROUND: Multiple institutions have developed international electives and sustainable global surgery initiatives to facilitate clinical, research, and outreach opportunities with hospitals in resource-poor areas. Despite increasing interest among programs, many institutions have not successfully reached potential involvement. OBJECTIVE: This study evaluates the experiences of Yale residents and faculty, measures interest in the development of an international surgical elective, and enumerates barriers to developing or participating in these opportunities...
July 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28728174/a-global-view-on-output-and-outcomes-of-cataract-surgery-with-national-indices-of-socioeconomic-development
#18
Wei Wang, William Yan, Andreas Müller, Mingguang He
Purpose: Cataract blindness accounts for a substantial proportion of blindness worldwide. Understanding the correlations between national levels of socioeconomic development with the quantity and quality of cataract surgery may provide insight for the prioritization and resource allocation for blindness prevention programs. Methods: The relationships between human development index (HDI), gross domestic product (GDP) per capita, and cataract surgical coverage (CSC) and visual outcome of cataract surgery were examined in a multinational study utilizing secondary data from the repository for Rapid Assessment of Avoidable Blindness (RAAB), World Health Organization, Global Burden of Disease, United Nations, and the World Bank...
July 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28723493/proteinuria-in-patients-undergoing-renal-cancer-surgery-impact-on-overall-survival-and-stability-of-renal-function
#19
Zhiling Zhang, Juping Zhao, Joseph Zabell, Erick Remer, Jianbo Li, Jack Campbell, Wen Dong, Diego Aguilar Palacios, Tulsi Patel, Sevag Demirjian, Steven C Campbell
BACKGROUND: Proteinuria is included in the Kidney Disease: Improving Global Outcomes (KDIGO) risk stratification for chronic kidney disease (CKD) in the general population. However, the importance of proteinuria in patients with renal cancer has not been adequately studied. OBJECTIVE: To evaluate the prognostic impact of preoperative proteinuria on overall survival (OS) and renal function stability (RFS) for patients managed with renal cancer surgery. DESIGN, SETTING, AND PARTICIPANTS: From 1999 to 2008, 977 patients who underwent renal cancer surgery had preoperative data recorded for the glomerular filtration rate (GFR) estimated using the CKD Epidemiology Collaboration equation (G1 ≥90, G2 60-89, G3a 45-59, G3b 30-44, G4 15-29, and G5 <15ml/min/1...
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723368/definition-of-success-after-surgery-for-female-stress-incontinence-or-voiding-dysfunction-an-attempt-at-standardization
#20
REVIEW
Maude E Carmel, Donna Y Deng, Tamsin J Greenwell, Philippe E Zimmern
CONTEXT: There is currently no standardized definition of success for surgery for stress urinary incontinence (SUI) and voiding dysfunction (VD) in women. OBJECTIVE: To review the use of outcome measures (OMs) and definitions of success in the literature on SUI and VD surgery in women in an attempt to provide recommendations for future publications. EVIDENCE ACQUISITION: A PubMed search of all English language full-text articles on SUI and VD surgery in women published between 2010 and 2015 was performed...
August 2016: European Urology Focus
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