Read by QxMD icon Read

Outcome, Risk Management

Sandra Aissou, Victoire Cartier, Antoine Hamy, Fleur Plumereau, Christophe Aube, Emilie Lermite
BACKGROUND: Liver resection is the curative treatment for patients with colorectal liver metastases (CRLMs), with five-year survival rates of 30-50%. Radiofrequency ablation (RFA) is a local and useful alternative for patients with non-resectable CRLMs to obtain complete tumor clearance. The aim of this study was to analyze survival rates with this local treatment. MATERIALS AND METHODS: All patients who underwent RFA and resection or RFA alone for unresectable CRLMs between 2001 and 2012 were included in a retrospective study...
October 26, 2016: Surgical Technology International
Amy M Kilbourne, Michelle M Barbaresso, Zongshan Lai, Kristina M Nord, Margretta Bramlet, David E Goodrich, Edward P Post, Daniel Almirall, Mark S Bauer
OBJECTIVE: Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. METHODS: This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a midwestern Veterans Affairs urban outpatient mental health clinic. Patients (N = 293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least 1 cardiovascular disease risk factor provided informed consent and were randomized (February 24, 2010, to April 29, 2015) to Life Goals (n = 146) or usual care (n = 147)...
October 25, 2016: Journal of Clinical Psychiatry
Marek Krawczyk, Michał Grąt, Rene Adam, Wojciech G Polak, Jurgen Klempnauer, Antonio Pinna, Fabrizio Di Benedetto, Franco Filipponi, Norbert Senninger, Aksel Foss, Sebastian Rufián-Peña, William Bennet, Johann Pratschke, Andreas Paul, Utz Settmacher, Giorgio Rossi, Mauro Salizzoni, Carlos Fernandez-Selles, Santiago T Martínez de Rituerto, Miguel A Gómez-Bravo, Jacques Pirenne, Olivier Detry, Pietro E Majno, Petr Nemec, Wolf O Bechstein, Michael Bartels, Silvio Nadalin, Francois R Pruvot, Darius F Mirza, Luigi Lupo, Michele Colledan, Giuseppe Tisone, Jan Ringers, Jorge Daniel, Ramón Charco Torra, Enrique Moreno González, Rafael Bañares Cañizares, Valentin Cuervas-Mons Martinez, Fernando San Juan Rodríguez, Sezai Yilmaz, Piotr Remiszewski
BACKGROUND: Liver transplantation is the most extreme form of surgical management of patients with hepatic trauma, with very limited literature data supporting its use. The aim of this study was to assess the results of liver transplantation for hepatic trauma. METHODS: This retrospective analysis based on European Liver Transplant Registry comprised data of 73 recipients of liver transplantation for hepatic trauma performed in 37 centers in the period between 1987 and 2013...
November 2016: Transplantation
Lawrence Tim Goodnough, Josep Comin-Colet, Santiago Leal-Noval, Sherri Ozawa, Jacqueline Takere, David Henry, Mazyar Javidroozi, Benjamin Hohmuth, Elvira Bisbe, Irwin Gross, Aryeh Shander
Anemia is an independent risk factor for adverse patient outcomes. There are no guidelines for management of anemia in patients withcongestive heart failure (CHF), despite itshigh incidence. Four objectives were defined by the International Anemia Management and Clinical Outcomes Expert Panel (AMCO), a multinational group of interdisciplinary experts identified by the Society for the Advancement of Blood Management (SABM) to: determine the prevalence of anemia in outpatients; to determine the prevalence of hospital-acquired anemia; to assess the impact of anemia management on clinical outcomes such as quality of life and functional status; and to provide recommendations for primary care physicians and specialists for the diagnosis, evaluation, and management of anemia in patients with CHF...
October 25, 2016: American Journal of Hematology
Kareem Bedeir, Raghu Seethala, Edward Kelly
BACKGROUND: Extracorporeal life support (ECLS) is a potentially life-saving procedure for trauma patients with severe respiratory failure. Despite this, only a limited number of publications report series of trauma patients who underwent ECLS. The performance and safety of this technology in trauma patients is not fully understood. We described the efficacy and complications of ECLS in trauma patients with respiratory failure. METHODS: A systematic review of published reports was performed utilizing the Medical Literature Analysis and Retrieval System Online (MEDLINE)...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Aijia Cai, Anja M Boos, Andreas Arkudas, Raymund E Horch
The introduction of neoadjuvant radiotherapy has allowed limb-preserving surgical treatment in patients with extremity soft tissue sarcoma, and the overall prognosis of this approach is similar to that of limb amputation. The benefits of this treatment, however, are often accompanied with a higher risk of major complications and blood vessel damage because of radiation-induced inflammation and necrosis of the vessel wall. In particular, it is associated with the rupture of large vessels like the femoral artery and more severe complications of wounds located in the proximal lower extremity...
October 25, 2016: International Wound Journal
G Greg Peterson, Jelena Zurovac, Randall S Brown, Kenneth D Coburn, Patricia A Markovich, Sherry A Marcantonio, William D Clark, Anne Mutti, Cara Stepanczuk
OBJECTIVES: To test whether a care management program could replicate its success in an earlier trial and determine likely explanations for why it did not. DATA SOURCES/SETTING: Medicare claims and nurse contact data for Medicare fee-for-service beneficiaries with chronic illnesses enrolled in the trial in eastern Pennsylvania (N = 483). STUDY DESIGN: A randomized trial with half of enrollees receiving intensive care management services and half receiving usual care...
October 24, 2016: Health Services Research
Navid Alem, Joseph Rinehart, Brian Lee, Doug Merrill, Safa Sobhanie, Kyle Ahn, Ran Schwarzkopf, Maxime Cannesson, Zeev Kain
BACKGROUND: Efforts to mitigate costs while improving surgical care quality have received much scrutiny. This includes the challenging issue of readmission subsequent to hospital discharge. Initiatives attempting to preclude readmission after surgery require planned and unified efforts extending throughout the perioperative continuum. Patient optimization prior to discharge, enhanced disease monitoring, and seamless coordination of care between hospitals and community providers is integral to this process...
2016: Perioperative Medicine
D Costa Santos, F Barros, M Frazão, M Maia
Face burns expose patients to a higher respiratory risk, and early prophylactic intubation before they enter the burn unit might be life-saving. However, unnecessary intubation may compromise their clinical evolution. Hence, the decision to perform pre-burn centre endotracheal intubation remains a clinical challenge. A retrospective study was developed to characterize the experience of the tertiary burn unit of the Hospital da Prelada with face burn patients arriving endotracheally-intubated between January 2009 and September 2013...
December 31, 2015: Annals of Burns and Fire Disasters
Guillermo J Pons-Estel, Laura Andreoli, Francesco Scanzi, Ricard Cervera, Angela Tincani
The antiphospholipid syndrome (APS) is an autoimmune disease characterized by the occurrence of venous and/or arterial thrombosis and pregnancy morbidity in the presence of pathogenic autoantibodies known as antiphospholipid antibodies (aPL). APS may be associated with other diseases, mainly systemic lupus erythematosus (SLE). The presence or absence of SLE might modify the clinical or serological expression of APS. Apart from the classical manifestations, APS patients with associated SLE more frequently display a clinical profile with arthralgias, arthritis, autoimmune hemolytic anemia, livedo reticularis, epilepsy, glomerular thrombosis, and myocardial infarction...
October 21, 2016: Journal of Autoimmunity
Jan-Malte Sinning, Anna Sonia Petronio, Nicolas Van Mieghem, Giulio Zucchelli, Georg Nickenig, Raffi Bekeredjian, Johan Bosmans, Francesco Bedogni, Marian Branny, Karl Stangl, Jan Kovac, Anna Nordell, Molly Schiltgen, Nicolo Piazza, Peter de Jaegere
Best practices for transcatheter aortic valve implantation with CoreValve include patient screening and valve size selection using multislice computed tomography, adherence to manufacturer recommendations for oversizing, control of implant depth to 6 mm or less, and management of conduction disturbances according to international guidelines. The ADVANCE II study implemented these strategies and demonstrated their relation to clinical outcomes. From October 2011 to April 2013, 200 patients with severe aortic stenosis were enrolled, and 194 were implanted...
September 30, 2016: American Journal of Cardiology
P Noufi, E Khoury, E Ayoub, N Naccache, S Richa
OBJECTIVES: Use of chronic opioid therapy has increased substantially over the past few years, even though opioid therapy is associated with potentially serious harms, including opioid-related adverse effects and outcomes. Prescription of opioids for chronic pain, particularly nonmalignant chronic pain, remains controversial. In the midst of this controversy, patterns of actual prescription and influences on these patterns are not well understood. This study aims to describe the frequency of prescription of opioid analgesics in a university hospital, the attitudes of doctors towards this category of drugs, and the follow-up modalities of patients taking these drugs...
October 21, 2016: L'Encéphale
A J Garcia-Prats, L du Plessis, H R Draper, A Burger, J A Seddon, K Zimri, A C Hesseling, H S Schaaf
SETTING: Isoniazid-resistant rifampicin-susceptible (H(R)R(S)) tuberculosis (TB) is the most prevalent form of drug-resistant TB globally, and may be a risk factor for poor outcomes, but has been poorly described in children. OBJECTIVE: To characterise the clinical presentation, treatment, and clinical and microbiological outcomes among children with culture-confirmed H(R)R(S) TB. DESIGN: Retrospective hospital-based cohort study. RESULTS: Of the 72 children included in the study, the median age was 50...
November 2016: International Journal of Tuberculosis and Lung Disease
Suzanne McMurtry Baird, Nan H Troiano, Margaret Betsy Babb Kennedy
"Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus...
October 2016: Journal of Perinatal & Neonatal Nursing
P Dhakal, V R Bhatt
Diagnosis and management of hematopoietic cell transplant-associated thrombotic microangiopathy (TA-TMA) are very complex and controversial, given multiple ongoing issues and comorbidities in sick transplant recipients. Complement activation via classic and alternative pathways is emerging as a potential pathogenetic mechanism in the development of TA-TMA. Complement-centric diagnostic strategy using functional and genetic tests may possibly support diagnosis, enhance molecular understanding and direct drug development...
October 24, 2016: Bone Marrow Transplantation
Abra Jeffers, Vanessa Sochat, Michael W Kattan, Changhong Yu, Erin Melcon, Kosi Yamoah, Timothy R Rebbeck, Alice S Whittemore
BACKGROUND: Prostate cancer prognosis is variable, and management decisions involve balancing patients' risks of recurrence and recurrence-free death. Moreover, the roles of body mass index (BMI) and race in risk of recurrence are controversial [1,2]. To address these issues, we developed and cross-validated RAPS (Risks After Prostate Surgery), a personal prediction model for biochemical recurrence (BCR) within 10 years of radical prostatectomy (RP) that includes BMI and race as possible predictors, and recurrence-free death as a competing risk...
October 24, 2016: Prostate
Eeva-Maija Kinnunen, Marisa De Feo, Daniel Reichart, Tuomas Tauriainen, Giuseppe Gatti, Francesco Onorati, Luca Maschietto, Ciro Bancone, Francesca Fiorentino, Sidney Chocron, Karl Bounader, Magnus Dalén, Peter Svenarud, Giuseppe Faggian, Ilaria Franzese, Giuseppe Santarpino, Theodor Fischlein, Daniele Maselli, Carmelo Dominici, Saverio Nardella, Riccardo Gherli, Francesco Musumeci, Antonino S Rubino, Carmelo Mignosa, Giovanni Mariscalco, Filiberto G Serraino, Francesco Santini, Antonio Salsano, Francesco Nicolini, Tiziano Gherli, Marco Zanobini, Matteo Saccocci, Vito G Ruggieri, Jean Philippe Verhoye, Andrea Perrotti, Fausto Biancari
BACKGROUND: Excessive bleeding and blood transfusion are associated with adverse outcome after cardiac surgery, but their mechanistic effects are difficult to disentangle in patients with increased operative risk. This study aimed to evaluate the incidence and prognostic impact of bleeding and transfusion of blood products in low-risk patients undergoing coronary artery bypass grafting (CABG). STUDY DESIGN AND METHODS: Sixteen tertiary European centers of cardiac surgery contributed to the prospective European registry of CABG (E-CABG)...
October 23, 2016: Transfusion
Jonas F Ludvigsson, Benjamin Lebwohl, Anders Ekbom, Ravi Kiran, Peter Hr Green, Jonas Höijer, Olof Stephansson
BACKGROUND & AIMS: Endoscopy is an integral part of the investigation and management of gastrointestinal disease. We aimed to examine outcomes of pregnancies for women who underwent endoscopy during their pregnancy. METHODS: We performed a nationwide population-based cohort study, linking data from the Swedish Medical Birth Registry (for births from 1992 through 2011) with those from the Swedish Patient Registry. We identified 3052 pregnancies exposed to endoscopy (2025 upper endoscopies, 1109 lower endoscopies, 58 endoscopic retrograde cholangiopancreatographies)...
October 20, 2016: Gastroenterology
Colleen K McIlvennan, JoAnn Lindenfeld, David P Kao
BACKGROUND: Mechanical circulatory support (MCS) is a widely available management strategy. No studies have described sex differences in both extracorporeal and durable MCS. We analyzed sex-related differences of in-hospital outcomes for extracorporeal and durable MCS using administrative hospital data. METHODS: In total, 134.5 million hospital records between 1994 and 2012 were screened for placement of MCS using procedure codes of the International Classification of Diseases-9, Clinical Modification...
August 20, 2016: Journal of Heart and Lung Transplantation
Ashvarya Mangla, Saurabh Gupta
Transcatheter aortic valve replacement (TAVR) has rapidly emerged as the standard of care for severe symptomatic aortic stenosis in patients whose comorbidities put them at prohibitive risk for surgical aortic valve replacement (SAVR). Several trials have demonstrated superior outcomes with TAVR compared to medical management alone. TAVR has also shown favorable outcomes in patients at high risk for SAVR. TAVR can be associated with significant vascular complications, which adversely impact outcomes, and operators should be cognizant of their early recognition and appropriate management...
September 2016: Indian Heart Journal
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"