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Christopher W Mangieri, Bryan P Hendren, Matthew A Strode, Bradley C Bandera, Byron J Faler
BACKGROUND: Laparoscopic cholecystectomy is the most commonly performed laparoscopic procedure. It is superior in nearly every regard compared to open cholecystectomies. The one significant aspect where the laparoscopic approach is inferior regards the association with bile duct injuries (BDI). The BDI rate with laparoscopic cholecystectomy is approximately 0.5%; nearly triple the rate compared to the open approach. We propose that 0.5% BDI rate with the laparoscopic approach is no longer accurate...
July 13, 2018: Surgical Endoscopy
Stefan Kuhle, Adam Muir, Christy G Woolcott, Mary M Brown, Sarah D McDonald, Mohamed Abdolell, Linda Dodds
BACKGROUND/OBJECTIVE: The association between maternal pre-pregnancy obesity and adverse child health outcomes is well described, but there are few data on the relationship with offspring health service use. We examined the influence of maternal pre-pregnancy obesity on offspring health care utilization and costs over the first 18 years of life. METHODS: This was a population-based retrospective cohort study of children (n = 35,090) born between 1989 and 1993 and their mothers, who were identified using the Nova Scotia Atlee Perinatal Database and linked to provincial administrative health data from birth through 2014...
July 13, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Rafi Sakhi, Sing-Chien Yap, Michelle Michels, Arend F L Schinkel, R Martijn Kauling, Jolien W Roos-Hesselink, Dominic A M J Theuns
BACKGROUND: The manufacturer has developed a new ECG screening tool to determine eligibility for the subcutaneous ICD (S-ICD), the "automatic screening tool" (AST), which may render manual ECG-screening unnecessary. The aim of the study was to determine the eligibility for the S-ICD using two methods (manual ECG-screening versus AST) in different patient categories including patients with cardiomyopathy, congenital heart disease and inherited primary arrhythmia syndrome. METHODS: We prospectively evaluated the ECG suitability for an S-ICD in consecutive patients at our outpatient clinic between February and June 2017...
July 6, 2018: International Journal of Cardiology
Maria Schubert, Roger Schürch, Soenke Boettger, David Garcia Nuñez, Urs Schwarz, Dominique Bettex, Josef Jenewein, Jasmina Bogdanovic, Marina Lynne Staehli, Rebecca Spirig, Alain Rudiger
BACKGROUND: Delirium is a well-known complication in cardiac surgery and intensive care unit (ICU) patients. However, in many other settings its prevalence and clinical consequences are understudied. The aims of this study were: (1) To assess delirium prevalence in a large, diverse cohort of acute care patients classified as either at risk or not at risk for delirium; (2) To compare these two groups according to defined indicators; and (3) To compare delirious with non-delirious patients regarding hospital mortality, ICU and hospital length of stay, nursing hours and cost per case...
July 13, 2018: BMC Health Services Research
Sandy Krammer, Martin Grosse Holtforth, Michael Soyka, Michael Liebrenz
BACKGROUND: This study tested whether it is possible to diagnose complex posttraumatic stress disorder (CPTSD) according to the beta version of ICD-11 by means of the Trauma Symptom Inventory 2 (TSI-2). Currently, there is no established measurement for this. METHODS: An algorithm for the TSI-2 was developed. This was tested in a sample of 100 psychiatric patients, who had experienced aversive and/or traumatic events. The frequency of CPTSD and differences regarding gender, age and traumatic events will be reported...
July 13, 2018: Fortschritte der Neurologie-Psychiatrie
Zhikuan Chen, Lanlan Liu, Ruijing Liang, Zhenyu Luo, Huamei He, Zhihao Wu, Hao Tian, Mingbin Zheng, Yifan Ma, Lintao Cai
An ideal cancer therapeutic strategy is expected to possess potent ability that not only can ablate primary tumor, but also can prevent the distance metastasis and relapse. In this study, human serum albumin was hybridized with hemoglobin by intermolecular disulfide bonds to develop a hybrid protein oxygen nanocarrier with chlorine e6 encapsulated (C@HPOC) for oxygen self-sufficient photodynamic therapy (PDT). C@HPOC realized the tumor-targeted co-delivery of photosensitizer and oxygen, which remarkably relieved tumor hypoxia...
July 13, 2018: ACS Nano
Daniel J Snyder, Sean N Neifert, Jonathan S Gal, Brian C Deutsch, Robert Rothrock, Samuel Hunter, John M Caridi
STUDY DESIGN: A retrospective study was performed including all patients that underwent posterior cervical decompression and fusion (PCDF) by an orthopedic or neurological surgeon at a single institution between January 1, 2006 and November 30, 2016, and all patients that underwent PCDF by a spine surgeon in the NSQIP database between 2007 and 2015. In-hospital complications were compared between surgical specialties. OBJECTIVE: The goal of this study was to determine if in-hospital complication rates differ significantly between surgical services for PCDF patients...
July 12, 2018: Spine
N F Majola, V Y Kong, H Mangray, V Govindasamy, G L Laing, D L Clarke
BACKGROUND: The ingestion or aspiration of foreign bodies (FBs) by children is a common problem around the world. Our centre in Pietermaritzburg, South Africa, has a dedicated paediatric surgical service, and all patients with an ingested or aspirated FB are managed under the direct care of a paediatric surgeon. OBJECTIVES: To review our centre's experience with this problem by means of a retrospective audit and use the data to develop and refine appropriate local management guidelines...
February 27, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Marlina E Lovett, Zubin S Shah, Melissa Moore-Clingenpeel, Eric Sribnick, Adam Ostendorf, Melissa G Chung, Jeffrey Leonard, Nicole F O'Brien
OBJECTIVE Focal intracranial infections such as intraparenchymal abscesses or localized infections in the epidural or subdural spaces are relatively rare infections associated with both morbidity and mortality in children. Although children with these infections frequently require surgical intervention, there is a paucity of literature describing the critical care resources required to manage these cases. This retrospective chart review was performed to evaluate the resources necessary to care for critically ill children with focal intracranial infections at the authors' institution...
July 13, 2018: Journal of Neurosurgery. Pediatrics
Karin Mohn Engebretsen
The search for causal explanations in medically unexplained syndromes such as burnout has not been resolved by evidence-based medicine. A biomedical model encourages a reductionist diagnostic practice and a dualist split between physical and psychological symptoms. Therefore, diagnosing and treating these syndromes remains a challenge. Depression is a common aspect in burnout and, as a result, clinicians often diagnose burnout patients as depressed. The Norwegian government expects medical efficiency to reduce sick leaves...
July 12, 2018: Journal of Evaluation in Clinical Practice
Eric M Ammann, Iftekhar Kalsekar, Andrew Yoo, Stephen S Johnston
PURPOSE: To quantify the sensitivity and positive predictive value (PPV) of body mass index (BMI)-related ICD-9-CM and ICD-10-CM diagnosis codes in claims data. METHODS: De-identified electronic health record (EHR) and claims data were obtained from the Optum Integrated Claims-Clinical Database for cross-sections of commercial and Medicare Advantage health plan members age ≥ 20 years in 2013, 2014, and 2016. In each calendar year, health plan members' BMI as coded in the insurance claims data (error-prone measure) was compared with their BMI as recorded in the EHR (gold standard) to estimate the sensitivity and PPV of BMI-related ICD-9-CM and ICD-10-CM diagnosis codes...
July 12, 2018: Pharmacoepidemiology and Drug Safety
Daniele Massera, Mary L Biggs, Marcella D Walker, Kenneth J Mukamal, Joachim H Ix, Luc Djousse, Rodrigo J Valderrábano, David S Siscovick, Russell P Tracy, Xiaonan Xue, Jorge R Kizer
OBJECTIVE: To investigate the relationship of osteocalcin (OC), a marker of bone formation, and C-telopeptide of type I collagen (CTX), a marker of bone resorption, with incident diabetes in older women. RESEARCH DESIGN AND METHODS: The analysis included 1,455 female participants from the population-based Cardiovascular Health Study (mean [SD] age 74.6 [5.0] years). The cross-sectional association of serum total OC and CTX levels with insulin resistance (HOMA-IR) was examined using multiple linear regression...
July 12, 2018: Diabetes Care
Morten Breinholt Søvsø, Sabina Bay Hermansen, Emil Færk, Tim Alex Lindskou, Marc Ludwig, Jørn Munkhof Møller, Jelena Jonciauskiene, Erika Frischknecht Christensen
BACKGROUND: Emergency departments handle a large proportion of acute patients. In 2007, it was recommended centralizing the Danish healthcare system and establishing emergency departments as the main common entrance for emergency patients. Since this reorganization, few studies describing the emergency patient population in this new setting have been carried out and none describing diagnoses and mortality. Hence, we aimed to investigate diagnoses and 1- and 30-day mortality of patients in the emergency departments in the North Denmark Region during 2014-2016...
July 13, 2018: BMC Health Services Research
So Young Kim, Jae-Sung Lim, Songyong Sim, Hyo Geun Choi
OBJECTIVES: To investigate the risk of stroke in SSNHL patients. STUDY DESIGN: A longitudinal follow-up cohort study. SETTING: The Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013. PATIENTS: The 4,944 SSNHL participants were matched with 19,776 controls for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia. The SSNHL subjects were diagnosed (International Classification of Disease [ICD]-10: H91...
July 9, 2018: Otology & Neurotology
Jenny W Sun, James R Rogers, Qoua Her, Emily C Welch, Catherine A Panozzo, Sengwee Toh, Joshua J Gagne
No abstract text is available yet for this article.
July 11, 2018: Medical Care
Michał Lewandowski, Paweł Syska, Ilona Kowalik, Aleksander Maciąg, Maciej Sterliński, Joanna Ateńska-Pawłowska, Hanna Szwed
AIMS: Young ICD recipients present high rate of complications. Some of them seem to be underestimated. We report our clinical experience with ICD therapy in children and young adults during a 15 years follow-up. METHODS: We reviewed database of ICD recipients in our institution and have chosen 73 patients consecutively implanted at age 6-21years. We analysed intervention rate, mortality, rate and character of complications and treatment options. RESULTS: 20/73 patients (27,4%) received ≥1 appropriate therapy(AT) for VT/VF(ATP or shock) and 24/73 patients (32,8%) had one or multiple inappropriate therapy (IT)...
July 11, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Annie M Wu, Connie M Wu, Paul B Greenberg, Fei Yu, Flora Lum, Anne L Coleman
Purpose: To describe the frequency and variation of intravitreal bevacizumab and ranibizumab use for branch retinal vein occlusion (BVO) in the United States (US). Methods: We obtained a 5% random sample of Medicare beneficiaries from the Medicare Denominator and Physician/Supplier Part B claims files from 2010 to 2013 and identified all beneficiaries with an ICD-9-CM code for branch retinal vein occlusion (BVO, 362.36). Patient age, gender, race, state of residence and Charlson Comorbidity Index (CCI) scores were collected...
September 2018: American Journal of Ophthalmology Case Reports
Vincent P Anto, Joshua B Brown, Andrew B Peitzman, Brian S Zuckerbraun, Matthew D Neal, Gregory Watson, Raquel Forsythe, Timothy R Billiar, Jason L Sperry
Background: Blunt cerebrovascular injuries (BCVI) are generally associated with high-energy injury mechanisms. Less is known regarding lower-energy injuries in elderly patients. We sought to determine the incidence of BCVI and characterize current BCVI screening practices and associated complications in elderly ground-level fall patients (EGLF, ≥ 65 years). We hypothesized that BCVI in EGLF patients would be clinically significant and screening would be less common. Methods: A retrospective study was performed utilizing the National Trauma Data Bank (NTDB, 2007-2014) and single institutional data...
2018: World Journal of Emergency Surgery: WJES
Celestino Sardu, Raffaele Marfella, Matteo Santamaria, Stefano Papini, Quintino Parisi, Cosimo Sacra, Daniele Colaprete, Giuseppe Paolisso, Maria R Rizzo, Michelangela Barbieri
Background: Internal cardioverter defibrillator (ICD) therapy reduced all-cause mortality. Conversely, few studies reported that ICDs' shocks may reduce survival. Recently authors suggested that, multiple inflammatory and molecular pathways were related to worse prognosis in metabolic syndrome (MS) patients treated by ICDs. Therefore, it may be relevant to find new biomarkers to predict ICDs' shock and worse prognosis in treated patients. Methods: In 99 MS vs. 107 no MS patients treated by ICD for primary prevention, we evaluated all-cause mortality, cardiac deaths, hospitalization for heart failure, appropriate and inappropriate therapy, and survival after appropriate ICD therapy...
2018: Frontiers in Physiology
Stephen M Mann, Daniel Banaszek, Katherine Lajkosz, Susan B Brogly, Shelby M Stanojev, Chris Evans, Davide D Bardana, Jeff Yach, Stephen Hall
INTRODUCTION: Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients with high-energy polytrauma. High-energy pelvic fractures are life-threatening injuries, with mortality estimates ranging from 6 to 35%. The purpose of this study was to examine trends in the incidence, diagnosis, treatment, and mortality rates of high-energy pelvic fractures in Ontario, Canada over a 10-year period. METHODS: A cohort of 3915 patients who sustained a high-energy pelvic fracture in Ontario between 01 April 2005 and 31 March 2015 was identified using the Ontario Trauma Registry and administrative healthcare data linked by the Institute for Clinical Evaluative Science (ICES)...
July 6, 2018: Injury
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