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https://www.readbyqxmd.com/read/28633175/the-marshall-family-medicine-residency-twintern-schedule-the-impact-of-an-innovative-hospital-coverage-scheme-on-resident-fatigue
#1
Adam Franks, Stephen M Petrany, Sydnee McElroy, Adam Alley
BACKGROUND AND OBJECTIVES: Work hour restriction has strained the balance between resident service and education. Night Float (NF) rotations are a popular answer to managing this balance but weakens continuity, an essential tenant of family medicine. An innovative short call system for Marshall University's Family Medicine Hospital Service (FMHS), the twINTERN call model, was created in response. We studied the impact of this approach on resident fatigue. METHODS: Anonymous surveys assessed fatigue of the Marshall University's 2013-2014 Family Medicine intern resident class while on NF rotations (ICU, Pediatrics and Surgery) and the twINTERN call...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28632593/functional-and-radiographic-outcomes-following-growth-sparing-management-of-early-onset-scoliosis
#2
Charles E Johnston, Dong-Phuong Tran, Anna McClung
BACKGROUND: In this study, we sought to evaluate radiographic, functional, and quality-of-life outcomes of patients who have completed growth-sparing management of early-onset scoliosis. METHODS: This prospective study involved patients with early-onset scoliosis who underwent growth-sparing treatment and either "final" fusion or observation for ≥2 years since the last lengthening procedure. Demographics, radiographic parameters, pulmonary function test (PFT) values, and scores of patient-reported assessments (Early-Onset Scoliosis Questionnaire [EOSQ] and Scoliosis Research Society [SRS]-30) were obtained...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#3
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28631830/overactive-bladder-symptoms-after-midurethral-sling-surgery-in-women-risk-factors-and-management
#4
Tom Marcelissen, Philip Van Kerrebroeck
INTRODUCTION: Overactive bladder syndrome (OAB) including urgency and urgency urinary incontinence (UUI) occurs frequently after stress urinary incontinence (SUI) surgery. It is important to identify the risk factors for the occurrence of OAB symptoms in order to adequately inform the patient before surgery. Furthermore, when facing OAB after sling surgery it is crucial to know how to manage these symptoms. METHODS: We conducted a literature review in order to assess the risk factors and management of OAB symptoms after SUI surgery...
June 20, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28631201/seven-esophageal-perforation-cases-after-aortic-replacement-stenting-for-thoracic-aortic-dissection-or-aneurysm
#5
Yoshihisa Yaguchi, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Tsuyoshi Inaba, Ryoji Fukushima
BACKGROUND: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. CASE PRESENTATION: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28629943/arthroscopically-assisted-fixation-is-a-reliable-option-for-patellar-fractures-a-literature-review
#6
REVIEW
Simone Cerciello, Mark Cote, Sébastien Lustig, Felix Dyrna, Leo Pauzenberger, Philippe Neyret, Augustus D Mazzocca
BACKGROUND: Proper reduction and stable fixation of articular fractures is essential for an early recovery and to avoid late complications. Arthroscopically assisted techniques for minimally invasive fixation have been introduced to reduce local morbidity and improve anatomic reduction of the fragments. However up to date no clear indications for surgery have been given. In addition, the precise rates of functional outcomes and complications are controversial. The hypothesis was the systematic analysis of the available literature would provide precise indications, outcomes and complications of arthroscopically assisted techniques for patellar fracture fixation...
June 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28629581/impact-of-a-teamstepps-trauma-nurse-academy-at-a-level-1-trauma-center
#7
V Kristen Peters, Ellen M Harvey, Andi Wright, Jennifer Bath, Dan Freeman, Bryan Collier
PROBLEM: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. METHODS: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers...
June 16, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28624011/peroneal-tendon-pathology-pre-and-post-operative-high-resolution-us-and-mr-imaging
#8
REVIEW
Yogesh Kumar, Ali Alian, Shivani Ahlawat, Dane K Wukich, Avneesh Chhabra
Peroneal tendon pathology is an important cause of lateral ankle pain and instability. Typical peroneal tendon disorders include tendinitis, tenosynovitis, partial and full thickness tendon tears, peroneal retinacular injuries, and tendon subluxations and dislocations. Surgery is usually indicated when conservative treatment fails. Familiarity with the peroneal tendon surgeries and expected postoperative imaging findings is essential for accurate assessment and to avoid diagnostic pitfalls. Cross-sectional imaging, especially ultrasound and MRI provide accurate pre-operative and post-operative evaluation of the peroneal tendon pathology...
July 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28623907/dna-methylation-dysregulations-in-rheumatic-heart-valve-disease
#9
Kangjun Shen, Hui Liu, Ran Jing, Jiangfeng Yi, Xinmin Zhou
BACKGROUND: The epigenetic changes underlying the development of rheumatic heart valve disease (RHVD) remain incompletely understood. Limited evidence suggests that abnormal DNA methylation might be involved in the pathogenesis of RHVD. In the present study, we evaluated the DNA methylation dysregulations from myocardial tissue in RHVD patients systematically. METHODS: Right atrial myocardial tissue obtained from rheumatic valvular patients who had undergone valve replacements surgery (n = 73) and were compared to healthy controls (n = 4)...
June 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28623570/enhanced-recovery-protocols-in-total-joint-arthroplasty-a-review-of-the-literature-and-their-implementation
#10
REVIEW
A S Galbraith, E McGloughlin, J Cashman
BACKGROUND: During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey...
June 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28623398/endothelial-vascular-markers-in-coronary-surgery
#11
Diana M Valencia-Nuñez, Willy Kreutler, Javier Moya-Gonzalez, Pedro Alados-Arboledas, Ignacio Muñoz-Carvajal, Andrés Carmona, Rafael Ramirez-Chamond, Julia Carracedo-Añon
Coronary heart disease is associated with high morbidity and mortality. Endothelial dysfunction in affected patients is linked to long-term atherosclerotic disease progression and cardiovascular event rates. The present paper reports on changes in the levels of endothelial progenitor cells (VEGFR2/CD133/CD34), essential for endothelial repair, and of endothelial microvesicles (CD31/annexin V) as indicators of endothelial lesion, in patients undergoing coronary bypass surgery with respect both to baseline levels and to counts in healthy subjects...
June 16, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28623081/multimorbidity-a-review-of-the-complexity-of-mental-health-issues-in-bariatric-surgery-candidates-informed-by-canadian-data
#12
REVIEW
Valerie H Taylor, Jennifer Hensel
BACKGROUND: Multimorbidity is significant for obesity and mental health issues. As a consequence, mental illness is overrepresented in patients seeking bariatric surgery. This review addresses that overlap, with a focus on Canadian data. CONCLUSION: The healthcare system in Canada is unique, but issues related to prevalence of mental health in patients seeking bariatric surgery are similar to those in studies conducted in other countries. Although data on suicide are lacking, Canadian data have shown similar rates of self-harm behaviours and linkages between psychopathology and weight regain after surgery...
June 13, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28622274/a-role-for-neurokinin-1-receptor-neurons-in-the-rostral-ventromedial-medulla-in-the-development-of-chronic-postthoracotomy-pain
#13
Sergey G Khasabov, Jeffrey Chi-Fei Wang, Donald A Simone, Gary R Strichartz
Thoracotomy results in chronic postoperative pain (CPTP) in half of the cases. Earlier findings in rat models of persistent post-surgical pain suggest that spinal pathways are critical for pain onset but not its maintenance. Descending systems from the brain stem modulate nociceptive transmission in the spinal cord and contribute to persistent pain, but their role in chronic postoperative pain has not been studied. Here, we ablated pronociceptive neurokinin-1 receptor (NK-1R)-expressing neurons in the rat rostral ventromedial medulla (RVM) to identify their role in CPTP...
July 2017: Pain
https://www.readbyqxmd.com/read/28622165/thoracic-imaging-after-bariatric-surgery
#14
Samuel J Galgano, Sushilkumar K Sonavane, Rupan Sanyal, Satinder P Singh, Christine O Menias, Sanjeev Bhalla
Obesity and its association with long-term health problems constitutes one of the major challenges in medicine. Though diet regulation and exercise are the primary treatment strategies, surgery is the most reliable long-term solution. Although bariatric surgical complications continue to decline, prompt recognition is essential to optimize patient outcomes. Despite their relative rarity, it is important to recognize thoracic complications, as several of these can result in severe morbidity and mortality. This article describes common bariatric surgical procedures performed, their expected postoperative appearances, and intrathoracic complications...
June 15, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28620900/new-treatment-options-and-management-considerations-in-borderline-resectable-pancreatic-cancer
#15
REVIEW
Zeljka Jutric, Laleh G Melstrom
In the United States, cancer of the pancreas accounts for nearly 40,000 deaths annually and is the fourth leading cause of cancer-related mortality. The vast majority of patients present with metastatic or unresectable disease. Only 20% of patients are candidates for surgery, and therefore curable. The 5-year survival rate for patients with pancreatic adenocarcinoma is only 6%, with surgical resection being essential for long-term survival. Recent research has identified a precise subset of patients with borderline resectable pancreatic cancer for whom resection yielding durable survival is possible...
June 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28619014/prognostic-impact-of-blood-and-urinary-angiogenic-factor-levels-at-diagnosis-and-during-treatment-in-patients-with-osteosarcoma-a-prospective-study
#16
Marie-Dominique Tabone, Laurence Brugières, Sophie Piperno-Neumann, Marie-Ange Selva, Perrine Marec-Bérard, Hélène Pacquement, Cyril Lervat, Nadège Corradini, Jean-Claude Gentet, Rémy Couderc, Aurélie Chevance, Céline Mahier-Ait Oukhatar, Natacha Entz-Werle, Jean-Yves Blay, Marie-Cecile Le Deley
BACKGROUND: Angiogenesis is essential for the progression and metastatic spread of solid tumours. Expression of vascular endothelial growth factor (VEGF) has been linked to poor survival among osteosarcoma patients but the clinical relevance of monitoring blood and urine angiogenic factors is uncertain. The aim of this study was to determine the prognostic significance of blood VEGF and blood and urinary basic fibroblast growth factor (bFGF) levels in osteosarcoma patients, both at diagnosis and during treatment...
June 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28617788/age-at-referral-for-undescended-testes-has-anything-changed-in-a-decade
#17
Mohit Bajaj, Vipul Upadhyay
AIM: Undescended testis (UDT) affects 1-6% of males and is one of the most common disorders in paediatric surgery.Updated consensus guidelines now recommend surgical management of UDT by 18 months. We compare the age at referral and subsequent timing of orchiopexy with data published from 1996-1998 at our institution, prior to the advent of updated guidelines. METHODS: A retrospective review of all patients undergoing an orchiopexy for UDT from 2014 to 2016 was conducted...
June 16, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28616598/laparoscopic-sentinel-node-navigation-surgery-for-early-gastric-cancer
#18
REVIEW
Shinichi Kinami, Takeo Kosaka
Currently, the most accurate method for identifying lymph node metastasis is intraoperative diagnosis by sentinel node (SN) biopsy. Based on the SNNS study-a recent large-scale, nationwide, multicenter prospective study-the SN concept seems to be scientifically valid in patients with early gastric cancer. SN biopsy is a multistep technique consisted of six essential elements: indication, the selection of a tracer, a proper tracer injection method, the objective detection of SNs, a reliable biopsy technique, and the precise detection of nodal metastasis...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28616347/intraoperative-care-for-aortic-surgery-using-circulatory-arrest
#19
REVIEW
Félix Ezequiel Fernández Suárez, David Fernández Del Valle, Adrián González Alvarez, Blanca Pérez-Lozano
The total circulatory arrest (CA) is necessary to achieve optimal surgical conditions in certain aortic pathologies, especially in those affecting the ascending aorta and aortic arch. During this procedure it is necessary to protect all the organs of ischemia, especially those of the central nervous system and for this purpose several strategies have been developed. The first and most important protective method is systemic hypothermia. The degree of hypothermia and the route of application have been evolving and currently tend to use moderate hypothermia (MH) (20...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616109/the-management-of-mixed-urinary-incontinence-in-women
#20
REVIEW
Blayne Welk, Richard J Baverstock
Mixed urinary incontinence is a common diagnosis among women with urinary leakage and is often present in women who are unable to characterize their incontinence. Research and optimized clinical treatment of these patients is limited by the challenges in objectively defining and stratifying this population. The evaluation of these patients should follow the same general principles as any assessment of any women with incontinence; however, it is essential to define whether urge or stress incontinence is the predominant symptom...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
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