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https://www.readbyqxmd.com/read/29458229/primary-closure-versus-bedside-silo-and-delayed-closure-for-gastroschisis-a-truncated-prospective-randomized-trial
#1
Ashwini S Poola, Pablo Aguayo, Jason D Fraser, Richard J Hendrickson, Katrina L Weaver, Katherine W Gonzalez, Shawn D St Peter
BACKGROUND: We report a prospective randomized trial comparing primary closure (PC) to bedside silo and delayed closure (DC) for babies with gastroschisis. METHODS: Patients were randomized to PC versus DC. We excluded those with atresia/necrosis, <34 weeks' gestation, or congenital anomalies. The primary outcome was length of stay (LOS). RESULTS: A total of 38 patients were included from August 2011 to August 2016; 18 patients underwent DC and 20 PC...
February 19, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29457334/establishing-a-successful-perioperative-geriatric-service-in-an-australian-acute-surgical-unit
#2
Lauren Styan, Skyle Murphy, Aisling Fleury, Brian McGowan, Martin Wullschleger
BACKGROUND: The purpose of this study was to assess the impact of a perioperative geriatric service (PGS) in an acute surgical unit (ASU) on patient and organizational outcomes. METHODS: Single centre retrospective cohort study. Inclusion criteria were patients over the age of 65 admitted to the ASU between January and June 2014 (pre-PGS) and 2015 (post-PGS). Chart reviews were performed to identify outcomes of interest including in-hospital morbidity and mortality, length of stay (LOS), 30-day representation and mortality...
February 18, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29456086/low-dose-propofol-for-pediatric-migraine-a-prospective-randomized-controlled-trial
#3
David C Sheridan, Matthew L Hansen, Amber L Lin, Rongwei Fu, Garth D Meckler
BACKGROUND: Migraine headaches are a common reason for pediatric emergency department (ED) visits. Small studies suggest the potential efficacy of sub-anesthetic doses of propofol for migraine with a favorable side effect profile and potentially decreased length of stay (LOS). OBJECTIVE: The objective of this study was to compare the efficacy of low-dose propofol (LDP) to standard therapy (ST) in pediatric migraine treatment. METHODS: We conducted a prospective, pragmatic randomized controlled trial from April 2014 through June 2016 in the ED at two pediatric hospitals...
February 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29455632/arthroscopic-undersurface-rotator-cuff-repair-versus-conventional-arthroscopic-double-row-rotator-cuff-repair-comparable-results-at-2-year-follow-up
#4
Benjamin Fu Hong Ang, Jerry Yongqiang Chen, William Yeo, Denny Tijauw Tjoen Lie, Paul Chee Cheng Chang
AIM: The aim of our study is to compare the improvement in clinical outcomes after conventional arthroscopic double-row rotator cuff repair and arthroscopic undersurface rotator cuff repair. METHOD: A consecutive series of 120 patients who underwent arthroscopic rotator cuff repair was analysed. Sixty-one patients underwent conventional double-row rotator cuff repair and 59 patients underwent undersurface rotator cuff repair. Several clinical outcomes, including numerical pain rating scale (NPRS), constant shoulder score (CSS), Oxford shoulder score (OSS) and University of California Los Angeles shoulder score (UCLASS), were prospectively recorded by a trained healthcare professional preoperatively and at 3, 6, 12 and 24 months after surgery...
January 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29455622/synthesis-of-low-cost-organometallic-type-catalysts-for-their-application-in-microbial-fuel-cell-technology
#5
A Zerrouki, M J Salar-García, V M Ortiz-Martínez, S Guendouz, H Ilikti, A P de Los Ríos, F J Hernández-Fernández, M Kameche
Microbial fuel cells (MFCs) are a promising technology that generates electricity from several biodegradable substrates and wastes. The main drawback of these devices is the need of using a catalyst for the oxygen reduction reaction at the cathode, which makes the process relatively expensive. In this work, two low cost materials are tested as catalysts in MFCs. A novel iron complex based on the ligand n-phenyledenparaethoxy aniline has been synthesized and its performance as catalyst in single chamber MFCs containing ionic liquids has been compared with a commercial inorganic material such as Raney nickel...
February 19, 2018: Environmental Technology
https://www.readbyqxmd.com/read/29455567/apixaban-or-rivaroxaban-versus-warfarin-for-treatment-of-submassive-pulmonary-embolism-after-catheter-directed-thrombolysis
#6
Lara M Groetzinger, Taylor J Miller, Ryan M Rivosecchi, Roy E Smith, Mark T Gladwin, Belinda N Rivera-Lebron
BACKGROUND: Little data exist on the use of direct oral anticoagulant (DOAC) factor Xa inhibitors for submassive pulmonary embolism (PE) after catheter-directed thrombolysis (CDT). The objective of this evaluation was to determine whether the transition from parenteral anticoagulation to DOACs for submassive PE after CDT would decrease hospital length of stay (LOS) compared to warfarin. METHODS: A retrospective review of patients diagnosed with submassive PE who underwent CDT was conducted from January 1, 2012, to February 28, 2017...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29455407/a-single-center-experience-examining-the-length-of-stay-and-safety-of-early-discharge-after-laparoscopic-roux-en-y-gastric-bypass-surgery
#7
Melanie H Howell, Aaron Praiss, Dina Podolsky, Natan Zundel, Erin Moran-Atkin, Jenny J Choi, Diego R Camacho
PURPOSE: This study's objective was to describe our experience and evaluate the safety of early discharge (ED) following laparoscopic Roux-en-Y gastric bypass (LRYGB) in a specific patient population. MATERIALS AND METHODS: Patients undergoing LRYGB at Montefiore Medical Center were retrospectively reviewed. Patients readmitted in the first 30 days following surgery were compared to those patients who were not readmitted. Data analysis was used to compare groups and to determine factors associated with readmission...
February 17, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29455347/a-prospective-comparative-study-of-hip-resurfacing-arthroplasty-and-large-diameter-head-metal-on-metal-total-hip-arthroplasty-in-younger-patients-a-minimum-of-five-year-follow-up
#8
Ran Tao, Fan Liu, Ya-Ke Liu, Yue Lu, Hua Xu, Yi Cao, Zhen-Yu Zhou, Wei Wang
INTRODUCTION: Both hip resurfacing arthroplasty (HRA) and large-diameter head metal-on-metal total hip arthroplasty (LDH MoM THA) are generally used for young and active patients. A number of comparative studies of HRA and total hip arthroplasty have been published in the literature. However, studies that have compared HRA with LDH MoM THA are rare. The purpose of this study is to compare the mid-term results of HRA with those of LDH MoM THA in young patients. PATIENTS AND METHODS: Between 2007 and 2011, 68 patients were enrolled in the study and randomized into two groups: HRA group (28 hips) and LDH MoM THA group (40 hips)...
February 18, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29454714/interphysician-differences-in-emergency-department-length-of-stay
#9
Stephen J Traub, Soroush Saghafian, Kurtis Judson, Christopher Russi, Bo Madsen, Stephen Cha, Hannah C Tolson, Leon D Sanchez, Jesse M Pines
BACKGROUND: Emergency physicians differ in many ways with respect to practice. One area in which interphysician practice differences are not well characterized is emergency department (ED) length of stay (LOS). OBJECTIVE: To describe how ED LOS differs among physicians. METHODS: We performed a 3-year, five-ED retrospective study of non-fast-track visits evaluated primarily by physicians. We report each provider's observed LOS, as well as each provider's ratio of observed LOS/expected LOS (LOSO/E ); we determined expected LOS based on site average adjusted for the patient characteristics of age, gender, acuity, and disposition status, as well as the time characteristics of shift, day of week, season, and calendar year...
February 14, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29454331/the-increasing-importance-of-a-continence-nurse-specialist-to-improve-outcomes-and-save-costs-of-urinary-incontinence-care-an-analysis-of-future-policy-scenarios
#10
Margreet G Franken, Isaac Corro Ramos, Jeanine Los, Maiwenn J Al
BACKGROUND: In an ageing population, it is inevitable to improve the management of care for community-dwelling elderly with incontinence. A previous study showed that implementation of the Optimum Continence Service Specification (OCSS) for urinary incontinence in community-dwelling elderly with four or more chronic diseases results in a reduction of urinary incontinence, an improved quality of life, and lower healthcare and lower societal costs. The aim of this study was to explore future consequences of the OCSS strategy of various healthcare policy scenarios in an ageing population...
February 17, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29454135/short-term-outcomes-following-posterior-cervical-fusion-among-octogenarians-with-cervical-spondylotic-myelopathy-a-nsqip-database-analysis
#11
Caroline E Vonck, Joseph E Tanenbaum, Thomas T Bomberger, Edward C Benzel, Jason W Savage, Iain H Kalfas, Thomas E Mroz, Michael P Steinmetz
BACKGROUND: Context: Degenerative changes in the cervical spine occur in an age-dependent manner. As the U.S. population continues to age, the incidence of age-dependent, multi-level, degenerative cervical pathologies is expected to increase. Similarly, the average age of patients with cervical spondylotic myelopathy (CSM) will likely trend upward. Posterior cervical fusion (PCF) is often the treatment modality of choice in the management of multi-level cervical spine disease. Although outcomes following anterior cervical fusion for degenerative disease have been studied among older patients (aged 80 years and older), it is unknown if these results extend to octogenarian patients undergoing PCF for the surgical management of CSM...
February 14, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29453585/predicting-hospital-length-of-stay-and-short-term-function-after-hip-or-knee-arthroplasty-are-both-performance-and-comorbidity-measures-useful
#12
Stéphane Poitras, Kendrick Au, Kristi Wood, Geoffrey Dervin, Paul E Beaulé
PURPOSE: Variations in hospital length of stay (LOS) and function are present after hip or knee arthroplasty. Comorbidity and performance measures have been associated with post-operative outcomes. It is however not known if both independently contribute to outcome prediction. The objective of this study was to evaluate the combined predictive ability of comorbidity scores (American Society of Anesthesiologists classification system (ASA), Charlson comorbidity index (CCI), 2008 version of the CCI (CCI08)) and a performance measure (Timed-Up-and-Go (TUG)) on LOS and short-term function in patients undergoing knee or hip arthroplasty...
February 17, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29452441/assessing-the-safety-and-efficacy-of-regional-anesthesia-for-lower-extremity-microvascular-reconstruction-enhancing-recovery
#13
Qing Zhao Ruan, Shawn Diamond, Scott Zimmer, Matthew L Iorio
BACKGROUND: Perioperative pain, increased sympathetic tone, and peripheral vasospasm may be safely managed with regional nerve blockade during microvascular reconstruction in the lower extremity. Limited reports exist in this setting; therefore, we evaluated our use of peripheral nerve catheters (PNCs) during microvascular limb salvage to determine safety and efficacy for both patient and flap. METHODS: A single-institution, retrospective review of a prospectively maintained database on all patients with lower extremity free tissue transfers between 2012 and 2017 was completed...
February 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29451415/clinical-and-economic-impact-of-an-enhanced-recovery-pathway-for-open-and-laparoscopic-rectal-surgery
#14
Richard Garfinkle, Marylise Boutros, Gabriela Ghitulescu, Carol-Ann Vasilevsky, Patrick Charlebois, Sender Liberman, Barry Stein, Liane S Feldman, Lawrence Lee
BACKGROUND: The short-term benefits of laparoscopy for rectal surgery are equivocal. The objective of this study was to determine the clinical and economic impact of an enhanced recovery pathway (ERP) for laparoscopic and open rectal surgery. MATERIALS AND METHODS: All patients who underwent elective rectal resection with primary anastomosis between January 2009 and March 2012 at two tertiary-care, university-affiliated institutions were identified. Patients who met inclusion criteria were divided into four groups, according to surgical approach (laparoscopic [lap] or open) and perioperative management (ERP or conventional care [CC])...
February 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29450935/community-violence-exposure-correlates-with-smaller-gray-matter-volume-and-lower-iq-in-urban-adolescents
#15
Oisin Butler, Xiao-Fei Yang, Corinna Laube, Simone Kühn, Mary Helen Immordino-Yang
Adolescents' exposure to community violence is a significant public health issue in urban settings and has been associated with poorer cognitive performance and increased risk for psychiatric illnesses, including PTSD. However, no study to date has investigated the neural correlates of community violence exposure in adolescents. Sixty-five healthy adolescents (age = 14-18 years; 36 females, 29 males) from moderate- to high-crime neighborhoods in Los Angeles reported their violence exposure, parents' education level, and free/reduced school lunch status (socio-economic status, SES), and underwent structural neuroimaging and intelligence testing...
February 15, 2018: Human Brain Mapping
https://www.readbyqxmd.com/read/29448872/emotional-well-being-and-public-health-proposal-for-a-model-national-initiative
#16
Sophie C Feller, Enrico G Castillo, Jared M Greenberg, Pilar Abascal, Richard Van Horn, Kenneth B Wells
In 2011, the National Prevention, Health Promotion, and Public Health Council named mental and emotional well-being as 1 of 7 priority areas for the National Prevention Strategy. In this article, we discuss emotional well-being as a scientific concept and its relevance to public health. We review evidence that supports the association between emotional well-being and health. We propose a national emotional well-being initiative and describe its 6 components: systematic measurement of emotional well-being, identification of the drivers of emotional well-being, formation of partnerships with diverse stakeholders, implementation and dissemination of evidence-based interventions to promote emotional well-being and its drivers, development of public health messaging, and identification of and strategies to address disparities in emotional well-being and its drivers...
January 1, 2018: Public Health Reports
https://www.readbyqxmd.com/read/29448850/treatment-changes-in-patients-with-psoriasis-on-etanercept-or-adalimumab-a-retrospective-chart-review
#17
Erica B Lee, Mina Amin, Alexander Egeberg, Jashin J Wu
PURPOSE: To determine the frequency of and reasons for treatment changes in patients with psoriasis. MATERIALS AND METHODS: A retrospective chart review of 140 patients with psoriasis treated with adalimumab or etanercept seen at Kaiser Permanente Los Angeles Medical Center between September 20, 2004 and September 8, 2017 was conducted. The first treatment change and reason for that change was documented. RESULTS: Of 140 patients, 103 patients had treatment changes, most commonly due to inefficacy, however complicating events and changes due to patient preference were also seen...
February 15, 2018: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/29448809/utilizing-machine-learning-and-automated-performance-metrics-to-evaluate-robot-assisted-radical-prostatectomy-performance-and-predict-outcomes
#18
Andrew Hung, Jian Chen, Zhengping Che, Tanachat Nilanon, Anthony Jarc, Micha Titus, Paul Oh, Inderbir Singh Gill, Yan Liu
Purpose Surgical performance is critical for clinical outcomes. We present a novel machine learning (ML) method of processing automated performance metrics (APMs) to evaluate surgical performance and predict clinical outcomes after robot-assisted radical prostatectomy (RARP). Methods We trained three ML algorithms utilizing APMs directly from robot system data (training material) and hospital length of stay (LOS; training label) (≤2 days and >2days) from 78 RARP cases, and selected the algorithm with the best performance...
February 16, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29447899/geographic-health-disparities-in-the-los-angeles-pediatric-esophageal-foreign-body-population
#19
Kevin Hur, Varun Angajala, Dennis Maceri, Christian Hochstim
OBJECTIVE: To assess geographical sociodemographic differences in the pediatric esophageal foreign body population of Los Angeles. METHODS: We retrospectively reviewed the medical records of 128 consecutive pediatric patients at Children's Hospital Los Angeles (CHLA) from 2014 to 2017 with a diagnosis of a retained foreign body in the esophagus removed by rigid or flexible esophagoscopy. Sociodemographic information including zip code of residence was extracted and analyzed with Chi-square, Fisher's exact test, and multivariable logistic regression...
March 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29447854/risk-factors-associated-complications-for-postoperative-urinary-retention-after-lumbar-surgery-for-lumbar-spinal-stenosis
#20
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
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