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https://www.readbyqxmd.com/read/28107366/comparative-analysis-of-direct-hospital-care-costs-between-aseptic-and-two-stage-septic-knee-revision
#1
Richard Kasch, Sebastian Merk, Grit Assmann, Andreas Lahm, Matthias Napp, Harry Merk, Steffen Flessa
BACKGROUND: The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available...
2017: PloS One
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#2
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107231/national-database-research-in-spine-surgery-limitations-in-the-current-literature
#3
Arjun S Sebastian
Many of the studies in the spine surgical literature using national databases have been directed at examining adverse events, readmission rates, cost, and risk factors for poorer outcomes. Although such studies allow for assessment of large cohorts taken from multiple institutions, they are limited by data collection methods, short-term follow-up, and minimal assessment of functional outcomes. Furthermore, few studies are directed at producing actionable practice changes to improve patient care. Recent work aimed at producing databases with more relevance to spine surgery represent exciting developments to the rapidly growing field of health outcomes research...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28106355/comparative-study-of-fiberoptic-guided-versus-intubating-laryngeal-mask-airway-assisted-awake-orotracheal-intubation-in-patients-with-unstable-cervical-spine-a-randomized-controlled-trial
#4
Tanmay Jadhav, Kamath Sriganesh, Madhusudan K Reddy, Dhritiman Chakrabarti
BACKGROUND: A safe airway technique minimizes intubation-associated cervical-spine movement and consequent neurological injury in patients with unstable cervical spine (UCS). Awake fiberoptic-guided intubation (FGI) is preferred in patients with UCS. Alternatively, intubating laryngeal mask airway assisted intubation (ILMA-AI) can be performed both during elective and emergency, requires less expertise and is cost-effective. This study evaluated cervical-spine movement during FGI and ILMA-AI in patients with UCS...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28106235/scleral-buckling-in-phakic-uncomplicated-primary-rhegmatogenous-retinal-detachment-long-term-outcomes
#5
Claudia Quijano, Micol Alkabes, Maria Gómez-Resa, Andrea Oleñik, Edoardo Villani, Borja Corcóstegui
PURPOSE: Scleral buckling (SB) is a surgical technique that has been used successfully to treat retinal detachments for the last 6 decades. The aim of this study was to report the long-term anatomical and functional outcomes of SB surgery in phakic patients with uncomplicated primary rhegmatogenous retinal detachment (PRRD). This article also outlines the benefits of SB compared to pars plana vitrectomy, such as reducing the risk of developing cataract, high intraocular pressure, and glaucoma, in addition to reducing surgical cost...
December 31, 2016: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28105620/-effect-of-a-clinical-pathway-in-patients-with-crohn-s-disease-complicated-with-intestinal-obstruction
#6
Zhen Guo, Lei Cao, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction. METHODS: CD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28105547/ability-to-predict-the-development-of-surgical-site-infection-in-cardiac-surgery-using-the-australian-clinical-risk-index-versus-the-national-nosocomial-infections-surveillance-derived-risk-index
#7
A Figuerola-Tejerina, E Bustamante, E Tamayo, C A Mestres, J Bustamante-Munguira
Surgical site infection (SSI) is a major infectious complication that increases mortality, morbidity, and healthcare costs. There are scores attempting to classify patients for calculating SSI risk. Our objectives were to validate the Australian Clinical Risk Index (ACRI) in a European population after cardiac surgery, comparing it against the National Nosocomial Infections Surveillance-derived risk index (NNIS) and analyzing the predictive power of ACRI for SSI in valvular patients. All the patients that who underwent cardiac surgery in a tertiary university hospital between 2011 and 2015 were analyzed...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28105528/cost-effectiveness-in-global-surgery-pearls-pitfalls-and-a-checklist
#8
REVIEW
Mark G Shrime, Blake C Alkire, Caris Grimes, Tiffany E Chao, Dan Poenaru, Stéphane Verguet
INTRODUCTION: Cost-effectiveness analysis can be a powerful policy-making tool. In the two decades since the first cost-effectiveness analyses in global surgery, the methodology has established the cost-effectiveness of many types of surgery in low- and middle-income countries (LMICs). However, with the crescendo of cost-effectiveness analyses in global surgery has come vast disparities in methodology, with only 15% of studies adhering to published guidelines. This has led to results that have varied up to 150-fold...
January 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#9
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28102961/assessing-the-use-of-4dct-ventilation-in-pre-operative-surgical-lung-cancer-evaluation
#10
Yevgeniy Vinogradskiy, Matthew Jackson, Leah Schubert, Bernard Jones, Richard Castillo, Edward Castillo, Thomas Guerrero, John Mitchell, Chad Rusthoven, Moyed Miften, Brian Kavanagh
PURPOSE: A primary treatment option for lung cancer patients is surgical resection. Patients who have poor lung function prior to surgery are at increased risk of developing serious and life-threatening complications after surgical resection. Surgeons use nuclear medicine ventilation-perfusion (VQ) scans along with pulmonary function test (PFT) information to assess a patient's pre-surgical lung function. The nuclear medicine images and pre-surgery PFTs are used to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung tissue that would be lost with surgical resection...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28101792/medical-management-of-diabesity-do-we-have-realistic-targets
#11
REVIEW
Joseph M Pappachan, Ananth K Viswanath
PURPOSE OF REVIEW: The global prevalence of "diabesity"-diabetes related to obesity-is increasing steadily over the past few decades because of the obesity epidemic. Although bariatric surgery is an effective treatment option for patients with diabesity, its limited availability, invasiveness, relatively high costs and the potential for surgical and postsurgical complications restrict its widespread use. Therefore, medical management is the only option for a majority of patients with diabesity...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28101720/enhanced-recovery-after-surgery-programs-for-liver-resection-a-meta-analysis
#12
Cheng Wang, Guoqun Zheng, Wenlong Zhang, Fabiao Zhang, Shangdong Lv, Aidong Wang, Zheping Fang
BACKGROUND AND AIMS: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy. METHODS: We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28100266/arranging-blood-for-elective-thyroid-surgeries-dilemma-continues-in-the-developing-world
#13
Salman Faridi, Aman Ahmad, Mirza Arshad Beg, Faisal Siddiqui, Muhammad Muzzammil Edhi, Mehmood Khan
BACKGROUND: Cross matched blood is frequently ordered based on a subjective anticipation of blood loss for a procedure. Excessive blood arrangement and wastage overburdens the blood bank in terms of work load and storage of blood, increases cost of medical care and results in injudicious use of a limited resource. The aim of this short report is to assess the current practice for arranging cross matched blood in elective thyroid surgeries by comparing cross match to blood transfused ratio...
January 18, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28098939/a-systematic-review-of-economic-evaluations-of-treatments-for-patients-with-epilepsy
#14
REVIEW
Ben F M Wijnen, Ghislaine A P G van Mastrigt, Silvia M A A Evers, Olga Gershuni, Danielle A J E Lambrechts, Marian H J M Majoie, Debby Postulart, Bert A P Aldenkamp, Reina J A de Kinderen
The increasing number of treatment options and the high costs associated with epilepsy have fostered the development of economic evaluations in epilepsy. It is important to examine the availability and quality of these economic evaluations and to identify potential research gaps. As well as looking at both pharmacologic (antiepileptic drugs [AEDs]) and nonpharmacologic (e.g., epilepsy surgery, ketogenic diet, vagus nerve stimulation) therapies, this review examines the methodologic quality of the full economic evaluations included...
January 18, 2017: Epilepsia
https://www.readbyqxmd.com/read/28098712/business-education-for-plastic-surgeons-a-systematic-review-development-and-implementation-of-a-business-principles-curriculum-in-a-residency-program
#15
Bahar Zarrabi, Karen K Burce, Stella M Seal, Scott D Lifchez, Richard J Redett, Kevin Frick, Amir H Dorafshar, Carisa M Cooney
BACKGROUND: Rising healthcare costs, decreasing reimbursement rates, and changes in American healthcare are forcing physicians to become increasingly business-minded. Both academic and private plastic surgeons can benefit from being educated in business principles. We conducted a systematic review to identify existing business curricula and integrated a business principles curriculum into residency training. METHODS: We anonymously surveyed our department regarding perceived importance of business principles and performed a systematic literature review from 1993-2013 using PubMed and Embase to identify residency training programs that had designed/implemented business curricula...
January 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28098574/new-developments-in-robotics-and-single-site-gynecologic-surgery
#16
Catherine A Matthews
Within the last 10 years there have been significant advances in minimal-access surgery. Although no emerging technology has demonstrated improved outcomes or fewer complications than standard laparoscopy, the introduction of the robotic surgical platform has significantly lowered abdominal hysterectomy rates. While operative time and cost were higher in robotic-assisted procedures when the technology was first introduced, newer studies demonstrate equivalent or improved robotic surgical efficiency with increased experience...
January 17, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28097913/cost-consequence-analysis-of-different-active-flowable-hemostatic-matrices-in-cardiac-surgical-procedures
#17
D Makhija, M Rock, Y Xiong, J D Epstein, M R Arnold, O M Lattouf, D Calcaterra
BACKGROUND: A recent retrospective comparative effectiveness study found that use of FLOSEAL® Hemostatic Matrix in cardiac surgery was associated with significantly lower risks of complications, blood transfusions, surgical revisions and shorter length of surgery than use of SURGIFLO(®) Hemostatic Matrix. These outcome improvements in cardiac surgery procedures may translate to economic savings for hospitals and payers. OBJECTIVE: The objective of this study was to estimate the cost-consequence of two flowable hemostatic matrices (FLOSEAL or SURGIFLO) in cardiac surgeries for US hospitals...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28097784/reliability-of-intraoperative-frozen-section-for-the-diagnosis-of-renal-tumors-suspicious-for-malignancy-in-children-and-adolescents
#18
Alonso Carrasco, Brian T Caldwell, Carrye R Cost, Brian S Greffe, Timothy P Garrington, Jennifer L Bruny, Jennifer O Black, Nicholas G Cost
BACKGROUND: The ability of intraoperative frozen section (IFS) to reliably diagnose renal tumors in children and adolescents is largely unknown. The objective of our study is to evaluate the ability of IFS to establish a histologic diagnosis for renal tumors in this population. METHODS: We reviewed our experience with patients who underwent IFS at the time of surgery for a renal tumor suspicious for malignancy from 2005 to 2015. The IFS was compared to the final pathology (FP)...
January 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#19
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28097246/three-year-follow-up-of-a-randomized-controlled-trial-comparing-preoperative-neuroscience-education-for-patients-undergoing-surgery-for-lumbar-radiculopathy
#20
Adriaan Louw, Ina Diener, Merrill R Landers, Kory Zimney, Emilio J Puentedura
BACKGROUND: Results from a previous multicenter randomized controlled trial (RCT) on preoperative pain neuroscience education (PNE) for lumbar radiculopathy found no significant difference in patient reported outcomes between groups. However, patients who received PNE viewed their surgical experience more favorably and utilized significantly less healthcare compared to those that did not. The purpose is to determine if the reduction in healthcare costs from 1-year would be continued at 3-year following surgery, and to explore differences (if any) in patient reported outcomes...
December 2016: Journal of Spine Surgery (Hong Kong)
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