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https://www.readbyqxmd.com/read/27924511/initial-12-h-operative-fluid-volume-is-an-independent-risk-factor-for-pleural-effusion-after-hepatectomy
#1
Xiang Cheng, Jia-Wei Wu, Ping Sun, Zi-Fang Song, Qi-Chang Zheng
Pleural effusion after hepatectomy is associated with significant morbidity and prolonged hospital stays. Several studies have addressed the risk factors for postoperative pleural effusion. However, there are no researches concerning the role of the initial 12-h operative fluid volume. The aim of this study was to evaluate whether the initial 12-h operative fluid volume during liver resection is an independent risk factor for pleural effusion after hepatectomy. In this study, we retrospectively analyzed clinical data of 470 patients consecutively undergoing elective hepatectomy between January 2011 and December 2012...
December 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27924391/our-experience-with-laparoscopic-partial-gastrectomy-by-the-lift-and-cut-method-for-gastric-gastrointestinal-stromal-tumor-with-maximal-preservation-of-the-remnant-stomach
#2
Shintaro Okumura, Seiichiro Kanaya, Hisahiro Hosogi, Takeshi Ito, Susumu Miura, Toshihiro Okada, Norihiro Shimoike, Shin Akagawa, Hironori Kawada, Akira Arimoto
BACKGROUND: Wedge resection is the most commonly used method in laparoscopic partial gastrectomy for gastric gastrointestinal stromal tumor (GIST). However, this method can involve inadvertent resection of additional gastric tissue and cause gastric deformation. To minimize the volume of resected gastric tissue, we have developed a laparoscopic partial gastrectomy with seromyotomy which we call the 'lift-and-cut method' for gastric GIST. Here, we report a case series of this surgery. METHOD: First, the seromuscular layer around the tumor is cut...
December 6, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27924105/innovating-affordable-neonatal-care-equipment-for-use-at-scale
#3
REVIEW
V Sashi Kumar, V K Paul, K Sathasivam
The care of small and sick neonates requires biomedical technologies, such as devices that can keep babies warm (radiant warmers and incubators), resuscitate (self-inflating bags), track growth (weighing scales), treat jaundice (phototherapy units) and provide oxygen or respiratory support (hoods, continuous positive airway pressure (CPAP) devices and ventilators). Until the 1990s, most of these products were procured through import at a high cost and with little maintenance support. Emerging demand and an informal collaboration of neonatologists, engineers and entrepreneurs has led to the production of good quality equipment of several high-volume categories at affordable cost in India...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27923615/impact-of-facility-type-and-surgical-volume-on-10-year-survival-in-patients-undergoing-hepatic-resection-for-hepatocellular-carcinoma
#4
Brandon C Chapman, Alessandro Paniccia, Patrick W Hosokawa, William G Henderson, Douglas M Overbey, Wells Messersmith, Martin D McCarter, Ana Gleisner, Barish H Edil, Richard D Schulick, Csaba Gajdos
BACKGROUND: Previous studies have demonstrated improved in-hospital mortality following hepatic resection for hepatocellular carcinoma (HCC) at teaching hospitals. The objective of this study was to evaluate if resection of HCCs at academic cancer programs (ACP) is associated with improved 10-year survival. STUDY DESIGN: Using the NCDB (1998-2011), we evaluated patients undergoing hepatic resection for HCC at ACPs, comprehensive community cancer programs (CCCPs), and community cancer programs (CCPs)...
December 3, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27922990/robotically-assisted-thoracic-surgery-proposed-guidelines-for-privileging-and-credentialing
#5
Faiz Y Bhora, Adnan M Al-Ayoubi, Sadiq S Rehmani, Craig M Forleiter, Wissam N Raad, Scott G Belsley
OBJECTIVE: Increased use of robotically assisted thoracic surgery (RATS) necessitates effective credentialing guidelines to ensure safe outcomes. We provide a stepwise algorithm for granting privileges and credentials in RATS. This algorithm reflects graduated responsibility and complexity of the surgical procedures performed. Furthermore, it takes into account volume, outcomes, surgeon's competency, and appropriateness of robot usage. METHODS: We performed a literature review for available strategies to grant privileges and credentials for implementing robotic surgery...
December 5, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922879/the-changes-in-pulse-pressure-variation-or-stroke-volume-variation-after-a-tidal-volume-challenge-reliably-predict-fluid-responsiveness-during-low-tidal-volume-ventilation
#6
Sheila Nainan Myatra, Natesh R Prabu, Jigeeshu Vasishtha Divatia, Xavier Monnet, Atul Prabhakar Kulkarni, Jean-Louis Teboul
OBJECTIVES: Stroke volume variation and pulse pressure variation do not reliably predict fluid responsiveness during low tidal volume ventilation. We hypothesized that with transient increase in tidal volume from 6 to 8 mL/kg predicted body weight, that is, "tidal volume challenge," the changes in pulse pressure variation and stroke volume variation will predict fluid responsiveness. DESIGN: Prospective, single-arm study. SETTING: Medical-surgical ICU in a university hospital...
December 5, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27921275/preoperative-characteristics-of-the-p-r-o-s-t-a-t-e-scores-a-novel-predictive-tool-for-the-risk-of-positive-surgical-margin-after-radical-prostatectomy
#7
Ben Xu, Cheng Luo, Qian Zhang, Jie Jin
OBJECTIVES: To propose a novel scoring system to predict the risk of positive surgical margin (PSM) after radical prostatectomy (RP) in prostate cancer (PCa) patients. MATERIALS AND METHODS: Eight reproducible variables available from preoperative characteristics of PCa patients were measured: PSA level (P), ratio of positive biopsy needles (R), obesity (O), scores of Gleason (S), T stage by preoperative MRI scan (T), age (A), tumor volume (T) and experience of the surgeon (E)...
December 5, 2016: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/27920548/platelet-count-and-platelet-indices-in-women-with-preeclampsia
#8
Muneera A AlSheeha, Rafi S Alaboudi, Mohammad A Alghasham, Javed Iqbal, Ishag Adam
BACKGROUND: Although the exact pathophysiology of preeclampsia is not completely understood, the utility of different platelets indices can be utilized to predict preeclampsia. OBJECTIVE: To compare platelet indices, namely platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), and PC to MPV ratio in women with preeclampsia compared with healthy controls. SETTING: Qassim Hospital, Kingdom of Saudi Arabia. DESIGN: A case-control study...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27920519/outcomes-of-a-telemonitoring-based-program-telepoc-in-frequently-hospitalized-copd-patients
#9
Cristóbal Esteban, Javier Moraza, Milagros Iriberri, Urko Aguirre, Begoña Goiria, José M Quintana, Myriam Aburto, Alberto Capelastegui
BACKGROUND: The increasing prevalence of chronic diseases requires changes in health care delivery. In COPD, telemedicine appears to be a useful tool. Our objective was to evaluate the efficacy (in improving health care-resource use and clinical outcomes) of a telemonitoring-based program (telEPOC) in COPD patients with frequent hospitalizations. MATERIALS AND METHODS: We conducted a nonrandomized observational study in an intervention cohort of 119 patients (Galdakao-Usansolo Hospital) and a control cohort of 78 patients (Cruces Hospital), followed up for 2 years (ClinicalTrials...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27920483/outcomes-of-partial-splenic-embolization-in-patients-with-massive-splenomegaly-due-to-idiopathic-portal-hypertension
#10
Omer Ozturk, Gonca Eldem, Bora Peynircioglu, Taylan Kav, Aysegul Görmez, Barbaros Erhan Cil, Ferhun Balkancı, Cenk Sokmensuer, Yusuf Bayraktar
AIM: To determine the outcomes of partial splenic embolization (PSE) for massive splenomegaly due to idiopathic portal hypertension (IPH). METHODS: In this prospective study, we evaluated the characteristics and prognosis of consecutive patients with IPH who underwent PSE for all indications at a single medical center between June 2009 and January 2015. The inclusion criteria were: presence of hypersplenism, massive splenomegaly, and resultant pancytopenia. The exclusion criteria were: presence of other diseases causing portal hypertension...
November 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27919580/variation-in-diagnoses-for-hip-arthroplasty-among-new-york-state-hospitals-implications-for-the-comprehensive-care-for-joint-replacement-model
#11
John A Buza, Jeffrey M Jancuska, James D Slover, Richard Iorio, Joseph A Bosco
BACKGROUND: The Comprehensive Care for Joint Replacement model is designed to minimize costs and improve quality for Medicare patients undergoing joint arthroplasty. The cost of hip arthroplasty (HA) episode varies depending on the preoperative diagnosis and is greater for fracture than for osteoarthritis. Hospitals that perform a higher percentage of HA for OA may therefore have an advantage in the Comprehensive Care for Joint Replacement model. The purposes of this study are to (1) determine the variability in underlying diagnosis for HA in New York State hospitals, and (2) determine hospital characteristics, such as volume, associated with this...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27919447/case-mix-adjusted-cost-of-colectomy-at-low-middle-and-high-volume-academic-centers
#12
Alex L Chang, Young Kim, Audrey E Ertel, Richard S Hoehn, Koffi Wima, Daniel E Abbott, Shimul A Shah
BACKGROUND: Efforts to regionalize surgery based on thresholds in procedure volume may have consequences on the cost of health care delivery. This study aims to delineate the relationship between hospital volume, case mix, and variability in the cost of operative intervention using colectomy as the model. METHODS: All patients undergoing colectomy (n = 90,583) at 183 academic hospitals from 2009-2012 in The University HealthSystems Consortium Database were studied...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27919396/think-time-a-novel-approach-to-analysis-of-clinicians-behavior-after-reduction-of-drug-drug-interaction-alerts
#13
Richard Schreiber, Julia A Gregoire, Jacob E Shaha, Steven H Shaha
OBJECTIVES: Pharmacologic interaction alerting offers the potential for safer medication prescribing, but research reveals persistent concerns regarding alert fatigue. Research studies have tried various strategies to resolve this problem, with low overall success. We examined the effects of targeted alert reduction on clinician behavior in a resource constrained hospital. METHODS: A physician and a pharmacy informaticist reduced alert levels of several drug-drug interactions (DDI) that clinicians almost always overrode with approval from and knowledge of the medical staff...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27917793/high-dose-oral-furosemide-with-salt-ingestion-in-the-treatment-of-refractory-ascites-of-liver-cirrhosis
#14
Tolga Yakar, Mehmet Demir, Ozlem Dogan, Alper Parlakgumus, Birol Ozer, Ender Serin
PURPOSE: We aimed to evaluate and compare the efficacy and safety of high-dose furosemide+salt orally by comparing HSS+ furosemide (i.v.) and repeated paracentesis in patients with RA. METHODS: This was a prospective study of 78 cirrhotic patients with RA, randomized into three groups: Group A (n= 25) i.v. furosemide (200-300 mg bid) and 3% hypotonic saline solution (HSS) (once or twice a day); Group B (n= 26) oral furosemide tablets (360-520 mg bid) and salt (2...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27917209/left-ventricular-systolic-function-in-sickle-cell-anaemia-an-echocardiographic-evaluation-in-adult-nigerian-patients
#15
Emmanuel Ejim, Nelson Oguanobi
BACKGROUND: Reliable diagnostic measures for the evaluation of left ventricular systolic performance in the setting of altered myocardial loading characteristics in sickle cell anaemia remains unresolved. OBJECTIVE: The study was designed to assess left ventricular systolic function in adult sickle cell patients using non-invasive endsystolic stress - end-systolic volume index ratio. METHODS: A descriptive cross sectional comparative study was done using 52 patients recruited at the adult sickle cell anaemia clinic of the University of Nigeria Teaching Hospital Enugu...
September 2016: African Health Sciences
https://www.readbyqxmd.com/read/27916069/-pregnancy-outcomes-and-symptom-improvement-of-patients-with-adenomyosis-treated-with-high-intensity-focused-ultrasound-ablation
#16
C Y Zhou, X J Xu, J He
Objective: To investigate the symptom improvement and pregnancy outcomes of patients with adenomyosis after treatment with high intensity focused ultrasound (HIFU) ablation. Methods: From October 2010 to October 2015, 68 patients with adenomyosis who wish to get pregnancies were treated with HIFU ablation in Suining Central Hospital. Among these patients, 56 presented with dysmenorrhea, 11 presented with menorrhagia, and 1 patient complained both; 41 of them had histories of abnormal pregnancy. The clinical data were analyzed retrospectively...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27914844/the-july-effect-in-total-shoulder-arthroplasty
#17
Allison J Rao, Daniel D Bohl, Rachel M Frank, Gregory L Cvetanovich, Gregory P Nicholson, Anthony A Romeo
BACKGROUND: New medical doctors enter their residency fields in July, a time in the hospital in which patient morbidity and mortality rates are perceived to be higher. It remains controversial whether a "July effect" exists in different areas of medicine and surgery, including in orthopedic surgery. The purpose of this study is to test for the July effect in patients undergoing primary total shoulder arthroplasty (TSA). METHODS: Patients who underwent primary TSA from 2005-2012 were identified using the American College of Surgeons National Surgical Quality Improvement Program database...
November 30, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27914715/prostate-cancer-in-young-adults-seventeen-year-clinical-experience-of-a-single-center
#18
Tzu-Hao Huang, Junne-Yih Kuo, Yi-Hsiu Huang, Hsiao-Jen Chung, William J S Huang, Howard H H Wu, Yen-Hwa Chang, Alex T L Lin, Kuang-Kuo Chen
BACKGROUND: In the general population, prostate adenocarcinoma affects predominately older men. If fact, most current guidelines suggest that males over the age of 50 years should undergo prostate cancer screening. However, the clinical behavior and prognosis of prostate cancer in young adults is not well defined. The aim of this study was to evaluate the clinical behavior, pathological characteristics, and prognosis of prostate cancer in young adults. METHODS: We retrospectively reviewed the records of young patients (age, ≤50 years) in our hospital with prostate adenocarcinoma between 1997 and 2013...
November 30, 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/27914502/rationale-and-design-of-the-progression-of-atherosclerotic-plaque-determined-by-computed-tomographic-angiography-imaging-paradigm-registry-a-comprehensive-exploration-of-plaque-progression-and-its-impact-on-clinical-outcomes-from-a-multicenter-serial-coronary
#19
Sang-Eun Lee, Hyuk-Jae Chang, Asim Rizvi, Martin Hadamitzky, Yong-Jin Kim, Edoardo Conte, Daniele Andreini, Gianluca Pontone, Valentina Volpato, Matthew J Budoff, Ilan Gottlieb, Byoung Kwon Lee, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Jonathon A Leipsic, Sanghoon Shin, Jung Hyun Choi, Namsik Chung, James K Min
BACKGROUND: The natural history of coronary artery disease (CAD) in patients with low-to-intermediate risk is not well characterized. Although earlier invasive serial studies have documented the progression of atherosclerotic burden, most were focused on high-risk patients only. The PARADIGM registry is a large, prospective, multinational dynamic observational registry of patients undergoing serial coronary computed tomographic angiography (CCTA). The primary aim of PARADIGM is to characterize the natural history of CAD in relation to clinical and laboratory data...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27913735/preoperative-pulmonary-rehabilitation-for-marginal-function-lung-cancer-patients
#20
Asra Hashmi, Frank A Baciewicz, Ayman O Soubani, Shirish M Gadgeel
BACKGROUND: This study aimed to evaluate the impact of preoperative pulmonary rehabilitation in lung cancer patients undergoing pulmonary resection surgery with marginal lung function. METHODS: Short-term outcomes of 42 patients with forced expiratory volume in 1 s < 1.6 L who underwent lung resection between 01/2006 and 12/2010 were reviewed retrospectively. They were divided into group A (no preoperative pulmonary rehabilitation) and group B (receiving pulmonary rehabilitation)...
December 2, 2016: Asian Cardiovascular & Thoracic Annals
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