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https://www.readbyqxmd.com/read/28441854/-correlation-between-anatomical-factors-of-spermatic-vessels-and-varicocele
#1
L Y Zhao, R H Tian, Y H Huang, H X Chen, P Li, Z Wan, C C Yao, C Yang, E L Zhi, Z Li
Objective: To analyze the correlation between anatomy of spermatic vessels and varicocele, providing reference for the preoperative assessment and treatment of varicocele. Methods: A total of 156 patients who underwent microsurgical left subinguinal varicocelectomy at Shanghai General Hospital between May 2015 and July 2016 were included in this study. The severity of varicocele and number of spermatic vessels detected in operations were recorded. According to the number of internal spermatic arteries (ISAs), the patients were divided into three groups: single-ISA group (55 cases), double-ISAs group (63 cases) and multi-ISAs group (38 cases), to analyze the correlation among spermatic vessels and to compare varicocele grade, the volume of testes, the parameter of semen analysis, serum reproductive hormone, surgery time, and hospital stay among the three groups...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#2
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441233/acute-respiratory-distress-syndrome-due-to-tuberculosis-in-a-respiratory-icu-over-a-16-year-period
#3
Valliappan Muthu, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal, Ritesh Agarwal
OBJECTIVE: Whether tuberculosis-related acute respiratory distress syndrome is associated with worse outcomes when compared with acute respiratory distress syndrome secondary to other causes remains unknown. Herein, we compare the outcomes between the two groups. DESIGN: Retrospective analysis of all subjects admitted with acute respiratory distress syndrome over the last 16 years. SETTING: Respiratory ICU of a tertiary care hospital in North India...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28438417/comparing-hospital-outcomes-between-open-and-closed-tibia-fractures-treated-with-intramedullary-fixation
#4
Evan J Smith, Xiangyu Kuang, Rajeev Pandarinath
INTRODUCTION: Tibial shaft fractures comprise a large portion of operatively treated long bone fractures, and present with the highest rate of open injuries. Intramedullary fixation has become the standard of care for both open and closed injuries. The rates of short term complications and hospital length of stay for open and closed fractures treated with intramedullary fixation is not fully known. Previous series on tibia fractures were performed at high volume centers, and data were not generalizable, further they did not report on length of stay and the impact of preoperative variables on infections, complications and reoperation...
March 30, 2017: Injury
https://www.readbyqxmd.com/read/28438333/can-postoperative-process-of-care-utilization-or-complication-rates-explain-the-volume-cost-relationship-for-cancer-surgery
#5
Vivian Ho, Marah N Short, Thomas A Aloia
BACKGROUND: Past studies identify an association between provider volume and outcomes, but less is known about the volume-cost relationship for cancer surgery. We analyze the volume-cost relationship for 6 cancer operations and explore whether it is influenced by the occurrence of complications and/or utilization of processes of care. METHODS: Medicare hospital and inpatient claims for the years 2005 through 2009 were analyzed for 6 cancer resections: colectomy, rectal resection, pulmonary lobectomy, pneumonectomy, esophagectomy, and pancreatic resection...
April 21, 2017: Surgery
https://www.readbyqxmd.com/read/28438320/critical-care-nurses-perceptions-of-the-outcomes-of-working-overtime-in-canada
#6
Vanessa M Lobo, Jenny Ploeg, Anita Fisher, Gladys Peachey, Noori Akhtar-Danesh
BACKGROUND: Nursing overtime is being integrated into the normal landscape of practice to ensure optimal staffing levels and addresses variations in patient volume and acuity. This is particularly true in critical care where fluctuations in either are difficult to predict. PURPOSE: The goal of this study was to explore critical care nurses' perceptions of the outcomes of working overtime. METHODS: Sally Thorne's interpretive description guided the collection and analysis of data...
January 7, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28438306/relation-of-quantity-of-subepicardial-adipose-tissue-to-infarct-size-in-patients-with-st-elevation-myocardial-infarction
#7
Loïc Bière, Vianney Behaghel, Victor Mateus, Antonildes Assunção, Christoph Gräni, Kais Ouerghi, Sylvain Grall, Serge Willoteaux, Fabrice Prunier, Raymond Kwong, Alain Furber
According to the so-called obesity paradox, obesity might present a protective role in patients with myocardial infarction. We aimed to assess the influence of the epicardial adipose tissue (EAT) volume on cardiac healing and remodeling in patients with acute ST-elevation myocardial infarction. We prospectively included 193 consecutive patients presenting a first STEMI without known coronary artery disease. Cardiac magnetic resonance imaging was performed at baseline and after a 3-month follow-up. EAT volume was computed, and the population was divided into quartiles: the highest quartile of EAT defining the high EAT group (h-EAT)...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28437802/surveillance-after-resection-of-pancreatic-ductal-adenocarcinoma-with-curative-intent-a-multicenter-survey-in-germany-and-review-of-the-literature
#8
Thomas J Ettrich, Lucas A Schulte, Natalie Eitel, Kristin Ettrich, Andreas W Berger, Lukas Perkhofer, Thomas Seufferlein
Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with high risk of relapse even after curative-intended resection. There are no evidence-based recommendations for surveillance in actual guidelines. Given this situation and as a basis for prospective studies, we wanted to determine the current practice of surveillance after pancreatic cancer resection in German institutions. Methods A web-based questionnaire was sent in 2015 to 300 German institutions (hospitals, outpatient clinics, and private practices) experienced in the care of patients with PDAC...
April 24, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28437601/maternal-hemodynamics-in-normal-pregnancies-reference-ranges-and-the-role-of-maternal-characteristics
#9
Dimuthu Vinayagam, Baskaran Thilaganathan, Oliver Stirrup, Elena Mantovani, Asma Khalil
OBJECTIVES: The main aim of this study was to construct reference ranges of the maternal central hemodynamic parameters during pregnancy. The second aim was to determine the maternal and pregnancy characteristics, which influence these hemodynamic parameters. METHODS: This was a prospective cohort study of low-risk pregnant women attending for routine antenatal care at St George's Hospital, London. The exclusion criteria included any medical disorder present at the time of study recruitment, or development of hypertension or intrauterine fetal growth restriction following study recruitment...
April 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28435916/feasibility-of-endoscopic-discectomy-by-inter-laminar-approach-at-a-high-volume-tertiary-public-hospital-in-a-developing-country
#10
Shardul Madhav Soman, Jayprakash Vrajlal Modi, Jimmy Chokshi
BACKGROUND: Surgical treatment for lumbar disc herniation consists of discectomy performed either open or minimally invasive techniques. Endoscopic discectomy using the tubular retractor is been increasingly used as it gives advantage of smaller incision, less tissue injury and faster recovery. The aim of this study was to check its feasibility and learning curve at a tertiary public sector hospital with a large volume load (more than 50 spine surgeries per month) with treatment provided free of cost...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435901/changes-in-electrocardiographic-findings-after-closed-thoracostomy-in-patients-with-spontaneous-pneumothorax
#11
Wonjae Lee, Yoonje Lee, Changsun Kim, Hyuk Joong Choi, Bossng Kang, Tae Ho Lim, Jaehoon Oh, Hyunggoo Kang, Junghun Shin
OBJECTIVE: We aimed to describe electrocardiographic (ECG) findings in spontaneous pneumothorax patients before and after closed thoracostomy. METHODS: This is a retrospective study which included patients with spontaneous pneumothorax who presented to an emergency department of a tertiary urban hospital from February 2005 to March 2015. The primary outcome was a difference in ECG findings between before and after closed thoracostomy. We specifically investigated the following ECG elements: PR, QRS, QTc, axis, ST segments, and R waves in each lead...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#12
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435485/impact-of-health-policy-changes-on-emergency-medicine-in-maryland-stratified-by-socioeconomic-status
#13
Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barrueto, Jon M Hirshon
INTRODUCTION: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD's Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435241/magnitude-of-exercise-capacity-and-quality-of-life-improvement-following-repeat-pulmonary-rehabilitation-in-patients-with-copd
#14
Jacqueline S Sandoz, Mary M Roberts, Jin-Gun Cho, John R Wheatley
BACKGROUND: Maintenance and repeated pulmonary rehabilitation programs (PRPs) for patients with COPD have attempted to prolong PRP benefits beyond 12-24 months. However, there is limited evidence as to the magnitude of benefit or the ideal interval between repeating the program under "real-world" conditions in which patients are referred based on clinical necessity. Therefore, we reviewed the effects of repeating PRP in a physician-referred cohort of patients with COPD. METHODS: A total of 141 individuals with COPD completed PRP twice and 35 completed PRP three times over a 12-year period...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28435034/cytoreductive-prostatectomy-for-metastatic-prostate-cancer-first-lessons-learned-from-the-multicentric-prospective-lomp-trial
#15
Filip Poelaert, Caroline Verbaeys, Bernard Rappe, Bart Kimpe, Ignace Billiet, Hendrik Plancke, Karel Decaestecker, Valérie Fonteyne, Sarah Buelens, Nicolaas Lumen
OBJECTIVE: To prospectively evaluate patients with newly diagnosed metastatic prostate cancer (mPCa) in the context of the LoMP trial (which investigates the role of cytoreductive radical prostatectomy [cRP] in addition to standard of care [SoC]). To provide a preliminary analysis of patient's characteristics, safety of cRP and early local symptoms. PATIENTS AND METHODS: cRP was performed in asymptomatic patients with a resectable tumor and fit to undergo surgery (group A, n=17)...
April 20, 2017: Urology
https://www.readbyqxmd.com/read/28434829/use-of-cutting-guides-during-craniosynostosis-sequelae-surgery-a-comparative-study-between-computer-assisted-planning-and-post-operative-results
#16
Chrystelle Queiros, Aline Joly, Arnaud Paré, Antoine Listrat, Nadine Travers, Dominique Goga, Boris Laure
BACKGROUND: The authors compared results of craniofacial reconstruction surgery using cutting guides with planned reconstruction on patients presenting craniosynostosis surgery sequelae. METHODS: This is a retrospective study performed on seven patients who had undergone craniofacial reconstructive surgery in University Hospital Center of Tours (France) in 2015. Patients had long-term sequelae of trigonocephaly and anterior plagiocephaly surgery. 3D computer model was constructed, based on CT scans and used for surgical planning...
March 28, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28434656/an-overview-of-eu-and-usa-intestinal-transplant-current-activity
#17
A Lauro, F Panaro, K R Iyer
AIM OF THE STUDY: To report the current activity of intestinal transplantation in Europe (EU) and Unites States of America (USA), underlining outcomes in the last 5 years and discussing possible trends. PATIENTS AND METHODS: Data review of results was performed through analysis of ITR and UNOS registries, Eurotransplant and newsletter transplant reports, congress abstracts, international published literature, personal communications and hospital web sites. RESULTS: The absence in Europe of a sole organization collecting donors and the presence of many low-volume centers (less than 5 cases/year) makes the difference with USA: in the last 5 years (2010-2014), 222 intestinal/multivisceral transplants have been performed in EU countries (most of them in the UK), while in USA, the number of transplants achieved 634 procedures in the same period of time...
April 20, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28434634/hypospadias-surgery-in-england-higher-volume-centres-have-lower-complication-rates
#18
David J Wilkinson, Patrick A Green, Shanthi Beglinger, Jessica Myers, Rachel Hudson, David Edgar, Simon E Kenny
INTRODUCTION: Hypospadias surgery has progressed steadily over recent years. There remains considerable variation in the operative management of boys with hypospadias in the UK, and it is therefore difficult to identify acceptable standards with regards to reoperation rates. OBJECTIVE: To determine the frequency of reoperations and complications from all centres performing hypospadias surgery in England and to identify variables that influence outcome. METHODS: All children undergoing NHS hypospadias surgery in England between 1999 and 2009 were identified using the Hospital Episode Statistics database...
February 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28434455/creating-a-pediatric-joint-council-to-promote-patient-safety-and-quality-governance-and-accountability-across-johns-hopkins-medicine
#19
Michael Rosen, Brigitta U Mueller, Aaron M Milstone, Denise R Remus, Renee Demski, Peter J Pronovost, Marlene R Miller
BACKGROUND: Large multihospital health systems with multiple children's hospitals are relatively few in number. With a paucity of national pediatric measures for quality and patient safety, there are unique challenges to ensuring consistent levels of care across diverse health care delivery settings. At Johns Hopkins Medicine, a Pediatric Joint Council was created to help ensure high-quality and safe care across a health system encompassing two full-service children's hospitals and two community hospitals with significant pediatric volumes across two states...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28433333/effects-of-hospital-safety-net-burden-and-hospital-volume-on-failure-to-rescue-after-open-abdominal-aortic-surgery
#20
Eric B Rosero, Girish P Joshi, Abu Minhajuddin, Carlos H Timaran, J Gregory Modrall
OBJECTIVE: Failure to rescue (FTR) is defined as the inability to rescue a patient from major perioperative complications, resulting in operative mortality. FTR is a known contributor to operative mortality after open abdominal aortic surgery. Understanding the causes of FTR is essential to designing interventions to improve perioperative outcomes. The objective of this study was to determine the relative contributions of hospital volume and safety-net burden (the proportion of uninsured and Medicaid-insured patients) to FTR...
April 19, 2017: Journal of Vascular Surgery
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