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https://www.readbyqxmd.com/read/27919455/potential-benefits-and-consequences-of-public-reporting-of-pediatric-cardiac-surgery-outcomes
#1
EDITORIAL
J William Gaynor, Sara K Pasquali, Richard G Ohye, Thomas L Spray
No abstract text is available yet for this article.
October 28, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27866778/historical-perspectives-of-the-american-association-for-thoracic-surgery-aldo-casta%C3%A3-eda
#2
EDITORIAL
Jennifer C Romano, J William Gaynor
No abstract text is available yet for this article.
October 24, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27864045/influence-of-chronic-l-dopa-treatment-on-immune-response-following-allogeneic-and-xenogeneic-graft-in-a-rat-model-of-parkinson-s-disease
#3
Ludivine S Breger, Korbinian Kienle, Gaynor A Smith, Stephen B Dunnett, Emma L Lane
Although intrastriatal transplantation of fetal cells for the treatment of Parkinson's disease had shown encouraging results in initial open-label clinical trials, subsequent double-blind studies reported more debatable outcomes. These studies highlighted the need for greater preclinical analysis of the parameters that may influence the success of cell therapy. While much of this has focused on the cells and location of the transplants, few have attempted to replicate potentially critical patient centered factors...
November 15, 2016: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/27832038/improving-prognosis-for-patients-with-hepatocellular-carcinoma-in-ireland-1994-2008
#4
Caroline Gaynor, Masood Iqbal, Harry Comber, Sandra Deady, Aiden McCormick
OBJECTIVES: The incidence of hepatocellular carcinoma (HCC) is increasing in low-prevalence countries such as the USA, UK and Ireland. Over the past two decades, diagnostic techniques have improved and new treatments have been introduced. The aim of this study was to determine whether there has been an impact on hepatoma mortality in Ireland. METHODS: Anonymized cancer registration data from the National Cancer Registry of Ireland were used to investigate patient characteristics and trends in treatment and survival for Irish patients diagnosed with histologically confirmed HCC between 1994 and 2008...
November 9, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27726857/completeness-and-accuracy-of-local-clinical-registry-data-for-children-undergoing-heart-surgery
#5
Meena Nathan, Marshall L Jacobs, J William Gaynor, Jane W Newburger, Carolyn Dunbar Masterson, Linda M Lambert, Danielle Hollenbeck-Pringle, Felicia L Trachtenberg, Owen White, Brett R Anderson, Margaret C Bell, Phillip T Burch, Eric M Graham, Jonathan R Kaltman, Kirk R Kanter, Carlos M Mery, Christian Pizarro, Marcus S Schamberger, Michael D Taylor, Jeffrey P Jacobs, Sara K Pasquali
BACKGROUND: Data routinely captured in clinical registries may be leveraged to enhance efficiency of prospective research. The quality of registry data for this purpose has not been studied, however. We evaluated the completeness and accuracy of perioperative data within congenital heart centers' local surgical registries. METHODS: Within 12 Pediatric Heart Network (PHN) sites, we evaluated 31 perioperative variables (and their subcategories, totaling 113 unique fields) collected via sites' local clinical registries for submission to The Society of Thoracic Surgeons Database, compared with chart review by PHN research coordinators...
October 7, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27530489/fetal-intrapericardial-teratoma-natural-history-and-management-including-successful-in-utero-surgery
#6
Jack Rychik, Nahla Khalek, J William Gaynor, Mark P Johnson, N Scott Adzick, Alan W Flake, Holly L Hedrick
BACKGROUND: Intrapericardial teratoma is a rare, lethal tumor often detected in fetal life. Tumor mass and pericardial effusion cause cardiac tamponade that, if relieved, could be life-saving. Optimal timing of intervention and methods for effective fetal treatment are unknown. OBJECTIVE: We describe our single-center experience with fetal intrapericardial teratoma including the first report of successful in utero surgical resection with survival to term. STUDY DESIGN: We reviewed our database for suspected fetal intrapericardial teratoma...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27497731/historical-perspectives-of-the-american-association-for-thoracic-surgery-richard-a-jonas
#7
Stephanie Fuller, J William Gaynor
No abstract text is available yet for this article.
November 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27457827/congenital-heart-surgery-case-mix-across-north-american-centers-and-impact-on-performance-assessment
#8
Sara K Pasquali, Amelia S Wallace, J William Gaynor, Marshall L Jacobs, Sean M O'Brien, Kevin D Hill, Michael G Gaies, Jennifer C Romano, David M Shahian, John E Mayer, Jeffrey P Jacobs
BACKGROUND: Performance assessment in congenital heart surgery is challenging due to the wide heterogeneity of disease. We describe current case mix across centers, evaluate methodology inclusive of all cardiac operations versus the more homogeneous subset of Society of Thoracic Surgeons benchmark operations, and describe implications regarding performance assessment. METHODS: Centers (n = 119) participating in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2010 through 2014) were included...
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27234796/an-innovative-approach-to-the-surgical-time-out-a-patient-focused-model
#9
Steven D Kozusko, Lily Elkwood, Diane Gaynor, Stephen A Chagares
The surgical time out is an integral component of patient safety in OR settings. At The Center for Outpatient Surgery (TCOPS), a team of nurses and plastic and breast surgeons evaluated discrepancies, wrong-site surgeries, near misses, team communication, and patient satisfaction to develop and implement a surgical checklist that would help improve efficiency and patient safety and reduce near misses. This checklist involves the surgical team and patient, and it includes preoperative, preincision, and postoperative time outs...
June 2016: AORN Journal
https://www.readbyqxmd.com/read/27183886/increasing-cumulative-exposure-to-volatile-anesthetic-agents-is-associated-with-poorer-neurodevelopmental-outcomes-in-children-with-hypoplastic-left-heart-syndrome
#10
Laura K Diaz, J William Gaynor, Shannon J Koh, Richard F Ittenbach, Marsha Gerdes, Judy C Bernbaum, Elaine H Zackai, Robert R Clancy, Mohamed A Rehman, Jeffrey W Pennington, Nancy Burnham, Thomas L Spray, Susan C Nicolson
OBJECTIVES: Despite improved survival in children with hypoplastic left heart syndrome (HLHS), significant concern persists regarding their neurodevelopmental (ND) outcomes. Previous studies have identified patient factors, such as prematurity and genetic syndromes, to be associated with worse ND outcomes. However, no consistent relationships have been identified among modifiable management factors, including cardiopulmonary bypass strategies, and ND outcomes after cardiac surgery in infancy...
August 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27173065/critical-care-nursing-s-impact-on-pediatric-patient-outcomes
#11
Patricia A Hickey, Sara K Pasquali, J William Gaynor, Xia He, Kevin D Hill, Jean A Connor, Kimberlee Gauvreau, Marshall L Jacobs, Jeffrey P Jacobs, Jennifer C Hirsch-Romano
BACKGROUND: Previous studies have demonstrated the effect of adult nursing skill mix, staffing ratios, and level of education on patient deaths, complication rates, and failure to rescue (FTR). To date, only one known study had examined the effect of nursing experience and education on postoperative pediatric cardiac operations. METHODS: Nursing survey data were linked to The Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database for patients undergoing cardiac operations (2010 to 2011)...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26892077/the-american-association-for-thoracic-surgery-consensus-guidelines-reasons-and-purpose
#12
REVIEW
Lars G Svensson, A Marc Gillinov, Richard D Weisel, Shaf Keshavjee, Emile A Bacha, Marc R Moon, Duke E Cameron, David J Sugarbaker, David H Adams, J William Gaynor, Joseph S Coselli, Pedro J Del Nido, David Jones, Thoralf M Sundt, Lawrence H Cohn, Jose L Pomar, Bruce W Lytle, Hartzell V Schaff
The time interval for the doubling of medical knowledge continues to decline. Physicians, patients, administrators, government officials, and payors are struggling to keep up to date with the waves of new information and to integrate the knowledge into new patient treatment protocols, processes, and metrics. Guidelines, Consensus Guidelines, and Consensus Statements, moderated by seasoned content experts, offer one method to rapidly distribute new information in a timely manner and also guide minimal standards of treatment of clinical care pathways as they are developed as part of bundled care programs...
April 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26543249/a-single-center-analysis-of-methylprednisolone-use-during-pediatric-cardiopulmonary-bypass
#13
Molly Dreher, Andrew C Glatz, Andrea Kennedy, Tami Rosenthal, J William Gaynor
Cardiac surgery with the use of cardiopulmonary bypass (CPB) is known to induce an inflammatory response in patients. This response may be even more pronounced in pediatric patients given their small body size compared to adults. Several interventions have been instituted in an effort to attenuate this response, including the use of corticosteroids in the pump prime. However, the clinical effectiveness and potential harmful effects of steroid use have been the source of recent debate. Therefore, our institution made the decision to evaluate the use of methylprednisolone in our CPB prime...
September 2015: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/26410159/improving-cardiac-surgical-site-infection-reporting-and-prevention-by-using-registry-data-for-case-ascertainment
#14
Vaidehi Nayar, Andrea Kennedy, Janine Pappas, Krista D Atchley, Cynthia Field, Sarah Smathers, Eva E Teszner, Julia S Sammons, Susan E Coffin, Jeffrey S Gerber, Thomas L Spray, James M Steven, Louis M Bell, Joan Forrer, Fernando Gonzalez, Albert Chi, William J Nieczpiel, John N Martin, J William Gaynor
BACKGROUND: The use of administrative data for surgical site infection (SSI) surveillance leads to inaccurate reporting of SSI rates [1]. A quality improvement (QI) initiative was conducted linking clinical registry and administrative databases to improve reporting and reduce the incidence of SSI [2]. METHODS: At our institution, The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) and infection surveillance database (ISD) were linked to the enterprise data warehouse containing electronic health record (EHR) billing data...
January 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26406789/long-term-angiographic-results-of-endovascularly-cured-intracranial-dural-arteriovenous-fistulas
#15
Sudheer Ambekar, Brandon G Gaynor, Eric C Peterson, Mohamed Samy Elhammady
OBJECTIVE: Dural arteriovenous fistulas (DAVFs) are complex lesions consisting of abnormal connections between meningeal arteries and dural venous sinuses and/or cerebral veins. The goal of treatment is surgical or endovascular occlusion of the fistula or fistulous nidus or at least the disconnection of the feeding vessels and the draining veins. Delayed angiographic data on previously embolized dural fistulas is lacking. The authors report their experience and the long-term angiographic results with embolization of intracranial DAVF using Onyx...
April 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/26245504/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-mortality-risk-model-part-2-clinical-application
#16
MULTICENTER STUDY
Jeffrey P Jacobs, Sean M O'Brien, Sara K Pasquali, J William Gaynor, John E Mayer, Tara Karamlou, Karl F Welke, Giovanni Filardo, Jane M Han, Sunghee Kim, James A Quintessenza, Christian Pizarro, Christo I Tchervenkov, Francois Lacour-Gayet, Constantine Mavroudis, Carl L Backer, Erle H Austin, Charles D Fraser, James S Tweddell, Richard A Jonas, Fred H Edwards, Frederick L Grover, Richard L Prager, David M Shahian, Marshall L Jacobs
BACKGROUND: The empirically derived 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database Mortality Risk Model incorporates adjustment for procedure type and patient-specific factors. The purpose of this report is to describe this model and its application in the assessment of variation in outcomes across centers. METHODS: All index cardiac operations in The Society of Thoracic Surgeons Congenital Heart Surgery Database (January 1, 2010, to December 31, 2013) were eligible for inclusion...
September 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26245503/impact-of-patient-characteristics-on-hospital-level-outcomes-assessment-in-congenital-heart-surgery
#17
MULTICENTER STUDY
Sara K Pasquali, Marshall L Jacobs, Sean M O'Brien, Xia He, J William Gaynor, Michael G Gaies, Eric D Peterson, Jennifer C Hirsch-Romano, John E Mayer, Jeffrey P Jacobs
BACKGROUND: Accurate hospital outcome measures in congenital heart surgery are important to multiple initiatives. While methods have been developed to account for differences in procedural case-mix, characteristics patients bring into the operation that may also vary across hospitals and influence outcome have received less attention. We evaluated the impact of these characteristics in a large cohort. METHODS: Patients undergoing congenital heart surgery at centers participating in The Society of Thoracic Surgeons Congenital Heart Surgery Database (2010 to 2013) with adequate data quality were included...
September 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26245502/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-mortality-risk-model-part-1-statistical-methodology
#18
Sean M O'Brien, Jeffrey P Jacobs, Sara K Pasquali, J William Gaynor, Tara Karamlou, Karl F Welke, Giovanni Filardo, Jane M Han, Sunghee Kim, David M Shahian, Marshall L Jacobs
BACKGROUND: This study's objective was to develop a risk model incorporating procedure type and patient factors to be used for case-mix adjustment in the analysis of hospital-specific operative mortality rates after congenital cardiac operations. METHODS: Included were patients of all ages undergoing cardiac operations, with or without cardiopulmonary bypass, at centers participating in The Society of Thoracic Surgeons Congenital Heart Surgery Database during January 1, 2010, to December 31, 2013...
September 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26218260/clinical-epidemiology-of-extubation-failure-in-the-pediatric-cardiac-icu-a-report-from-the-pediatric-cardiac-critical-care-consortium
#19
MULTICENTER STUDY
Michael Gaies, Sarah Tabbutt, Steven M Schwartz, Geoffrey L Bird, Jeffrey A Alten, Lara S Shekerdemian, Darren Klugman, Ravi R Thiagarajan, J William Gaynor, Jeffrey P Jacobs, Susan C Nicolson, Janet E Donohue, Sunkyung Yu, Sara K Pasquali, David S Cooper
OBJECTIVE: To describe the clinical epidemiology of extubation failure in a multicenter cohort of patients treated in pediatric cardiac ICUs. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium registry. PATIENTS: All patients admitted to the CICU at Pediatric Cardiac Critical Care Consortium hospitals. INTERVENTIONS: None...
November 2015: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/26184555/quality-cost-relationship-in-congenital-heart-surgery
#20
MULTICENTER STUDY
Sara K Pasquali, Jeffrey P Jacobs, Edward L Bove, J William Gaynor, Xia He, Michael G Gaies, Jennifer C Hirsch-Romano, John E Mayer, Eric D Peterson, Nelangi M Pinto, Samir S Shah, Matt Hall, Marshall L Jacobs
BACKGROUND: There is an increasing focus on optimizing health care quality and reducing costs. The care of children undergoing heart surgery requires significant investment of resources, and it remains unclear how costs of care relate to quality. We evaluated this relationship across a multicenter cohort. METHODS: Clinical data from The Society of Thoracic Surgeons Database were merged with cost data from the Pediatric Health Information Systems Database for children undergoing heart surgery (2006 to 2010)...
October 2015: Annals of Thoracic Surgery
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