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Surgical outcomes research

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https://www.readbyqxmd.com/read/28437224/structure-process-and-culture-of-intensive-care-units-treating-patients-with-severe-traumatic-brain-injury-survey-of-centers-participating-in-the-american-college-of-surgeons-trauma-quality-improvement-program
#1
Aziz S Alali, Victroia McCredie, Todd G Mainprize, David Gomez, Avery B Nathens
Outcome after severe traumatic brain injury (TBI) differs substantially between hospitals. Explaining this variation begins with understanding the differences in structures and processes of care, particularly at intensive care units (ICUs) where acute TBI care takes place. We invited trauma medical directors (TMDs) from 187 centers participating in the American College of Surgeons Trauma Quality Improvement Program to complete a survey. The survey domains included ICU model, type, availability of specialized units, staff, training programs, standard protocols and order sets, approach to withdrawal of life support, and perceived level of neurosurgeons' engagement in the ICU management of TBI...
February 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28434634/hypospadias-surgery-in-england-higher-volume-centres-have-lower-complication-rates
#2
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/28434104/mullerian-dysgenesis-a-critical-review-of-the-literature
#3
REVIEW
Souzana Choussein, Dimitrios Nasioudis, Dimitrios Schizas, Konstantinos P Economopoulos
PURPOSE: To present an update of the genetic, clinical, diagnostic, and therapeutic aspects of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. METHODS: Studies were considered eligible if they have evaluated patients with MRKH syndrome. Eligible articles were identified by a search of MEDLINE bibliographical database from 1950 to August 2016. A purely descriptive approach was adopted concerning all outcomes examined by the individual studies. RESULTS: MRKH syndrome is defined as congenital aplasia of the upper vagina and impairment of uterine development in normal 46XX females...
April 22, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28426557/loop-ileostomy-vs-total-colectomy-as-surgical-treatment-for-clostridium-difficile-associated-disease-an-eastern-association-for-the-surgery-of-trauma-multicenter-trial
#4
Paula Ferrada, Rachael Callcut, Martin D Zielinski, Brandon Bruns, Daniel Dante Yeh, Tanya L Zakrison, Jonathan P Meizoso, Babak Sarani, Richard D Catalano, Peter Kim, Valerie Plant, Amelia Pasley, Linda A Dultz, Asad J Choudhry, Elliott R Haut
OBJECTIVES: The mortality of patients with Clostridum Dificile Associated Disease (CDAD) requiring surgery continues to be very high. Loop ileostomy (LI) was introduced as an alternative procedure to total colectomy (TC) for CDAD by a single center study. To date, no reproducible results have been published. The objective of this study is to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need. METHODS: This was a retrospective multicenter study conducted under the sponsorship of the Eastern Association for the Surgery of Trauma (EAST)...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424776/socially-responsible-surgery-building-recognition-and-coalition
#5
Tyler D Robinson, Thiago M Oliveira, Theresa R Timmes, Jacqueline M Mills, Nichole Starr, Matthew Fleming, Megan Janeway, Diane Haddad, Feroze Sidhwa, Ryan D Macht, Douglas F Kauffman, Tracey A Dechert
IMPORTANCE: Socially responsible surgery (SRS) integrates surgery and public health, providing a framework for research, advocacy, education, and clinical practice to address the social barriers of health that decrease surgical access and worsen surgical outcomes in underserved patient populations. These patients face disparities in both health and in health care, which can be effectively addressed by surgeons in collaboration with allied health professionals. OBJECTIVE: We reviewed the current state of surgical access and outcomes of underserved populations in American rural communities, American urban communities, and in low- and middle-income countries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28424506/long-term-outcomes-of-ams-spectra%C3%A2-penile-prosthesis-implantation-and-satisfaction-rates
#6
F Akdemir, E Okulu, Ö Kayıgil
The aim of this study was to evaluate the surgical implantation techniques of AMS Spectra malleable penile prosthesis, its intraoperative and postoperative complications, and the rates of patient and partner satisfaction. Forty-six patients on whom AMS Spectra malleable penile prosthesis implantation was performed between 2009 and 2014 were retrospectively examined. Any complications seen intraoperatively and postoperatively were determined. International Index of Erectile Function (IIEF)-5, total IIEF erectile function domain scores were calculated preoperatively...
April 20, 2017: International Journal of Impotence Research
https://www.readbyqxmd.com/read/28422849/temporal-trends-in-centralization-and-racial-disparities-in-utilization-of-high-volume-hospitals-for-lung-cancer-surgery
#7
Wil Lieberman-Cribbin, Bian Liu, Emanuele Leoncini, Raja Flores, Emanuela Taioli
Racial disparities have been suggested in hospital utilization and outcome for lung cancer surgery, but the effect of hospital centralization on closing this gap is unknown. We hypothesized that centralization has increased the utilization of high- or very-high-volume (HV/VHV) hospitals, a proxy for access to high-quality care, over the study period independently from race.Inpatient records were extracted from the New York Statewide Planning and Research Cooperative System database (1995-2012) according to Clinical Modification of the International Classification of Diseases, 9th Revision diagnosis codes 162...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422280/integrating-frailty-research-into-the-medical-specialties-report-from-a-u13-conference
#8
Jeremy Walston, Thomas N Robinson, Susan Zieman, Frances McFarland, Christopher R Carpenter, Keri N Althoff, Melissa K Andrew, Caroline S Blaum, Patrick J Brown, Brian Buta, E Wesley Ely, Luigi Ferrucci, Kevin P High, Stephen B Kritchevsky, Kenneth Rockwood, Kenneth E Schmader, Felipe Sierra, Kaycee M Sink, Ravi Varadhan, Arti Hurria
Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardiology, human immunodeficiency virus care, and nephrology, and in the behavioral and social sciences. Lack of a consensus definition, proliferation of measurement tools, inadequate understanding of the biology of frailty, and lack of validated clinical algorithms for frail individuals hinders incorporation of frailty assessment and frailty research into the specialties...
April 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28421386/technology-assessment-and-cost-effectiveness-in-orthopedics-how-to-measure-outcomes-and-deliver-value-in-a-constantly-changing-healthcare-environment
#9
REVIEW
Jeremy M Burnham, Fabien Meta, Vincent Lizzio, Eric C Makhni, Kevin J Bozic
PURPOSE OF REVIEW: The purpose of this study is to review the basic concepts of healthcare value, patient outcome measurement, and cost-effectiveness analyses as they relate to the introduction of new surgical techniques and technologies in the field of orthopedic surgery. RECENT FINDINGS: An increased focus on financial stewardship in healthcare has resulted in a plethora of cost-effectiveness and patient outcome research. Recent research has made great progress in identifying orthopedic technologies that provide exceptional value and those that do not meet adequate standards for widespread adoption...
April 19, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28420664/the-uk-cardiac-and-vascular-surgery-interventional-anaemia-response-caviar-study-protocol-for-an-observational-cohort-study-to-determine-the-impact-and-effect-of-preoperative-anaemia-management-in-cardiac-and-vascular-surgical-patients
#10
Marisa Chau, Toby Richards, Caroline Evans, Anna Butcher, Timothy Collier, Andrew Klein
INTRODUCTION: Preoperative anaemia is linked to poor postsurgical outcome, longer hospital stays, greater risk of complications and mortality. Currently in the UK, some sites have developed anaemia clinics or pathways that use intravenous iron to correct iron deficiency anaemia prior to surgery as their standard of care. Although intravenous iron has been observed to be effective in a variety of patient settings, there is insufficient evidence in its use in cardiac and vascular patients...
April 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28420039/utilizing-salmonella-to-treat-solid-malignancies
#11
REVIEW
Nancy D Ebelt, Edwin R Manuel
Despite intensive research into novel treatment strategies for cancer, it remains the second most common cause of death in industrialized populations. Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive disease with dismal prognosis. Currently, surgical resection offers the best chance for extended survival, yet recurrence remains high and is associated with poor outcome. Systemic treatment has evolved from non-specific, cytotoxic chemotherapy to the use of cancer-targeting agents, profoundly changing treatment approaches in the metastatic and adjuvant settings...
April 18, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28419885/registry-of-implants-for-the-reconstruction-of-pelvic-floor-in-males-and-females-a-feasibility-case-series
#12
Dimitri Barski, Holger Gerullis, Thorsten Ecke, Jennifer Kranz, Laila Schneidewind, Nadine Leistner, Fabian Queissert, Sandra Mühlstädt, Markus Grabbert, Rana Tahbaz, Alexandre Egon Pelzer, Ralf Joukhadar, Uwe Klinge, Mihaly Boros, Werner Bader, Gert Naumann, Frank Puppe, Thomas Otto
INTRODUCTION: Most aspects of implant-assisted reconstruction of pelvic floor in males and females are under debate and the research is not standardized. Registries are supposed to shed light to the indications, surgical techniques and material properties and to establish a standardized evaluation. METHODS: A working group was formed to create an online platform for registration and outcome measurement of implant-assisted operations for pelvic organ prolapse (POP) and female and male stress urinary incontinence (SUI)...
April 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28419639/differences-in-intraoperative-hemodynamics-between-spinal-and-general-anesthesia-in-infants-undergoing-pyloromyotomy
#13
Caleb Ing, Lena S Sun, Alexander F Friend, Minjae Kim, Mitchell F Berman, William Paganelli, Guohua Li, Robert K Williams
BACKGROUND: Hypotension and bradycardia are known side effects of spinal anesthesia in pregnant women undergoing cesarean section and adults undergoing other surgical procedures. Whether children experience similar hemodynamic changes is unclear. AIMS: The purpose of this study is to evaluate hemodynamic effects of spinal anesthesia compared to general anesthesia in a cohort of healthy infants. METHODS: The University of Vermont Medical Center almost exclusively used spinal anesthesia for infant pyloromyotomy surgery between 2008 and 2013, while Columbia University Medical Center relied on general anesthesia...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28419189/propensity-scores-with-misclassified-treatment-assignment-a-likelihood-based-adjustment
#14
Danielle Braun, Malka Gorfine, Giovanni Parmigiani, Nils D Arvold, Francesca Dominici, Corwin Zigler
Propensity score methods are widely used in comparative effectiveness research using claims data. In this context, the inaccuracy of procedural or billing codes in claims data frequently misclassifies patients into treatment groups, that is, the treatment assignment ($T$) is often measured with error. In the context of a validation data where treatment assignment is accurate, we show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis: (i) propensity score estimation; (ii) propensity score implementation; and (iii) outcome analysis conducted conditional on the estimated propensity score and its implementation...
April 17, 2017: Biostatistics
https://www.readbyqxmd.com/read/28415894/should-patients-be-optimistic-about-surgery-resolving-a-conflicted-literature
#15
Kate Sweeny, Sara E Andrews
Following surgery, some patients suffer distress, disappointment, regret, poor adjustment, and poor quality-of-life. Surgeons may define "success" based on objective clinical outcomes, but patients' perceptions of surgical success rely primarily on a comparison to their initial expectations. We review the literature on the relationship between patients' surgical expectations and psychosocial outcomes and attempt to resolve a conflict in the literature. Specifically, we propose that conflicting conclusions regarding the merits of optimism primarily stem from differing methodological approaches by researchers in the field...
April 17, 2017: Health Psychology Review
https://www.readbyqxmd.com/read/28414168/decompression-alone-versus-fusion-for-pyogenic-spondylodiscitis
#16
Sung Hyun Noh, Ho Yeol Zhang, Hyun Sun Lim, Hyeon Jin Song, Kyung Hwa Yang
BACKGROUND CONTEXT: A spinal infection is a serious problem for a spine surgeon, and there is currently much debate regarding how best to treat pyogenic spondylodiscitis using antibiotics and the instrumentations that have been developed to date. PURPOSE: The purpose of this study was to determine which is better method for treating pyogenic spondylodiscitis. STUDY DESIGN/SETTING: A retrospective chart review was performed. PATIENT SAMPLE: Thirty-one patients with pyogenic spondylodiscitis underwent surgical treatment between 2000 and 2016 at the authors' institution...
April 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28413830/an-observational-study-on-surgically-treated-adult-idiopathic-scoliosis-patients-quality-of-life-outcomes-at-1-and-2-year-follow-ups-and-comparison-to-controls
#17
Jennifer C Theis, Anna Grauers, Elias Diarbakerli, Panayiotis Savvides, Allan Abbott, Paul Gerdhem
BACKGROUND: Prospective data on health-related quality of life in patients with idiopathic scoliosis treated surgically as adults is needed. We compared preoperative and 1- and 2-year follow-up data in surgically treated adults with idiopathic scoliosis with juvenile or adolescent onset. Results were compared to untreated adults with scoliosis and population normative data. METHODS: A comparison of preoperative and 1- and 2-year follow-up data of 75 adults surgically treated for idiopathic scoliosis at a mean age of 28 years (range 18 to 69) from a prospective national register study, as well as a comparison with age- and sex-matched data from 75 untreated adults with less severe scoliosis and 75 adults without scoliosis, was made...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28412586/volume-outcome-relation-in-palliative-systemic-treatment-of-metastatic-oesophagogastric-cancer
#18
N Haj Mohammad, N Bernards, M van Putten, V E P P Lemmens, M G H van Oijen, H W M van Laarhoven
INTRODUCTION: Palliative systemic therapy has been shown to improve survival in metastatic oesophagogastric cancer. Administration of palliative systemic therapy in metastatic oesophagogastric cancer varies between hospitals. We aimed to explore the association between the annual hospital volume of oesophagogastric cancer patients and survival. METHODS: Patients diagnosed in the Netherlands between 2005 and 2013 with metastatic oesophagogastric cancer were identified in the Netherlands Cancer Registry...
April 13, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28411340/attainment-and-retention-of-force-moderation-following-laparoscopic-resection-training-with-visual-force-feedback
#19
Rafael Hernandez, Arzu Onar-Thomas, Francesco Travascio, Shihab Asfour
BACKGROUND: Laparoscopic training with visual force feedback can lead to immediate improvements in force moderation. However, the long-term retention of this kind of learning and its potential decay are yet unclear. METHODS: A laparoscopic resection task and force sensing apparatus were designed to assess the benefits of visual force feedback training. Twenty-two male university students with no previous experience in laparoscopy underwent relevant FLS proficiency training...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28410777/evidence-for-neurocognitive-improvement-after-bariatric-surgery-a-systematic-review
#20
REVIEW
Gurneet Thiara, Michela Cigliobianco, Alexei Muravsky, Riccardo A Paoli, Rodrigo Mansur, Raed Hawa, Roger S McIntyre, Sanjeev Sockalingam
BACKGROUND: Bariatric surgery is an effective means of weight reduction in severely obese patients and correlates with improvements in quality of life, mental health outcomes, and neurocognition, especially in those with high psychosocial burden. OBJECTIVE: The primary purpose of this systematic review was to evaluate the impact of bariatric surgery on long-term neurocognitive functioning and neuropsychological outcomes. METHODS: OVID Medline and PsychInfo databases from January 1990 to August 2015 were searched with key terms and phrases: "bariatric surgery" and "cognition...
February 21, 2017: Psychosomatics
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