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Surgical outcomes research

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https://www.readbyqxmd.com/read/29140848/mortality-trends-after-a-voluntary-checklist-based-surgical-safety-collaborative
#1
Alex B Haynes, Lizabeth Edmondson, Stuart R Lipsitz, George Molina, Bridget A Neville, Sara J Singer, Aunyika T Moonan, Ashley Kay Childers, Richard Foster, Lorri R Gibbons, Atul A Gawande, William R Berry
OBJECTIVE: To determine whether completion of a voluntary, checklist-based surgical quality improvement program is associated with reduced 30-day postoperative mortality. BACKGROUND: Despite evidence of efficacy of team-based surgical safety checklists in improving perioperative outcomes in research trials, effective methods of population-based implementation have been lacking. The Safe Surgery 2015 South Carolina program was designed to foster state-wide engagement of hospitals in a voluntary, collaborative implementation of a checklist program...
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29139364/advanced-management-of-severe-keloids
#2
REVIEW
Thomas Hagele, Hoka Nyanda, Nishit Patel, Nicole Russell, George Cohen, Christopher Nelson
Keloids negatively impact the health and quality of life of many affected dermatologic patients. Treating keloids is often difficult, and suboptimal responses are frequent. Fortunately, there are many treatment options available to the clinician that may lead to improved clinical outcomes. We present a review of currently available therapeutic options. Intralesional steroid injection remains the first-line treatment for keloids. Imiquimod, direct interferon therapy, or intralesional 5-flurouracil may alleviate the need for excessive corticosteroid therapy...
2017: Skinmed
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#3
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137416/analysis-of-clinical-and-neurological-outcomes-in-patients-with-cauda-equina-syndrome-caused-by-acute-lumbar-disc-herniation-a-retrospective-prospective-study
#4
Si-Dong Yang, Feng Zhang, Wen-Yuan Ding
Objectives: In this research we analyzed the results of surgical treatment of cauda equina syndrome (CES) caused by acute lumbar disc herniation. We emphasize the early treatment for good neurological recovery. Methods: A retrospective-prospective, non randomized, clinical study was performed between Jan 2010 and Dec 2014. We retrospectively collected medical records of 18 patients who suffered from CES due to acute lumbar disc herniation and followed up them regularly...
October 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/29134816/liquifying-pldlla-anchor-fixation-in-achilles-reconstruction-for-insertional-tendinopathy
#5
Stephanie A Boden, Allison L Boden, Danielle Mignemi, Jason T Bariteau
Insertional Achilles tendinopathy (IAT) is a frequent cause of posterior heel pain and is often associated with Haglund's deformity. Surgical correction for refractory cases of IAT has been well studied; however, the method of tendon fixation to bone in these procedures remains controversial, and to date, no standard technique has been identified for tendon fixation in these surgeries. Often, after Haglund's resection, there is large exposed cancellous surface for Achilles reattachment, which may require unique fixation to optimize outcomes...
November 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29134342/an-introduction-and-overview-of-machine-learning-in-neurosurgical-care
#6
REVIEW
Joeky T Senders, Mark M Zaki, Aditya V Karhade, Bliss Chang, William B Gormley, Marike L Broekman, Timothy R Smith, Omar Arnaout
BACKGROUND: Machine learning (ML) is a branch of artificial intelligence that allows computers to learn from large complex datasets without being explicitly programmed. Although ML is already widely manifest in our daily lives in various forms, the considerable potential of ML has yet to find its way into mainstream medical research and day-to-day clinical care. The complex diagnostic and therapeutic modalities used in neurosurgery provide a vast amount of data that is ideally suited for ML models...
November 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29133704/survival-trends-in-glioma-experience-at-a-tertiary-care-centre
#7
Ratnadip Bose, Karanjit S Narang, Deepak Bhangale, Rishabh Kedia, Vikas Sharma, Ajaya N Jha
BACKGROUND: Even after decades of research in the field of gliomas, the overall prognosis is still quite dismal. Several factors have been proposed that affect the outcome and survival length of patients with a glioma. Here, we present a series of 471 patients, who underwent surgical resection of their glioma at a tertiary level neurosurgical centre. MATERIALS AND METHODS: We noted retrospective data of patients' age, histological tumor grade, and whether or not intraoperative magnetic resonance imaging (MRI) was used, and assessed the survival length of these patients from the day of surgery...
November 2017: Neurology India
https://www.readbyqxmd.com/read/29132626/early-hospital-mortality-prediction-of-intensive-care-unit-patients-using-an-ensemble-learning-approach
#8
Aya Awad, Mohamed Bader-El-Den, James McNicholas, Jim Briggs
BACKGROUND: Mortality prediction of hospitalized patients is an important problem. Over the past few decades, several severity scoring systems and machine learning mortality prediction models have been developed for predicting hospital mortality. By contrast, early mortality prediction for intensive care unit patients remains an open challenge. Most research has focused on severity of illness scoring systems or data mining (DM) models designed for risk estimation at least 24 or 48h after ICU admission...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132568/molecular-subtypes-and-local-regional-control-of-breast-cancer
#9
REVIEW
Simona Maria Fragomeni, Andrew Sciallis, Jacqueline S Jeruss
In the era of personalized medicine, there has been significant progress regarding the molecular analysis of breast cancer subtypes. Research efforts have focused on how classification of subtypes could provide information on prognosis and influence treatment planning. Although much is known about the impact of different molecular subtypes on disease-specific survival, more recent studies have investigated the role of the different molecular subtypes on local-regional recurrence. This is an area of active study, and in recent years there has been significant progress...
January 2018: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#10
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29131754/perioperative-local-and-systemic-warming-in-surgical-site-infection-a-systematic-review-and-meta-analysis
#11
K Ousey, K-L Edward, S Lui, J Stephenson, K Walker, J Duff, D Leaper
OBJECTIVE: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care. METHOD: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs...
November 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29129946/application-of-materials-as-medical-devices-with-localized-drug-delivery-capabilities-for-enhanced-wound-repair
#12
Esther J Lee, Beom Kang Huh, Se Na Kim, Jae Yeon Lee, Chun Gwon Park, Antonios G Mikos, Young Bin Choy
The plentiful assortment of natural and synthetic materials can be leveraged to accommodate diverse wound types, as well as different stages of the healing process. An ideal material is envisioned to promote tissue repair with minimal inconvenience for patients. Traditional materials employed in the clinical setting often invoke secondary complications, such as infection, pain, foreign body reaction, and chronic inflammation. This review surveys the repertoire of surgical sutures, wound dressings, surgical glues, orthopedic fixation devices and bone fillers with drug eluting capabilities...
August 2017: Progress in Materials Science
https://www.readbyqxmd.com/read/29129576/cardiometabolic-outcomes-and-mortality-in-medically-treated-primary-aldosteronism-a-retrospective-cohort-study
#13
Gregory L Hundemer, Gary C Curhan, Nicholas Yozamp, Molin Wang, Anand Vaidya
BACKGROUND: Mineralocorticoid receptor (MR) antagonists are the recommended medical therapy for primary aldosteronism. Whether this recommendation effectively reduces cardiometabolic risk is not well understood. We aimed to investigate the risk of incident cardiovascular events in patients with primary aldosteronism treated with MR antagonists compared with patients with essential hypertension. METHODS: We did a cohort study using patients from a research registry from Brigham and Women's Hospital, Massachusetts General Hospital, and their affiliated partner hospitals...
November 9, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29129549/application-of-acosog-z1071-effect-of-results-on-patient-care-and-surgical-decision-making
#14
Jacquelyn A V Palmer, Teresa Flippo-Morton, Kendall K Walsh, Lejla Hadzikadic Gusic, Terry Sarantou, Myra M Robinson, Richard L White
BACKGROUND: The ACOSOG (American College of Surgeons Oncology Group) Z1071 assessed the feasibility of performing sentinel lymph node biopsy (SLNB) in node-positive patients who completed neoadjuvant chemotherapy (NACT). Historically, adoption of clinical research into practice takes years. The goal of this study was to determine the effect of Z1071 on our practice. MATERIALS AND METHODS: This is a retrospective review of Z1071's influence on a single institution's practice...
October 12, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29129525/multicenter-evaluation-of-the-clinical-utility-of-laparoscopy-assisted-ercp-in-patients-with-roux-en-y-gastric-bypass
#15
Ali M Abbas, Andrew T Strong, David L Diehl, Brian C Brauer, Iris H Lee, Rebecca Burbridge, Jaroslav Zivny, Jennifer T Higa, Marcelo Falcão, Ihab I El Hajj, Paul Tarnasky, Brintha K Enestvedt, Alexander R Ende, Adarsh M Thaker, Rishi Pawa, Priya Jamidar, Kartik Sampath, Eduardo Guimarães Hourneaux de Moura, Richard S Kwon, Alejandro L Suarez, Murad Aburajab, Andrew Y Wang, Mohammad H Shakhatreh, Vivek Kaul, Lorna Kang, Thomas E Kowalski, Rahul Pannala, Jeffrey Tokar, A Aziz Aadam, Demetrios Tzimas, Mihir S Wagh, Peter V Draganov, M D The LA-Ercp Research Group Jeffrey Ponsky, Bruce D Greenwald, Lance T Uradomo, Alyson A McGhan, Shahrad Hakimian, Andrew Ross, Stuart Sherman, Benjamin L Bick, Christopher E Forsmark, Dennis Yang, Anand Gupte, Shailendra Chauhan, Steven J Hughes, Karen Saks, Gennadiy Bakis, Adam W Templeton, Michael Saunders, Alireza Sedarat, John A Evans, Thiruvengadam Muniraj, Timothy B Gardner, Almino C Ramos, Marco Aurelio Santo, Andrew Nett, Gregory A Coté, B Joseph Elmunzer, Kulwinder S Dua, Michael J Nosler, Daniel S Strand, Paul Yeaton, Shivangi Kothari, Asad Ullah, Pushpak Taunk, Patrick Brady, Haim Pinkas, Ashley L Faulx, Haroon Shahid, Jordan Holmes, Davinderbir Pannu, Srinadh Komanduri, Juan Carlos Bucobo, Harry Dhaliwal, Alaa Rostom, Brent W Acker
BACKGROUND AND AIMS: The obesity epidemic has led to increased use of Roux-en-Y gastric bypass (RYGB). These patients have an increased incidence of pancreaticobiliary diseases yet standard ERCP is not possible due to surgically altered gastroduodenal anatomy. Laparoscopic-ERCP (LA-ERCP) has been proposed as an option but supporting data are derived from single center small case-series. Therefore, we conducted a large multicenter study to evaluate the feasibility, safety, and outcomes of LA-ERCP...
November 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29128581/trends-in-resource-utilization-and-rate-of-cervical-disc-arthroplasty-and-anterior-cervical-discectomy-and-fusion-throughout-the-united-states-from-2006-to-2013
#16
Comron Saifi, Arielle Fein, Alejandro Cazzulino, Ronald Lehman, Frank M Phillips, Howard S An, K Daniel Riew
BACKGROUND CONTEXT: The typically accepted surgical procedure for cervical disc pathology has been the anterior cervical discectomy and fusion (ACDF), although recent trials have demonstrated equivalent or improved outcomes with cervical disc arthroplasty (CDA). Trends for these two procedures regarding utilization, revision procedures, along with other demographic information have not been sufficiently explored. PURPOSE: To provide data regarding ACDF and CDA from 2006-2013 in the U...
November 8, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29127700/historical-perspectives-and-future-directions-in-the-surgical-management-of-retroperitoneal-sarcoma
#17
REVIEW
William W Tseng, Hyun Jae Seo, Raphael E Pollock, Alessandro Gronchi
Retroperitoneal sarcomas (RPS) have fascinated and intrigued physicians both past and present. Operative mortality rates were historically very high and complete resection was not possible for the majority of patients until only the last 2 decades. More recently, changes to the surgical approach and clinical decision-making in RPS have improved patient outcomes. With select integration of nonsurgical therapies, continued RPS-specific research, and ongoing collaborative efforts among major referral centers, the future appears promising...
November 11, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29126577/the-efficacy-of-postoperative-iron-therapy-in-improving-clinical-and-patient-centered-outcomes-following-surgery-a-systematic-review-and-meta-analysis
#18
REVIEW
Iris Perelman, Remington Winter, Lindsey Sikora, Guillaume Martel, Elianna Saidenberg, Dean Fergusson
Postoperative anemia is a common occurrence in surgical patients and leads to an increased risk for allogeneic blood transfusions. The efficacy of iron therapy in treating postoperative anemia has not been firmly established. The objective of this systematic review was to evaluate the efficacy of postoperative oral and intravenous (IV) iron therapy in increasing hemoglobin levels and improving patient outcomes following elective surgery. The databases Medline, EMBASE, CENTRAL, the Transfusion Evidence Library, and ClinicalTrials...
October 22, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/29125433/a-points-based-algorithm-for-prognosticating-clinical-outcome-of-chiari-malformation-type-i-with-syringomyelia-results-from-a-predictive-model-analysis-of-82-surgically-managed-adult-patients
#19
Sumit Thakar, Laxminadh Sivaraju, Kuruthukulangara S Jacob, Aditya Atal Arun, Saritha Aryan, Dilip Mohan, Narayanam Anantha Sai Kiran, Alangar S Hegde
OBJECTIVE Although various predictors of postoperative outcome have been previously identified in patients with Chiari malformation Type I (CMI) with syringomyelia, there is no known algorithm for predicting a multifactorial outcome measure in this widely studied disorder. Using one of the largest preoperative variable arrays used so far in CMI research, the authors attempted to generate a formula for predicting postoperative outcome. METHODS Data from the clinical records of 82 symptomatic adult patients with CMI and altered hindbrain CSF flow who were managed with foramen magnum decompression, C-1 laminectomy, and duraplasty over an 8-year period were collected and analyzed...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29125183/ovarian-surgery-for-symptom-relief-in-women-with-polycystic-ovary-syndrome
#20
REVIEW
Sam Lepine, Junyoung Jo, Mostafa Metwally, Ying C Cheong
BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo- or anovulation, clinical or biochemical hyperandrogenism or both, or polycystic ovaries.Women with PCOS can have a wide range of health problems, including infrequent and irregular periods, unwanted hair growth and acne, and subnormal fertility. Long-term health concerns include an increased risk of heart disease, diabetes and the development of precancerous disease of the womb...
November 10, 2017: Cochrane Database of Systematic Reviews
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