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Surgical outcomes research

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https://www.readbyqxmd.com/read/28110453/update-on-the-diagnosis-and-treatment-of-cholangiocarcinoma
#1
REVIEW
Bryan Doherty, Vinod E Nambudiri, William C Palmer
PURPOSE OF REVIEW: Cholangiocarcinoma is a rare biliary adenocarcinoma associated with poor outcomes. Cholangiocarcinoma is subdivided into extrahepatic and intrahepatic variants. Intrahepatic cholangiocarcinoma is then further differentiated into (1) peripheral mass-forming tumors and (2) central periductal infiltrating tumors. We aimed to review the currently known risk factors, diagnostic tools, and treatment options, as well as highlight the need for further clinical trials and research to improve overall survival rates...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28109160/antibiotics-for-infection-prevention-after-excision-of-the-cervical-transformation-zone
#2
REVIEW
Chumnan Kietpeerakool, Bandit Chumworathayi, Jadsada Thinkhamrop, Butsakorn Ussahgij, Pisake Lumbiganon
BACKGROUND: Excision of the transformation zone of the cervix is the most commonly used approach to treat cervical precancerous lesions (cervical intraepithelial neoplasia (CIN)) to reduce the risk of developing cervical cancer. As the excision of the transformation zone leaves a raw area on the cervix, there is a risk of infection following the procedure. The incidence of infection after cold knife conization (CKC) is 36%, whereas the incidence for large loop excision of the transformation zone (LLETZ, also known as loop electrical excision procedure (LEEP)) is much lower (0...
January 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28108932/patient-centered-outcomes-in-surgical-research-and-practice
#3
Blake Fernandez, Livingstone Dore, Vic Velanovich
No abstract text is available yet for this article.
January 20, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28107231/national-database-research-in-spine-surgery-limitations-in-the-current-literature
#4
Arjun S Sebastian
Many of the studies in the spine surgical literature using national databases have been directed at examining adverse events, readmission rates, cost, and risk factors for poorer outcomes. Although such studies allow for assessment of large cohorts taken from multiple institutions, they are limited by data collection methods, short-term follow-up, and minimal assessment of functional outcomes. Furthermore, few studies are directed at producing actionable practice changes to improve patient care. Recent work aimed at producing databases with more relevance to spine surgery represent exciting developments to the rapidly growing field of health outcomes research...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28106608/a-perioperative-systems-design-to-improve-intraoperative-glucose-monitoring-is-associated-with-a-reduction-in-surgical-site-infections-in-a-diabetic-patient-population
#5
Jesse M Ehrenfeld, Jonathan P Wanderer, Maxim Terekhov, Brian S Rothman, Warren S Sandberg
BACKGROUND: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. METHODS: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose...
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28103829/a-comparison-of-the-effects-of-oral-vs-intravenous-hydration-on-subclinical-acute-kidney-injury-in-living-kidney-donors-a-protocol-of-a-randomised-controlled-trial
#6
Shona Mackinnon, Emma Aitken, Ryan Ghita, Marc Clancy
BACKGROUND: Optimal treatment for established renal failure is living donor kidney transplantation. However this pathway exposes healthy individuals to significant reduction in nephron mass via major surgical procedure. Laparoscopic donor nephrectomy is now the most common method for live donor transplantation, reducing both donor post-operative pain and recovery time. However this procedure exposes kidneys to additional haemodynamic stresses. It has been suggested that donor hydration-particularly the use of preoperative intravenous fluids-may counteract these stresses, reducing subclinical acute kidney injury and ultimately improving long-term renal function...
January 19, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28103161/nurses-practice-in-preventing-postoperative-wound-infections-an-observational-study
#7
S Ding, F Lin, A P Marshall, B M Gillespie
OBJECTIVE: Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28102658/implantation-of-the-sorin-perceval%C3%A2-sutureless-aortic-valve-a-step-by-step-approach
#8
Steffen Pfeiffer, Joachim Sirch, Ferdinand Vogt, Theodor Fischlein, Giuseppe Santarpino
Since the introduction of the sutureless Perceval® (Sorin Group, Saluggia, Italy) in Europe after CE mark in 2012, the "sutureless approach" is becoming more and more popular. Sutureless implantation in general is easy, fast and safe, but bears several potential pitfalls. This might result in inferior functional results affecting also clinical outcomes. In our center, more than 300 implant procedures have been performed up to date by mainly two senior surgeons. The technique is in the process of spreading to all surgeons performing aortic valve procedures...
April 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28100943/comparison-of-the-clinical-outcome-and-complications-in-laparoscopic-hernia-repair-of-inguinal-hernia-with-mesh-fixation-using-fibrin-glue-vs-tacker
#9
Prasant Chandra, Deepak Phalgune, Shashank Shah
Although laparoscopic repair offers a quick and less morbid way of treating hernias, complications like hematoma, seroma, neuralgia, recurrence, mesh infection, hydrocele, etc. are known. The present study was undertaken to compare various clinical outcomes between mesh fixation using fibrin glue and mesh fixation with tacker in a 3-months follow-up. One hundred patients aged 18 to 60 years having inguinal hernia admitted in Poona Hospital and Research Centre, Pune, between October 2012 and November 2014 for laparoscopic hernia surgery and ready to participate in this study were included...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100277/stress-echo-2020-the-international-stress-echo-study-in-ischemic-and-non-ischemic-heart-disease
#10
Eugenio Picano, Quirino Ciampi, Rodolfo Citro, Antonello D'Andrea, Maria Chiara Scali, Lauro Cortigiani, Iacopo Olivotto, Fabio Mori, Maurizio Galderisi, Marco Fabio Costantino, Lorenza Pratali, Giovanni Di Salvo, Eduardo Bossone, Francesco Ferrara, Luna Gargani, Fausto Rigo, Nicola Gaibazzi, Giuseppe Limongelli, Giuseppe Pacileo, Maria Grazia Andreassi, Bruno Pinamonti, Laura Massa, Marco A R Torres, Marcelo H Miglioranza, Clarissa Borguezan Daros, José Luis de Castro E Silva Pretto, Branko Beleslin, Ana Djordjevic-Dikic, Albert Varga, Attila Palinkas, Gergely Agoston, Dario Gregori, Paolo Trambaiolo, Sergio Severino, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Paolo Colonna
BACKGROUND: Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS: In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information...
January 18, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28099323/anesthesia-and-databases-pediatric-cardiac-disease-as-a-role-model
#11
David F Vener, Sara K Pasquali, Emad B Mossad
Large data sets have now become ubiquitous in clinical medicine; they are particularly useful in high-acuity, low-volume conditions such as congenital heart disease where data must be collected from many centers. These data fall into 2 categories: administrative data arising from hospital admissions and charges and clinical data relating to specific diseases or procedures. In congenital cardiac diseases, there are now over a dozen of these data sets or registries focusing on various elements of patient care...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28095650/bone-tissue-engineering-in-oral-peri-implant-defects-in-preclinical-in-vivo-research-a-systematic-review-and-meta-analysis
#12
REVIEW
Siddharth Shanbhag, Nikolaos Pandis, Kamal Mustafa, Jens R Nyengaard, Andreas Stavropoulos
Regeneration and establishment of osseointegration within oral peri-implant bone defects remains a clinical challenge. Bone tissue engineering (BTE) is emerging as a promising alternative to autogenous and/or biomaterial-based bone grafting. The objective of this systematic review was to answer the focused question: in animal models, do cell-based BTE strategies enhance bone regeneration and/or implant osseointegration in experimental peri-implant defects, compared to grafting with autogenous bone or only biomaterial scaffolds? Electronic databases were searched for controlled animal studies reporting on peri-implant defects and implantation of mesenchymal stem cells (MSC) or other cells seeded on biomaterial scaffolds, following PRISMA guidelines...
January 17, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28093118/surgical-fires-and-operative-burns-lessons-learned-from-a-33-year-review-of-medical-litigation
#13
Asad J Choudhry, Nadeem N Haddad, Mohammad A Khasawneh, Daniel C Cullinane, Martin D Zielinski
OBJECTIVE: We aimed to understand the setting and litigation outcomes of surgical fires and operative burns. METHODS: Westlaw, an online legal research data-set, was utilized. Data were collected on patient, procedure, and case characteristics. RESULTS: One hundred thirty-nine cases were identified; 114 (82%) operative burns and 25 (18%) surgical fires. Median plaintiff (patient) age was 46 (IQR:28-59). Most common site of operative burn was the face (26% [n = 36])...
December 12, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28091894/mechanisms-of-action-of-surgical-interventions-on-weight-related-diseases-the-potential-role-of-bile-acids
#14
REVIEW
Mohsen Mazidi, Pedro Paulo P de Caravatto, John R Speakman, Ricardo V Cohen
Surgical interventions for weight-related diseases (SWRD) may have substantial and sustainable effect on weight reduction, also leading to a higher remission rate of type 2 diabetes (T2D) mellitus than any other medical treatment or lifestyle intervention. The resolution of T2D after Roux-en-Y gastric bypass (RYGB) typically occurs too quickly to be accounted for by weight loss alone, suggesting that these operations have a direct impact on glucose homeostasis. The mechanisms underlying these beneficial effects however remain unclear...
January 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28091816/pediatric-cerebral-sinovenous-thrombosis-following-cranial-surgery
#15
Dmitriy Petrov, Michael Y Uohara, Rebecca Ichord, Zarina Ali, Laura Jastrzab, Shih-Shan Lang, Lori Billinghurst
PURPOSE: Pediatric cerebral sinovenous thrombosis (CSVT) is an important, though less common subtype of pediatric stroke. It has been linked to several risk factors, including cranial procedures, with few studies highlighting this relationship. The aim of this study was to characterize the diagnosis and treatment of CSVT after cranial surgery. METHODS: An institutional pediatric stroke research database was used to identify all CSVT cases diagnosed within 30 days of cranial surgery from November 2004 to December 2014...
January 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#16
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28087231/psychosocial-outcome-in-adult-men-born-with-hypospadias
#17
L Örtqvist, M Andersson, A Strandqvist, A Nordenström, L Frisén, G Holmdahl, A Nordenskjöld
INTRODUCTION: Hypospadias, which is a surgically treated congenital malformation of the male urethra, may have a negative impact on quality of life. This aspect has previously been subject to limited research. This study examined the long-term psychosocial outcome of a large cohort of adult males born with hypospadias. OBJECTIVE: The purpose of this case-control study was to assess a possible negative influence on the psychosocial outcome in adult males with hypospadias...
September 9, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28086937/a-meta-analysis-of-randomized-control-trials-of-surgical-methods-with-osteosarcoma-outcomes
#18
REVIEW
Xiaojun He, Zhenzhen Gao, Hongwei Xu, Zhongwei Zhang, Peng Fu
BACKGROUND: Osteosarcoma is a high malignant neoplasm, and conflicting findings have been reported on the survival and function recovery of osteosarcoma patients experiencing limb salvage or amputation. In the present study, we compared limb salvage surgery (LSS) with amputation in clinical outcomes of osteosarcoma patients by a meta-analysis. METHODS: The survival rate of osteosarcoma patients was collected from research reports from CNKI, MEDLINE, EMBASE, the Cochrane Database, and Google Scholar till April 30, 2016...
January 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#19
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28075516/quantifying-severe-urinary-complications-after-radical-prostatectomy-the-development-and-validation-of-a-surgical-performance-indicator-using-hospital-administrative-data
#20
A Sujenthiran, S C Charman, M Parry, J Nossiter, A Aggarwal, P Dasgupta, H Payne, N W Clarke, P Cathcart, J van der Meulen
OBJECTIVES: To develop and validate a surgical performance indicator based on severe urinary complications that require an intervention within two years after radical prostatectomy (RP) identified in hospital administrative data. PATIENTS AND METHODS: Men who underwent RP between 2008 and 2012 in England were identified using hospital administrative data. A transparent coding-framework based on procedure codes was developed to identify severe urinary complications which were grouped into "stricture", "incontinence" and "other"...
January 11, 2017: BJU International
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