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https://www.readbyqxmd.com/read/28099985/-prospective-evaluation-of-the-quality-of-the-results-of-thyroid-surgery-in-an-ent-department
#1
Peter Rolf Issing, Hendrik Tebben, Martin Wenger, Torsten Köhler
Although the thyroid gland is located in the neck it is not a matter of fact that it is a clinical issue for the otorhinolaryngologist in Germany. Probably due to historic reasons general surgeons usually perform operations on the thyroid. As at our department this kind of treatment is an established procedure we prospectively evaluated our thyroid cases in order to present our results.The prospective study started in the year of 2014. So far 231 patients were enrolled with an average age of 53,5 years (16-89)...
January 18, 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28099733/implementation-of-a-modified-obstetric-early-warning-system-to-improve-the-quality-of-obstetric-care-in-zimbabwe
#2
Abi Merriel, Bobb T Murove, Samuel W D Merriel, Thabani Sibanda, Sikangezile Moyo, Joanna Crofts
OBJECTIVE: To implement a modified obstetric early warning system (MOEWS) to promote identification and stabilization of unwell women. METHODS: A before-and-after study of MOEWS implementation took place between April 2013 and January 2014 in a government referral hospital in Bulawayo, Zimbabwe. After piloting MOEWS, cesarean case files were retrospectively assessed to compare preoperative stabilization. A longitudinal "spot-check" study measured use of MOEWS and action taken on abnormal results...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099323/anesthesia-and-databases-pediatric-cardiac-disease-as-a-role-model
#3
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/28093301/protocol-driven-management-of-suspected-common-duct-stones
#4
Anthony Manning, Richard Frazee, Stephen Abernathy, Claire Isbell, Travis Isbell, Justin Regner, Yolanda Munoz Maldanado, Randall Smith
INTRO: Common duct stones can be diagnosed by magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound/endoscopic retrograde cholangiopancreatography (EUS/ERCP), and intra-operative cholangiogram (IOC). In 2015, our group adopted a standard approach of preoperative EUS/ERCP followed by laparoscopic cholecystectomy for patients with an admission bilirubin over 4.0 (mg/dL). For bilirubin less than 4.0, laparoscopic cholecystectomy with IOC was the initial procedure. Post-operative EUS/ERCP with endoscopic sphincterotomy was pursued for positive IOC...
January 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28089437/systems-innovation-model-an-integrated-interdisciplinary-team-approach-pre-and-post-bariatric-surgery-at-a-veterans-affairs-va-medical-center
#5
Dan Eisenberg, Jessica A Lohnberg, Eric P Kubat, Cheryl C Bates, Lauren M Greenberg, Susan M Frayne
BACKGROUND: Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. OBJECTIVES: To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management...
November 15, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28069021/preoperative-optimization-of-patient-expectations-improves-long-term-outcome-in-heart-surgery-patients-results-of-the-randomized-controlled-psy-heart-trial
#6
Winfried Rief, Meike C Shedden-Mora, Johannes A C Laferton, Charlotte Auer, Keith J Petrie, Stefan Salzmann, Manfred Schedlowski, Rainer Moosdorf
BACKGROUND: Placebo effects contribute substantially to outcome in most fields of medicine. While clinical trials typically try to control or minimize these effects, the potential of placebo mechanisms to improve outcome is rarely used. Patient expectations about treatment efficacy and outcome are major mechanisms that contribute to these placebo effects. We aimed to optimize these expectations to improve outcome in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: In a prospective three-arm randomized clinical trial with a 6 month follow-up, 124 patients scheduled for CABG surgery were randomized to either a brief psychological pre-surgery intervention to optimize outcome expectations (EXPECT); or a psychological control intervention focusing on emotional support and general advice, but not on expectations (SUPPORT); or to standard medical care (SMC)...
January 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28061841/supervised-neuromuscular-exercise-prior-to-hip-and-knee-replacement-12-month-clinical-effect-and-cost-utility-analysis-alongside-a-randomised-controlled-trial
#7
Linda Fernandes, Ewa M Roos, Søren Overgaard, Allan Villadsen, Rikke Søgaard
BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery...
January 6, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28059918/quality-improvement-initiatives-in-colorectal-surgery-value-of-physician-feedback
#8
Joshua A Waters, Todd Francone, Peter W Marcello, Patricia L Roberts, David J Schoetz, Thomas E Read, Caitlin Stafford, Rocco Ricciardi
BACKGROUND: The impact of process improvement through surgeon feedback on outcomes is unclear. OBJECTIVE: We sought to evaluate the effect of biannual surgeon-specific feedback on outcomes and adherence to departmental and Surgical Care Improvement Project process measures on colorectal surgery outcomes. DESIGN: This was a retrospective analysis of prospectively collected 100% capture surgical quality improvement data. SETTING: This study was conducted at the department of colorectal surgery at a tertiary care teaching hospital from January 2008 through December 2013...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059916/does-hospital-transfer-impact-outcomes-after-colorectal-surgery
#9
Christopher J Chow, Wolfgang B Gaertner, Christine C Jensen, Bradford Sklow, Robert D Madoff, Mary R Kwaan
BACKGROUND: With increasing public reporting of outcomes and bundled payments, hospitals and providers are scrutinized for morbidity and mortality. The impact of patient transfer before colorectal surgery has not been well characterized in a risk-adjusted fashion. OBJECTIVE: We hypothesized that hospital-to-hospital transfer would independently predict morbidity and mortality beyond traditional predictor variables. DESIGN: We constructed a retrospective cohort of 158,446 patients who underwent colorectal surgery using the 2009-2013 American College of Surgeons National Surgical Quality Improvement Program database...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059679/perioperative-outcomes-for-pediatric-neurosurgical-procedures-analysis-of-the-national-surgical-quality-improvement-program-pediatrics
#10
Benjamin J Kuo, Joao Ricardo N Vissoci, Joseph R Egger, Emily R Smith, Gerald A Grant, Michael M Haglund, Henry E Rice
OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform...
January 6, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28045745/avoiding-complications-in-endoscopic-skull-base-surgery
#11
Jannis Constantinidis, Iordanis Konstantinidis
PURPOSE OF REVIEW: Endoscopic skull base surgery has become an established approach for the removal of tumors and cerebrospinal fluid fistulae repair. Compared with external approaches, it provides better aesthetic results and quality of life postoperatively. However, as it becomes popular and expands its indications possible complications should be reassessed in terms of incidence and variability in order to confirm its efficacy and safety. This article reviews the recent literature describing the main categories of possible complications suggesting strategies to minimize their incidence...
December 23, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28029503/iron-deficiency-and-iron-deficiency-anaemia-in-women
#12
REVIEW
Laura Percy, Diana Mansour, Ian Fraser
Iron deficiency (ID) is the most common micronutrient deficiency worldwide with >20% of women experiencing it during their reproductive lives. Hepcidin, a peptide hormone mostly produced by the liver, controls the absorption and regulation of iron. Understanding iron metabolism is pivotal in the successful management of ID and iron deficiency anaemia (IDA) using oral preparations, parenteral iron or blood transfusion. Oral preparations vary in their iron content and can result in gastrointestinal side effects...
October 1, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28028281/-sequential-post-operative-nutrition-care-at-home-for-patients-receiving-surgical-treatment-for-esophageal-cancer
#13
Mio Matsuoka, Shohei Iijima
OBJECTIVE AND METHODS: We evaluated the outcomes of sequential nutrition care provided at home to patients who had undergone surgery for esophageal cancer. For 44 such patients, we investigated caloric intake(kcal), percentage of preoperative body weight(%), and requests and complains related to home nutrition care every 3 months for 1 year after surgery. RESULTS: Duringthe observation period, the mean postoperative caloric intake decreased to a minimum level at 1 month, but nearly recovered to the baseline at 12 months...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28027422/care-related-predictors-for-negative-intrusive-thoughts-after-prostate-cancer-diagnosis-data-from-the-prospective-lappro-trial
#14
Thordis Thorsteinsdottir, Heiddis Valdimarsdottir, Arna Hauksdottir, Johan Stranne, Ulrica Wilderäng, Eva Haglind, Gunnar Steineck
OBJECTIVE: Negative intrusive thoughts about one's prostate cancer have been associated with depressive mood and impaired quality of life among prostate cancer patients. However, little is known about possible predictors for negative intrusive thoughts among this group. We aimed to identify health- and care-related predictors for such thoughts among a population of men newly diagnosed with prostate cancer and undergoing radical prostatectomy. METHODS: In the LAPPRO-trial, 3154 men (80%) answered study-specific questionnaires at admission and three months after surgery...
December 27, 2016: Psycho-oncology
https://www.readbyqxmd.com/read/28027187/analysis-of-morbidity-readmission-and-reoperation-after-craniosynostosis-repair-in-children
#15
Kevin T Jubbal, Nikhil Agrawal, Larry H Hollier
The impact of specific patient comorbidities on outcomes in craniosynostosis surgical repair is not well defined. The aim of this retrospective review was to evaluate the short-term 30-day reoperation rate, unplanned readmission rate, and overall morbidity of craniosynostosis surgical repair using the 2012 through 2014 American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-Pediatric) database. Overall morbidity included pneumonia, wound occurrence, shock/sepsis, venous thromboembolism, cardiac complication, renal and urinary complications, or nerve injury...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28027059/avoiding-complications-in-endoscopic-skull-base-surgery
#16
Jannis Constantinidis, Iordanis Konstantinidis
PURPOSE OF REVIEW: Endoscopic skull base surgery has become an established approach for the removal of tumors and cerebrospinal fluid fistulae repair. Compared with external approaches, it provides better aesthetic results and quality of life postoperatively. However, as it becomes popular and expands its indications possible complications should be reassessed in terms of incidence and variability in order to confirm its efficacy and safety. This article reviews the recent literature describing the main categories of possible complications suggesting strategies to minimize their incidence...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28017810/access-to-quaternary-care-surgery-implications-for-accountable-care-organizations
#17
J Hunter Mehaffey, Robert B Hawkins, Matthew G Mullen, Max O Meneveau, Bruce Schirmer, Irving L Kron, R Scott Jones, Peter T Hallowell
BACKGROUND: Accountable Care Organizations (ACO) attempt to provide the most efficient and effective care to patients within a region. We hypothesize that patients who undergo surgery closer to home have improved survival due to proximity of preoperative and post-discharge care. STUDY DESIGN: All (17,582) institutional American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) patients with a documented zip code and predicted risk who underwent surgery at our institution (2005-2014) were evaluated...
December 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28017586/operative-variables-are-better-predictors-of-postdischarge-infections-and-unplanned-readmissions-in-vascular-surgery-patients-than-patient-characteristics
#18
Caitlin W Hicks, Michael Bronsert, Karl E Hammermeister, William G Henderson, Douglas R Gibula, James H Black, Natalia O Glebova
OBJECTIVE: Although postoperative readmissions are frequent in vascular surgery patients, the reasons for these readmissions are not well characterized, and effective approaches to their reduction are unknown. Our aim was to analyze the reasons for vascular surgery readmissions and to report potential areas for focused efforts aimed at readmission reduction. METHODS: The 2012 to 2013 American College of Surgeons National Quality Improvement Program (ACS NSQIP) data set was queried for vascular surgery patients...
December 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28013451/a-new-algorithm-to-reduce-the-incidence-of-gastroesophageal-reflux-symptoms-after-laparoscopic-sleeve-gastrectomy
#19
Ilhan Ece, Huseyin Yilmaz, Fahrettin Acar, Bayram Colak, Serdar Yormaz, Mustafa Sahin
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is one of the most prefered treatment option for morbid obesity. However, the effects of LSG on gastroesophageal reflux disease (GERD) are controversial. Asymptomatic GERD and hiatal hernia (HH) is common in obese patients. Therefore, it is important to identify the high risk patients prior to surgery. This study aims to evaluate efficacy of cruroplasty for HH during LSG in morbidly obese patients using ambulatory pH monitoring (APM) results, and to investigate the patients' selection criteria for this procedure...
December 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/28012043/prospective-evaluation-of-health-related-quality-of-life-after-radical-cystectomy-focus-on-peri-and-postoperative-complications
#20
Alexander Kretschmer, Tobias Grimm, Alexander Buchner, Markus Grabbert, Friedrich Jokisch, Birte-Swantje Schneevoigt, Maria Apfelbeck, Gerald Schulz, Christian G Stief, Alexander Karl
OBJECTIVES: To analyse the impact of perioperative complications and complex treatment courses on postoperative health-related quality of life (HRQOL) after radical cystectomy (RC) and continent (ONB) or incontinent (IC) urinary diversion at multiple prospective time points. METHODS: A total of 121 consecutive patients underwent RC with curative intent between 2013 and 2014. HRQOL was prospectively assessed preoperatively, after 3 and 12 months, using the QLQ-C30 questionnaire...
December 23, 2016: World Journal of Urology
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