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https://www.readbyqxmd.com/read/28224443/report-of-the-clinical-and-functional-primary-outcomes-in-men-of-the-acl-sports-trial-similar-outcomes-in-men-receiving-secondary-prevention-with-and-without-perturbation-training-1-and-2-years-after-acl-reconstruction
#1
Amelia J H Arundale, Kathleen Cummer, Jacob J Capin, Ryan Zarzycki, Lynn Snyder-Mackler
BACKGROUND: Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28222805/use-of-activity-tracking-in-major-visceral-surgery-the-enhanced-perioperative-mobilization-epm-trial-study-protocol-for-a-randomized-controlled-trial
#2
Steffen Wolk, Theresa Meißner, Sebastian Linke, Benjamin Müssle, Ann Wierick, Andreas Bogner, Dorothée Sturm, Nuh N Rahbari, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. "Early mobilization" is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands...
February 21, 2017: Trials
https://www.readbyqxmd.com/read/28211248/anesthetic-considerations-for-pediatric-electroconvulsive-therapy
#3
REVIEW
Andrew D Franklin, Jenna H Sobey, Eric T Stickles
Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28206936/independent-preoperative-predictors-of-prolonged-length-of-stay-after-laparoscopic-appendectomy-in-patients-over-30-years-of-age-experience-from-a-single-institution
#4
Eric S Wise, Stephen P Gadomski, Annette M Ilg, Camilo Bermudez, Emily W Chan, Michelle L Izmaylov, Samantha J Gridley, Jessica V Kaczmarek, Sir Norman T Melancon, Sarwat Ahmad, Kyle M Hocking, Jose J Diaz, Stephen M Kavic
Prompt discharge after laparoscopic appendectomy (LA) is a marker of quality of care, fiscally desirable and feasible in select patients. Patients over 30 comprise a more heterogeneous cohort known to experience worse outcomes after LA. We aimed to identify easily available preoperative risk factors portending a postoperative length of stay ≥2 days among patients above age 30. In this investigation, 296 included patients from a single institution who underwent LA for acute appendicitis from 2010 to 2014 were retrospectively reviewed for preoperative demographics, laboratory studies, comorbidities, presentation characteristics, radiographic finding, and other rationally selected factors for association with postoperative length of stay ≥2 days...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28191698/short-and-long-term-complications-and-the-impact-on-quality-of-life-after-cervical-conization-by-harmonic-scalpel
#5
Megumi Furugori, Mikiko Asai-Sato, Kayoko Katayama, Fumiki Hirahara, Etsuko Miyagi
AIM: The incidence of non-obstetrical complications after cervical conization is low, and women receive minimal postsurgical attention. In this study, we investigated whether women felt any discomfort after undergoing conization by harmonic scalpel, one of the hot-knife devices widely used in Japan. METHODS: Eighty-eight women aged 20-47 years who were still experiencing menstrual cycles and had undergone harmonic conization participated in a questionnaire survey regarding perisurgical complications and postsurgical changes in gynecological issues...
February 13, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28188428/cochlear-implant-treatment-of-patients-with-single-sided-deafness-or-asymmetric-hearing-loss
#6
S Arndt, R Laszig, A Aschendorff, F Hassepass, R Beck, T Wesarg
BACKGROUND: The rehabilitation of patients with single-sided deafness (SSD) or asymmetric hearing loss can be achieved with conventional (Bi)CROS hearing aids ((Bi)CROS-HA, (Bi)CROS), bone conduction devices (BCI) or with cochlear implants (CI). Unfortunately, only small case series have been published on the treatment outcomes in SSD patients after CI surgery and there are only a few comparative studies evaluating rehabilitation outcomes. OBJECTIVE: The aim of this study was to provide evidence of successful treatment of SSD and asymmetric hearing loss with a CI compared to the untreated, monaural hearing condition and the therapy options of BCI and (Bi)CROS in a large number of patients...
February 10, 2017: HNO
https://www.readbyqxmd.com/read/28183542/impact-of-ejection-fraction-on-infectious-renal-and-respiratory-morbidity-for-patients-undergoing-noncardiac-surgery
#7
Michael D Maile, William F Armstrong, Elizabeth S Jewell, Milo C Engoren
OBJECTIVE: We sought to determine if decreased left ventricular systolic function was associated with an increased risk of postoperative infectious, respiratory, or renal complications in patients undergoing noncardiac surgery. DESIGN: Retrospective cohort study. SETTING: Single tertiary-care, university-based medical center. PATIENTS: We studied individuals who participated in the American College of Surgeons National Quality Improvement Program and had a preoperative echocardiogram conducted at our institution...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28174658/making-safer-preoperative-arrangements-for-patients-using-vitamin-k-antagonists
#8
Joris van Fessem, Jessica Willems, Marieke Kruip, Sanne Hoeks, Robert Jan Stolker
Use of vitamin K antagonists creates a risk for patient health and safety. The Dutch framework "Nationwide Standard Integrated Care of Anticoagulation" propagates a shared plan and responsibility by surgeon and anesthesiologist together in the preoperative setting. In our institution, this framework had not been implemented. Therefore, a quality-improvement project was started at the Anesthesia Department to improve perioperative safety. After exploration of barriers, multiple interventions were carried out to encourage co-workers at the preoperative screening department to take shared responsibility: distribution of prints, adjustments in electronic patient records, introduction of a protocol and education sessions...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28169959/the-impact-of-preoperative-depression-on-hospital-consumer-assessment-of-healthcare-providers-and-systems-hcahps-survey-results-in-a-lumbar-fusion-population
#9
Jay M Levin, Robert D Winkelman, Gabriel A Smith, Joseph Tanenbaum, Edward C Benzel, Thomas E Mroz, Michael P Steinmetz
STUDY DESIGN: A retrospective cohort study at a single institution. OBJECTIVE: To determine the effect of preoperative depression on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores in a lumbar fusion population. SUMMARY OF BACKGROUND DATA: HCAHPS surveys are used to assess the quality of the patient experience, and directly influences reimbursement for hospital systems and spine surgeons nationwide. Untreated depression has been linked to worse functional outcomes in spine surgery...
February 6, 2017: Spine
https://www.readbyqxmd.com/read/28143731/patient-body-image-self-esteem-and-cosmetic-results-of-minimally-invasive-robotic-cardiac-surgery
#10
Taner İyigün, Mehmet Kaya, Sevil Özgül Gülbeyaz, Nurhan Fıstıkçı, Gözde Uyanık, Bilge Yılmaz, Burak Onan, Korhan Erkanlı
BACKGROUND: Patient-reported outcome measures reveal the quality of surgical care from the patient's perspective. We aimed to compare body image, self-esteem, hospital anxiety and depression, and cosmetic outcomes by using validated tools between patients undergoing robot-assisted surgery and those undergoing conventional open surgery. MATERIALS AND METHODS: This single-center, multidisciplinary, randomized, prospective study of 62 patients who underwent cardiac surgery was conducted at Hospital from May 2013 to January 2015...
January 29, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28128706/standardizing-preoperative-preparation-to-reduce-surgical-site-infections-among-pediatric-neurosurgical-patients
#11
Joshua K Schaffzin, Katherine Simon, Beverly L Connelly, Francesco T Mangano
OBJECTIVE Surgical site infections (SSIs) are costly to patients and the health care system. Pediatric neurosurgery SSI risk factors are not well defined. Intraoperative protocols have reduced, but have not eliminated, SSIs. The effect of preoperative intervention is unknown. Using quality improvement methods, a preoperative SSI prevention protocol for pediatric neurosurgical patients was implemented to assess its effect on SSI rate. METHODS Patients who underwent a scheduled neurosurgical procedure between January 2014 and December 2015 were included...
January 27, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#12
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28121380/practice-trends-over-time-in-the-care-of-infants-with-hypoplastic-left-heart-syndrome-a-report-from-the-national-pediatric-cardiology-quality-improvement-collaborative
#13
Waldemar F Carlo, James F Cnota, Robert J Dabal, Jeffrey B Anderson
OBJECTIVE: The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) was established in 2008 to improve outcomes of hypoplastic left heart syndrome (HLHS) during the interstage period. They evaluated changes in patient variables and practice variation between early and late eras. DESIGN: Data including demographic, operative, discharge, and follow-up variables from the first 100 patients (6/2008-1/2010) representing 18 centers were compared with the most recent 100 patients (1/2014-11/2014) from these same centers...
January 25, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28120729/-patient-expectations-and-satisfaction-concerning-total-knee-arthroplasty
#14
T Duivenvoorden, H Verburg, J A N Verhaar, S M A Bierma-Zeinstra, M Reijman
BACKGROUND: Approximately 5-10% of patients is dissatisfied after a total knee arthroplasty. Several studies suggest that unrealistic expectations contribute to this; however, a systematic overview of the literature is missing. DESIGN: Systematic literature review METHOD: Using a systematic search strategy, prospective and retrospective studies with a follow-up of a minimum of six months, were obtained from PubMed publisher, MEDLINE, Embase, Cochrane, PsycINFO, CINAHL, and Web-of-Science...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#15
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28099985/-prospective-evaluation-of-the-quality-of-the-results-of-thyroid-surgery-in-an-ent-department
#16
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
#17
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
#18
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
#19
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
#20
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
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