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https://www.readbyqxmd.com/read/28817500/disease-specific-care-spine-surgery-program-development
#1
Katie Koerner, Lauren Franker, Barbara Douglas, Edgardo Medero, Jennifer Bromeland
Minimal literature exists describing the process for development of a Joint Commission comprehensive spine surgery program within a community hospital health system. Components of a comprehensive program include structured communication across care settings, preoperative education, quality outcomes tracking, and patient follow-up. Organizations obtaining disease-specific certification must have clear knowledge of the planning, time, and overall commitment, essential to developing a successful program. Health systems benefit from disease-specific certification because of their commitment to a higher standard of service...
August 16, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28808946/perioperative-care-of-elderly-surgical-outpatients
#2
REVIEW
Xuezhao Cao, Paul F White, Hong Ma
The ambulatory setting offers potential advantages for elderly patients undergoing elective surgery due to the advancement in both surgical and anesthetic techniques resulting in quicker recovery times, fewer complications, higher patient satisfaction, and reduced costs of care. This review article aims to provide a practical guide to anesthetic management of elderly outpatients. Important considerations in the preoperative evaluation of elderly outpatients with co-existing diseases, as well as the advantages and disadvantages of different anesthetic techniques on a procedural-specific basis, and recommendations regarding the management of common postoperative complications (e...
August 14, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28803334/surgical-approaches-to-adenocarcinoma-of-the-gastroesophageal-junction-the-siewert-ii-conundrum
#3
REVIEW
Andrew M Brown, Danica N Giugliano, Adam C Berger, Michael J Pucci, Francesco Palazzo
BACKGROUND: The Siewert classification system for gastroesophageal junction adenocarcinoma has provided morphological and topographical information to help guide surgical decision-making. Evidence has shown that Siewert I and III tumors are distinct entities with differing epidemiologic and histologic characteristics and distinct patterns of disease progression, requiring different treatment. Siewert II tumors share some of the characteristics of type I and III lesions, and the surgical approach is not universally agreed upon...
August 12, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28802289/home-enteral-nutrition-s-effects-on-nutritional-status-and-quality-of-life-after-esophagectomy
#4
Jian Zeng, Jian Hu, Qixun Chen, Jianguo Feng
BACKGROUND AND OBJECTIVES: We aimed to characterize the effect of home enteral nutrition (HEN) on the nutritional status and the quality of life (QOL) of esophageal cancer patients who underwent Ivor Lewis esophagectomy for cancer. METHODS AND STUDY DESIGN: Sixty patients with esophageal cancer were assigned to receive either HEN (n=30) or standard care only (n=30) from 1 week to 24 weeks following surgery. Nutritional status was evaluated using The Mini Nutritional Assessment at 1 week preoperatively and at 12 and 24 weeks postoperatively...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28801404/systematic-review-of-preoperative-physical-activity-and-its-impact-on-postcardiac-surgical-outcomes
#5
D Scott Kehler, Andrew N Stammers, Navdeep Tangri, Brett Hiebert, Randy Fransoo, Annette S H Schultz, Kerry Macdonald, Nicholas Giacomontonio, Ansar Hassan, Jean-Francois Légaré, Rakesh C Arora, Todd A Duhamel
OBJECTIVES: The objective of this systematic review was to study the impact of preoperative physical activity levels on adult cardiac surgical patients' postoperative: (1) major adverse cardiac and cerebrovascular events (MACCEs), (2) adverse events within 30 days, (3) hospital length of stay (HLOS), (4) intensive care unit length of stay (ICU LOS), (5) activities of daily living (ADLs), (6) quality of life, (7) cardiac rehabilitation attendance and (8) physical activity behaviour. METHODS: A systematic search of MEDLINE, Embase, AgeLine and Cochrane library for cohort studies was conducted...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28795214/derivation-validation-and-application-of-a-pragmatic-risk-prediction-index-for-benchmarking-of-surgical-outcomes
#6
Richard T Spence, David C Chang, Haytham M A Kaafarani, Eugenio Panieri, Geoffrey A Anderson, Matthew M Hutter
BACKGROUND: Despite the existence of multiple validated risk assessment and quality benchmarking tools in surgery, their utility outside of high-income countries is limited. We sought to derive, validate and apply a scoring system that is both (1) feasible, and (2) reliably predicts mortality in a middle-income country (MIC) context. METHODS: A 5-step methodology was used: (1) development of a de novo surgical outcomes database modeled around the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) in South Africa (SA dataset), (2) use of the resultant data to identify all predictors of in-hospital death with more than 90% capture indicating feasibility of collection, (3) use these predictors to derive and validate an integer-based score that reliably predicts in-hospital death in the 2012 ACS-NSQIP, (4) apply the score in the original SA dataset and demonstrate its performance, (5) identify threshold cutoffs of the score to prompt action and drive quality improvement...
August 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28794840/virtual-reality-distraction-decreases-routine-intravenous-sedation-and-procedure-related-pain-during-preoperative-adductor-canal-catheter-insertion-a-retrospective-study
#7
Pooja G Pandya, T Edward Kim, Steven K Howard, Erica Stary, Jody C Leng, Oluwatobi O Hunter, Edward R Mariano
BACKGROUND: Virtual reality (VR) distraction is a nonpharmacological method to prevent acute pain that has not yet been thoroughly explored for anesthesiology. We present our experience using VR distraction to decrease routine intravenous sedation for patients undergoing preoperative perineural catheter insertion. METHODS: This 1-month quality improvement project involved all elective unilateral primary total knee arthroplasty patients who received a preoperative adductor canal catheter...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28777227/patient-reported-outcomes-from-the-united-states-clinical-trial-for-a-hybrid-cochlear-implant
#8
David C Kelsall, Renée J G Arnold, Leonard Lionnet
OBJECTIVE: To assess patient-reported outcomes (PROs) in individuals with significant residual low-frequency hearing and severe-to-profound high-frequency sensorineural hearing loss (SNHL) who received the hybrid cochlear implant (CI). STUDY DESIGN: Prospective, multicenter, nonrandomized, single-arm repeated measures, single-subject design. SETTING: Tertiary centers, ambulatory care. PATIENTS: Fifty adults with severe-to-profound high-frequency SNHL and residual low-frequency hearing with aided word recognition scores between 10 and 60% in the ear to be implanted, and in the contralateral ear greater than or equal to implant ear less than or equal to 80%...
August 2, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28776633/risk-factors-for-hospital-admission-following-arthroscopic-bankart-repair
#9
Steven F DeFroda, Steven L Bokshan, Brett D Owens
Arthroscopic Bankart repair, a commonly performed procedure in the United States, is usually done on an outpatient basis. All instances of arthroscopic Bankart repair from 2005 to 2014 from the American College of Surgeons National Surgical Quality Improvement Program prospective database were analyzed. Both univariate analysis and binary logistic regression were performed to determine risk factors for admission following surgery. Of 2291 patients undergoing arthroscopic Bankart repair, 173 (7.6%) required inpatient hospital admission following surgery...
August 3, 2017: Orthopedics
https://www.readbyqxmd.com/read/28762228/-a-systematic-review-and-meta-analysis-of-the-pros-and-cons-of-consuming-liquids-preoperatively
#10
Fang-Tzu Lin, Tsai-Rung Lin, Chia-Wei Liao, Shu-Hui Chen
BACKGROUND: Preoperative anesthesia long time fasting, may increase patient hemodynamic instability during surgery and may affect the patient's post-surgery electrolyte balance. No meta-analysis has been conducted to explore the effects of preoperative liquid intake amount on gastric fluid PH, gastric fluid volume, surgery inhalation of pulmonary complications, and patient self-perceptions quality of care systematic review and meta-analysis of the literature. PURPOSE: To assess the pros and cons of preoperative liquid intake using a systematic review of the literature...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28760151/pureair-protocol-randomized-controlled-trial-of-intensive-pulmonary-rehabilitation-versus-standard-care-in-patients-undergoing-surgical-resection-for-lung-cancer
#11
Stefania Fugazzaro, Stefania Costi, Carlotta Mainini, Besa Kopliku, Cristian Rapicetta, Roberto Piro, Roberta Bardelli, Patricia Filipa Sobral Rebelo, Carla Galeone, Giorgio Sgarbi, Filippo Lococo, Massimiliano Paci, Tommaso Ricchetti, Silvio Cavuto, Domenico Franco Merlo, Sara Tenconi
BACKGROUND: Non-small cell lung cancer is the most common type of lung cancer. Surgery is proven to be the most effective treatment in early stages, despite its potential impact on quality of life. Pulmonary rehabilitation, either before or after surgery, is associated with reduced morbidity related symptoms and improved exercise capacity, lung function and quality of life. METHODS: We describe the study protocol for the open-label randomized controlled trial we are conducting on patients affected by primary lung cancer (stages I-II) eligible for surgical treatment...
July 31, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28742757/concurrent-validity-and-responsiveness-of-promis-health-domains-among-patients-presenting-for-anterior-cervical-spine-surgery
#12
Taylor E Purvis, Elena Andreou, Brian J Neuman, Lee H Riley, Richard L Skolasky
STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine validity and responsiveness of Patient-Reported Outcomes Measurement Information System (PROMIS) health domains. SUMMARY OF BACKGROUND DATA: PROMIS health domains (anxiety, depression, fatigue, pain, physical function, satisfaction with participation in social roles, sleep disturbance) may measure quality of care and determine minimal important differences (MIDs) after spine surgery...
July 24, 2017: Spine
https://www.readbyqxmd.com/read/28740672/effectiveness-of-perioperative-pulmonary-rehabilitation-in-thoracic-surgery
#13
Attila Vagvolgyi, Zsolt Rozgonyi, Maria Kerti, Paul Vadasz, Janos Varga
BACKGROUND: Functional condition is crucial for operability of patients with lung cancer and/or chronic respiratory diseases. The aim of the study was to measure changes of functional and quality of life parameters in terms of the effectiveness of perioperative pulmonary rehabilitation (PR). METHODS: A total of 208 COPD patients (age: 63±9 years, man/woman: 114/94, FEV1: 62±14%pred) participated in a perioperative PR program. The indication was primary lung cancer in 72% of the patients...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28738944/predicting-postoperative-complications-for-acute-care-surgery-patients-using-the-acs-nsqip-surgical-risk-calculator
#14
Jessica R Burgess, Benjamin Smith, Rebecca Britt, Leonard Weireter, Travis Polk
The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator has been used to assist surgeons in predicting the risk of postoperative complications. This study aims to determine if the risk calculator accurately predicts complications in acute care surgical patients undergoing laparotomy. A retrospective review was performed on all patients on the acute care surgery service at a tertiary hospital who underwent laparotomy between 2011 and 2012. The preoperative risk factors were used to calculate the estimated risks of postoperative complications in both the original ACS NSQIP calculator and updated calculator (June 2016)...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738723/patients-expectations-for-the-functional-and-psychosocial-outcomes-of-orbital-decompression-surgery-for-thyroid-eye-disease-a-qualitative-study
#15
Sadie Wickwar, Hayley McBain, Matthew R Edmunds, Daniel G Ezra, Geoffrey E Rose, Stanton P Newman
Patients with appearance-altering conditions may be dissatisfied with the outcomes of reconstructive surgery due to unmet expectations. This study explored patients' expectations of orbital decompression surgery for thyroid eye disease (TED) and whether these were met. Semi-structured interviews were conducted at two times: (1) in the weeks after patients were listed for decompression surgery and before surgery; (2) up to 12 months after surgery. Thematic analysis was performed for each time point, to identify themes within the data...
July 25, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28737598/epidemiology-and-outcomes-of-cardiac-arrest-in-pediatric-cardiac-icus
#16
Jeffrey A Alten, Darren Klugman, Tia T Raymond, David S Cooper, Janet E Donohue, Wenying Zhang, Sara K Pasquali, Michael G Gaies
OBJECTIVES: In-hospital cardiac arrest occurs in 2.6-6% of children with cardiac disease and is associated with significant morbidity and mortality. Much remains unknown about cardiac arrest in pediatric cardiac ICUs; therefore, we aimed to describe cardiac arrest epidemiology in a contemporary multicenter cardiac ICU cohort. DESIGN: Retrospective analysis within the Pediatric Cardiac Critical Care Consortium clinical registry. SETTING: Cardiac ICUs within 23 North American hospitals...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28735120/outpatient-lumbar-microdiscectomy-in-france-from-an-economic-imperative-to-a-clinical-standard-an-observational-study-of-201-cases
#17
Bertrand Debono, Pascal Sabatier, Valérie Garnault, Olivier Hamel, Philippe Bousquet, Jean-Paul Lescure, Jean-Yves Plas
PURPOSE: The outpatient lumbar discectomy procedures have been established for more than 2 decades. However, especially in Europe, there are still obstacles to the development of these procedures, which may be related to medicoeconomic imperatives, and to several factors concerning both surgeons and patients. We describe our initial experience in introducing this method in our institution. METHODS: During a 3-year period, 201 patients met the criteria for ambulatory lumbar microdiscectomy...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28730301/biopsychosocial-factors-predict-quality-of-life-in-thoracolumbar-spine-surgery
#18
Dean A Tripp, Edward Abraham, Maude Lambert, Kate Wagg, Erin Bigney, Eden Daly, Phylicia Verreault, Neil Manson
PURPOSE: Surgical intervention is a treatment option for various spinal pathology but many patients report no improvement or even an exacerbation of symptoms like pain. This study examined the association of preoperative (pre-op) biopsychosocial risk factors with poor quality of life at 2 and 6 months using hierarchical models controlling demographic and medical variables. METHOD: Participants undergoing thoracolumbar spine surgery (N = 214) were provided with questionnaire packages to complete pre-op, at 2 and at 6-month postoperative clinical follow-ups (i...
July 20, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28728329/liposuction-in-the-treatment-of-lipedema-a-longitudinal-study
#19
Mehran Dadras, Peter Joachim Mallinger, Cord Christian Corterier, Sotiria Theodosiadi, Mojtaba Ghods
BACKGROUND: Lipedema is a condition consisting of painful bilateral increases in subcutaneous fat and interstitial fluid in the limbs with secondary lymphedema and fibrosis during later stages. Combined decongestive therapy (CDT) is the standard of care in most countries. Since the introduction of tumescent technique, liposuction has been used as a surgical treatment option. The aim of this study was to determine the outcome of liposuction used as treatment for lipedema. METHODS: Twenty-five patients who received 72 liposuction procedures for the treatment of lipedema completed a standardized questionnaire...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28727858/association-of-velopharyngeal-insufficiency-with-quality-of-life-and-patient-reported-outcomes-after-speech-surgery
#20
Aditi Bhuskute, Jonathan R Skirko, Christina Roth, Ahmed Bayoumi, Blythe Durbin-Johnson, Travis T Tollefson
Importance: Patients with cleft palate and other causes of velopharyngeal insufficiency (VPI) suffer adverse effects on social interactions and communication. Measurement of these patient-reported outcomes is needed to help guide surgical and nonsurgical care. Objectives: To further validate the VPI Effects on Life Outcomes (VELO) instrument, measure the change in quality of life (QOL) after speech surgery, and test the association of change in speech with change in QOL...
July 20, 2017: JAMA Facial Plastic Surgery
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