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Smoking and surgery

Barry A Finegan, Daniel Roblin, Fadi Hammal
Quality problem: For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Initial assessment: Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented...
March 14, 2018: International Journal for Quality in Health Care
Hannah M Carl, A Karim Ahmed, Nancy Abu-Bonsrah, Rafael De la Garza Ramos, Eric W Sankey, Zachary Pennington, Ali Bydon, Timothy F Witham, Jean-Paul Wolinsky, Ziya L Gokaslan, Justin M Sacks, C Rory Goodwin, Daniel M Sciubba
OBJECTIVE Resection of metastatic spine tumors can improve patients' quality of life by addressing pain or neurological compromise. However, resections are often complicated by wound dehiscence, infection, instrumentation failures, and the need for reoperation. Moreover, when reoperations are needed, the most common indication is surgical site infection and wound breakdown. In turn, wound reoperations increase morbidity as well as the length and cost of hospitalization. The aim of this study was to examine perioperative risk factors associated with increased rate of wound reoperations after metastatic spine tumor resection...
March 16, 2018: Journal of Neurosurgery. Spine
Alison Luther, Joseph Gabriel, Richard P Watson, Nader K Francis
BACKGROUND: Despite advances in perioperative care, post-operative clinical and functional outcomes after major abdominal surgery can be suboptimal. Prehabilitation programmes attempt to optimise a patient's preoperative condition to improve outcomes. Total body prehabilitation includes structured exercise, nutritional optimisation, psychological support and cessation of negative health behaviours. This systematic review aims to report on the current literature regarding the impact of total body prehabilitation prior to major abdominal surgery...
March 15, 2018: World Journal of Surgery
Marc A Furrer, Antoni Vilaseca, Renato B Corradi, Silvan Boxler, George N Thalmann, Daniel P Nguyen
BACKGROUND: A growing number of men undergo repeat biopsies prior to radical prostatectomy for prostate cancer. However, the long-term impact of repeat biopsies on functional outcomes in this patient population remains unelucidated. Thus, we compared functional outcomes between patients who underwent single biopsy versus repeat biopsies before radical prostatectomy. METHODS: From 1996 to 2015, 1015 consecutive patients underwent radical prostatectomy, and subsequently had urinary continence and erectile function assessed for >2 years follow-up...
March 14, 2018: Prostate
Ronaldo Lira-Junior, Sigvard Åkerman, Björn Klinge, Elisabeth A Boström, Anders Gustafsson
BACKGROUND: Analysis of saliva is emerging as a promising tool to diagnose and monitor diseases which makes determination of the salivary microbial profile in different scenarios essential. OBJECTIVE: To evaluate the effects of age, periodontal disease, sex, smoking, and medical conditions on the salivary microbial profile. DESIGN: A randomly selected sample of 441 individuals was enrolled (51% women; mean age 48.5±16.8). Participants answered a health questionnaire and underwent an oral examination...
2018: PloS One
Bente T Jensen, Susanne V Lauridsen, Jørgen B Jensen
PURPOSE OF REVIEW: Whether prehabilitation in radical cystectomy adds to the effort of reducing postoperative morbidity and impairments in the survivorship phase has until recently received limited attention. This narrative review aims to summarize the current evidence base on prehabilitaion interventions focusing on the efficacy of procedure-specific interventions and the influence on postoperative outcomes. RECENT FINDINGS: Given the oncological risk, there is a relative short window to intervene and proactively optimize the patient before radical cystectomy...
March 13, 2018: Current Opinion in Urology
Sayaka Suzuki, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Mizuo Ando, Tatsuya Yamasoba
BACKGROUND: Data have been limited on donor-site mechanical bowel obstruction after pharyngolaryngectomy with free jejunum graft reconstruction. METHODS: Using a nationwide Japanese inpatient database, we extracted data on patients who underwent pharyngolaryngectomy for hypopharyngeal cancer between July 2007 and March 2014. A Cox proportional hazard model was used to determine the association between background characteristics and the occurrence of mechanical bowel obstruction...
March 14, 2018: Head & Neck
Irene Papanicolas, Liana R Woskie, Ashish K Jha
Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations...
March 13, 2018: JAMA: the Journal of the American Medical Association
Wenli Chang, Hongzhi Lv, Chen Feng, Peizhi Yuwen, Ning Wei, Wei Chen, Yingze Zhang
OBJECTIVE: Although many studies have reported risk factors of mortality following hip fracture surgery, the preventable risk factors of mortality following hip fracture surgery have not been well-identified. The aim of this study was to identify the preventable risk factors of mortality following hip fracture surgery. METHODS: We searched PubMed, Web of Science, Google scholar, and the Chinese National Knowledge Infrastructure (CNKI) databases from January 1997 to March 2017 for studies reporting risk factors of mortality following hip fracture surgery...
March 9, 2018: International Journal of Surgery
Penny Fang, Wen Jiang, Rajayogesh Davuluri, Cai Xu, Sunil Krishnan, Radhe Mohan, Albert C Koong, Charles C Hsu, Steven H Lin
BACKGROUND AND PURPOSE: Neoadjuvant chemoradiation (nCRT) can reduce tumor infiltrating lymphocytes. We examined absolute lymphocyte count (ALC) nadir during nCRT for esophageal cancer (EC) and pathologic complete response (pCR). MATERIALS AND METHODS: Patients with stage I-IVA EC (n = 313) treated 2007-2013 with nCRT followed by surgery were analyzed. ALC was obtained before, during/weekly, and one month after CRT. pCR was defined as no viable tumor cells at surgery...
March 9, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Fisun Sözen, Yasemin Çetinel, Özdemir Efe Kul, Atilla Sezgin
OBJECTIVES: Smoking is an important risk factor for development of complications in heart transplant patients and plays an important role in the mortality of these patients. The aim of this study was to compare the survival of heart transplant patients after transplant versus their smoking status before transplant. MATERIALS AND METHODS: Patients who had heart transplant procedures at the Baskent University Hospital Cardiovascular Surgery Department between 2005 and 2016 were analyzed retrospectively with regard to their smoking status and survival after transplant...
March 2018: Experimental and Clinical Transplantation
Ning Li, Fengwei Tan, Bin Qiu, Jiagen Li, Jun Zhao, Yushun Gao, Dali Wang, Yousheng Mao, Qi Xue, Juwei Mu, Shugeng Gao, Jie He
BACKGROUND: Surgeons are the direct decision-makers and performers in the surgical treatment of patients with lung cancer. Whether the differences among doctors affect the survival of patients is unclear. This study analyzed the five-year survival rates of different thoracic surgeries in patients undergoing surgery to assess the physician's impact and impact. METHODS: A retrospective analysis of five years between 2002-2007 in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, for surgical treatment of lung cancer patients...
February 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
S Ben Saad, B Melki, L Douik El Gharbi, F Soraya, N Chaouch, H Aouina, J Cherif, A Hamzaoui, A Merghli, H Daghfous, F Tritar
BACKGROUND: Pneumothorax is a serious complication of cavitary pulmonary tuberculosis. The aim of this study was to describe clinical futures, to highlight challenges of its management. METHODS: A retrospective multicentric and descriptive study including 65 patients treated for PT (1999-2015) was conducted to figure out clinical futures and its work-up. RESULTS: The mean age was 37.8 years. The sex ratio was 3.6. Smoking history and incarceration were noted respectively in 67...
March 6, 2018: Revue de Pneumologie Clinique
Douglas W Jones, Philip P Goodney, Jens Eldrup-Jorgensen, Marc L Schermerhorn, Jeffrey J Siracuse, Jeanwan Kang, Jesse A Columbo, Bjoern D Suckow, David H Stone
OBJECTIVE: Performing lower extremity bypass (LEB) in actively smoking claudicants remains controversial. Whereas some surgeons advocate a strict nonoperative approach to active smokers, citing perceived inferior outcomes, others will proceed with surgical bypass if the patient is anatomically suited and medical management has failed. The purpose of this study was to determine the impact of active smoking on LEB outcomes among claudicants. METHODS: All patients undergoing infrainguinal LEB for claudication in the Vascular Study Group of New England from 2003 to 2016 were analyzed...
March 6, 2018: Journal of Vascular Surgery
Xi Wang, Yin Li, Yunfei Gao, Dian Ouyang, Zhuming Guo
BACKGROUND: We investigated risk and prognostic factors for second primary squamous cell carcinoma (SCC) in patients with nasopharyngeal carcinoma (NPC) after radiotherapy (RT). METHODS: A total of 49 021 patients with NPC were treated at Sun Yat-Sen Cancer Center between January 1970 and December 2009. The incidence and management of second primary SCCs were analyzed. RESULTS: A total of 142 patients (0.29%) developed second primary SCC, with 78...
March 9, 2018: Head & Neck
Karen J Riemenschneider
Prevention of hospital-acquired pressure injuries (HAPIs) remains a crucial clinical challenge especially for those patients undergoing surgery. The purpose of this project was to examine whether a 5-layer silicone foam dressing applied to the sacrum of patients undergoing vascular surgery decreased the occurrence of sacral pressure injuries and to explore participant characteristics associated with the development of operating room (OR)-related pressure injuries. A pre-/postintervention design, quality improvement project in a convenience sample of 81 patients undergoing vascular surgery, in a 700-bed level I trauma acute care setting, in the Northeastern United States...
March 2018: Journal of Wound, Ostomy, and Continence Nursing
Junqian Zhang, Christopher J Miller, Victoria O'Malley, Jeremy R Etzkorn, Thuzar M Shin, Joseph F Sobanko
BACKGROUND: Changes in patient perceptions of quality of life (QOL) after Mohs micrographic surgery (MMS) may benefit from different counseling or treatment. OBJECTIVE: To measure QOL before and after MMS and to identify risk factors associated with impaired QOL. METHODS: Prospective observational study of 727 skin cancer patients who self-reported QOL via the Skin Cancer Index immediately before and at 1-2 weeks and 3 months after MMS. RESULTS: QOL fluctuated after MMS...
March 5, 2018: Journal of the American Academy of Dermatology
Jean Wong, Raviraj Raveendran, Junior Chuang, Zeev Friedman, Mandeep Singh, Jayadeep Patras, David T Wong, Frances Chung
BACKGROUND: Patients who smoke put themselves at increased risk for serious surgical complications, yet it is not currently routine practice to educate patients about the risk of complications due to smoking. Computer-based smoking cessation programs are increasingly being utilized in the general population and may overcome some of the barriers such as lack of time, knowledge, and training to provide interventions. Our objective was to develop and implement a patient e-learning program designed for surgical patients as part of a multifaceted program aimed at assisting them to quit smoking and to determine the factors cross-sectionally and longitudinally associated with abstinence...
March 5, 2018: Anesthesia and Analgesia
Tianxiang Zhang, Qiang Guo, Ye Zhang, Zhidong Liu, Shijie Zhou, Shaofa Xu
Background: Although there is a strong evidence that adjuvant chemotherapy after surgery was effective in Stages II and IIIA patients involved nonsmall cell lung cancer (NSCLC), its eligibility in Stage IB disease has been unknown. Therefore, this meta-analysis was aimed to compare the effects of adjuvant chemotherapy versus surgery alone in patients with Stage IB NSCLC. Materials and Methods: We systematically searched for articles from their inclusion to July 2016...
January 2018: Journal of Cancer Research and Therapeutics
Sara Khor, Danielle Lavallee, Amy M Cizik, Carlo Bellabarba, Jens R Chapman, Christopher R Howe, Dawei Lu, A Alex Mohit, Rod J Oskouian, Jeffrey R Roh, Neal Shonnard, Armagan Dagal, David R Flum
Importance: Functional impairment and pain are common indications for the initiation of lumbar spine surgery, but information about expected improvement in these patient-reported outcome (PRO) domains is not readily available to most patients and clinicians considering this type of surgery. Objective: To assess population-level PRO response after lumbar spine surgery, and develop/validate a prediction tool for PRO improvement. Design, Setting, and Participants: This statewide multicenter cohort was based at 15 Washington state hospitals representing approximately 75% of the state's spine fusion procedures...
March 7, 2018: JAMA Surgery
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