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https://www.readbyqxmd.com/read/28651296/early-discharge-hospital-at-home
#1
REVIEW
Daniela C Gonçalves-Bradley, Steve Iliffe, Helen A Doll, Joanna Broad, John Gladman, Peter Langhorne, Suzanne H Richards, Sasha Shepperd
BACKGROUND: Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. OBJECTIVES: To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. SEARCH METHODS: We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28650884/can-surgeon-demographic-factors-predict-postoperative-complication-rates-after-elective-spinal-fusion
#2
Danielle S Chun, Ralph W Cook, Joseph A Weiner, Michael S Schallmo, Kathryn A Barth, Sameer K Singh, Ryan D Freshman, Alpesh A Patel, Wellington K Hsu
STUDY DESIGN: Retrospective cohort. OBJECTIVE: Determine whether surgeon demographic factors influence postoperative complication rates after elective spine fusion procedures. BACKGROUND: Surgeon demographic factors have been shown to impact decision making in the management of degenerative disease of the lumbar spine. Complication rates are frequently reported outcome measurements used to evaluate surgical treatments, quality-of-care, and determine health care reimbursements...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650773/a-successful-live-birth-with-in-vitro-fertilization-and-thawed-embryo-transfer-after-conservative-treatment-of-recurrent-endometrial-cancer
#3
Sung Woo Kim, Hoon Kim, Seung-Yup Ku, Chang Suk Suh, Seok Hyun Kim, Young Min Choi
Estrogen-dependent early stage endometrial cancer is relatively common in young women of reproductive age. The standard treatment is hysterectomy and bilateral salpingo-oophorectomy (BSO), even in early stage well-differentiated endometrial cancer patients. This surgical option results in permanent loss of fertility. There have been some reports of live births using in vitro fertilization after conservative management of endometrial cancer with high-dose progestin for the purpose of fertility preservation. However, most were not recurrent cases and pregnancy was achieved through conventional in vitro fertilization, which usually raises serum estradiol levels and may lead to the recurrence of endometrial cancer...
June 26, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28650251/managed-care-peer-led-teaching-an-innovative-learning-approach-outside-the-college-of-pharmacy-core-curriculum
#4
SyHui Tang, Julia Smith, Wilson Lau, Isaac Tse, Christine Tan, Ryan Cotten, Amy Pittenger
BACKGROUND: Managed care pharmacy is a growing field, but there are still limited educational opportunities available in pharmacy school core curricula. Students often seek self-directed learning opportunities to further explore the field. OBJECTIVES: To (a) evaluate practicality and effectiveness of a student-designed managed care pharmacy elective and (b) determine emerging best practices for design and sustainability of peer-led, self-directed courses. METHODS: A managed care elective course was designed as a student, peer-led course during the 2012-2013 school year at the University of Minnesota College of Pharmacy...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28649755/preoperative-geriatric-assessment-and-tailored-interventions-in-frail-older-patients-with-colorectal-cancer-a-randomised-controlled-trial
#5
Nina Ommundsen, Torgeir B Wyller, Arild Nesbakken, Arne O Bakka, Marit S Jordhøy, Eva Skovlund, Siri Rostoft
BACKGROUND: Colorectal cancer (CRC) is prevalent in the older population, and surgery is the mainstay in curative treatment. A preoperative geriatric assessment (GA) can identify frail older patients at risk for developing postoperative complications. In this randomised controlled trial we wanted to investigate whether tailored interventions based on a preoperative GA could reduce the frequency of postoperative complications in frail patients operated for CRC. METHODS: Patients >65 years scheduled for elective CRC surgery and fulfilling predefined criteria for frailty were randomised to either a preoperative GA followed by a tailored intervention, or care as usual...
June 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28649565/increasing-regional-anesthesia-use-in-a-serbian-teaching-hospital-through-an-international-collaboration
#6
REVIEW
Curtis L Baysinger, Borislava Pujic, Ivan Velickovic, Medge D Owen, Joanna Serafin, Matthew S Shotwell, Ferne Braveman
Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV), a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28648540/pedicled-vein-grafts-in-coronary-operation-perioperative-data-from-a-randomized-trial
#7
Øystein Pettersen, Per Magnus Haram, Anders Winnerkvist, Asbjørn Karevold, Alexander Wahba, Maryann Stenvik, Rune Wiseth, Knut Hegbom, Dag Ole Nordhaug
BACKGROUND: Less-than-optimal long-term patency of the saphenous vein is one of the main obstacles for the success of coronary artery bypass grafting (CABG). Results from the IMPROVE-CABG trial has shown that harvesting the saphenous vein with a pedicle of perivascular tissue less than 5 mm while using manual distention provides comparable occlusion rates but significantly less intimal hyperplasia at early follow-up. The impact of pedicled veins on duration of operations, leg wound infections, and postoperative bleeding is unknown...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28648536/outcomes-of-elective-aortic-hemiarch-reconstruction-for-aneurysmal-disease-in-the-elderly
#8
Arman Kilic, George J Arnaoutakis, Joseph E Bavaria, Ibrahim Sultan, Nimesh D Desai, Prashanth Vallabhajosyula, Matthew L Williams, Rita K Milewski, Wilson Y Szeto
BACKGROUND: This study evaluated outcomes of elective aortic hemiarch reconstruction for aneurysmal disease in the elderly. METHODS: Patients undergoing elective aortic hemiarch reconstruction for aneurysmal disease at a single institution between 2009 and 2014 were retrospectively reviewed. Patients were stratified into nonelderly (aged less than 75 years) versus elderly (aged 75 years or more). Outcomes included operative mortality and morbidity. RESULTS: In all, 629 patients (95 elderly; 15%) were included...
June 22, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28648481/outcomes-of-concomitant-renal-reconstruction-during-open-paravisceral-aortic-aneurysm-repair
#9
Mathew Wooster, Martin Back, Shivangi Patel, Adam Tanious, Paul Armstrong, Murray Shames
OBJECTIVE: The objective of this study was to review the outcomes of renal artery revascularizations during open aortic aneurysm repair. METHODS: Open abdominal aneurysm repairs performed from 2010 to 2015 at a single institution were reviewed, including type IV thoracoabdominal, suprarenal, and juxtarenal aneurysms. Direct renal reconstruction techniques included eversion endarterectomy, bypass, and vessel reimplantation based on the patient's anatomy. Renal loss was defined by artery occlusion...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648422/troponin-i-elevation-after-elective-percutaneous-coronary-interventions-prevalence-and-risk-factors
#10
Roberto Muniz Ferreira, Nelson Albuquerque de Souza E Silva, Lúcia Helena Alvares Salis, Paula Dias Maia, Lucas Felipe Bastos Horta
Troponin elevation after coronary angioplasty is a prognostic marker associated with significant morbidity and mortality, although its prevalence varies according to clinical and procedural characteristics. We analyzed the frequency of post-procedural enzyme elevation among 112 elective interventions between 2013 and 2014 in a private hospital in Brazil. Troponin increase was observed in 62.5% of the procedures, and was related to age, female sex, low pre-procedural hemoglobin, prior angiotensin converting enzyme inhibitor or angiotensin receptor blocker use and multivessel angioplasty...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28648393/etiologies-trends-and-predictors-of-30-day-readmissions-in-patients-with-diastolic-heart-failure
#11
Shilpkumar Arora, Sopan Lahewala, Hafeez Ul Hassan Virk, Saman Setareh-Shenas, Prashant Patel, Varun Kumar, Byomesh Tripathi, Harshil Shah, Viralkumar Patel, Umesh Gidwani, Abhishek Deshmukh, Apurva Badheka, Radha Gopalan
An estimated half of all heart failure (HF) populations has been categorized to have diastolic HF (DHF), but sparse data are available describing etiologies and predictors of 30-day readmission in DHF population. The study cohort was derived from the National Readmission Database 2013 to 2014, a subset of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. DHF was identified using International Classification of Diseases, 9th Revision code 428.3x in primary diagnosis field...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#12
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28648152/-wandering-spleen-in-a-patient-hospitalized-with-acute-abdomen
#13
Ari Demirel, Marlene Aagaard Hansen, Kåre Gotschalck Sunesen, Peter Nerstrøm
An 11-year-old girl was hospitalized with a two-day history of lower abdominal pain. The patient had a localized peritoneal reaction in the right lower quadrant, an elevated C-reactive protein level, and an increased white blood cell count. On the suspicion of acute appendicitis a diagnostic laparoscopy was performed. This revealed a misplaced spleen in the right side of the pelvis with a partly torsion of a long vascular pedicle. The splenic tissue was vital without any sign of ischaemia. However, splenopexy was not possible, and an uncomplicated elective splenectomy was performed...
June 19, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28648116/emboli-and-cognitive-state-in-surgical-vs-transcatheter-aortic-valve-replacement
#14
Tom Friedman, Oved Cohen, Avishai Ziser, Arthur Kerner, Keren Bitton-Worms, Gil Bolotin
Background Neurologic complications and neurocognitive impairment due to cerebral emboli are common following heart surgery. This study aimed to compare the number of emboli detected in the middle cerebral artery in open aortic valve replacement, apical and femoral transcatheter aortic valve replacement, and also to test for an association between the number of emboli captured in each procedure and changes in the patient's cognitive state. Methods Forty-four patients were enrolled in the study, 36 of whom were included in the final analyses: 14 underwent open aortic valve replacement, 2 had femoral transcatheter aortic valve replacement, and 10 had apical transcatheter aortic valve replacement...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28647860/sub-optimal-testing-and-awareness-of-hcv-and-hbv-among-high-risk-individuals-at-an-underserved-safety-net-hospital
#15
Robert J Wong, Brendan Campbell, Benny Liu, Rachel Baden, Taft Bhuket
Sub-optimal screening for chronic hepatitis C virus (HCV) and chronic hepatitis B virus (HBV) among high risk groups delays diagnosis and treatment. We aimed to evaluate overall rates of HCV and HBV screening and patient knowledge of their testing result. Adults age ≥18 years undergoing elective outpatient endoscopy at a large, urban safety-net hospital from July 2015 to July 2016 were prospectively evaluated to determine rates of HCV and HBV testing, the results of those completed tests, and patient knowledge of test results among high risk individuals (as determined by U...
June 24, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28647838/preoperative-education-for-hip-and-knee-replacement-never-stop-learning
#16
REVIEW
Paul K Edwards, Simon C Mears, C Lowry Barnes
PURPOSE OF REVIEW: Participation in alternative payment models has focused efforts to improve outcomes and patient satisfaction while also lowering cost for elective hip and knee replacement. The purpose of this review is to determine if preoperative education classes for elective hip and knee replacement achieve these goals. RECENT FINDINGS: Recent literature demonstrates that patients who attend education classes prior to surgery have decreased anxiety, better post-operative pain control, more realistic expectations of surgery, and a better understanding of their surgery...
June 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28647725/percutaneous-coronary-intervention-patients-and-cardiologists-experiences-of-the-informed-consent-process-in-northern-england-a-qualitative-study
#17
Joy Probyn, Joanne Greenhalgh, Janet Holt, Dwayne Conway, Felicity Astin
OBJECTIVE: Informed consent is central to ethical medical practice, but little is known about how the process takes place in clinical practice. Percutaneous coronary intervention (PCI) is a common revascularisation procedure. Studies report that patients overestimate benefits, forget the risks and are unaware of alternative treatments. The aim of this study was to describe PCI patients' and cardiologists' experiences of the informed consent process in acute care settings. DESIGN/SETTING/PARTICIPANTS: A qualitative study with a maximum variation sample of elective and acute PCI patients and cardiologists taking their consent, recruited from a district general hospital and tertiary centre...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28647631/a-prospective-randomized-multicenter-clinical-trial-on-the-safety-and-efficacy-of-a-ready-to-use-fibrin-sealant-as-an-adjunct-to-hemostasis-during-vascular-surgery
#18
Ian Chetter, Gerard Stansby, José Aurelio Sarralde, Vicente Riambau, Antonio Giménez-Gaibar, Kent MacKenzie, Francisco Acín, Jordi Navarro-Puerto
PURPOSE: Anastomotic or "stitch hole" bleeding is common during vascular surgery with synthetic material such as Dacron or polytetrafluoroethylene (PTFE). Hemostatic adjuncts such as fibrin sealant (FS) may reduce blood loss and operating time in such circumstances. We evaluated the safety and the hemostatic effectiveness of a ready-to-use human plasma-derived FS in vascular surgery. METHODS: Patients with mild / moderate suture line bleeding during elective, open, vascular surgery using synthetic grafts or patches were studied...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647576/robotic-assisted-excision-of-a-urachal-diverticulum
#19
Pamela Frazzini Padilla, Soo Kwon
OBJECTIVE: To demonstrate a combined robotic assisted laparoscopic technique with concomitant cystoscopy use for excision of a urachal diverticulum, to ensure complete resection of diverticulum and bladder cuff. DESIGN: Step-by-step demonstration and explanation of the procedure using video illustration. IRB/Ethics Committee ruled that approval was not required for this case report, however patient consent was obtained. SETTING: Vesicourachal diverticula account for approximately 3-5% of congenital urachal anomalies...
June 21, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28647355/random-start-ovarian-stimulation-in-women-desiring-elective-cryopreservation-of-oocytes
#20
Nigel Pereira, Anna Voskuilen-Gonzalez, Kolbe Hancock, Jovana P Lekovich, Glenn L Schattman, Zev Rosenwaks
The current study investigates the utility of random-start ovarian stimulation in women desiring elective oocyte cryopreservation. Women in the study cohort underwent random-start ovarian stimulation, and were subdivided based on the phase of the menstrual cycle that ovarian stimulation began, i.e. early follicular, late follicular or luteal phase. Women undergoing conventional cycle day (CD) 2/3 ovarian stimulation start were controls. A total of 1302 women were included - 859 (66.0%) conventional CD 2/3, 342 (26...
June 12, 2017: Reproductive Biomedicine Online
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