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https://www.readbyqxmd.com/read/28432613/pediatric-tonsillectomy-is-a-resource-intensive-procedure-a-study-of-canadian-health-administrative-data
#1
Kimmo T T Murto, Sherri L Katz, Daniel I McIsaac, Matthew A Bromwich, Régis Vaillancourt, Carl van Walraven
BACKGROUND: The majority of pediatric surgeries are performed in a day surgery setting. The rate of adverse postoperative outcomes and the factors that influence them are poorly described in the Canadian setting. Concerns about the safety of adenotonsillectomy (AT) have been raised. The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT...
April 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28431419/creation-and-validation-of-an-automated-algorithm-to-determine-postoperative-ventilator-requirements-after-cardiac-surgery
#2
Eilon Gabel, Ira S Hofer, Nancy Satou, Tristan Grogan, Richard Shemin, Aman Mahajan, Maxime Cannesson
BACKGROUND: In medical practice today, clinical data registries have become a powerful tool for measuring and driving quality improvement, especially among multicenter projects. Registries face the known problem of trying to create dependable and clear metrics from electronic medical records data, which are typically scattered and often based on unreliable data sources. The Society for Thoracic Surgery (STS) is one such example, and it supports manually collected data by trained clinical staff in an effort to obtain the highest-fidelity data possible...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431256/neurodevelopmental-outcomes-of-neonates-undergoing-surgery-under-general-anesthesia-for-malrotation-of-intestines
#3
Suresh Birajdar, Shripada Rao, Judy McMichael
BACKGROUND: It is difficult to differentiate between the potential adverse effects of general anesthesia (GA) on the developing brain and the role of associated co-morbidities and syndromes that can adversely affect neurodevelopmental outcomes in neonates undergoing GA. Neonates with malrotation of the intestines without volvulus usually do not have co-morbidities or syndromes. In addition, majority of them recover very well after surgery and are discharged home within a few days. Neonates with malrotation are a clean cohort of babies to study the role of a single episode of GA on the developing brain...
April 18, 2017: Early Human Development
https://www.readbyqxmd.com/read/28431197/serum-c-reactive-protein-procalcitonin-and-lactate-dehydrogenase-for-the-diagnosis-of-pancreatic-necrosis
#4
REVIEW
Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with pancreatic necrosis differs from that of people with oedematous pancreatitis. It is important to know the diagnostic accuracy of serum C-reactive protein (CRP), serum procalcitonin, and serum lactate dehydrogenase (LDH) as a triage test for the detection of pancreatic necrosis in people with acute pancreatitis, so that an informed decision can be made as to whether the person with pancreatic necrosis needs further investigations such as computed tomography (CT) scan or magnetic resonance imaging (MRI) scan and treatment for pancreatic necrosis started...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28431186/unfractionated-heparin-versus-low-molecular-weight-heparins-for-avoiding-heparin-induced-thrombocytopenia-in-postoperative-patients
#5
REVIEW
Daniela R Junqueira, Liliane M Zorzela, Edson Perini
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction presenting as a prothrombotic disorder related to antibody-mediated platelet activation. It is a paradoxical immune reaction resulting in thrombin generation in vivo, which leads to a hypercoagulable state and the potential to initiate venous or arterial thrombosis. A number of factors are thought to influence the incidence of HIT including the type and preparation of heparin (unfractionated heparin (UFH) or low molecular weight heparin (LMWH)) and the heparin-exposed patient population, with the postoperative patient population at higher risk...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28431130/safety-concerns-with-thoracoabdominal-acupuncture-experience-at-a-tertiary-care-emergency-department
#6
Hak Jin Lee, Youn-Jung Kim, Won Young Kim
Objective.:  To evaluate serious complications caused by acupuncture treatment and to increase awareness of this complication. Design.:  A retrospective observational study. Setting. : At the emergency department of a tertiary hospital in an urban area during a five-year period (2010-2014) in Seoul, Korea. Subjects.:  Patients with postacupuncture mechanical complications in the thoracoabdominal region. Methods...
April 19, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28430754/biomarkers-for-early-acute-kidney-injury-diagnosis-and-severity-prediction-a-pilot-multicenter-canadian-study-of-children-admitted-to-the-icu
#7
Jennifer Palermo, Allison B Dart, Alanna De Mello, Prasad Devarajan, Ronald Gottesman, Gonzalo Garcia Guerra, Greg Hansen, Ari R Joffe, Cherry Mammen, Nick Majesic, Catherine Morgan, Peter Skippen, Michael Pizzi, Ana Palijan, Michael Zappitelli
OBJECTIVE: Acute kidney injury occurs early in PICU admission and increases risks for poor outcomes. We evaluated the feasibility of a multicenter acute kidney injury biomarker urine collection protocol and measured diagnostic characteristics of urine neutrophil gelatinase-associated lipocalin, interleukin-18, and liver fatty acid binding protein to predict acute kidney injury and prolonged acute kidney injury. DESIGN: Prospective observational pilot cohort study...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28430722/the-use-of-liposomal-bupivacaine-administered-with-standard-bupivacaine-in-ankle-fractures-requiring-open-reduction-internal-fixation-a-single-blinded-randomized-controlled-trial
#8
Roy Davidovitch, Abraham Goch, Adam Driesman, Sanjit Konda, Christian Pean, Kenneth Egol
OBJECTIVES: To determine the efficacy of liposomal bupivacaine compared to placebo for post-operative pain control in patients undergoing operative fixation of ankle fractures. DESIGN: Prospective single blinded randomized control trial SETTING:: Academic Medical CenterPatients/Participants: After IRB approval, seventy-six patients who sustained an acute ankle fracture (OTA 44A-C) requiring operative fixation met inclusion criteria. INTERVENTION: Patients were randomly assigned to one of two groups, control (local intra-operative sterile saline injection under general anesthesia) or interventional (local intra-operative liposomal bupivacaine and bupivacaine injection under general anesthesia)...
April 6, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28430675/identifying-risk-factors-leading-to-unanticipated-postoperative-readmission
#9
Peter A Felice, David T Kerekes, Bruce A Mast
INTRODUCTION: Unanticipated postoperative readmissions are a grading metric directly linked to both the quality of patient care and physician reimbursement. However, little data exist to define factors responsible for these readmissions in the plastic surgery patient population. This study aims to identify patient risk factors contributing to unanticipated postoperative readmissions to optimize perioperative patient care and mitigate negative financial impact upon providers. METHODS: We present an institutional review board-approved study retrospective review of 819 plastic surgery patients undergoing operative procedures performed at our institution between January 1, 2013, and December 31, 2014...
April 20, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28430555/beyond-wires-and-seeds-reflector-guided-breast-lesion-localization-and-excision
#10
Victoria L Mango, Ralph T Wynn, Sheldon Feldman, Lauren Friedlander, Elise Desperito, Sejal N Patel, Ameer Gomberawalla, Richard Ha
Purpose To evaluate outcomes of Savi Scout (Cianna Medical, Aliso Viejo, Calif) reflector-guided localization and excision of breast lesions by analyzing reflector placement, localization, and removal, along with target excision and rates of repeat excision (referred to as re-excision). Materials and Methods A single-institution retrospective review of 100 women who underwent breast lesion localization and excision by using the Savi Scout surgical guidance system from June 2015 to May 2016 was performed. By using image guidance 0-8 days before surgery, 123 nonradioactive, infrared-activated, electromagnetic wave reflectors were percutaneously inserted adjacent to or within 111 breast targets...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28430322/prewound-assisted-technique-for-hydrophobic-foldable-intraocular-lens-implantation
#11
Takuya Shiba, Hiroshi Tsuneoka
PURPOSE: To describe a technique for intraocular lens (IOL) implantation that lessens the degree of surgical invasiveness by implanting a tightly rolled IOL through a small incision without touching the eye with the cartridge tip. METHODS: An IOL was inserted through an incision by first allowing the leading haptic to protrude slightly from the cartridge tip. It was then injected through the incision without allowing any part of the cartridge to touch the eye during IOL implantation...
April 7, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28430045/laparoscopic-sleeve-gastrectomy-changes-in-the-last-decade-differences-in-morbidity-and-weight-loss
#12
Andrea Balla, Silvia Quaresima, Frida Leonetti, Emanuela Paone, Marco Brunori, Teresa Messina, Ardit Seitaj, Alessandro M Paganini
PURPOSE: Aim is to report the learning curve and standardization process of Laparoscopic Sleeve Gastrectomy (LSG), describing the evolution in surgical technique and patient management in the authors' experiences. METHODS: One hundred twenty-seven patients were divided in three Groups (A, B, and C), based on bougie size and technical details, and included 36, 46, and 45 patients, respectively. RESULTS: Mean operative time in Groups A, B, and C was 201...
April 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28429473/surgery-for-limited-stage-small-cell-lung-cancer
#13
REVIEW
Hayley Barnes, Katharine See, Stephen Barnett, Renée Manser
BACKGROUND: Current treatment guidelines for limited-stage small-cell lung cancer (SCLC) recommend concomitant platinum-based chemo-radiotherapy plus prophylactic cranial irradiation, based on the premise that SCLC disseminates early, and is chemosensitive. However, although there is usually a favourable initial response, relapse is common and the cure rate for limited-stage SCLC remains relatively poor. Some recent clinical practice guidelines have recommended surgery for stage 1 (limited) SCLC followed by adjuvant chemotherapy, but this recommendation is largely based on the findings of observational studies...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28429334/thrombolysis-of-deep-vein-thrombosis-and-inhibiting-chemotaxis-of-macrophage-by-mcp-1-blockage
#14
Z-W Wang, J-J Wang, J-Z Zhang, Z-J Xue, J Miao, L Li, W-X Hu
OBJECTIVE: Deep vein thrombosis (DVT) is one common vascular complication after trauma or surgery. Macrophage plays an important role in recanalization of thrombosis and monocyte chemotactic protein 1 (MCP-1) has a potent chemotactic role for macrophage. This study investigated the role of MCP-1 and macrophage in DVT thrombolysis. MATERIALS AND METHODS: DVT mice model was established for evaluating thrombosis grades, and divided into DVT, DVT + MCP-1 recombinant protein, and DVT + MCP-1 neutralizing antibody groups...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28429119/single-port-hysterectomy-robotic-versus-laparoscopic
#15
Mete Gungor, Korhan Kahraman, Polat Dursun, Esra Ozbasli, Canan Genim
This study evaluated the feasibility and safety of robotic single port hysterectomy and laparoscopic single port hysterectomy, and to compare the perioperative parameters of the two systems. Twenty patients underwent robotic single port hysterectomy and 25 patients underwent laparoscopic single port hysterectomy. All hysterectomies were successfully performed via a single port and there were no conversions to conventional multi-port laparoscopy, multi-port robotic, open surgery, or vaginal surgery. The median operative time and hysterectomy time in robotic and laparoscopic groups were 90 vs...
April 20, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28428283/regulatory-aspects-of-optical-methods-and-exogenous-targets-for-cancer-detection
#16
Willemieke S Tummers, Jason M Warram, Kiranya E Tipirneni, John Fengler, Paula Jacobs, Lalitha Shankar, Lori Henderson, Betsy Ballard, Brian W Pogue, Jamey P Weichert, Michael Bouvet, Jonathan Sorger, Christopher H Contag, John V Frangioni, Michael F Tweedle, James P Basilion, Sanjiv S Gambhir, Eben L Rosenthal
Considerable advances in cancer-specific optical imaging have improved the precision of tumor resection. In comparison to traditional imaging modalities, this technology is unique in its ability to provide real-time feedback to the operating surgeon. Given the significant clinical implications of optical imaging, there is an urgent need to standardize surgical navigation tools and contrast agents to facilitate swift regulatory approval. Because fluorescence-enhanced surgery requires a combination of both device and drug, each may be developed in conjunction, or separately, which are important considerations in the approval process...
April 20, 2017: Cancer Research
https://www.readbyqxmd.com/read/28428080/the-effect-of-preoperative-lumbar-epidural-corticosteroid-injection-on-post-operative-infection-rate-in-patients-undergoing-single-level-lumbar-decompression
#17
Jonathan G Seavey, George C Balazs, Theodore Steelman, Melvin Helgeson, David E Gwinn, Scott C Wagner
BACKGROUND CONTEXT: Lumbar epidural corticosteroid injections (LECI) are frequently used in the treatment of lumbar intervertebral disc herniation with radiculopathy and lumbar spinal stenosis. Although widely utilized, their effect on the outcomes and complications of subsequent surgery is unclear. Post-operative infection can be a morbid complication following spine surgery, and recent literature has suggested that the risk may be increased in patients undergoing lumbar spinal surgery who had previously received LECI...
April 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28426675/indicators-of-suboptimal-biologic-therapy-over-time-in-patients-with-ulcerative-colitis-and-crohn-s-disease-in-the-united-states
#18
Haridarshan Patel, Trevor Lissoos, David T Rubin
This study assessed the occurrence of indicators for suboptimal biologic therapy among ulcerative colitis (UC) and Crohn's disease (CD) patients over time in the United States (US). Data from a large US claims database (2005-2013) were used to retrospectively identify patients with diagnosed with either UC or CD who were new biologic users. Indicators of suboptimal biologic therapy included: dose escalation during the maintenance phase, discontinuation of the initial biologic, switch to another biologic within 90 days following the last day of supply of the initial biologic, augmentation with a non-biologic systemic therapy, UC- or CD-related surgery, UC- or CD-related urgent care, and development of fistula (for CD only)...
2017: PloS One
https://www.readbyqxmd.com/read/28426541/transfer-between-hospitals-is-a-risk-situation-for-patients-after-lung-cancer-surgery
#19
Trine Oksholm, Tone Rustoen, Mirjam Ekstedt
BACKGROUND: Patients with lung cancer often undergo surgery shortly after diagnosis. Despite undergoing extensive operation, many patients are transferred to a local hospital a few days after surgery. Transitions between different levels of care are risky due to common medication and follow-up errors. OBJECTIVE: The study purpose was to explore patients' experiences of transfer between hospitals after lung cancer surgery. The study aim was to improve the quality of transitional care...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28426477/incidence-of-adhesive-bowel-obstruction-after-colon-cancer-surgery-and-its-risk-factors-a-nationwide-claim-study
#20
Gi Hyeon Seo, Eun Kyung Choe, Kyu Joo Park, Young Jun Chai
OBJECTIVE: To elucidate the incidence of adhesive postoperative bowel obstruction (PBO) after colon cancer surgery and its risk factors using nationwide claim data. BACKGROUND: PBO has a significant impact on quality of life and medical costs after colectomy, though most of the literature consists of single-institution analyses. METHODS: Data from 24,645 patients who underwent regional colectomy for colon cancer from 2010 to 2012 and had at least 3 years of follow up were obtained from the Health Insurance Review and Assessment Service database...
April 19, 2017: Annals of Surgery
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