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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
#1
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 two decades. However, especially in Europe, there are still obstacles to the development of these procedures, which may be related to medico-economic imperatives, and to several factors concerning both surgeons and patients. We describe our initial experience in introducing this method in our institution. METHODS: Over a three year period, 201 patients met the criteria for ambulatory lumbar microdiscectomy...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28729428/fluorine-18-labeled-carboplatin-derivative-for-pet-imaging-of-platinum-drug-distribution
#2
Narottam Lamichhane, Gajanan K Dewkar, Sundaresan Gobalakrishnan, Li Wang, Purnima Jose, Muhammad Otabashi, Jean-Luc Morelle, Nicholas Farrell, Jamal Zweit
Increasing evidence indicates that reduced intracellular drug accumulation is the parameter most consistently associated with platinum drug resistance, and emphasizes the need to directly measure intra-tumor drug concentration. In the era of precision medicine and with the advent of powerful imaging and proteomics technologies, there is an opportunity to better understand drug resistance, by exploiting these techniques to provide new knowledge on drug-target interactions. Here, we are contributing to this endeavor by reporting on the development of a fluorine-18 labeled carboplatin derivative ((18)F-FCP) that can be used to potentially image drug uptake and retention, including intra-tumoral distribution, by positron emission tomography (PET)...
July 20, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28726359/earplugs-during-the-first-night-after-cardiothoracic-surgery-may-improve-a-fast-track-protocol
#3
Johannes Menger, Bernhard Urbanek, Keso Skhirtladze-Dworschak, Viktoria Wolf, Arabella Fischer, Harald Rinösl, Martin Dworschak
BACKGROUND: Sleep deprivation after major surgery is common and associated with worse outcome. Noise is one important reason for sleep fragmentation, which contributes to enhanced morbidity. The purpose of this work was to evaluate the impact of earplugs on patients' sleep quality during their first night after cardiothoracic surgery to eventually improve an existing fast-track concept. METHODS: Sixty-three patients undergoing cardiothoracic surgery eligible for a postoperative fast- track regimen on our cardiothoracic post anaesthesia care unit (C-PACU) were prospectively included...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28714834/adjusting-patients-streaming-initiated-by-a-wait-time-threshold-in-emergency-department-for-minimizing-opportunity-cost
#4
Byungjoon B J Kim, Theodore R Delbridge, Dawn B Kendrick
Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28711332/predictors-of-operating-room-extubation-in-adult-cardiac-surgery
#5
Kathirvel Subramaniam, Diana S DeAndrade, Daniel R Mandell, Andrew D Althouse, Rajan Manmohan, Stephen A Esper, Jeffrey M Varga, Vinay Badhwar
OBJECTIVE: The primary objective of the study was to identify perioperative factors associated with successful immediate extubation in the operating room after adult cardiac surgery. The secondary objective was to derive a simplified predictive scoring system to guide clinicians in operating room extubation. METHODS: All 1518 patients in this retrospective cohort study underwent standardized fast-track cardiac anesthetic protocol during adult cardiac surgery. Perioperative variables between patients who had successful extubation in the operating room versus in the intensive care unit were retrospectively analyzed using both univariate and multivariable logistic regression analyses...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28691536/mabp1-for-the-treatment-of-colorectal-cancer
#6
Geraldine O'Sullivan Coyne, Mauricio Burotto
Inflammation is an established process in colorectal cancer development and a hallmark of progression, and pro-inflammatory cytokines have been implicated in the morbidity and functional compromise associated with malignancy. MABp1, described as a first-in-class true human antibody against interleukin-1α, has undergone clinical trial evaluation in a number of indications, recently completing late phase clinical trial testing under Fast Track designation for cancer anorexia-cachexia syndrome in colorectal cancer patients...
July 10, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28689784/gedos-secot-consensus-on-the-care-process-of-patients-with-knee-osteoarthritis-and-arthoplasty
#7
M A Ruiz Iban, A Tejedor, E Gil Garay, C Revenga, J C Hermosa, J Montfort, M J Peña, J M López Millán, A Montero Matamala, A Capa Grasa, M J Navarro, M Gobbo, E Loza
OBJECTIVE: To develop recommendations on the evaluation and management procedure in patients undergoing total knee replacement based on best evidence and the experience of a panel of experts. METHODS: A multidisciplinary group of 12 experts was selected that defined the scope, users and the document parts. Three systematic reviews were performed in patients undergoing knee replacement: (i)efficacy and safety of fast-tracks; (ii)efficacy and safety of cognitive interventions in patients with catastrophic pain, and (iii) efficacy and safety of acute post-surgical pain management on post-surgical outcomes...
July 6, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28682892/in-patients-undergoing-fast-track-total-knee-arthroplasty-addition-of-buprenorphine-to-a-femoral-nerve-block-has-no-clinical-advantage-a-prospective-double-blinded-randomized-placebo-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Rienk van Beek, Harry J Zonneveldt, Tjeerd van der Ploeg, Jeroen Steens, Phillip Lirk, Marcus W Hollmann
BACKGROUND: Several adjuvants have been proposed to prolong the effect of peripheral nerve blocks, one of which is buprenorphine. In this randomized double blinded placebo controlled trial we studied whether the addition of buprenorphine to a femoral nerve block prolongs analgesia in patients undergoing total knee arthroplasty in a fast track surgery protocol. METHODS: The treatment group (B) was given an ultrasound-guided femoral nerve block with ropivacaine 0...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28681427/delirium-after-fast-track-hip-and-knee-arthroplasty-a-cohort-study-of-6331-elderly-patients
#9
P B Petersen, C C Jørgensen, H Kehlet
BACKGROUND: Postoperative delirium (PD) is a well-known complication among elderly surgical patients and associated with increased morbidity, mortality and length of stay (LOS). In elective orthopedic surgery, including hip and knee arthroplasty (THA/TKA), most studies report incidences between 5% and 10%. The multimodal optimization of perioperative care (fast-track) aims to enhance recovery and reduce morbidity and LOS, but limited data are available on the effect on PD. Consequently, the study investigated signs of PD associated with LOS > 4 days...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28657396/preoperative-methylprednisolone-does-not-reduce-loss-of-knee-extension-strength-after-total-knee-arthroplastya-randomized-double-blind-placebo-controlled-trial-of-61-patients
#10
Viktoria Lindberg-Larsen, Thomas Q Bandholm, Camilla K Zilmer, Jens Bagger, Mette Hornsleth, Henrik Kehlet
Background and purpose - Patients undergoing total knee arthroplasty (TKA) face challenges related to postoperative reduction in knee-extension strength. We evaluated whether inhibition of the inflammatory response by a single preoperative dose of methylprednisolone (MP) reduces the pronounced loss of knee-extension strength at discharge after fast-track TKA. Patients and methods - 70 patients undergoing elective unilateral TKA were randomized (1:1) to preoperative intravenous (IV) MP 125 mg (group MP) or isotonic saline IV (group C)...
June 28, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28655311/diagnostic-delay-for-giant-cell-arteritis-a-systematic-review-and-meta-analysis
#11
James A Prior, Hoda Ranjbar, John Belcher, Sarah L Mackie, Toby Helliwell, Jennifer Liddle, Christian D Mallen
BACKGROUND: Giant cell arteritis (GCA), if untreated, can lead to blindness and stroke. The study's objectives were to (1) determine a new evidence-based benchmark of the extent of diagnostic delay for GCA and (2) examine the role of GCA-specific characteristics on diagnostic delay. METHODS: Medical literature databases were searched from inception to November 2015. Articles were included if reporting a time-period of diagnostic delay between onset of GCA symptoms and diagnosis...
June 28, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28645119/the-application-of-enhanced-recovery-after-surgery-eras-fast-track-surgery-in-gastrectomy-for-gastric-cancer-a-systematic-review-and-meta-analysis
#12
REVIEW
Jie Ding, Benlong Sun, Peng Song, Song Liu, Hong Chen, Min Feng, Wenxian Guan
BACKGROUND: The study aimed to compare the safety and effectiveness of Enhanced recovery after surgery (ERAS) with conventional care in gastrectomy for gastric cancer. METHODS: Search strategy from Pubmed, Embase, Web of science, Cochrane library and reference lists was performed. The collected studies were randomized controlled trials and published only in English, and undergoing ERAS in gastrectomy for gastric cancer from January 1994 to August 2016. RESULTS: A total of eight studies including 801 patients were included...
June 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28640070/early-outcomes-of-the-new-uk-deceased-donor-kidney-fast-track-offering-scheme
#13
Chris J Callaghan, Lisa Mumford, Laura Pankhurst, Richard J Baker, J Andrew Bradley, Christopher J E Watson
BACKGROUND: The UK Kidney Fast-Track Scheme (KFTS) was introduced in 2012 to identify kidneys at high risk of discard and to rapidly facilitate transplantation. A retrospective analysis of kidneys transplanted through the KFTS was undertaken. METHODS: UK Transplant Registry data were collected on deceased donor kidneys implanted between 1 November 2012 and 30 April 2015 (DBD donors) and 1 March 2013 and 30 April 2015 (DCD donors). Posttransplant outcomes included 1-year eGFR and death-censored graft survival (DCGS)...
June 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28636191/-fast-track-development-and-approval-process-for-heart-failure-therapeutics
#14
L Papadimitriou, J Butler
Heart failure (HF) is a global epidemic, with a high mortality and morbidity burden. In such diseases, earlier access to lifesaving therapeutic regimens is imperative, and could be accomplished by improving the drug development and approval process, without jeopardizing patient safety. The US Food and Drug Administration (FDA) has already established mechanisms facilitating the latter, but further guidance to enhance and expedite the process holds promise to further improve patient outcomes.
June 21, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28630756/fast-track-in-hip-arthroplasty
#15
Torben Bæk Hansen
'Fast-track' surgery was introduced more than 20 years ago and may be defined as a co-ordinated peri-operative approach aimed at reducing surgical stress and facilitating post-operative recovery.The fast-track programmes have now been introduced into total hip arthroplasty (THA) surgery with reduction in post-operative length of stay, shorter convalescence and rapid functional recovery without increased morbidity and mortality. This has been achieved by focusing on a multidisciplinary collaboration and establishing 'fast-track' units, with a well-defined organisational set-up tailored to deliver an accelerated peri-operative course of fast-track surgical THA procedures...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28630755/advances-in-hip-arthroplasty-surgery-what-is-justified
#16
Luigi Zagra
Total hip arthroplasty (THA) surgery has shown dramatic changes in terms of increased number of procedures and of technical development in recent years. It has been described as "the operation of the 20(th) century" for the excellent results, the high satisfaction of the patients and the improvement of the quality of life.A lot of variations have been introduced over the last few decades in THA especially in terms of indications (both in younger and older patients), techniques and devices (approaches, tissue preservation, biomaterials and industrial finishing), per-operative management (blood loss and pain control) and post-operative protocols (the so called "fast track" surgery)...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28629228/use-of-provider-debriefing-to-improve-fast-track-extubation-rates-following-cardiac-surgery-at-an-academic-medical-center
#17
Jordan E Goldhammer, Jillian M Dashiell, Scott Davis, Marc C Torjman, Hitoshi Hirose
When used in appropriate patient populations, fast-track extubation (FTE) anesthetic techniques and intensive care unit (ICU) protocols safely reduce intubation times, ICU length of stay, and resource utilization. The authors hypothesized that perioperative provider debriefing on success or failure of FTE would improve FTE success. This retrospective observational study included consecutive patients undergoing elective coronary artery bypass graft (CABG), valve, or combined CABG/valve surgery between February 2015 and May 2016 (N = 313)...
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28628534/daily-physical-activity-in-total-hip-arthroplasty-patients-undergoing-different-surgical-approaches-a-cohort-study
#18
Monika Engdal, Olav A Foss, Kristin Taraldsen, Vigdis S Husby, Siri B Winther
OBJECTIVE: Muscle weakness due to trauma from the surgical approach is anticipated to affect the ability of the patient to undertake daily physical activity early after total hip arthroplasty (THA). The objective of this study was to compare daily physical activity on days 1 to 4 after discharge, in patients following THA performed by 1 of 3 surgical approaches. DESIGN: A cohort study included 60 hip osteoarthritis patients, scheduled for THA, allocated to direct lateral approach, posterior approach, or anterior approach...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28625311/cancers-de-l%C3%A2-ovaire-brca-mut%C3%A3-consultation-d%C3%A2-oncog%C3%A3-n%C3%A3-tique-et-prescription-des-inhibiteurs-de-parp
#19
Laurence Gladieff, Dominique Stoppa Lyonnet, Alain Lortholary, Alexandra Leary, Catherine Genestie, Isabelle Ray-Coquard
GENETIC COUNSELING AND PARP INHIBITORS PRESCRIPTION: Upon the availability of the PARP inhibitors in relapsed ovarian carcinoma, the pathways of the oncogenetic counseling were modified. Any research for a constitutional alteration of the BRCA1 and BRCA2 genes must be accompanied by an oncogenetic counseling. BRCA testing is recommended from the diagnosis to every woman with an ovarian or fallopian tube or peritoneum of high grade adenocarcinoma, whatever the age at the diagnosis and her family history. In case of sensitive relapse or potential inclusion in a clinical trial and in the absence of preliminary constitutional research, the oncogenetic counseling is organized according to a fast track pathway and a somatic analysis can be realized in parallel...
May 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28611728/are-movement-artifacts-in-magnetic-resonance-imaging-a-real-problem-a-narrative-review
#20
REVIEW
Inger Havsteen, Anders Ohlhues, Kristoffer H Madsen, Janus Damm Nybing, Hanne Christensen, Anders Christensen
Movement artifacts compromise image quality and may interfere with interpretation, especially in magnetic resonance imaging (MRI) applications with low signal-to-noise ratio such as functional MRI or diffusion tensor imaging, and when imaging small lesions. High image resolution has high sensitivity to motion artifacts and often prolongs scan time that again aggravates movement artifacts. During the scan fast imaging techniques and sequences, optimal receiver coils, careful patient positioning, and instruction may minimize movement artifacts...
2017: Frontiers in Neurology
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