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https://www.readbyqxmd.com/read/28912198/frequency-of-low-value-care-in-alberta-canada-a-retrospective-cohort-study
#1
Finlay A McAlister, Meng Lin, Jeff Bakal, Stafford Dean
OBJECTIVE: To determine how frequently 10 low-value services highlighted by Choosing Wisely are done and what factors influence their provision. METHODS: This is a retrospective cohort study using routinely collected health data from five linked data sets from 2012 to 2015 in the Canadian province of Alberta to determine the frequency with which 10 low-value services were provided. RESULTS: Between 2012 and 2015, 162 143 people (4% of all 3 814 536 adult Albertans and 5% of the 3 423 135 who saw a physician at least once in that time frame) received at least one of the 10 low-value services, including 29...
September 14, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28877362/trends-in-urodynamic-testing-prior-to-midurethral-sling-placement-what-was-the-value-of-the-value-trial
#2
Jessica C Lloyd, Elodi Dielubanza, Howard B Goldman
BACKGROUND: Many urologists use urodynamic testing (UDS) to assist clinical decision-making. The VALUE study, a multi-institutional, randomized controlled trial published in 2012, demonstrated that UDS prior to midurethral sling placement for uncomplicated stress urinary incontinence (SUI) did not change management. We sought to determine whether use of UDS for evaluation of SUI diminished thereafter. METHODS: Records of patients who underwent isolated mid-urethral sling surgery at our tertiary-care referral center from 2008 to 2009 (pre-VALUE) and 2014 to 2016 (post-VALUE) were reviewed...
September 6, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28869431/a-method-to-investigate-the-biomechanical-alterations-in-perthes-disease-by-hip-joint-contact-modeling
#3
Remel Alingalan Salmingo, Tina Lercke Skytte, Marie Sand Traberg, Lars Pilgaard Mikkelsen, Kaj-Åge Henneberg, Christian Wong
Perthes' disease is a destructive hip joint disorder characterized by malformation of the femoral head in young children. While the morphological changes have been widely studied, the biomechanical effects of these changes still need to be further elucidated. The objective of this study was to develop a method to investigate the biomechanical alterations in Perthes' disease by finite element (FE) contact modeling using MRI. The MRI data of a unilateral Perthes' case was obtained to develop the three-dimensional FE model of the hip joint...
2017: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/28826786/surgical-treatment-of-chronic-lateral-ankle-instability-using-an-inferior-extensor-retinaculum-flap-a-retrospective-study
#4
Faycal Trichine, Toufik Friha, Azzedine Boukabou, Lamine Belaid, Terek Bouzidi, Mahdjoub Bouzitouna
Chronic lateral ankle instability causes significant problems with physical activity. The purpose of the present study was to evaluate the results of ligamentous retensioning combined with reinforcement using an extensor retinaculum flap. A consecutive series of 38 patients were included with a minimum follow-up duration of 2 years. The functional results were assessed using the Karlsson and American Orthopaedic Foot and Ankle Society scale scores. The pre- and postoperative radiologic assessment was performed using stress radiographs to measure varus tilt and anterior drawer tests...
August 17, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28798831/an-in-house-composix%C3%A2-based-pubovaginal-sling-trial-for-female-stress-urinary-incontinence-five-year-comparative-followup-to-tension-free-and-transobturator-vaginal-tapes
#5
Tal Ben-Zvi, Katherine Moore, Nadim Haidar, Mireille Gregoire
INTRODUCTION: We compared the efficacy of three slings in the long-term treatment of stress urinary incontinence (SUI): tension-free vaginal tape (TVT), vaginal tape-obturator (TVT-O), and an in-house two-layered polypropylene mesh with a submicronic polytetrafluoroethylene (Composix™). Our primary endpoint was the objective measurement of continence (24-hour pad test). Secondarily, we measured the satisfaction and complication rates. METHODS: This prospective, non-randomized study included 128 patients with SUI...
August 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28761200/a-prospective-study-of-altered-inflammatory-response-and-its-clinical-outcome-following-laparoscopic-and-open-cholecystectomy
#6
Sayyed Ehtesham Hussain Naqvi, Atia Zaka-Ur-Rab, Najmul Islam, Eram Ali
BACKGROUND: Inflammatory response following surgical trauma has long been a matter of study. Results, however, have been varied. We sought to assess changes in the levels of proinflammatory and anti-inflammatory cytokines in patients undergoing laparoscopic and open cholecystectomy and their impact on the clinical outcome of patients concerning the postoperative pain score. METHODS: The study involved 90 cholecystectomies (55 laparoscopic and 35 open) for chronic cholecystitis...
July 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28742427/a-comparison-of-multimodal-analgesic-approaches-in-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery-pharmacological-agents
#7
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Enhanced Recovery After Surgery (ERAS(®)) protocols are the cornerstone of improved recovery after colorectal surgery. Their implementation leads to reduced morbidity and shorter hospital stays while attenuating the surgical stress response. Multimodal analgesia is an important part of ERAS protocols. We compared and contrasted protocols from 15 institutions to test our hypothesis that there is a fundamental consensus among them. MATERIALS AND METHODS: ERAS protocols for open and laparoscopic colorectal surgery were compared from 15 different healthcare facilities...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28737999/effect-of-laparotomy-on-the-pituitary-adrenal-axis-in-dogs
#8
Emily J Skovira, Ellen N Behrend, Linda G Martin, Lee E Palmer, Robert J Kemppainen, Hollie P Lee
OBJECTIVE To assess effects of major abdominal surgery on serum cortisol and aldosterone and plasma canine ACTH (cACTH) concentrations. ANIMALS 39 healthy dogs undergoing laparotomy during veterinary student surgical laboratories. PROCEDURES Blood samples were obtained before and at completion of surgery. Serum cortisol and aldosterone and plasma cACTH concentrations were measured by use of validated radioimmunoassays. Changes in concentrations (postoperative concentration minus preoperative concentration) were calculated...
August 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28693543/finite-element-analysis-of-porously-punched-prosthetic-short-stem-virtually-designed-for-simulative-uncemented-hip-arthroplasty
#9
Matthew Jian-Qiao Peng, Hai-Yan Chen, Yong Hu, XiangYang Ju, Bo Bai
BACKGROUND: There is no universal hip implant suitably fills all femoral types, whether prostheses of porous short-stem suitable for Hip Arthroplasty is to be measured scientifically. METHODS: Ten specimens of femurs scanned by CT were input onto Mimics to rebuild 3D models; their *stl format dataset were imported into Geomagic-Studio for simulative osteotomy; the generated *.igs dataset were interacted by UG to fit solid models; the prosthesis were obtained by the same way from patients, and bored by punching bears designed by Pro-E virtually; cements between femora and prosthesis were extracted by deleting prosthesis; in HyperMesh, all compartments were assembled onto four artificial joint style as: (a) cemented long-stem prosthesis; (b) porous long-stem prosthesis; (c) cemented short-stem prosthesis; (d) porous short-stem prosthesis...
July 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28537693/surgical-management-of-female-paraurethral-cyst-with-concomitant-stress-urinary-incontinence
#10
Tarik Yonguc, Ibrahim Halil Bozkurt, Salih Polat, Serkan Yarimoglu, Ismail Gulden, Volkan Sen, Suleyman Minareci
Paraurethral cysts are usually asymptomatic and frequently detected incidentally during routine pelvic examination however, patients can present with complaints of a palpable cyst or with lower urinary tract symptoms (LUTS) and also dyspareunia. In most cases, diagnosis can be made on physical examination but for more detailed evaluation and to differentiate from malign lesions ultrasonography (US), voiding cystourethrogram (VCUG), computerized tomography (CT), or magnetic resonance imaging (MRI) can also be used...
May 23, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28439634/long-term-clinical-outcomes-with-the-retropubic-tension-free-vaginal-tape-tvt-procedure-compared-to-burch-colposuspension-for-correcting-stress-urinary-incontinence-sui
#11
Bjørn Holdø, Margareta Verelst, Rune Svenningsen, Ian Milsom, Finn Egil Skjeldestad
INTRODUCTION AND HYPOTHESIS: The retropubic tension-free vaginal tape (TVT) procedure replaced Burch colposuspension as the primary surgical method for stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) in women in our department in 1998. In this study we compared the short-term and long-term clinical outcomes of these surgical procedures. METHODS: Using a case series design, we compared the last 5 years of the Burch procedure (n = 127, 1994-1999) with the first 5 years of the retropubic TVT procedure (n = 180, 1998-2002)...
April 24, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28434547/stress-dose-corticosteroid-versus-placebo-in-neonatal-cardiac-operations-a-randomized-controlled-trial
#12
Pertti K Suominen, Juho Keski-Nisula, Tiina Ojala, Paula Rautiainen, Timo Jahnukainen, Johanna Hästbacka, Pertti J Neuvonen, Olli Pitkänen, Jussi Niemelä, Anu Kaskinen, Jukka Salminen, Risto Lapatto
BACKGROUND: Corticosteroids can improve the hemodynamic status of neonates with postoperative low cardiac output syndrome after cardiac operations. This study compared a prophylactically administered stress-dose corticosteroid (SDC) regimen against placebo on inflammation, adrenocortical function, and hemodynamic outcome. METHODS: Forty neonates undergoing elective open heart operations were randomized into two groups. The SDC group received perioperatively 2 mg/kg methylprednisolone, and 6 hours after the operation, a hydrocortisone infusion (0...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28430723/colpocleisis-a-survey-of-current-practice-patterns
#13
Keisha Jones, Gary Wang, Robert Romano, Peter St Marie, Oz Harmanli
BACKGROUND: Currently, there are no standard treatment guidelines for colpocleisis. Clinical practice varies widely for this safe and effective procedure. OBJECTIVE: The aim of this study was to evaluate the current practice patterns in the United States among surgeons who perform colpocleisis. METHODS: A 27-item anonymous Web-based survey was sent to all practicing physicians affiliated with the American Urogynecologic Society. It consisted of questions regarding the demographic background of the physicians and their current practice as it relates to colpocleisis...
July 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28412104/cement-stress-predictions-after-anatomic-total-shoulder-arthroplasty-are-correlated-with-preoperative-glenoid-bone-quality
#14
Alexandre Terrier, Raphaël Obrist, Fabio Becce, Alain Farron
HYPOTHESIS: We hypothesized that biomechanical parameters typically associated with glenoid implant failure after anatomic total shoulder arthroplasty (aTSA) would be correlated with preoperative glenoid bone quality. METHODS: We developed an objective automated method to quantify preoperative glenoid bone quality in different volumes of interest (VOIs): cortical bone, subchondral cortical plate, subchondral bone after reaming, subchondral trabecular bone, and successive layers of trabecular bone...
April 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28405960/outcome-measures-of-adjustable-transobturator-male-system-with-pre-attached-scrotal-port-for-male-stress-urinary-incontinence-after-radical-prostatectomy-a-prospective-study
#15
Javier C Angulo, Ignacio Arance, Cristina Esquinas, Juan F Dorado, João P Marcelino, Francisco E Martins
INTRODUCTION: The objective of this study was to report outcome measures with third-generation pre-attached scrotal port adjustable transobturator male system (ATOMS) for male stress urinary incontinence (SUI) after radical prostatectomy. METHODS: A prospective open study was conducted on consecutive patients. Evaluation included cough test, urethroscopy, filling and voiding cystometry, 24-h pad count and pad test, patient-reported outcomes (ICIQ-SF, IIQ-7, PGI, GRA, and VAS), complications according to the Clavien-Dindo system, operative results, number of adjustments, and filling of the system...
April 12, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28394497/prediction-of-mid-urethral-sling-failure-with-clinical-findings-and-urodynamics
#16
Serdar Aydin, Çağrı Arioğlu Aydin, Fırat Ersan
OBJECTIVE: Mid-urethral slings (MUS) become a standard, minimally invasive surgery to treat urinary stress incontinence. Our aim is to investigate the contribution of preoperative urodynamics to mid-urethral slings success and determine predictors for choosing mid-urethral sling route. METHODS: Women with stress urinary incontinence and who desired surgical correction of their incontinence were included in the study. The selection of the procedure was according to an algorithm used in an institution...
May 2017: Lower Urinary Tract Symptoms
https://www.readbyqxmd.com/read/28366670/improvement-of-voiding-characteristics-in-morbidly-obese-women-after-bariatric-surgery-a-single-center-study-with-a-1-year-follow-up
#17
Jae Heon Kim, Hwa Yeon Sun, Hyun Young Lee, Min Ju Soh, Suyeon Park, Yong Jin Kim, Yun Seob Song
BACKGROUND: It is well known that morbid obesity in women is related to lower urinary tract symptoms, including urinary incontinence. Although several studies have reported on the improvement in urinary incontinence after bariatric surgery, few reports have focused on the detailed changes in other voiding characteristics. OBJECTIVE: To demonstrate the real benefit of bariatric surgery on lower urinary tract symptoms. SETTING: Bariatric Center of Excellence and Health Promotion at Soonchunhyang University Hospital...
February 7, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28344958/perioperative-administration-of-propranolol-to-women-undergoing-ovarian-cancer-surgery-a-pilot-study
#18
Hye-In Jang, Soo-Hyun Lim, Yoo-Young Lee, Tae-Joong Kim, Chel Hun Choi, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae
OBJECTIVE: This study was done to evaluate whether perioperative propranolol (ß-blocker) in ovarian cancer patients undergoing debulking surgery reduced perioperative tumor growth induced by surgical stress. METHODS: This was a prospective randomized single institution analysis. The primary objective was to compare the changes in CA 125 level (changes between preoperation day 2 and postoperative day 7). As a study arm, patients received a low dose of propranolol 40 mg/day (4×10 mg) starting two days before surgery and 40 mg twice daily for three days following surgery...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28341056/temporal-changes-in-plasma-markers-of-oxidative-stress-following-laparoscopic-sleeve-gastrectomy-in-subjects-with-impaired-glucose-regulation
#19
Sarah L Prior, Jonathan D Barry, Scott Caplin, Thinzar Min, Danielle A Grant, Jeffrey W Stephens
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is an effective treatment for obesity and associated metabolic complications. Obesity and type 2 diabetes are associated with increased oxidative stress. Previous studies have examined changes in plasma oxidative stress after laparoscopic Roux-en-Y gastric bypass, but there is limited evidence of the effects of LSG. OBJECTIVES: To examine the effects of LSG on plasma thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAOS) at 1 and 6 months after LSG in patients with obesity and impaired glucose regulation...
February 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28333778/cochlear-implant-in-severe-impaired-psychiatric-patients-a-case-series
#20
Ioana T Herisanu, Mark Praetorius, Margarete Mattern
OBJECTIVE: Psychotic disorders and intelligence deficiencies are no longer contraindications for cochlear implantation regarding the revised German guidelines from May 2012. This article aims to evaluate the outcome of patients with severe psychiatric comorbidities. Therefore the database of the Cochlear Implant Center of the University Hospital of Heidelberg was investigated. STUDY DESIGN: Retrospective case review. METHODS: We present three patients who received a cochlear implant (CI) despite a serious psychiatric disorder...
July 2017: Otology & Neurotology
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