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Hospital operation

Jarrod D Frizzell, Li Liang, Phillip J Schulte, Clyde W Yancy, Paul A Heidenreich, Adrian F Hernandez, Deepak L Bhatt, Gregg C Fonarow, Warren K Laskey
Importance: Several attempts have been made at developing models to predict 30-day readmissions in patients with heart failure, but none have sufficient discriminatory capacity for clinical use. Machine-learning (ML) algorithms represent a novel approach and may have potential advantages over traditional statistical modeling. Objective: To develop models using a ML approach to predict all-cause readmissions 30 days after discharge from a heart failure hospitalization and to compare ML model performance with models developed using "conventional" statistically based methods...
October 26, 2016: JAMA Cardiology
Nicholas B Frisch, Andrew M Pepper, Edward Rooney, Craig Silverton
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes...
October 25, 2016: Orthopedics
Juliana de Oliveira Freitas Miranda, Climene Laura de Camargo, Carlito Lopes Nascimento, Daniel Sales Portela, Alan Monaghan, Katia Santana Freitas, Renata Fonseca Mendoza
Objective: to translate and adapt the BPEWS for the Portuguese language, with the purpose of verifying its applicability in the Brazilian context studied. Method: methodological study guided by international and nationally accepted recommendations for translation and adaptation of health measurement instruments. Stages of conceptual, item, semantic, operational and pre-test equivalence are described for obtaining the BPEWS Portuguese version to be used in Brazil...
September 2016: Revista Brasileira de Enfermagem
Philip W Chiu, Anthony Y Teoh, Vivien W Wong, Hon Chi Yip, Shannon M Chan, Simon K Wong, Enders K Ng
Minimally invasive esophagectomy (MIE) is technically challenging. Da Vinci Robotic system could improve surgical dissection with additional degree of freedom from robotic arms. This study aimed to assess the feasibility and safety of performing MIE using Da Vinci Robotic system among patients with esophageal cancers. From 2009 to 2013, consecutive patients with esophageal cancers who received robotic-assisted MIE were recruited. We excluded tumors with suspected invasion to adjacent organs. Preoperative staging included EUS, CT thorax and abdomen and bronchoscopy...
October 25, 2016: Journal of Robotic Surgery
A Onder, C Benlice, J Church, H Kessler, E Gorgun
BACKGROUND: In the current study, we aimed to compare peri- and postoperative 30-day outcomes of patients undergoing laparoscopic versus open total colectomy with ileorectal anastomosis in a case-matched design using data procedure-targeted database. METHODS: Patients who underwent elective total colectomy with ileorectal anastomosis in 2012 and 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Patients were divided into two groups according to the type of surgical approach (laparoscopic and open)...
October 25, 2016: Techniques in Coloproctology
Raoul A Droeser, Johan Ottosson, Andreas Muth, Hella Hultin, Karin Lindwall-Åhlander, Anders Bergenfelz, Martin Almquist
PURPOSE: Case reports suggest that patients with previous gastric bypass have an increased risk of severe hypocalcemia after total thyroidectomy, but there are no population-based studies. The prevalence of gastric bypass before thyroidectomy and the risk of hypocalcemia after thyroidectomy in patients with previous gastric bypass were investigated. METHODS: By cross-linking The Scandinavian Quality Registry for Thyroid, Parathyroid and Adrenal Surgery with the Scandinavian Obesity Surgery Registry patients operated with total thyroidectomy without concurrent or previous surgery for hyperparathyroidism were identified and grouped according to previous gastric bypass...
October 26, 2016: Langenbeck's Archives of Surgery
Anna E Sharrock, Jenny McLachlan, Robert Chambers, Ian S Bailey, James Kirkby-Bott
BACKGROUND: The United Kingdom population is ageing. Half of patients requiring an emergency laparotomy are aged over 70, 20 % die within 30 days, and less than half receive good care. Frailty and delay in management are associated with poor surgical outcomes. P-POSSUM risk scoring is widely accepted, but its validity in patients aged over 70 undergoing emergency laparotomy is unclear. AIMS: To assess if P-POSSUM risk stratification reliably predicts inpatient mortality in this group and establish whether those who died within 30 days received delayed care...
October 25, 2016: World Journal of Surgery
Giovanni D Tebala, Sean Keane, Abdelsalam Osman, Mina Ip, Abdul Q Khan, Luciano Perrone
BACKGROUND: Enhanced recovery (ER) programs are policies and protocols meant to improve postoperative recovery after surgery. As a consequence of a smoother recovery, patients can be discharged early. This paper describes the impact of an ER program in colorectal surgery in a rural hospital. MATERIALS AND METHODS: In total, 132 patients had colorectal resection within the ER program. Data were collected prospectively. The ER pathway affects perioperative management in the following ways in order to: (1) improve patient's general condition before surgery, (2) minimize intraoperative surgical trauma by using a laparoscopic approach in all cases, and (3) facilitation of a quicker postoperative return of physiological function...
October 25, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Ryan M Moore, Jonathan Rimler, Brian R Smith, Garrett A Wirth, Keyianoosh Z Paydar
BACKGROUND: Venous thromboembolic events result in significant morbidity, mortality, and costly therapeutic interventions. As medical resource allocation strategies are becoming more pervasive, appropriate risk stratification and prophylactic regimens are essential. Previous studies have shown a decreased incidence of perioperative venous thromboembolism in the chronic spinal cord injury population. The question remains of whether chronic spinal cord injury is protective against venous thromboembolism...
November 2016: Plastic and Reconstructive Surgery
Caroline A Yao, Jordan Swanson, Dayana Chanson, Trisa B Taro, Barrie Gura, Jane C Figueiredo, Heather Wipfli, Kristin Hatcher, Richard Vanderburg, William P Magee
BACKGROUND: Despite health system advances, residents of low- and middle-income countries continue to experience substantial barriers in accessing health care, particularly for specialized care such as plastic and reconstructive surgery. METHODS: A cross-sectional household survey of patients seeking surgical care for cleft lip and/or cleft palate was completed at five Operation Smile International mission sites throughout Vietnam (Hanoi, Nghe An, Hue, Ho Chi Minh City, An Giang, and Bac Lieu) in November of 2014...
November 2016: Plastic and Reconstructive Surgery
Asmaa N Mohammad, Khairy H Morsy, Moustafa A Ali
BACKGROUND/AIMS: To find the most accurate, suitable, and applicable scoring system for the prediction of outcome in cirrhotic patients with bleeding varices. MATERIALS AND METHODS: A prospective study was conducted comprising 120 cirrhotic patients with acute variceal bleeding who were admitted to Tropical Medicine and Gastroenterology Department in Sohag University Hospital, over a 1-year period (1/2015 to 1/2016). The clinical, laboratory, and endoscopic parameters were studied...
September 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Pilar Brea-Rivero, Manuel Herrera-Usagre, Ana Rojas-de-Mora-Figueroa, Thomas Esposito
: . The accreditation of professional competence: the analysis of nursing interventions to control anxiety in surgical patients. INTRODUCTION: The preoperative anxiety is a state of discomfort or unpleasant tension resulting from concerns about illness, hospitalization, anesthesia, surgery or the unknown. Nurses play a vital role reducing preoperative anxiety. An accreditation program was developed in Andalusia (Spain) to measure nurses' competences in this and others fields...
July 2016: Assistenza Infermieristica e Ricerca: AIR
S Waanders, M Visscher, R R Wildeboer, T O B Oderkerk, H J G Krooshoop, B Ten Haken
Sentinel lymph node biopsy has become a staple tool in the diagnosis of breast cancer. By replacing the morbidity-plagued axillary node clearance with removing only those nodes most likely to contain metastases, it has greatly improved the quality of life of many breast cancer patients. However, due to the use of ionizing radiation emitted by the technetium-based tracer material, the current sentinel lymph node biopsy has serious drawbacks. Most urgently, the reliance on radioisotopes limits the application of this procedure to small parts of the developed world, and it imposes restrictions on patient planning and hospital logistics...
November 21, 2016: Physics in Medicine and Biology
R Mugnai, N Della Rosa, L Tarallo
Injuries to the scapholunate interosseous ligament (SLIL) are the most common cause of carpal instability. A SLIL injury typically follows a fall on an outstretched hand, with the wrist in hyperextension, ulnar deviation and intercarpal supination. We hypothesize that repetitive axial loading on the wrist in hyperextension, during the reception and digging motions of volleyball, can lead to functional overloading of the SLIL. To identify patients and to determine the clinical history and surgical treatment performed, we analyzed hospital records, X-rays, electronic databases containing all the operations performed, and image files (including before and after surgery and follow-up)...
October 2016: Hand Surgery and Rehabilitation
Domenico Tamburrino, Stefano Partelli, Claudio Renzi, Stefano Crippa, Francesca Muffatti, Carolina Perali, Amilcare Parisi, Julius Randolph, Giuseppe Kito Fusai, Roberto Cirocchi, Massimo Falconi
BACKGROUND: The safety of laparoscopic resections (LPS) of pancreatic neuroendocrine neoplasms (PNENs) has been well established in the literature. METHODS: Studies conducted between January 2003 and December 2015 that reported on LPS and open surgery (OPS) were reviewed. The primary outcomes were the rate of post-operative complications and the length of hospital stay (LoS) after laparoscopic and open surgical resection. The rate of recurrence was the secondary outcome...
October 26, 2016: Expert Review of Gastroenterology & Hepatology
Shangjie Xiao, Wenyi Yang, Like Yuan, Ying Zhang, Tao Song, Lu Xu, Song Tian, Wuping Ge, Jialiang Zhou, Xiaochun Zhu
OBJECTIVE: To investigate the operation timing of newborns with rectosigmoid Hirschsprung's disease (HD). METHODS: From March 2013 to September 2015, 35 newborns diagnosed as rectosigmoid HD in our department were prospectively and randomly divided into 2 groups: less than 3 months treatment group (18 cases) and more than 3 months treatment group (17 cases, conservative treatment for 3 months). They all underwent laparoscopic-assisted transanal endorectal pull-through (LATEP) (modified Soave) procedure...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Hong Zhang, Wei Zhong, Jing Sun, Qiuming He, Yong Wang, Le Li, Jiakang Yu, Zhe Wang, Zhihua Ye, Kailin Tang, Huimin Xia
OBJECTIVE: To explore the feasibility and safety of Bishop-Koop stoma procedure in the treatment of neonates with refractory congenital intestinal atresia. METHODS: Clinical and follow-up data of 25 neonates with refractory congenital intestinal atresia undergoing Bishop-Koop stoma procedure in our center from January 2011 to December 2014 were retrospectively analyzed. Of 25 neonates, 13 (52%) were male, 12(48%) were female, the birth weight was 1600-3800 g (mean 2920 g), the age of admission was 10 hours to 20 days, and the age of operation was 1-58 d (mean 7 d)...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Jiayin Li, Yang Liu, Jianbo Gao, Dandan Guo
OBJECTIVE: To investigate the value of CT perfusion imaging in differential diagnosis between Borrmann types II( and III( gastric cancer. METHODS: All the patients were proven as ulcerated gastric cancer by preoperative gastroscopy and underwent CT perfusion scanning with Aquilion ONE 320 spiral CT from October 2013 to June 2014 in The First Affiliated Hospital of Zhengzhou University, including 19 patients as Borrmann type II( gastric cancer and 23 patients as Borrmann type III( gastric cancer by pathology...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Jun Huang, Jiaming Zhou, Yingjie Wan, Yanghao Lin, Yanhong Deng, Zhiyang Zhou, Jianping Qiu, Jianping Wang, Meijin Huang
OBJECTIVE: To evaluate the influences of inferior mesenteric artery (IMA) types and Riolan artery arcade absence on the incidence of anastomotic leakage(AL) after laparoscopic resection of rectal cancer. METHODS: Clinical data of 116 local advanced rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2014 were analyzed retrospectively. IMA and Riolan artery arcade were examined by preoperative computed tomography angiography (CTA) reconstruction...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Shaolan Qin, Minhao Yu, Yifei Mu, Yang Qi, Yier Qiu, Yang Luo, Ran Cui, Ming Zhong
OBJECTIVE: To investigate the efficacy of complete mesocolic excision (CME) in the radical operation for right hemicolon cancer. METHODS: Clinical data of 336 cases of right hemicolon cancer undergoing radical resection, including 218 cases of CME surgery group and 118 cases of traditional surgery group, from January 2005 to December 2014 in Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University were retrospectively analyzed...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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