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Navid Alem, Joseph Rinehart, Brian Lee, Doug Merrill, Safa Sobhanie, Kyle Ahn, Ran Schwarzkopf, Maxime Cannesson, Zeev Kain
BACKGROUND: Efforts to mitigate costs while improving surgical care quality have received much scrutiny. This includes the challenging issue of readmission subsequent to hospital discharge. Initiatives attempting to preclude readmission after surgery require planned and unified efforts extending throughout the perioperative continuum. Patient optimization prior to discharge, enhanced disease monitoring, and seamless coordination of care between hospitals and community providers is integral to this process...
2016: Perioperative Medicine
Karen Thomson, Sophie R Pestieau, Janish J Patel, Heather Gordish-Dressman, Ariana Mirzada, Zeev N Kain, Matthew E Oetgen
BACKGROUND: The Perioperative Surgical Home (PSH) is a patient-centered, team-based approach that aims to improve the value of perioperative care. We implemented a PSH for patients with adolescent idiopathic scoliosis who were undergoing posterior spinal fusion at Children's National Health System. We hypothesized that this PSH would improve patient surgical outcomes and reduce hospital length of stay (LOS). METHODS: A multidisciplinary group created evidence-based protocols for the preoperative, operative, postoperative, and postdischarge care of this patient population...
October 3, 2016: Anesthesia and Analgesia
Marco Pozzi, Valentino Conti, Federica Locatelli, Sara Galbiati, Sonia Radice, Emilio Clementi, Sandra Strazzer
OBJECTIVE: Information on course and treatment of paroxysmal sympathetic hyperactivity (PSH) during rehabilitation and in pediatric patients is lacking. To increase knowledge on the course and treatment of PSH in pediatric patients during rehabilitation, we retrospectively analyzed 23 pediatric patients with PSH, describing the course of PSH and administered drugs, and explored the association of PSH remission with drug doses. SETTING: Neurorehabilitation unit of IRCCS Eugenio Medea, Bosisio Parini (LC), Italy...
September 6, 2016: Journal of Head Trauma Rehabilitation
Seung-Hyun Jung, Min Sung Kim, Sung-Hak Lee, Hyun-Chun Park, Hyun Joo Choi, Leeso Maeng, Ki Ouk Min, Jeana Kim, Tae In Park, Ok Ran Shin, Tae-Jung Kim, Haidong Xu, Kyo Young Lee, Tae-Min Kim, Sang Yong Song, Charles Lee, Yeun-Jun Chung, Sug Hyung Lee
Pulmonary sclerosing hemangioma (PSH) is a benign tumor with two cell populations (epithelial and stromal cells), for which genomic profiles remain unknown. We conducted exome sequencing of 44 PSHs and identified recurrent somatic mutations of AKT1 (43.2%) and β-catenin (4.5%). We used a second subset of 24 PSHs to confirm the high frequency of AKT1 mutations (overall 31/68, 45.6%; p.E17K, 33.8%) and recurrent β-catenin mutations (overall 3 of 68, 4.4%). Of the PSHs without AKT1 mutations, two exhibited AKT1 copy gain...
September 20, 2016: Proceedings of the National Academy of Sciences of the United States of America
Riccardo Memeo, Vito de Blasi, René Adam, Diane Goéré, Daniel Azoulay, Ahmet Ayav, Emilie Gregoire, Reza Kianmanesh, Francis Navarro, Antonio Sa Cunha, Patrick Pessaux
OBJECTIVE: The aim of this study is to evaluate whether a parenchymal-sparing strategy provides similar results in terms of morbidity, mortality, and oncological outcome of non-PSH hepatectomies in a propensity score matched population (PSMP) in case of multiple (>3) bilobar colorectal liver metastases (CLM). BACKGROUND: The surgical treatment of bilobar liver metastasis is challenging due to the necessity to achieve complete resection margins and a sufficient future remnant liver...
September 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Manish Joseph Mathew, Akhil Deepika, Dhaval Shukla, Bhagavatula Indira Devi, Venkatapura J Ramesh
BACKGROUND: Paroxysmal sympathetic hyperactivity (PSH) is a less-known complication of traumatic brain injury (TBI). This study was done to assess the clinical features and outcome of patients who develop PSH following severe TBI. METHODS: A prospective observational study was done on patients, admitted in the intensive care unit, for treatment of severe TBI. The clinical characteristics and outcome of patients, with and without PSH, was compared. At the time of discharge, patients were assessed with the Disability Rating Scale (DRS), and at 6 months with the Glasgow Outcome Score Extended (GOSE)...
November 2016: Acta Neurochirurgica
María C De Paoli, Dino Moretti, Carlos M Scolari Pasinato, Martín G Buncuga
The Henoch-Schönlein purpura (HSP) is a small vessel vasculitis with IgA immune complex deposition. The presentation in adults is rare and severe. Reported cases of HSP in patients infected with HIV are scarce. Neutrophil cytoplasmic antibodies (ANCA) are commonly found in other systemic vasculitis, but rarely in HSP and even more unusual the perinuclear pattern. Beside small vessel vasculitis, positivity of ANCA can be detected in a number of different pathological conditions in association with infectious processes, including HIV, or cocaine use, and especially the pattern of ANCA-p, associated with drugs, inflammatory bowel or autoimmune diseases...
2016: Medicina
Hitoshi Hino, Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Masakatsu Numata, Akinobu Furutani, Takuya Suzuki, Kakeru Torii
BACKGROUND: The therapeutic benefits of extraperitoneal colostomy with laparoscopic surgery remain unclear. The aim of this study was to investigate the relationship between the route for stoma creation with laparoscopic surgery and stoma-related complications, especially parastomal hernia (PSH). METHODS: From January 2007 to March 2015, a total of 59 patients who underwent laparoscopic abdominoperineal resection or Hartmann procedure were investigated. Patient demographic and treatment characteristics, including stoma-related complications, were analyzed retrospectively...
August 23, 2016: Surgical Endoscopy
Bat-Erdene Jugder, Jeffrey Welch, Nady Braidy, Christopher P Marquis
Hydrogenases are metalloenzymes that reversibly catalyse the oxidation or production of molecular hydrogen (H2). Amongst a number of promising candidates for application in the oxidation of H2 is a soluble [Ni-Fe] uptake hydrogenase (SH) produced by Cupriavidus necator H16. In the present study, molecular characterisation of the SH operon, responsible for functional SH synthesis, was investigated by developing a green fluorescent protein (GFP) reporter system to characterise PSH promoter activity using several gene cloning approaches...
2016: PeerJ
Chunyuan Qiu, Maxime Cannesson, Atef Morkos, Vu T Nguyen, Diana LaPlace, Narendra S Trivedi, Armond Khachatourians, Joseph Rinehart, Zeev N Kain
BACKGROUND: In this article, we report on the implementation and impact of a Perioperative Surgical Home (PSH) model for the total knee arthroplasty at an integrated delivery system (Kaiser Permanente). METHODS: A multidisciplinary committee developed and implemented a series of PSH protocols that included the entire continuum of care from the decision for surgery until 30 days after surgery. Five hundred forty-six subjects were included in the preimplementation phase (Fast Track [T-fast]), and 518 patients were included in the postimplementation phase (PSH)...
September 2016: Anesthesia and Analgesia
Jose Miguel Baena-Díez, Judit Peñafiel, Isaac Subirana, Rafel Ramos, Roberto Elosua, Alejandro Marín-Ibañez, María Jesús Guembe, Fernando Rigo, María José Tormo-Díaz, Conchi Moreno-Iribas, Joan Josep Cabré, Antonio Segura, Manel García-Lareo, Agustín Gómez de la Cámara, José Lapetra, Miquel Quesada, Jaume Marrugat, Maria José Medrano, Jesús Berjón, Guiem Frontera, Diana Gavrila, Aurelio Barricarte, Josep Basora, Jose María García, Natalia C Pavone, David Lora-Pablos, Eduardo Mayoral, Josep Franch, Manel Mata, Conxa Castell, Albert Frances, María Grau
OBJECTIVE: Diabetes is a common cause of shortened life expectancy. We aimed to assess the association between diabetes and cause-specific death. RESEARCH DESIGN AND METHODS: We used the pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35-79 years old. Diabetes status was self-reported or defined as glycemia >125 mg/dL at baseline. Vital status and causes of death were ascertained by medical records review and linkage with the official death registry...
August 4, 2016: Diabetes Care
Angelo Zinellu, Alessandro Giuseppe Fois, Salvatore Sotgia, Elisabetta Sotgiu, Elisabetta Zinellu, Fabiana Bifulco, Arduino A Mangoni, Pietro Pirina, Ciriaco Carru
BACKGROUND: Elevated plasma concentrations of the endogenous nitric oxide synthase (NOS) inhibitor asymmetric dimethylarginine (ADMA) have been observed in respiratory conditions such as asthma and cystic fibrosis. Since oxidative stress has been shown to increase the activity of arginine methylating enzymes, hence increased ADMA synthesis, and to reduce ADMA degrading enzymes, hence increased ADMA concentrations, we assessed methylated arginines concentrations in chronic obstructive pulmonary disease (COPD), a disease characterized by increased oxidative stress...
2016: PloS One
Henk-Thijs Brandsma, Birgitta M E Hansson, Theo J Aufenacker, Dick van Geldere, Felix M V Lammeren, Chander Mahabier, Peter Makai, Pascal Steenvoorde, Tammo S de Vries Reilingh, Marinus J Wiezer, Johannes H W de Wilt, Robert P Bleichrodt, Camiel Rosman
OBJECTIVE: The aim of this study was to investigate the incidence of parastomal hernias (PSHs) after end-colostomy formation using a polypropylene mesh in a randomized controlled trial versus conventional colostomy formation. BACKGROUND: A PSH is the most frequent complication after stoma formation. Symptoms may range from mild abdominal pain to life-threatening obstruction and strangulation. The treatment of a PSH is notoriously difficult and recurrences up to 20% have been reported despite the use of mesh...
July 29, 2016: Annals of Surgery
Cynthia Saver
No abstract text is available yet for this article.
June 2016: OR Manager
Cynthia Saver
No abstract text is available yet for this article.
June 2016: OR Manager
J H Zhang, D X Zhang, L P Zhao, T T Yan, Q Zhang, J Z Jia, Y S Huang
OBJECTIVE: To explore the effects of rapamycin on the migration of human epidermal cell line HaCaT, and to analyze its molecular mechanism. METHODS: HaCaT cells were conventionally cultured with RPMI 1640 culture medium containing 10% fetal calf serum (hereinafter referred to as culture medium). (1) According to the random number table, HaCaT cells in logarithmic phase were divided into control group and 1, 5, 50, 100, 200 nmol/L rapamycin groups, with 6 wells in each group...
January 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Lisa Letzkus, Jessica Keim-Malpass, Christine Kennedy
BACKGROUND: Children who suffer from moderate-to-severe brain injury can develop a complicating phenomenon known as paroxysmal sympathetic hyperactivity (PSH), characterized by autonomic instability and identified clinically as a cluster of symptoms that can include recurrent fever without a source of infection, hypertension, tachycardia, tachypnea, agitation, diaphoresis and dystonia. Studies with adults have demonstrated that this cluster of symptoms is associated with poorer clinical outcomes (prolonged hospitalizations, poorer cognitive and motor function)...
2016: Brain Injury: [BI]
Duy L Phan, Kyle Ahn, Joseph B Rinehart, Michael-David Calderon, Wei-Der Wu, Ran Schwarzkopf
AIM: To determine the impact of different characteristics on postoperative outcomes for patients in a joint arthroplasty Perioperative Surgical Home (PSH) program. METHODS: A retrospective review was performed for patients enrolled in a joint arthroplasty PSH program who had undergone primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Patients were preoperatively stratified based on specific procedure performed, age, gender, body mass index (BMI), American Society of Anesthesiologists Physical Classification System (ASA) score, and Charleston Comorbidity Index (CCI) score...
June 18, 2016: World Journal of Orthopedics
Qi'er Wu, Lu Lyu, Haiming Xin, Liang Luo, Yalin Tong, Yongliang Mo, Yigang Yue
OBJECTIVE: To investigate the effects of culture supernatant of human amnion mesenchymal stem cells (hAMSCs-CS) on biological characteristics of human fibroblasts. METHODS: (1) hAMSCs were isolated from deprecated human fresh amnion tissue of placenta and then sub-cultured. The morphology of hAMSCs on culture day 3 and hAMSCs of the third passage were observed with inverted phase contrast microscope. (2) Two batches of hAMSCs of the third passage were obtained, then the expression of vimentin of cells was observed with immunofluorescence method, and the expression of cell surface marker CD90, CD73, CD105, and CD45 was detected by flow cytometer...
June 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
James Cyriac, Leslie Garson, Ran Schwarzkopf, Kyle Ahn, Joseph Rinehart, Shermeen Vakharia, Maxime Cannesson, Zeev Kain
BACKGROUND: Previously, our group successfully established one of the nation's first Perioperative Surgical Homes (PSHs) aimed at coordinating services to patients undergoing primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). As we now focus on extending the PSH to other service lines within the hospital, the long-term sustainability of this practice model is an important factor to consider moving forward. METHODS: We prospectively collected data from all patients who underwent elective primary TKA and THA at our institution between October 1, 2012, and September 30, 2014...
July 2016: Anesthesia and Analgesia
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