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https://www.readbyqxmd.com/read/28101609/patient-preparation-for-transitions-of-surgical-care-is-failing-to-prepare-surgical-patients-preparing-them-to-fail
#1
Luke A Martin, Samuel R G Finlayson, Benjamin S Brooke
BACKGROUND: Transitions of care before and after surgery are critical for patient preparation. We sought to determine whether the degree of exposure to health information resources before and after surgery increases preparedness and decreases hospital readmission. METHODS: A national Web-based, cross-sectional survey was conducted of 1917 patients and caregivers who had a recent surgical encounter. Health information resources used before and after surgery were correlated with patient level of preparedness...
January 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28089084/predicting-the-need-for-intra-operative-large-volume-blood-transfusions-during-thoraco-abdominal-aortic-aneurysm-repair
#2
M Pieri, P Nardelli, M De Luca, G Landoni, S Frassoni, G Melissano, A Zangrillo, R Chiesa, F Monaco
OBJECTIVE: Thoraco-abdominal aortic aneurysm (TAAA) repair is a complex procedure performed in patients at high cardiovascular risk. High volume intra-operative bleeding is often recorded, and the amount of intra-operative blood product transfusion is associated with relevant morbidity and mortality. The aim of the study was to identify pre-operative predictors of intra-operative large volume blood transfusions (LVBT) to stratify patients pre-operatively. METHODS: This was a retrospective analysis of prospectively collected data of all patients who underwent open TAAA surgery at San Raffaele Scientific Institute from January 2009 to December 2015...
January 6, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28074799/basic-arterial-blood-gas-biomarkers-as-a-predictor-of-mortality-in-tetralogy-of-fallot-patients
#3
Vandana Bhardwaj, Poonam Malhotra Kapoor, Kalpana Irpachi, Suruchi Ladha, Ujjwal Kumar Chowdhury
BACKGROUND: Serum lactate and base deficit have been shown to be a predictor of morbidity and mortality in critically ill patients. Poor preoperative oxygenation appears to be one of the significant factors that affects early mortality in tetralogy of Fallot (TOF). There is little published literature evaluating the utility of serum lactate, base excess (BE), and oxygen partial pressure (PO 2 ) as simple, widely available, prognostic markers in patients undergoing surgical repair of TOF...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#4
J S Evans, S J Huang, A S McLean, M Nalos
The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28069528/personal-and-professional-well-being-of-surgical-residents-in-new-england
#5
Peter S Yoo, John J Tackett, Mark W Maxfield, Rosemarie Fisher, Stephen J Huot, Walter E Longo
BACKGROUND: Although there is increasing literature about burnout and attrition among surgeons, little is known about personal and professional well-being of surgical trainees. STUDY DESIGN: General surgery residents from the six New England states participated in a cross-sectional, qualitative, self-reported survey to assess the domains of personal health maintenance, personal finance, work environment, and fatigue management as they relate to surgical training...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28069526/opportunities-to-improve-care-of-hepatocellular-carcinoma-in-vulnerable-patient-populations
#6
Richard S Hoehn, Dennis J Hanseman, Vikrom Dhar, Derek E Go, Michael J Edwards, Shimul A Shah
BACKGROUND: Hepatocellular carcinoma (HCC) patients with Medicaid or no health insurance have inferior survival compared to privately-insured patients. Safety-net hospitals that care for these patients are often criticized for their inferior outcomes. We hypothesized that HCC survival was related to appropriate surgical management. STUDY DESIGN: The American College of Surgeons National Cancer Data Base was queried for patients diagnosed with HCC (n=111,481) from 1998-2010...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28068239/stereotactic-body-radiation-therapy-for-locally-advanced-pancreatic-cancer-a-systematic-review-and-pooled-analysis-of-19-trials
#7
REVIEW
Fausto Petrelli, Tiziana Comito, Antonio Ghidini, Valter Torri, Marta Scorsetti, Sandro Barni
PURPOSE: Although surgery is the standard of care for resectable pancreatic cancer (PC), standard-dose chemoradiation therapy and chemotherapy alone are suitable for patients with unresectable disease. Stereotactic body radiation therapy (SBRT) is an alternative, focused local therapy that delivers high radiation doses within a few fractions to the cancer, sparing the surrounding critical tissue. We performed a systematic review and pooled analysis of published trials to evaluate the efficacy and safety of this emerging treatment modality...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28066676/image-guided-localization-of-small-lung-nodules-in-video-assisted-thoracic-surgery
#8
REVIEW
Ze-Rui Zhao, Rainbow W H Lau, Peter S Y Yu, Randolph H L Wong, Calvin S H Ng
The advancement of imaging technology has recently facilitated single port minimally-invasive thoracic surgery techniques. Cone-beam computed tomography (CBCT) shows promising results in visualizing the target lesion and its surrounding critical anatomy, with an error of less than 2 mm. The integration of CBCT with the operating room (OR) to form the hybrid OR, provides unparalleled real-time imaging of the patient, which can be used with electromagnetic navigation bronchoscopy to confirm successful navigation and increase procedural accuracy particularly for small peripheral pulmonary targets...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28060054/patient-reported-and-objectively-measured-function-before-and-after-reverse-shoulder-arthroplasty
#9
Wendy J Hurd, Melissa M Morrow, Emily J Miller, Robert A Adams, John W Sperling, Kenton R Kaufman
BACKGROUND AND PURPOSE: Documenting functional outcomes after reverse shoulder arthroplasty (RSA) is critical to advancing patient care. The interplay been self-reported and objectively measured outcome measures has not been widely described. The utilization of wearable devices to document upper extremity limb activity is a new approach for objectively measuring outcomes. Therefore, the purpose of this study was to evaluate changes in pain, and self-reported function and objectively measured limb activity after RSA...
January 5, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28054356/impact-of-a-peri-operative-quality-improvement-programme-on-postoperative-pulmonary-complications
#10
J A Moore, D H Conway, N Thomas, D Cummings, D Atkinson
Postoperative pulmonary complications are common, with a reported incidence of 2-40%, and are associated with adverse outcomes that include death, longer hospital stay and reduced long-term survival. Enhanced recovery is now a standard of care for patients undergoing elective major surgery. Despite the high prevalence of pulmonary complications in this population, few elements of enhanced recovery specifically address reducing these complications. In 2013, a prevalence audit confirmed a postoperative pulmonary complication rate of 16/83 (19...
January 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28052526/effectiveness-of-a-multi-layer-foam-dressing-in-preventing-sacral-pressure-ulcers-for-the-early-acute-care-of-patients-with-a-traumatic-spinal-cord-injury-comparison-with-the-use-of-a-gel-mattress
#11
Andréane Richard-Denis, Cynthia Thompson, Jean-Marc Mac-Thiong
Individuals with spinal cord injury are at risk of sacral pressure ulcers due to, among other reasons, prolonged immobilisation. The effectiveness of a multi-layer foam dressing installed pre-operatively in reducing sacral pressure ulcer occurrence in spinal cord injured patients was compared to that of using a gel mattress, and stratified analyses were performed on patients with complete tetraplegia and paraplegia. Socio-demographic and clinical data were collected from 315 patients admitted in a level-I trauma centre following a spinal cord injury between April 2010 and March 2016...
January 4, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28050887/assessment-of-in-silico-protein-sequence-analysis-in-the-clinical-classification-of-variants-in-cancer-risk-genes
#12
Iain D Kerr, Hannah C Cox, Kelsey Moyes, Brent Evans, Brianna C Burdett, Aric van Kan, Heather McElroy, Paris J Vail, Krystal L Brown, Dechie B Sumampong, Nicholas J Monteferrante, Kennedy L Hardman, Aaron Theisen, Erin Mundt, Richard J Wenstrup, Julie M Eggington
Missense variants represent a significant proportion of variants identified in clinical genetic testing. In the absence of strong clinical or functional evidence, the American College of Medical Genetics recommends that these findings be classified as variants of uncertain significance (VUS). VUSs may be reclassified to better inform patient care when new evidence is available. It is critical that the methods used for reclassification are robust in order to prevent inappropriate medical management strategies and unnecessary, life-altering surgeries...
January 3, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/28039651/prevention-of-internal-hernias-and-pelvic-adhesions-following-laparoscopic-left-sided-colorectal-resection-the-role-of-fibrin-sealant
#13
Pierluigi Angelini, Antonio Sciuto, Diego Cuccurullo, Felice Pirozzi, Stefano Reggio, Francesco Corcione
BACKGROUND: Laparoscopy has increasingly become the standard of care for patients who undergo colorectal surgery for both benign and malignant diseases. This growing experience has also resulted in more reports of postoperative complications from the minimally invasive approach to primary colorectal resection. Small bowel obstruction from internal hernias and pre-sacral adhesions is an uncommon but not negligible complication. However, there is little literature specific to this topic with recommendations for different methods to prevent it...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28039247/using-predicted-30%C3%A2-day-mortality-to-plan-postoperative-colorectal-surgery-care-a-cohort-study
#14
M Swart, J B Carlisle, J Goddard
BACKGROUND: Preoperative identification of high-risk surgical patients might help to reduce postoperative morbidity and mortality. Using a patient's predicted 30 day mortality to plan postoperative high-dependency unit (HDU) care after elective colorectal surgery might be associated with reduced postoperative morbidity. METHODS: The 30 day postoperative mortality was predicted for 504 elective colorectal surgical patients in a preoperative clinic. The prediction was used to determine postoperative surgical ward or HDU care...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28033203/outcomes-of-extracorporeal-life-support-during-surgery-for-the-critical-airway-stenosis
#15
Seon Hee Kim, Seunghwan Song, Yeong Dae Kim, Hoseok I, Jeong Su Cho, Hyo Yeong Ahn, Jonggeun Lee, Do Hyung Kim, Bong Soo Son
Anesthetic management of critical airway stenosis is often very challenging. Extracorporeal membrane oxygenation (ECMO) may provide adequate respiratory support when conventional approaches fail. We report our experience of ECMO support for critical airway surgery. Between April 2012 and March 2015, nine patients underwent ECMO-supported airway operation. The reason for surgery was tracheal stenosis in nine patients, and tracheomalacia, tracheal tumor, and external tracheal compression by mediastinal mass in one patient each...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28033081/clinical-databases-and-registries-in-congenital-and-pediatric-cardiac-surgery-cardiology-critical-care-and-anesthesiology-worldwide
#16
David F Vener, Michael Gaies, Jeffrey P Jacobs, Sara K Pasquali
The growth in large-scale data management capabilities and the successful care of patients with congenital heart defects have coincidentally paralleled each other for the last three decades, and participation in multicenter congenital heart disease databases and registries is now a fundamental component of cardiac care. This manuscript attempts for the first time to consolidate in one location all of the relevant databases worldwide, including target populations, specialties, Web sites, and participation information...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28032562/a-novel-secure-transfixing-blood-vessel-occluder-comparison-with-the-hemoclip-in-the-porcine-model
#17
Arnold Miller, Nir Lilach, Ana-Maria Botero-Anug, Udi Willenz, Raanan Miller
BACKGROUND: Secure vessel occlusion is critical to the success of all surgical and interventional procedures. The purpose of this study was to compare in vivo the use of the Amsel Vessel Occluder (AVO), a novel occlusion clip device for secure blood vessel closure, with one of the many commercially available hemoclips, the Ligaclip, in the porcine model. METHODS: Vessel closure of arteries and veins was performed on 10 swine to compare the ease of use, safety, and efficacy of the AVO with the Ligaclip as well as the tissue response at 7 and 30 d...
October 5, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/28032432/perception-of-prognosis-of-cancer-patients-by-non-oncologists
#18
Hadar Goldvaser, Yonatan Milman, Tal Dujovni, Anat Stern, Muhamad Mahamid, Ekaterina Hanovich, Amir Zivony, Tzippy Shochat, Rinat Yerushalmi, Anat Gafter-Gvili, Baruch Brenner, Daniel Shepshelovich
BACKGROUND: Data are lacking regarding the perception of cancer patients' prognosis by physicians who are not oncologists. METHODS: This was a multicenter survey of seven university-affiliated hospitals, assessing physicians' perception of the median survival of patients with seven advanced malignancies. The study cohort included physicians from all 73 internal medicine, surgery, emergency medicine and critical care departments in the participating hospitals. Family practitioners were contacted through email...
December 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28031145/a-surgery-trainee-s-guide-to-writing-a-manuscript
#19
Tiffany W Liang, David V Feliciano, Leonidas G Koniaris
Publishing clinical and research work for dissemination is a critical part of the academic process. Learning how to write an effective manuscript should be a goal for medical students and residents who hope to participate in publishing. While there are a number of existing texts that address how to write a manuscript, there are fewer guides that are specifically targeted towards surgery trainees. This review aims to direct and hopefully encourage surgery trainees to successfully navigate the process of converting ideas into a publication that ultimately helps understanding and improves the care of patients...
December 23, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28030932/usage-of-perioperative-anxiety-neuromarker-for-improving-the-quality-of-life-of-a-patient-operated-on-for-critical-stenosis-of-the-internal-carotid-artery
#20
Mariusz Trystuła, Paweł Półrola, Juri Kropotov
OBJECTIVE: The aim of the study was to find a neuromarker of perioperative anxiety in a patient with critical carotid stenosis through the use of neuromarkers in Quantitative EEG (QEEG) and Event Related Potentials (ERPs). The indirect purpose of the research was evaluation of improvement in the patient's quality of life. CASE STUDY: A 45-year-old woman was admitted to the Department of Vascular Surgery and Endovascular Interventions at the John Paul II Hospital in Krakow, with the diagnosis of critical internal carotid stenosis (over 80%), confirmed by Doppler Ultrasound and Angio-CT examinations...
23, 2016: Annals of Agricultural and Environmental Medicine: AAEM
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