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https://www.readbyqxmd.com/read/28340494/postoperative-care-of-patients-with-high-grade-glioma-is-there-a-real-need-for-the-neurocritical-icu-and-early-ct-scan
#1
Roberto Altieri, Fabio Cofano, Alessandro Agnoletti, Riccardo Fornaro, Marco Ajello, Francesco Zenga, Alessandro Ducati, Diego Garbossa
Background Pressure on economic resources now requires a careful rationalization of services. For adult patients with supratentorial gliomas, there is no consensus on the real need for care in a postoperative neurocritical intensive care unit (NICU) and on the timing of a postsurgical computed tomography (CT) scan. In this retrospective nonrandomized study, we assessed if and when there is a real need for NICU and if an early CT scan could be justified in the absence of neurologic worsening. Methods Of 264 patients, 21 were admitted to the NICU after the procedure as planned before the surgery for their clinical features (Karnofsky performance status < 70, American Society of Anesthesiologists score > 2, or Charlson Comorbidity Index > 5)...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28340218/user-centered-design-of-discharge-warnings-tool-for-colorectal-surgery-patients
#2
Aanand D Naik, Molly J Horstman, Linda T Li, Michael K Paasche-Orlow, Bryan Campbell, Whitney L Mills, Levi I Herman, Daniel A Anaya, Barbara W Trautner, David H Berger
Objectives: Readmission following colorectal surgery, typically due to surgery-related complications, is common. Patient-centered discharge warnings may guide recognition of early complication signs after colorectal surgery. Materials and Methods: User-centered design of a discharge warnings tool consisted of iterative health literacy review and a heuristic evaluation with human factors and clinical experts as well as patient end users to establish content validity and usability...
March 16, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28338553/consequences-of-hybrid-procedure-addition-to-robotic-assisted-direct-coronary-artery-bypass
#3
Feras Khaliel, Vincenzo Giambruno, Michael W A Chu, Kumar Sridhar, Patrick Teefy, Bob B Kiaii
OBJECTIVE: Patients postcoronary artery revascularization surgery often receives blood product transfusion, which could delay their intensive care unit and hospital discharge. We investigated our robotic-assisted direct coronary artery bypass (RADCAB) transfusion rate to determine whether performing the minimal invasive coronary surgery with percutaneous coronary intervention in one stage would increase the incidence of blood transfusion, morbidity, and length of stay. METHODS: Between November 2003 and November 2015, 483 consecutive patients underwent RADCAB surgery...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28338215/delirium-during-postacute-nursing-home-admission-and-risk-for-adverse-outcomes
#4
Cyrus M Kosar, Kali S Thomas, Sharon K Inouye, Vincent Mor
OBJECTIVES: To identify the rate of delirium present during admission to postacute care (PAC) in the nursing home setting and to determine whether patients with delirium had higher risk for adverse outcomes. DESIGN: Retrospective cohort study. SETTING: US Medicare- and Medicaid-certified nursing homes, 2011 to 2014. PARTICIPANTS: Individuals admitted to all US nursing homes for PAC, aged ≥65 years, and without prior history of nursing home residence (n = 5,588,702)...
March 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28336255/homelessness-following-disability-related-discharges-from-active-duty-military-service-in-afghanistan-and-iraq
#5
Jamison D Fargo, Emily Brignone, Stephen Metraux, Rachel Peterson, Marjorie E Carter, Tyson Barrett, Miland Palmer, Andrew Redd, Matthew H Samore, Adi V Gundlapalli
BACKGROUND: Many dynamics in the relationship among military service-related disabilities, health care benefits, mental health disorders, and post-deployment homelessness among US Veterans are not well understood. OBJECTIVES: Determine whether Veterans with a disability-related discharge from military service are at higher risk for homelessness, whether Veterans Health Administration (VHA) service-connected disability benefits mitigates that risk, and whether risks associated with discharge type, service-connected disability, or the interaction between them vary as a function of mental health disorders...
March 10, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28336090/trace-metal-behavior-in-sediments-of-jiulong-river-estuary-and-implication-for-benthic-exchange-fluxes
#6
Wenhao Wang, Wen-Xiong Wang
Severe metal pollution due to industrial effluents releases has been documented in Jiulong River estuary, Southern China. However, integrated understanding of trace metal behavior in the sediment is lacking. In the present study, DGT (diffusive gradients in thin films) technique was employed together with sediment cores to study the porewater dynamics of trace metals as well as the benthic exchange fluxes from four sampling sites over three different months. The sedimentary environment showed distinct spatial and temporal variations due to effluent discharge and biological activities...
March 20, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28334033/a-qualitative-study-mothers-of-late-preterm-infants-relate-their-experiences-of-community-based-care
#7
Shahirose S Premji, Genevieve Currie, Sandra Reilly, Aliyah Dosani, Lynnette May Oliver, Abhay K Lodha, Marilyn Young
PURPOSE: In Alberta, the high occurrence of late preterm infants and early hospital discharge of mother-infant dyads has implications for postpartum care in the community. Shortened hospital stay and complexities surrounding the care of biologically and developmentally immature late preterm infants heighten anxiety and fears. Our descriptive phenomenological study explores mothers' experience of caring for their late preterm infants in the community. METHODS: Eleven mothers were interviewed using a semi-structured interview guide...
2017: PloS One
https://www.readbyqxmd.com/read/28331804/infected-ascites-distinguishing-secondary-peritonitis-from-spontaneous-bacterial-peritonitis-in-a-cirrhotic-patient-with-classic-symptoms
#8
Marvin Louis Roy Lu, Akanksha Agarwal, Josh Sloan, Aaron Kosmin
INTRODUCTION: Spontaneous bacterial peritonitis can be differentiated from secondary bacterial peritonitis by the absence of a surgically treatable intra-abdominal source of infection. However, oftentimes this is unapparent and other clinical clues need to be sought after to make the right diagnosis. CASE: A 64-year-old woman was admitted because of three days of worsening diffuse abdominal pain and distention. She was morbidly obese and had a history of non-alcoholic steatohepatitis (NASH) cirrhosis...
2017: IDCases
https://www.readbyqxmd.com/read/28330452/a-structure-process-and-outcome-evaluation-of-the-geriatric-emergency-department-intervention-model-of-care-a-study-protocol
#9
Elizabeth Marsden, Andrea Taylor, Marianne Wallis, Alison Craswell, Marc Broadbent, Adrian Barnett, Kim-Huong Nguyen, Julia Crilly, Colleen Johnston, Amanda Glenwright
BACKGROUND: Emergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed...
March 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28329450/public-views-on-pulse-oximetry-screening-for-critical-congenital-heart-disease
#10
Praveen Kumar, Hari Iyengar, Prerna Kumar
OBJECTIVES: To understand public views on pulse oximetry screening for critical congenital heart disease. METHODS: Two hundred thirteen adults read a brief vignette describing the importance of early detection of critical congenital heart disease and then answered five questions on a five-point scale of how likely or unlikely they were to support pulse oximetry screening. Responses were tabulated and analyzed using a Fisher exact test, and logistic regression was used to estimate odds ratios for adjusted associations using generalized estimating equations...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329433/understanding-maternal-postpartum-needs-a-descriptive-survey-of-current-maternal-health-services
#11
Mona Ma Almalik
OBJECTIVE: To assess mothers' learning needs and concerns after giving birth and to examine whether these needs were met at 6-8 weeks postpartum. BACKGROUND: Women experience many physiologic and psychological changes during postpartum period which is considered a vital transitional time. Exploring and meeting women's needs help woman to pass this period with little complications and enhance health care provider's ability to provide appropriate care following childbirth...
March 22, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#12
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28329232/mid-term-results-of-bilateral-lung-transplant-with-postoperatively-extended-intraoperative-extracorporeal-membrane-oxygenation-for-severe-pulmonary-hypertension%C3%A2
#13
Jawad Salman, Fabio Ius, Wiebke Sommer, Thierry Siemeni, Christian Kuehn, Murat Avsar, Dietmar Boethig, Ulrich Molitoris, Christoph Bara, Jens Gottlieb, Tobias Welte, Axel Haverich, Marius M Hoeper, Gregor Warnecke, Igor Tudorache
OBJECTIVES: In severe pulmonary hypertension, diastolic dysfunction of the left ventricle causes significant morbidity and mortality after lung transplantation, which may be successfully reversed using a protocol based on perioperative veno-arterial extracorporeal membrane oxygenation (ECMO) and early extubation. Here, we present echocardiographic data and mid-term outcomes. METHODS: The records of lung transplanted patients at our institution between May 2010 and January 2016 were retrospectively reviewed...
March 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329112/comparison-of-paracorporeal-and-continuous-flow-ventricular-assist-devices-in-children-preliminary-results%C3%A2
#14
Mohamed S Nassar, Asif Hasan, Teresa Chila, Stephan Schueler, Carola Pergolizzi, Zdenka Reinhardt, Stephen Lord, Fabrizio De Rita, Lee Ferguson, Jon Smith, Simon Haynes, John O'Sullivan, Bari Murtuza
OBJECTIVES: With the scarcity of organs, a durable, reliable ventricular assist device (VAD) is required. The Berlin Heart EXCOR ® (BH) remains the most established VAD in the paediatric population. Implantable continuous flow (CF) VADs have been introduced to the paediatric field with encouraging early results. In this study, we compared the results of a newly introduced CF VAD (HeartWare VAD [HVAD] ® ) to results in a matched group of BH recipients. METHODS: The study included patients aged <16 years who received mechanical left VAD (LVAD) support between December 2005 and January 2016...
February 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329111/hypoplastic-left-heart-syndrome-a-novel-surgical-strategy-for-small-volume-centres-%C3%A2
#15
Margaux Pontailler, Régis Gaudin, Marien Lenoir, Ayman Haydar, Diala Kraiche, Damien Bonnet, Pascal Vouhé, Olivier Raisky
OBJECTIVES: We describe in a prospective study, a novel surgical technique for the management of hypoplastic left heart syndrome inspired by the hybrid Norwood approach. METHODS: This new neonatal palliation comprises replacement of the patent ductus arteriosus (PDA) and aortic arch plasty with a pulmonary homograft associated with the banding of both pulmonary arteries and atrial septectomy, under cardiopulmonary bypass without aortic clamping and cardioplegia...
February 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328756/pectoralis-and-serratus-fascial-plane-blocks-each-provide-early-analgesic-benefits-following-ambulatory-breast-cancer-surgery-a-retrospective-propensity-matched-cohort-study
#16
Faraj W Abdallah, David MacLean, Caveh Madjdpour, Tulin Cil, Anuj Bhatia, Richard Brull
BACKGROUND: Pectoralis and serratus blocks have been described recently for use in breast surgery, but evidence supporting their analgesic benefits is limited. This cohort study evaluates the benefits of adding a pectoralis or serratus block to conventional opioid-based analgesia (control) in patients who underwent ambulatory breast cancer surgery at Women's College Hospital between July 2013 and May 2015. We tested the joint hypothesis that adding a pectoralis or serratus block reduced postoperative in-hospital (predischarge) opioid consumption and nausea and vomiting (PONV)...
March 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28328299/early-left-ventricular-ejection-fraction-as-a-predictor-of-survival-after-cardiac-arrest
#17
Barry Burstein, Dev Jayaraman, Regina Husa
Although echocardiograms are frequently performed within 24 h of sudden cardiac death, the utility of left ventricular ejection fraction (LVEF) to predict survival is unknown. In this is single center retrospective cohort study of patients admitted to the intensive care unit or coronary care unit after in-hospital or out-of-hospital sudden cardiac death, LVEF <40% was not a significant predictor of survival at 30 days or hospital discharge. ABSTRACT Background: Cardiopulmonary resuscitation and early defibrillation have been shown to improve outcomes of cardiac arrest...
March 22, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/28326863/use-of-patient-controlled-psychiatric-hospital-admissions-patients-perspective
#18
Trine Ellegaard, Vibeke Bliksted, Kirsten Lomborg, Mimi Mehlsen
BACKGROUND: By patient-controlled admission (PCA), psychiatric patients with a PCA contract can initiate a brief admission without a health professional gatekeeper. However, research regarding use of PCA is scarce. AIMS: In this Danish multi-centre study, motives for and satisfaction with PCA were explored. METHODS: During a 1-year period, patients from 11 Danish mental health units evaluated PCA using a questionnaire developed for the purpose...
March 22, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28326468/day-case-laparoscopic-cholecystectomy-analysis-of-the-factors-allowing-early-discharge
#19
Giovanni Domenico Tebala, Angela Belvedere, Sean Keane, Abdul Qayyum Khan, Abdelsalam Osman
Despite a number of studies have already demonstrated that majority of patients can be safely discharged early after laparoscopic cholecystectomy, this approach did not gain widespread diffusion yet. The present study was set up to assess safety and feasibility of 24 h or same-day discharge after laparoscopic cholecystectomy and to identify the prognostic factors. Perioperative variables of 229 patients undergoing cholecystectomy have been analyzed. Primary endpoints were: postoperative length of stay, rate of patients discharged within 24 h, and rate of those discharged on the same day...
March 21, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28326453/violent-trauma-recidivism-does-all-violence-escalate
#20
R M Nygaard, A P Marek, S R Daly, J M Van Camp
PURPOSE: Rates of trauma patients presenting with history of prior trauma range from 25 to 44%. Outcomes involving recidivists in the setting of intentional trauma, especially penetrating trauma, are conflicting. We hypothesized that if violence does escalate with successive incidence, then injuries due to successive violence should escalate or become increasingly severe with successive admissions. METHODS: The trauma registry from an urban level I adult and pediatric trauma center was queried for injuries due to blunt assault, stabbing, and firearm injury...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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