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https://www.readbyqxmd.com/read/29352753/factors-predicting-length-of-stay-following-bariatric-surgery-retrospective-review-of-a-single-uk-tertiary-centre-experience
#1
Fahad Mahmood, Alistair J Sharples, Adriana Rotundo, Nagammapudur Balaji, Vittal S R Rao
BACKGROUND: Laparoscopic Roux Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) are the most commonly performed bariatric procedures. Improvement in techniques and perioperative management of patients have resulted in shorter hospital stay and reduced overall costs. Many post-operative protocols aspire to post-operative day 1 discharge with studies showing reduction in length of stay without increasing complications. In this study, we investigate the factors predictive of early discharge at our high-volume bariatric centre...
January 19, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29352586/the-impact-of-enhanced-recovery-after-surgery-eras-protocol-compliance-on-morbidity-from-resection-for-primary-lung-cancer
#2
Luke J Rogers, David Bleetman, David E Messenger, Natasha A Joshi, Lesley Wood, Neil J Rasburn, Timothy J P Batchelor
OBJECTIVE: The adoption of Enhanced Recovery After Surgery programs in thoracic surgery is relatively recent with limited outcome data. This study aimed to determine the impact of an Enhanced Recovery After Surgery pathway on morbidity and length of stay in patients undergoing lung resection for primary lung cancer. METHODS: This prospective cohort study collected data on consecutive patients undergoing lung resection for primary lung cancer between April 2012 and June 2014 at a regional referral center in the United Kingdom...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29351330/use-of-influenza-antivirals-in-patients-hospitalized-in-hong-kong-2000-2015
#3
Benjamin J Cowling, Celine S L Chui, Wey Wen Lim, Peng Wu, Christopher K M Hui, J S Malik Peiris, Esther W Chan
OBJECTIVES: We aimed to describe patterns in the usage of antivirals to treat influenza virus infection in hospitals in Hong Kong from 2000 through 2015. METHODS: We analyzed centralized electronic health records that included dispensation information and diagnosis codes. Information collected on admissions included patient age, sex, admission year and month, and medications dispensed, and were matched with the first 15 discharge diagnosis codes. We divided monthly admission episodes by relevant population denominators to obtain admission rates, and stratified analyses by drug type, age group, and diagnosis codes...
2018: PloS One
https://www.readbyqxmd.com/read/29350375/neurological-recovery-after-traumatic-cauda-equina-syndrome-due-to-glass-fragments-an-unusual-case
#4
Mehmet Şenoğlu, Ali Karadağ, Çağlar Türk, Füsun Demirçivi Özer
Penetrating spinal injuries with foreign bodies are exceedingly rare. To date, pathological problems due to glass fragments in the spinal canal have rarely been reported. In this report, the case presenting with a back laceration, leg pain, and leg weakness was found to have glass frag-ments in the spinal canal at the L2-L3 level by lumbar computed tomography and magnetic resonance imaging. After L2 total laminectomy and retrieval of the glass fragments, the dura was re-paired. The patient was discharged from the hospital after complete neurological recovery...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29346633/intraoperative-epicardial-focal-pulmonary-venous-electrocardiography-in-patients-with-atrial-fibrillation
#5
Grzegorz Suwalski, Robert Emery, Jakub Mróz, Kamil Kaczejko, Leszek Gryszko, Andrzej Cwetsch, Andrzej Skrobowski
OBJECTIVES: In patients referred to off-pump coronary artery bypass grafting, pulmonary vein isolation (PVI) may be used for those with persistent atrial fibrillation (AF), an alternative to the Maze procedure. However, the success rate of PVI in persistent AF is limited. The study assesses the prognostic value of focal epicardial electrocardiography of the pulmonary veins (PVs) for surgical ablation results. METHODS: We mapped 140 PV in 35 cases undergoing off-pump coronary artery bypass grafting...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29346299/meteo-and-hydrodynamic-measurements-to-detect-physical-processes-in-confined-shallow-seas
#6
Francesca De Serio, Michele Mossa
Coastal sites with typical lagoon features are extremely vulnerable, often suffering from scarce circulation. Especially in the case of shallow basins subjected to strong anthropization and urban discharges, it is fundamental to monitor their hydrodynamics and water quality. The proper detection of events by high performance sensors and appropriate analysis of sensor signals has proved to be a necessary tool for local authorities and stakeholders, leading to early warning and preventive measures against environmental degradation and related hazards...
January 18, 2018: Sensors
https://www.readbyqxmd.com/read/29344471/a-6-month-old-girl-with-incontinentia-pigmenti-presenting-as-status-epilepticus
#7
Moon Young Seo, Su Jeong You, Soung Hee Kim, Woo Ho Cho, Jong Hee Chae
Incontinentia pigmenti (IP) is an uncommon neurocutaneous syndrome. Its initial diagnosis is based primarily on characteristic papulovesicular skin lesions and early-onset neonatal seizures. In contrast to typical early neurologic manifestations, we encountered a normally developed 6-month-old female patient with hyperpigmented whorls on her body. Following respiratory syncytial virus infection and fever, the patient exhibited status epilepticus. Brain magnetic resonance imaging studies of the patient were compatible with the findings of acute encephalopathy in IP...
December 2017: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/29344183/a-patient-with-chronic-myeloid-leukemia-and-situs-inversus-totalis-a-case-report
#8
Yunxia Sun, Xiaoli Li, Lijun Li, Huan Liu, Qian Xu, Bei Liu
In the present study, a case of chronic myeloid leukemia (CML) with complete situs inversus in a 68-year-old female patient was reported. The patient presented with general weakness, abdominal distension and tenderness in the right hypochondrium. A chest X-ray revealed a right-sided heart. Ultrasonography revealed situs inversus totalis. A bone marrow smear demonstrated CML in the accelerated phase. Imatinib mesylate was subsequently administered; the patient stopped taking imatinib mesylate following discharge from the hospital...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29343479/postsurgical-prescriptions-for-opioid-naive-patients-and-association-with-overdose-and-misuse-retrospective-cohort-study
#9
Gabriel A Brat, Denis Agniel, Andrew Beam, Brian Yorkgitis, Mark Bicket, Mark Homer, Kathe P Fox, Daniel B Knecht, Cheryl N McMahill-Walraven, Nathan Palmer, Isaac Kohane
OBJECTIVE: To quantify the effects of varying opioid prescribing patterns after surgery on dependence, overdose, or abuse in an opioid naive population. DESIGN: Retrospective cohort study. SETTING: Surgical claims from a linked medical and pharmacy administrative database of 37 651 619 commercially insured patients between 2008 and 2016. PARTICIPANTS: 1 015 116 opioid naive patients undergoing surgery. MAIN OUTCOME MEASURES: Use of oral opioids after discharge as defined by refills and total dosage and duration of use...
January 17, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29340818/changes-in-plasma-albumin-levels-in-early-detection-of-infectious-complications-after-laparoscopic-colorectal-cancer-surgery-with-eras-protocol
#10
Mateusz Wierdak, Magdalena Pisarska, Beata Kuśnierz-Cabala, Jan Witowski, Jadwiga Dworak, Piotr Major, Piotr Małczak, Piotr Ceranowicz, Andrzej Budzyński, Michał Pędziwiatr
BACKGROUND: Combination of laparoscopic approach with ERAS protocol in colorectal surgery allows for an early discharge. However there is a risk that some of the discharged patients are developing, asymptomatic at the time, infectious complications. This may lead to a delay in diagnostics and proper treatment introduction. We aimed to assess the usefulness of preoperative plasma albumin concentration and their changes as indicators of infectious complications in patients undergoing colorectal cancer surgery...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340723/veno-venous-extracorporeal-membrane-oxygenation-vv-ecmo-for-acute-respiratory-failure-following-injury-outcomes-in-a-high-volume-adult-trauma-center-with-a-dedicated-unit-for-vv-ecmo
#11
Jay Menaker, Ronald B Tesoriero, Ali Tabatabai, Ronald P Rabinowitz, Christopher Cornachione, Terence Lonergan, Katelyn Dolly, Raymond Rector, James V O'Connor, Deborah M Stein, Thomas M Scalea
INTRODUCTION: The use of veno-venous extracorporeal membrane oxygenation (VV ECMO) has increased over the past decade. The purpose of this study was to evaluate outcomes in adult trauma patients requiring VV ECMO. METHODS: Data were collected on adult trauma patients admitted between January 1, 2015, and November 1, 2016. Demographics, injury-specific data, ECMO data, and survival to discharge were recorded. Medians [interquartile range (IQR)] were reported. A p value ≤0...
January 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29340624/early-and-long-term-outcomes-of-mitral-valve-repair-for-barlow-s-disease-a-single-centre-16-year-experience
#12
Anton Tomšic, Yasmine L Hiemstra, Stephanie L van der Pas, Hein Putter, Michel I M Versteegh, Thomas J van Brakel, Nina Ajmone Marsan, Robert J M Klautz, Meindert Palmen
OBJECTIVES: Following mitral valve repair for Barlow's disease, recurrent mitral regurgitation (MR) is believed to occur frequently and is mainly attributed to disease progression. METHODS: Between January 2000 and December 2015, 180 patients (40% women, mean age 58.7 ± 13.5 years) with Barlow's disease underwent mitral valve repair. To provide a longitudinal assessment of mitral valve repair durability, a multistate model for interval-censored observations (4 states: 1, Grade 0/1+ MR; 2, Grade 2+ MR; 3, Grade 3+/4+ MR; 4, reintervention/death) was developed...
January 10, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29336360/early-neurological-deterioration-after-recanalization-treatment-in-patients-with-acute-ischemic-stroke-a-retrospective-study
#13
Ying-Bo Zhang, Ying-Ying Su, Yan-Bo He, Yi-Fei Liu, Gang Liu, Lin-Lin Fan
BACKGROUND: Early neurological deterioration (END) is a prominent issue after recanalization treatment. However, few studies have reported the characteristics of END after endovascular treatment (EVT) as so far. This study investigated the incidence, composition, and outcomes of END after intravenous recombinant tissue plasminogen activator (IV rt-PA) and EVT of acute ischemic stroke, and identified risk factors for END. METHODS: Medical records of patients who received recanalization treatment between January 1, 2014, and December 31, 2015 were reviewed...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29335822/emergency-department-throughput-an-intervention
#14
Nowreen Haq, Rona Stewart-Corral, Eric Hamrock, Jamie Perin, Waseem Khaliq
Shortening emergency department (ED) boarding time and managing hospital bed capacity by expediting the inpatient discharge process have been challenging for hospitals nationwide. The objective of this study is was to explore the effect of an innovative prospective intervention on hospital workflow, specifically on early inpatient discharges and the ED boarding time. The intervention consisted of a structured nursing "admission discharge transfer" (ADT) protocol receiving new admissions from the ED and helping out floor nursing with early discharges...
January 15, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29335472/provided-support-caregiver-burden-and-well-being-in-partners-of-persons-with-spinal-cord-injury-5-years-after-discharge-from-first-inpatient-rehabilitation
#15
Eline W M Scholten, Anneroos Kieftenbelt, Chantal F Hillebregt, Sonja de Groot, Marjolijn Ketelaar, Johanna M A Visser-Meily, Marcel W M Post
STUDY DESIGN: Cross-sectional study. OBJECTIVES: To describe type and regularity of support given by partners for individuals with paraplegia versus tetraplegia 5 years after discharge from first inpatient rehabilitation; to describe perceived caregiver burden, mental health and life satisfaction among partners; and to analyse determinants of perceived burden and the partner's mental health and life satisfaction. SETTING: The Netherlands. METHODS: Participants were partners of persons with spinal cord injury (SCI) 5 years after discharge from first inpatient rehabilitation (N = 67)...
January 16, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29334903/a-rare-case-of-pericarditis-and-pleural-empyema-secondary-to-transdiaphragmatic-extension-of-pyogenic-liver-abscess
#16
Eunae Cho, Sang Woo Park, Chung Hwan Jun, Sang Soo Shin, Eun Kyu Park, Kyo Seon Lee, Seon Young Park, Chang Hwan Park, Hyun Soo Kim, Sung Kyu Choi, Jong Sun Rew
BACKGROUND: Transdiaphragmatic extension of pyogenic liver abscess is the rarest cause of pericarditis and pleural empyema. It is a rapidly progressive and highly lethal infection with mortality rates reaching 100% if left untreated. However, the transmission route, treatment methods and prognosis have not been well studied. CASE PRESENTATION: A 65-year-old male patient presented with a fever, dyspnea, and right upper quadrant abdominal pain. Computed tomography of the chest and abdomen showed huge liver abscess without full liquefaction in the left lobe, large amount of left pleural effusion, and mild pericardial effusion, and the patient was treated with parenteral antibiotics and pigtail insertion at the left pleura...
January 15, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29334273/the-barthel-index-and-the-cumulated-ambulation-score-are-superior-to-the-de-morton-mobility-index-for-the-early-assessment-of-outcome-in-patients-with-a-hip-fracture-admitted-to-an-acute-geriatric-ward
#17
Signe Hulsbæk, Rikke Faebo Larsen, Susanne Rosthøj, Morten Tange Kristensen
PURPOSE: To examine clinimetric properties of the de Morton Mobility Index (DEMMI) in patients with hip fracture in comparison with the modified Barthel Index (BI), Cumulated Ambulation Score (CAS), and 30-s Chair Stand Test (30-s CST). MATERIALS AND METHODS: Two hundred and twenty two patients with a hip fracture admitted to a geriatric ward following surgery were assessed on day 1 and at discharge (mean of 9 [SD 5.1] post-surgery days). RESULTS: Ninety eight percent and 89% of patients were not able to perform the 30-s CST at baseline and at discharge (large floor effect), respectively...
January 15, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#18
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29327310/c-reactive-protein-on-postoperative-day-1-is-a-reliable-predictor-of-pancreas-specific-complications-after-pancreaticoduodenectomy
#19
Théophile Guilbaud, David Jérémie Birnbaum, Coralie Lemoine, Mircea Chirica, Olivier Risse, Stéphane Berdah, Edouard Girard, Vincent Moutardier
BACKGROUND: Postoperative pancreatic fistula and pancreas-specific complications have a significant influence on patient management and outcomes after pancreatoduodenectomy. The aim of the study was to assess the value of serum C-reactive protein on the postoperative day 1 as early predictor of pancreatic fistula and pancreas-specific complications. METHODS: Between 2013 and 2016, 110 patients underwent pancreaticoduodenectomy. Clinical, biological, intraoperative, and pathological characteristics were prospectively recorded...
January 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29327197/-new-kidney-function-tests-renal-functional-reserve-and-furosemide-stress-test
#20
REVIEW
D Kindgen-Milles, T Slowinski, T Dimski
Acute kidney injury (AKI) occurs in 30-50% of all intensive care patients. Renal replacement therapy (RRT) has to be initiated in 10-15%. The early in-hospital mortality is about 50%. Up to 20% of all survivors develop chronic kidney disease after intensive care discharge and progress to end-stage kidney disease within the next 10 years. For timely initiation of prophylactic or therapeutic interventions, it is crucial to exactly determine the actual kidney function, i. e., glomerular filtration rate (GFR), and to gain insight into the further development of kidney function...
January 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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