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Surgical, clinical practice guidelines

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https://www.readbyqxmd.com/read/28532515/what-do-we-know-about-assessing-healthcare-students-and-professionals-knowledge-attitude-and-practice-regarding-female-genital-mutilation-a-systematic-review
#1
REVIEW
Jasmine Abdulcadir, Lale Say, Christina Pallitto
INTRODUCTION: Improving healthcare providers' capacities of prevention and treatment of female genital mutilation (FGM) is important given the fact that 200 million women and girls globally are living with FGM. However, training programs are lacking and often not evaluated. Validated and standardized tools to assess providers' knowledge, attitude and practice (KAP) regarding FGM are lacking. Therefore, little evidence exists on the impact of training efforts on healthcare providers' KAP on FGM...
May 22, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28530481/hormone-replacement-therapy-in-pre-menopausal-women-undergoing-bilateral-salpingo-oophorectomy-for-benign-disease-a-review-of-practice
#2
Alison Richardson, Emily West, Mike Cust
Introduction The National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of the menopause states that women who are likely to go through the menopause as a result of surgical treatment should be offered information about the menopause and the importance of starting hormonal replacement therapy before they have their treatment. Objectives To determine compliance with NICE guidelines at the Royal Derby Hospital. Study design We undertook a retrospective review of all pre-menopausal women undergoing bilateral salpingo-oophorectomy for benign pathology between 1 January 2016 and 30 June 2016...
January 1, 2017: Post Reproductive Health
https://www.readbyqxmd.com/read/28526041/implementation-of-enhanced-recovery-after-surgery-a-strategy-to-transform-surgical-care-across-a-health-system
#3
Leah M Gramlich, Caroline E Sheppard, Tracy Wasylak, Loreen E Gilmour, Olle Ljungqvist, Carlota Basualdo-Hammond, Gregg Nelson
BACKGROUND: Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system...
May 19, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28516187/-the-aged-scalp-a-dermato-oncological-focus-point
#4
REVIEW
N Wroblewski, K Wylon, C Ulrich
Non-melanoma skin cancer and its precursor lesions are common diagnoses in dermatological practice, due to rising incidence and prevalence. Diagnosis is often clinical with subsequent histological confirmation. First-choice treatment for invasive carcinomas is complete surgical excision. Other therapeutic options, such as radiation or systemic therapies, should only be considered when excision is impossible. Mostly located on parts of the scalp that are poorly visible and accessible, particularly for elderly patients, these lesions are a challenge for physicians and patients alike...
May 17, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28515258/evolving-treatment-of-soft-tissue-sarcoma
#5
Suzanne George
Soft tissue sarcomas comprise multiple histologic subtypes, occur at a number of anatomic sites, and require individualized treatment. Over the past 5 years, 4 new drugs were approved for sarcoma, most of which are driven by histology or the anticipated response to treatment. Surgical resection remains the primary treatment for resectable tumors. For unresectable or metastatic disease, doxorubicin remains the backbone of chemotherapy, but other agents have improved on its single-agent efficacy. Chief among them is olaratumab, which, in combination with doxorubicin, is preferred over doxorubicin alone in the updated NCCN Clinical Practice Guidelines in Oncology for Soft Tissue Sarcoma...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28511976/fertility-pregnancy-and-prolactinoma-a-survey-of-pituitary-surgeons-view-and-review-of-the-literature
#6
Walter C Jean, Daniel R Felbaum
OBJECTIVE: Pituitary surgeons frequently encounter female prolactinoma patients seeking treatment to restore fertility. Current medical guidelines recommend using dopamine agonist (DA) for this, but for fetal safety, DA should stop upon pregnancy confirmation. The probability that prolactinoma may grow during pregnancy makes this last recommendation imperfect. With the advances in endoscopic surgery, we queried the potential role for surgery in these infertile patients, who may be ambivalent about both stopping and continuing DA while pregnant...
May 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28507731/patient-engagement-with-surgical-site-infection-prevention-an-expert-panel-perspective
#7
REVIEW
E Tartari, V Weterings, P Gastmeier, J Rodríguez Baño, A Widmer, J Kluytmans, A Voss
Despite remarkable developments in the use of surgical techniques, ergonomic advancements in the operating room, and implementation of bundles, surgical site infections (SSIs) remain a substantial burden, associated with increased morbidity, mortality and healthcare costs. National and international recommendations to prevent SSIs have been published, including recent guidelines by the World Health Organization, but implementation into clinical practice remains an unresolved issue. SSI improvement programs require an integrative approach with measures taken during the pre-, intra- and postoperative care from the numerous stakeholders involved...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#8
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28501114/evaluation-of-palliative-care-training-and-skills-retention-by-medical-students
#9
Priti P Parikh, Mary T White, Lynne Buckingham, Kathryn M Tchorz
BACKGROUND: Training in palliative and end-of-life care has been introduced in medical education; however, the impact of such training and the retention of skills and knowledge have not been studied in detail. This survey study examines long-term follow-up on end-of-life communication skills training, evaluation, and skills retention in medical students. MATERIALS AND METHODS: During the surgical clerkship, all third-year medical students received communication skills training in palliative care using simulated patients...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28488953/atypical-meningioma-referral-patterns-treatment-and-adherence-to-guidelines
#10
Majed Alghamdi, Haocheng Li, Ivo Olivotto, Jay Easaw, John Kelly, Robert Nordal, Gerald Lim
OBJECTIVE: To determine the referral rate to radiation oncologist (RO), use of postoperative radiotherapy (PORT) and the impact of a clinical practice guideline (CPG) on patients with atypical meningioma (AM). METHODS: A retrospective review of meningioma patients (n=526) treated between 2003 and 2013 was undertaken. Patients' characteristics, extent of surgical resection (EOR), RO referral, PORT, date and treatment of first recurrence were collected for all patients >18 years with a new diagnosis of AM after surgical resection (n=83)...
May 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28469043/prospective-evaluation-of-the-relationship-between-mechanical-stability-and-response-to-palliative-radiotherapy-for-symptomatic-spinal-metastases
#11
Joanne M van der Velden, Anne L Versteeg, Helena M Verkooijen, Charles G Fisher, Edward Chow, F Cumhur Oner, Marco van Vulpen, Lorna Weir, Jorrit-Jan Verlaan
BACKGROUND: A substantial number of patients with spinal metastases experience no treatment effect from palliative radiotherapy. Mechanical spinal instability, due to metastatic disease, could be associated with failed pain control following radiotherapy. This study investigates the relationship between the degree of spinal instability, as defined by the Spinal Instability Neoplastic Score (SINS), and response to radiotherapy in patients with symptomatic spinal metastases in a multi-institutional cohort...
May 3, 2017: Oncologist
https://www.readbyqxmd.com/read/28467526/centers-for-disease-control-and-prevention-guideline-for-the-prevention-of-surgical-site-infection-2017
#12
Sandra I Berríos-Torres, Craig A Umscheid, Dale W Bratzler, Brian Leas, Erin C Stone, Rachel R Kelz, Caroline E Reinke, Sherry Morgan, Joseph S Solomkin, John E Mazuski, E Patchen Dellinger, Kamal M F Itani, Elie F Berbari, John Segreti, Javad Parvizi, Joan Blanchard, George Allen, Jan A J W Kluytmans, Rodney Donlan, William P Schecter
Importance: The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies. Objective: To provide new and updated evidence-based recommendations for the prevention of SSI...
May 3, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28464569/-enhanced-recovery-after-surgery-for-the-gastrointestinal-surgery
#13
L Chen, K C Zhang, H Q Xi, B Wei
It has already been ten years since the concept of enhanced recovery after surgery (ERAS) was introduced in China. The ERAS protocol focuses on relieving surgical stress and accelerating physiological recovery. From our perspective, besides the post hospital stay, it would be better to evaluate patient's recovery by different indicators. It is important to improve the compliance of ERAS protocol. The guideline-related factors, administration, medical staff and patients have impact on compliance. Integrating stakeholders, strengthening communication and cooperation among multidiscipline teams, combining theory with practice would facilitate use of ERAS protocol in clinical settings...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28464217/oncoplastic-breast-surgery-achieving-oncological-and-aesthetic-outcomes
#14
Maaike W van Paridon, Parisa Kamali, Marek A Paul, Winona Wu, Ahmed M S Ibrahim, Kari J Kansal, Mary Jane Houlihan, Donald J Morris, Bernard T Lee, Samuel J Lin, Ranjna Sharma
BACKGROUND AND OBJECTIVES: Oncoplastic reconstruction allows more patients to become candidates for breast-conserving surgery (BCS). Oncologic resection of a breast lesion is combined with plastic surgical techniques to improve aesthetic results. Choosing the best oncoplastic method is essential to optimize outcomes, improve cosmesis, and minimize postoperative complications. The aim of this study is to present a treatment algorithm incorporating oncoplastic techniques based on diagnosis, tumor size, tumor location, and breast size and shape...
May 2, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28457173/a-survey-on-pulmonary-thromboendarterectomy-in-the-asia-pacific-region
#15
Mohammad Bashar Izzat, Farouk Almohammad, Ahmad F Raslan
Background Surgical pulmonary thromboendarterectomy has been established as the treatment of choice for chronic thromboembolic pulmonary hypertension. We conducted a survey among Asia-Pacific cardiothoracic surgeons to examine their current practice demographics and reflect their views on the future prospects for pulmonary thromboendarterectomy surgery. Methods All cardiothoracic surgeons who were registered on the CTSNet.org website and based in the Asia-Pacific region were invited to participate in an online survey...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28454611/inadvertent-perioperative-hypothermia-current-nursing-knowledge
#16
Karen K Giuliano, Jane Hendricks
Inadvertent perioperative hypothermia is estimated to affect 70% of surgical patients and is associated with adverse clinical outcomes, lengthened hospital stays, and increased costs. To better understand the current level of nursing knowledge on this subject since the release of the "Guideline for prevention of unplanned patient hypothermia," we conducted an e-mail survey of AORN members. The overall response rate was 6.5% (N = 324), and most responding nurses overestimated or underestimated the lower and upper limits for normothermia...
May 2017: AORN Journal
https://www.readbyqxmd.com/read/28452170/trends-in-the-surgical-management-of-stage-1-renal-cell-carcinoma-findings-from-a-population-based-study
#17
V White, D J T Marco, D Bolton, I D Davis, M Jefford, D Hill, H M Prince, J L Millar, I M Winship, M Coory, G G Giles
OBJECTIVES: To determine whether use of nephron sparing surgery (NSS) for treatment of stage 1 renal cell carcinomas changed between 2009 and end 2013 in Australia. PATIENTS AND METHODS: All adult cases of renal cell carcinoma diagnosed in 2009, 2012, and 2013 were identified through the population-based Victorian Cancer Registry. For each identified patient, trained data-abstractors attended treating hospitals or clinician rooms to extract tumour and treatment data through medical record review...
April 28, 2017: BJU International
https://www.readbyqxmd.com/read/28450309/decreasing-exposure-to-radiation-surgical-risk-and-costs-for-pediatric-complicated-pneumonia-a-guideline-evaluation
#18
Rachel D Quick, Michael J Auth, Marisol Fernandez, Tory Meyer, Kathryn G Merkel, Lynn M Thoreson, Sarmistha B Hauger
OBJECTIVES: This report describes the creation and successful implementation of a complicated pneumonia care algorithm at our institution. Outcomes are measured for specific goals of the algorithm: to decrease radiation exposure, surgical risk, and patient charges without adversely affecting clinical outcomes. METHODS: We describe steps involved in algorithm creation and implementation at our institution. To depict outcomes of the algorithm, we completed a retrospective cohort study of hospitalized pediatric patients with a diagnosis of complicated pneumonia at a single institution between January 2010 and April 2016 who met criteria for the algorithm...
April 27, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28447063/lymphadenectomy-how-to-do-it
#19
REVIEW
Simone Giacopuzzi, Maria Bencivenga, Chiara Cipollari, Jacopo Weindelmayer, Giovanni de Manzoni
According to the more recent European guidelines, the D2 lymphadenectomy is considered the standard for curative intent treatment of patients with gastric cancer. Although, the surgical definition of D2 dissection and its technical aspects had been learned from Eastern surgeons in the past decades, some variations in the approach to D2 lymphadenectomy by European surgeons were detectable in randomized clinical trials dealing with lymphadenectomy. Despite in more recent years an improvement in surgical quality has been reported in European series, some differences in the practice of D2 dissection are thought to persist...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28441255/european-society-of-gynaecological-oncology-guidelines-for-the-management-of-patients-with-vulvar-cancer
#20
Maaike H M Oonk, François Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brännström, Fabio Landoni, Sven Mahner, Umesh Mahantshetty, Mansoor Mirza, Cordula Petersen, Denis Querleu, Sigrid Regauer, Lukas Rob, Roman Rouzier, Elena Ulrikh, Jacobus van der Velden, Ignace Vergote, Linn Woelber, Ate G J van der Zee
OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe)...
May 2017: International Journal of Gynecological Cancer
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