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Surgical, clinical practice guidelines

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https://www.readbyqxmd.com/read/28224190/what-is-a-periprosthetic-shoulder-infection-a-systematic-review-of-two-decades-of-publications
#1
REVIEW
Jason E Hsu, Jeremy S Somerson, Kiet V Vo, Frederick A Matsen
PURPOSE: While as many as 50% of revision shoulder arthroplasties are culture positive, a consistent, clinically useful definition of a "periprosthetic shoulder infection" is lacking. We conducted a systematic review of the published literature with respect to (1) the definition of a "periprosthetic shoulder infection", (2) the pre-operative evaluation for possible infection, and (3) the harvesting and culturing of specimens at the time of surgical revision. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified 20 studies concerning infection at the time of revision shoulder arthroplasty...
February 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28220751/upper-extremity-sarcoma-impact-of-current-practice-guidelines-and-controversies-on-reconstructive-approaches
#2
Marek Dobke, Gina A Mackert
The goals of sarcoma management include both a cure and the functional preservation of involved tissues and adjacent critical structures with common opinions favoring immediate reconstruction. The question arises whether these goals are contradictory. This paper discusses the question based on the experience of 28 patients with different types of extremity sarcoma, with 24 surgically treated by the University of California San Diego (UCSD) orthopedic and plastic surgery team (2011-2016) and the collection of evidence from published practice guidelines, reviews, case studies, and clinical trials...
2017: SICOT-J
https://www.readbyqxmd.com/read/28215487/executive-summary-of-management-of-prosthetic-joint-infections-clinical-practice-guidelines-by-the-spanish-society-of-infectious-diseases-and-clinical-microbiology-seimc
#3
Javier Ariza, Javier Cobo, Josu Baraia-Etxaburu, Natividad de Benito, Guillermo Bori, Javier Cabo, Pablo Corona, Jaime Esteban, Juan Pablo Horcajada, Jaime Lora-Tamayo, Oscar Murillo, Julián Palomino, Jorge Parra, Carlos Pigrau, José Luis Del Pozo, Melchor Riera, Dolores Rodríguez, Mar Sánchez-Somolinos, Alex Soriano, M Dolores Del Toro, Basilio de la Torre
The incidence of prosthetic joint infection (PJI) is expected to increase in the coming years. PJI has serious consequences for patients, and high costs for the health system. The complexity of these infections makes it necessary to organize the vast quantity of information published in the last several years. The indications for the choice of a given surgical strategy and the corresponding antimicrobial therapy are specifically reviewed. The authors selected clinically relevant questions and then reviewed the available literature in order to give recommendations according to a pre-determined level of scientific evidence...
February 16, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28213925/rotator-cuff-disease-opinion-regarding-surgical-criteria-and-likely-outcome
#4
Alison Thorpe, Mark Hurworth, Peter O'Sullivan, Tim Mitchell, Anne Smith
BACKGROUND: Clinical guidelines for the management of rotator cuff disease are not clear. Surgeon surveys in the USA and UK lack agreement regarding surgical indications. Physical examination tests aid surgical decision-making but also lack robust evidence. Study aims were to evaluate: Western Australian orthopaedic surgeons' perceptions about surgical indications; utility of physical examination tests; findings at surgery predictive of outcome and surgeon opinion of a successful surgical outcome...
February 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28212161/hearing-impairment-and-the-amelioration-of-avoidable-medical-error-a-cross-sectional-survey
#5
Patrick Henn, Colm OʼTuathaigh, Darrelle Keegan, Simon Smith
OBJECTIVES: Hearing loss contributes to suboptimal medical treatment. We investigated the nature and magnitude of potential health-care harm of hearing loss alone on a patient's understanding of medical consultations, investigations, and treatments of health conditions unrelated to their hearing loss. METHODS: A cross-sectional, questionnaire-based design of a convenience sample of students with hearing loss, registered with the institutional disability support service in 8 Irish and 15 UK third-level institutions...
February 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28193298/does-drug-induced-sleep-endoscopy-change-the-surgical-decision-in-surgically-na%C3%A3-ve-non-syndromic-children-with-snoring-sleep-disordered-breathing-from-the-standard-adenotonsillectomy-a-retrospective-cohort-study
#6
Malak Jamal Gazzaz, André Isaac, Scott Anderson, Noura Alsufyani, Yaser Alrajhi, Hamdy El-Hakim
BACKGROUND: Adenotonsillectomy is the most commonly performed operation for pediatric snoring/sleep disordered breathing (S/SDB). However, 20-40% of patients will fail to improve. Drug-induced sleep endoscopy (DISE) may provide a more individualized surgical plan and limit unsuccessful surgeries. The aim of this study was to assess the impact of DISE on surgical decision-making in surgically naïve children with S/SDB. METHODS: A retrospective observational cohort study was undertaken at the Stollery Children's Hospital...
February 13, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28188188/locally-advanced-colon-cancer-evaluation-of-current-clinical-practice-and-treatment-outcomes-at-the-population-level
#7
Charlotte E L Klaver, Lieke Gietelink, Willem A Bemelman, Michel W J M Wouters, Theo Wiggers, Rob A E M Tollenaar, Pieter J Tanis
Background: The goal of this study was to evaluate current clinical practice and treatment outcomes regarding locally advanced colon cancer (LACC) at the population level. Methods: Data were used from the Dutch Surgical Colorectal Audit from 2009 to 2014. A total of 34,527 patients underwent resection for non-LACC and 6,918 for LACC, which was defined as cT4 and/or pT4 stage. LACC was divided into those with multivisceral resection (LACC-MV; n=3,385) and without (LACC-noMV; n=1,595). Guideline adherence, treatment strategy, and short-term outcomes were evaluated...
February 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28182589/bicuspid-aortic-valve-aortopathy-mechanistic-and-clinical-insights-from-recent-studies
#8
David G Guzzardi, Subodh Verma, Paul W M Fedak
PURPOSE OF REVIEW: This focused review summarizes key insights from the past 12 months of basic science and clinical research on bicuspid aortic valve (BAV)-associated aortopathy. RECENT FINDINGS: Recent studies in BAV-associated aortopathy support a heterogeneous spectrum of disease with distinct phenotypes. Basic science studies provide further support for the concept of regional differences in the severity of aortopathy within the aorta of BAV patients. Clinical studies compared outcomes of BAV patients after isolated aortic valve replacement and showed that those with primarily valvular insufficiency as compared with stenosis may be at greater risk for important aortic events over time...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28181818/recommendations-for-the-management-of-adrenal-incidentalomas-what-is-pertinent-for-radiologists
#9
Anju Sahdev
Adrenal incidentalomas are unsuspected, asymptomatic adrenal masses detected on imaging. Most are non-functioning benign adrenocortical adenomas, but can represent other benign lesions or lesions requiring therapeutic intervention including adrenocortical carcinoma, pheochromocytoma, hormone-producing adenoma or metastasis. This review summarises and highlights radiological recommendations within the recently issued guidelines for the management of adrenal incidentalomas from European Society of Endocrinology Clinical Practice in collaboration with European Network for Study of Adrenal Tumours...
February 9, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28173790/dcis-and-axillary-nodal-evaluation-compliance-with-national-guidelines
#10
Katrina B Mitchell, Heather Lin, Yu Shen, Alfred Colfry, Henry Kuerer, Simona F Shaitelman, Gildy V Babiera, Isabelle Bedrosian
BACKGROUND: The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) provide guidelines regarding axillary nodal evaluation in ductal carcinoma in situ (DCIS), but data regarding national compliance with these guidelines remains incomplete. METHODS: We conducted a retrospective review of the National Cancer Data Base (NCDB) analyzing all surgical approaches to axillary evaluation in patients with DCIS. Logistic regression analysis was used to assess the multivariate relationship between patient demographics, clinical characteristics, and probability of axillary evaluation...
February 7, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28168953/stroke-disclosing-primary-aldosteronism-report-on-three-cases-and-review-of-the-literature
#11
Amina Nasri, Malek Mansour, Zeineb Brahem, Amel Kacem, Ahmed Abou Hassan, Hager Derbali, Meriem Messelmani, Jamel Zaouali, Ridha Mrissa
OBJECTIVES: There is a growing evidence of increased risk of cerebrovascular events in primary aldosteronism (PA). Nevertheless, acute neurologic ailment as presenting feature of PA is uncommon. Our aim is to highlight the diagnosis challenges in stroke unmasking PA and to discuss the underlying physiopathology and management dilemmas. MATERIALS AND METHODS: We hereby describe three consecutive rare cases of stroke revealing PA. All patients had brain imaging and thorough biological and morphological assessment to rule out other etiologies of stroke...
February 3, 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/28165791/improving-documentation-in-surgical-operation-notes
#12
Hammad Parwaiz, Rushan Perera, John Creamer, Hamish Macdonald, Ian Hunter
BACKGROUND: Accurate documentation in surgical operation notes is crucial in facilitating the postoperative care of surgical patients and forms an important medicolegal document. This study audited the quality and completeness of documentation in surgical operation notes at a single district general hospital against the Royal College of Surgeons (2014) Good Surgical Practice guidelines, and looked to improve clinical practice through improved compliance with these guidelines. METHOD: A total of 101 operation notes were audited from a variety of surgical specialities in November 2014 (cycle 1) and 100 notes in May 2015 (cycle 2)...
February 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28164291/surgical-or-medical-interventions-for-female-genital-mutilation
#13
Helen Smith, Karin Stein
Deinfibulation can prevent or treat gynecological and obstetric complications in women living with type III female genital mutilation (FGM), and subsequently improve childbirth outcomes. Recently published WHO guidelines recommend use of deinfibulation in both circumstances. However, to really impact practice, evidence-based guidance needs to be matched with evidence-based implementation strategies. This qualitative evidence synthesis provides information on the factors that facilitate or act as barriers to use of deinfibulation, and the context and conditions that are necessary for implementing the procedure, including healthcare providers' knowledge and experience, the service delivery environment, as well as broader health system contexts...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28159076/preventing-unplanned-perioperative-hypothermia-in-children
#14
Susan E Beedle, Amy Phillips, Shirley Wiggins, Leeza Struwe
Unplanned perioperative hypothermia is a common surgical risk. Unplanned hypothermia is defined as a body temperature below 36° C (96.8° F) during any phase of the perioperative period. Perioperative nurses at a Midwestern tertiary pediatric hospital developed an evidence-based clinical practice guideline (CPG) designed to maintain normothermia for the pediatric surgical population. This CPG outlined standard thermoregulation nursing interventions and required the consistent use of a temporal artery thermometer...
February 2017: AORN Journal
https://www.readbyqxmd.com/read/28156521/development-and-implementation-of-a-clinical-pathway-for-radiation-of-bone-metastases-on-a-palliative-radiation-oncology-service
#15
Joseph Killoran, Tracy A Balboni, Monica Shalini Krishnan, Allison Taylor, Neil E Martin
: 170 Background: Clinical pathways increase compliance with treatment guidelines and reduce in-hospital complications. Evidence around treatment of complicated bone metastases is increasingly nuanced and although ASTRO/ACR recommend single fraction radiation therapy for uncomplicated bone metastases, implementation is variable. We sought to determine the effects of a bone metastases-focused clinical pathway on the practice patterns of our institution's palliative radiation oncology service (SPRO), which sees 600 patients yearly and on a rotating basis, involves 23 physicians, 28 residents, 2 nurse practitioners, and 1 fellow...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152903/refining-the-use-of-an-electronic-medical-record-emr-to-define-and-implement-psychosocial-distress-screening-and-treatment
#16
(no author information available yet)
: 144 Background: All cancer patients experience some level of distress associated with cancer and its treatment at all stages of the disease. Psychological and social problems created or exacerbated by cancer cause additional suffering, weaken adherence to prescribed treatments and threaten patients' return to health." Health care providers often tend to under estimate psychological distress. Screening and early identification of distress promote improved management of symptoms, which facilitates medical care...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28150482/life-threatening-complications-after-ureteroscopy-for-urinary-stones-survey-and-revision-of-the-current-literature
#17
Luca Cindolo, Pietro Castellan, Giulia Primiceri, Andras Hoznek, Cecilia M Cracco, Cesare M Scoffone, Antonio Galfano, Giovanni Petralia, Michele DE Angelis, Filippo Annino, Emilio Malacasa, Luigi Cormio, Pietro Acquati, Elisa DE Lorenzis, Orazio Maugeri, Giuseppe Arena, Antonio Celia, Guido Giusti, Luigi Schips
Retrograde ureteroscopy (URS) has become a common procedure for the management of urinary stones. Although its efficacy and safety are well known, the literature about major complications is still poor. This study highlighted some cases of life-threatening complications after semirigid ureteroscopy (s-URS) or flexible ureteroscopy (f-URS). We enrolled experienced endourologists (more than 75 cases/year in the last 3 years) and we performed a survey asking to review their series and report the cases encumbered by major complications (Clavien-Dindo IIIb-IV grade)...
February 1, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28145848/clinical-practice-guideline-improving-nasal-form-and-function-after-rhinoplasty-executive-summary
#18
Lisa E Ishii, Travis T Tollefson, Gregory J Basura, Richard M Rosenfeld, Peter J Abramson, Scott R Chaiet, Kara S Davis, Karl Doghramji, Edward H Farrior, Sandra A Finestone, Stacey L Ishman, Robert X Murphy, John G Park, Michael Setzen, Deborah J Strike, Sandra A Walsh, Jeremy P Warner, Lorraine C Nnacheta
Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28145847/plain-language-summary-improving-nasal-form-and-function-after-rhinoplasty
#19
Lisa E Ishii, Sarah S O'Connor, Deborah J Strike, Sandra A Walsh
This plain language summary serves as an overview in explaining rhinoplasty and to aid patients and clinicians in their discussion of expectations, planning care, and improving surgical outcomes. The summary applies to patients 15 years of age and older and is based on the 2017 "Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty." The evidence-based guideline includes research to support effective identification and treatment of rhinoplasty candidates. The guideline was developed as a quality improvement opportunity for pre- and postoperative management of rhinoplasty patients by creating clear recommendations to use in medical practice...
February 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28145823/clinical-practice-guideline-improving-nasal-form-and-function-after-rhinoplasty
#20
Lisa E Ishii, Travis T Tollefson, Gregory J Basura, Richard M Rosenfeld, Peter J Abramson, Scott R Chaiet, Kara S Davis, Karl Doghramji, Edward H Farrior, Sandra A Finestone, Stacey L Ishman, Robert X Murphy, John G Park, Michael Setzen, Deborah J Strike, Sandra A Walsh, Jeremy P Warner, Lorraine C Nnacheta
Objective Rhinoplasty, a surgical procedure that alters the shape or appearance of the nose while preserving or enhancing the nasal airway, ranks among the most commonly performed cosmetic procedures in the United States, with >200,000 procedures reported in 2014. While it is difficult to calculate the exact economic burden incurred by rhinoplasty patients following surgery with or without complications, the average rhinoplasty procedure typically exceeds $4000. The costs incurred due to complications, infections, or revision surgery may include the cost of long-term antibiotics, hospitalization, or lost revenue from hours/days of missed work...
February 2017: Otolaryngology—Head and Neck Surgery
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