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"Acute care surgery"

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https://www.readbyqxmd.com/read/28465716/acute-care-surgery-a-means-for-providing-cost-effective-quality-care-for-gallstone-pancreatitis
#1
Patrick B Murphy, Dave Paskar, Richard Hilsden, Jennifer Koichopolos, Tina S Mele
BACKGROUND: Modern practice guidelines recommend index cholecystectomy (IC) for patients admitted with gallstone pancreatitis (GSP). However, this benchmark has been difficult to widely achieve. Previous work has demonstrated that dedicated acute care surgery (ACS) services can facilitate IC. However, the associated financial costs and economic effectiveness of this intervention are unknown and represent potential barriers to ACS adoption. We investigated the impact of an ACS service at two hospitals before and after implementation on cost effectiveness, patient quality-adjusted life years (QALY) and impact on rates of IC...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28452889/surgical-management-of-pancreatic-necrosis-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#2
Nathan T Mowery, Brandon R Bruns, Heather MacNew, Suresh Agarwal, Toby Enniss, Mansoor Khan, Weidun Alan Guo, Jeremy W Cannon, Matthew Lissauer, Therese M Duane, Amy N Hildreth, Peter Pappas, Lynn Gries, Meghann Kaiser, Bryce Robinson
BACKGROUND: Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. METHODS: A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28450134/variability-in-integrated-cardiothoracic-training-program-curriculum
#3
Elizabeth H Stephens, Dustin M Walters, Amanda L Eilers, Vakhtang Tchantchaleishvili, Andrew B Goldstone, Erin A Gillaspie, Amy Fiedler, Damien J LaPar
BACKGROUND: Development of curricula that appropriately progress a resident from medical school graduate to fully trained cardiothoracic surgeon is a key challenge for integrated cardiothoracic training programs. This study examined variability and perceived challenges in integrated curricula. METHODS: Responses to the 2016 TSDA/TSRA survey that accompanies the annual in-training exam taken by current cardiothoracic surgery residents were analyzed. Standard statistical methods were utilized to examine trends in participant responses...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28444405/focus-on-acute-care-surgery
#4
EDITORIAL
F J Turégano
No abstract text is available yet for this article.
April 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28427944/creating-a-global-acute-care-surgery-fellowship-to-meet-international-need
#5
Amina I Merchant, Camila B Walters, Julie Valenzuela, Kelly A McQueen, Addison K May
INTRODUCTION: Existing Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity...
April 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28342097/a-systematic-review-of-propensity-score-methods-in-the-acute-care-surgery-literature-avoiding-the-pitfalls-and-proposing-a-set-of-reporting-guidelines
#6
T L Zakrison, P C Austin, V A McCredie
BACKGROUND: Propensity score methods are techniques commonly employed in observational research to account for confounding when estimating the effects of treatments and exposures. These methods have been increasingly employed in the acute care surgery literature in an attempt to infer causality; however, the adequacy of reporting and the appropriateness of statistical analyses when using propensity score matching remain unclear. OBJECTIVES: The goal of this systematic review is to assess the adequacy of reporting of propensity score methods, with an emphasis on propensity score matching (to assess balance and the use of appropriate statistical tests), in acute care surgery (ACS) studies and to provide suggestions for improvement for junior investigators...
March 24, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#7
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28328684/eastern-association-for-the-surgery-of-trauma-society-of-trauma-nurses-advanced-practitioner-position-paper-optimizing-the-integration-of-advanced-practitioners-in-trauma-and-critical-care
#8
Jonathan Messing, Jasmine Garces-King, Dennis Taylor, Jonathan Van Horn, Babak Sarani, A Britton Christmas
Nurse Practitioners and Physician Assistants, collectively known as advanced practitioners (APs), enhance the provision of care for the acutely injured patient. Despite their prevalence, institutions employ, train, and utilize these providers with significant variability. The Eastern Association for the Surgery of Trauma (EAST), the Society of Trauma Nurses (STN), and the American Association of Surgical Physicians Assistants (AASPA) acknowledge the value of APs and support their utilization in the management of injured and critically ill patients...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28258628/intracorporeal-anastomoses-in-emergency-laparoscopic-colorectal-surgery-from-a-series-of-59-cases-where-and-how-to-do-it-a-technical-note
#9
Salomone Di Saverio, Arianna Birindelli, Matteo Mandrioli, Mauro Podda, Gian Andrea Binda
BACKGROUND: Laparoscopy offers the benefits of minimally invasive surgery and faster recovery. Acute surgical patients may potentially benefit from the greatest advantages of emergency laparoscopy, even more clinically relevant in acute rather than elective patients. Fashioning a laparoscopic intra-corporeal anastomosis (ICA) after emergent colorectal resection, whenever technically feasible and non-contraindicated for the patients' general and hemodynamic condition, represents the most challenging technical skill to be learned...
March 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28121678/greater-mortality-after-emergency-laparotomy-in-the-united-kingdom-compared-with-united-states-a-window-into-the-quality-of-acute-care-surgery-in-the-united-states
#10
John R Bergquist, Cornelius A Thiels, Joseph A Hyder, Martin D Zielinski
No abstract text is available yet for this article.
January 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28045742/management-of-anticoagulation-with-rivaroxaban-in-trauma-and-acute-care-surgery-complications-and-reversal-strategies-as-compared-to-warfarin-therapy
#11
Sara P Myers, Esmaeel R Dadashzadeh, Jessica Cheung, Louis Alarcon, Matthew Kutcher, Joshua B Brown, Matthew D Neal
BACKGROUND: Rivaroxaban has gained popularity as an anticoagulant (AC) for stroke prevention in nonvalvular atrial fibrillation (afib) and venous thromboembolism (VTE). Although adverse bleeding events are associated with all AC, lack of point-of-care testing to measure the effect of rivaroxaban in emergent situations has contributed to perceived increased risk among physicians. METHODS: This study aims to describe a single-center experience with trauma and emergency general surgery (EGS) patients taking rivaroxaban and evaluate outcomes compared with patients taking warfarin using a propensity score analysis...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28045741/is-your-graduating-general-surgery-resident-qualified-to-take-trauma-call-a-15-year-appraisal-of-the-changes-in-general-surgery-education-for-trauma
#12
Aaron Strumwasser, Daniel Grabo, Kenji Inaba, Kazuhide Matsushima, Damon Clark, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: Trauma training in general surgery residency is undergoing an evolution. Hour restrictions, the growth of subspecialty care, and the trend toward nonoperative management have altered resident exposure to operative trauma. We sought to identify trends in resident trauma training since the inception of the 80-hour workweek. METHODS: The Accreditation Council for General Medical Education Case Log Statistical Reports for Surgery was abstracted for general surgery resident trauma operative volume for the years 1999-2014...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28009772/acute-kidney-injury-following-exploratory-laparotomy-and-temporary-abdominal-closure
#13
Tyler J Loftus, Azra Bihorac, Tezcan Ozrazgat-Baslanti, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Acute kidney injury (AKI) following exploratory laparotomy and temporary abdominal closure (TAC) is poorly understood but clinically significant. We hypothesized that the prevalence of AKI would be highest 96 hours following TAC, early hypoxemia would predict AKI, and that AKI would be an independent predictor of mortality. METHODS: We performed a retrospective analysis of 251 acute care surgery patients managed with TAC by negative pressure wound therapy (NPWT)...
December 22, 2016: Shock
https://www.readbyqxmd.com/read/27932029/implementing-a-resident-acute-care-surgery-service-improving-resident-education-and-patient-care
#14
Olga Kantor, Andrew B Schneider, Marko Rojnica, Andrew J Benjamin, Nancy Schindler, Mitchell C Posner, Jeffrey B Matthews, Kevin K Roggin
BACKGROUND: To simulate the duties and responsibilities of an attending surgeon and allow senior residents more intraoperative and perioperative autonomy, our program created a new resident acute care surgery consult service. METHODS: We structured resident acute care surgery as a new admitting and inpatient consult service managed by chief and senior residents with attending supervision. When appropriate, the chief resident served as a teaching assistant in the operation...
March 2017: Surgery
https://www.readbyqxmd.com/read/27916358/transfer-of-acute-care-surgery-patients-in-a-rural-state-a-concerning-trend
#15
Brittany Misercola, Kristen Sihler, Molly Douglas, Stephen Ranney, Jonathan Dreifus
BACKGROUND: Regionalized care of complex patients to larger hospitals is an increasingly common practice as the population ages and the physician shortage evolves. The Acute Care Surgery model is new, and there are limited data on the patients being transferred through this system. We hypothesized transfer patients would be older, more complex, and require additional resources. MATERIALS AND METHODS: Retrospective chart review of Acute Care Surgery patients admitted to a single tertiary facility...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27900227/urachal-cyst-causing-small-bowel-obstruction-in-an-adult-with-a-virgin-abdomen
#16
Michael P O'Leary, Zane W Ashman, David S Plurad, Dennis Y Kim
Introduction. A patent urachus is a rare congenital or acquired pathology, which can lead to complications later in life. We describe a case of urachal cystitis as the etiology of small bowel obstruction in an adult without prior intra-abdominal surgery. Case Report. A 64-year-old male presented to the acute care surgery team with a 5-day history of right lower quadrant abdominal pain, distention, nausea, and vomiting. He had a two-month history of urinary retention and his past medical history was significant for benign prostate hyperplasia...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27893639/surgical-rescue-the-next-pillar-of-acute-care-surgery
#17
Matthew E Kutcher, Jason L Sperry, Matthew R Rosengart, Deepika Mohan, Marcus K Hoffman, Matthew D Neal, Louis H Alarcon, Gregory A Watson, Juan Carlos Puyana, Graciela M Bauzá, Vaishali D Schuchert, Anisleidy Fombona, Tianhua Zhou, Samuel J Zolin, Robert D Becher, Timothy R Billiar, Raquel M Forsythe, Brian S Zuckerbraun, Andrew B Peitzman
BACKGROUND: The evolving field of acute care surgery (ACS) traditionally includes trauma, emergency general surgery, and critical care. However, the critical role of ACS in the rescue of patients with a surgical complication has not been explored. We here describe the role of "surgical rescue" in the practice of ACS. METHODS: A prospective, electronic medical record-based ACS registry spanning January 2013 to May 2014 at a large urban academic medical center was screened by ICD-9 codes for acute surgical complications of an operative or interventional procedure...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27830672/an-approach-to-complicated-diverticular-disease-a-retrospective-study-in-an-acute-care-surgery-service-recently-established
#18
Savino Occhionorelli, Monica Zese, Daniela Tartarini, Domenica Lacavalla, Stefano Maccatrozzo, Giacomo Groppo, Maria Grazia Sibilla, Rocco Stano, Lorenzo Cappellari, Giorgio Vasquez
AIM: Acute diverticulitis is a frequent disease in the Western Countries. The increase number of patients admitted in the Surgery Departments led the necessity of new Scores and Classifications in order to clarify, in absence of clear guidelines, the best treatments to offer in the different situations. METHODS: A retrospective study of ninety-nine patients treated in our Department from June 2010 and March 2015. RESULTS: In our study 41 patients were treated conservatively, the remaining 58 were operated, 56 laparotomic and 2 laparoscopic...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27828819/timely-surgical-care-for-acute-biliary-disease-an-indication-of-quality
#19
Patrick B Murphy, Kelly N Vogt, Tina S Mele, S Morad Hameed, Chad G Ball, Neil G Parry
No abstract text is available yet for this article.
December 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27816201/fast-track-pathway-for-perforated-appendicitis
#20
Richard Frazee, Stephen Abernathy, Matthew Davis, Travis Isbell, Justin Regner, Randall Smith
BACKGROUND: Perforated appendicitis is associated with an increased morbidity and length of stay. "Fast track" protocols have demonstrated success in shortening hospitalization without increasing morbidity for a variety of surgical processes. This study evaluates a fast track pathway for perforated appendicitis. METHODS: In 2013, a treatment pathway for perforated appendicitis was adopted by the Acute Care Surgery Service for patients having surgical management of perforated appendicitis...
April 2017: American Journal of Surgery
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