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"Acute care surgery"

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https://www.readbyqxmd.com/read/27916358/transfer-of-acute-care-surgery-patients-in-a-rural-state-a-concerning-trend
#1
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
#2
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
#3
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 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 Acute Care Surgery (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...
November 23, 2016: 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
#4
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...
October 10, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27828819/timely-surgical-care-for-acute-biliary-disease-an-indication-of-quality
#5
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
#6
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...
October 20, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27805997/this-too-shall-pass-a-study-of-ingested-sharp-foreign-bodies
#7
Kirellos R Zamary, James W Davis, Emily E Ament, Rachel C Dirks, John E Garry
BACKGROUND: Gastrointestinal foreign body (GFB) ingestion is a common problem and often results in surgical consultation. Current literature is limited to case reports and fails to provide data regarding the management of sharp GFB ingestion. We hypothesized that patients who ingest sharp objects rarely have perforation or obstruction requiring surgical intervention. METHODS: Patients presenting with GFBs from 1/05-12/15 at a level 1 trauma center with an acute care surgery program were retrospectively reviewed...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27788918/comparison-of-outcomes-of-patients-with-acute-appendicitis-between-an-acute-care-surgery-model-and-traditional-call-coverage-model-in-the-same-community
#8
Shaina Schaetzel, Rachel Dirks, James Davis
BACKGROUND: This study compared outcomes, patient flow, and cost between an acute care surgery (ACS) and traditional call model (TRAD) for acute appendicitis in the same community and time period. METHODS: Patients who underwent appendectomy from 7/1/2012 to 6/30/2014 were retrospectively reviewed. An ACS and TRAD were compared. Demographic data, outcomes, cost, and time intervals were compared. RESULTS: Of the 945 patients reviewed, the ACS group had more perforated appendicitis on preoperative computed tomography scan (9% vs 3%, P < ...
October 3, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27779596/acute-care-surgery-fellowship-graduates-practice-patterns-the-additional-training-is-an-asset
#9
Clay Cothren Burlew, Kimberly A Davis, John J Fildes, Thomas J Esposito, Christopher J Dente, Gregory J Jurkovich
Over the past decade, the American Association for the Surgery of Trauma (AAST) Acute Care Surgery (ACS) fellowship program has matured to 20 verified programs. As part of an ongoing curricular evaluation, we queried the current practice patterns of the graduates of ACS fellowship programs regarding their view on their ACS training. Surveys were submitted by 56 of 77 graduates for a completion rate of 73%. While 93% of graduates practice in urban/suburban areas, there was a mixture of University, University-affiliated, and community institutions and an almost even division of level I and II designation...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27779594/international-rotations-a-valuable-source-to-supplement-operative-experience-for-acute-care-surgery-trauma-and-surgical-critical-care-fellows
#10
Paula Ferrada, Rao R Ivatury, David A Spain, Kimberly A Davis, Michel Aboutanos, John J Fildes, Thomas M Scalea
INTRODUCTION: Acute Care Surgery (ACS), Trauma and Surgical Critical Care (SCC) fellowships graduate fellows deemed qualified to perform complex cases immediately upon graduation. We hypothesize international fellow rotations (IFR) can be a resource to supplement operative case exposure METHODS: A survey was sent to all program directors of ACS and SCC fellowships via email. Data was captured and analyzed using the Research Electronic Data Capture (REDCap) tool. RESULTS: The survey was sent to 113 program directors (PDs) with a response rate of 42%...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27779592/improved-outcomes-following-implementation-of-an-acute-gastrointestinal-bleeding-multidisciplinary-protocol
#11
Tyler J Loftus, Kristina L Go, Steven J Hughes, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: Effective multidisciplinary management of gastrointestinal bleeding (GIB) requires effective communication. We instituted a protocol to standardize communication practices with the hypothesis that outcomes would improve following protocol initiation. METHODS: We performed a retrospective cohort analysis of 442 patients who required procedural management of acute GIB at our institution during a 50 month period spanning 25 months before and 25 months after implementation of a multidisciplinary communication protocol...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27634425/general-surgery-resident-rotations-in-surgical-critical-care-trauma-and-burns-what-is-optimal-for-residency-training
#12
Lena M Napolitano, Thomas W Biester, Gregory J Jurkovich, Jo Buyske, Mark A Malangoni, Frank R Lewis
BACKGROUND: There are no specific Accreditation Council for Graduate Medical Education General Surgery Residency Program Requirements for rotations in surgical critical care (SCC), trauma, and burn. We sought to determine the experience of general surgery residents in SCC, trauma, and burn rotations. METHODS: Data analysis of surgical rotations of American Board of Surgery general surgery resident applicants (n = 7,299) for the last 8 years (2006 to 2013, inclusive) was performed through electronic applications to the American Board of Surgery Qualifying Examination...
October 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27634424/acute-care-surgery-trauma-critical-care-emergency-general-surgery-%C3%A2-and-preventative-health
#13
Greg Hambright, Vaidehi Agrawal, Phillip L Sladek, Suzanne M Slonim, Michael S Truitt
BACKGROUND: Acute care surgeons (ACS) often care for patients with limited access to health care. They may not participate in preventative screenings and interventions (PSIs) such as mammography, colonoscopy, or pneumococcal vaccinations (VAs). We sought to identify barriers to compliance and determine if ACS have an opportunity to facilitate PSI participation. METHODS: All patients evaluated by an ACS were considered for inclusion in the study. Patients meeting national PSI inclusion criteria were enrolled...
August 3, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27621021/trends-in-open-vascular-surgery-for-trauma-implications-for-the-future-of-acute-care-surgery
#14
Joseph D Forrester, Thomas G Weiser, Paul Maggio, Timothy Browder, Lakshika Tennakoon, David Spain, Kristan Staudenmayer
BACKGROUND: Trauma patients with vascular injuries have historically been within a general surgeon's operative ability. Changes in training and decline in operative trauma have decreased trainees' exposure to these injuries. We sought to determine how frequently vascular procedures are performed at US trauma centers to quantify the need for general surgeons trained to manage vascular injuries. METHODS: We conducted a retrospective analysis of the National Trauma Data Base (NTDB) from 2012 compared with 2002...
September 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27616689/invited-commentary-on-acute-care-surgery-trauma-critical-care-egs-%C3%A2-and-preventative-health
#15
John Mayberry
No abstract text is available yet for this article.
August 17, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27580513/analysis-of-the-causes-of-surgery-related-medical-disputes-in-taiwan-need%C3%A2-for-acute-care-surgeons-to-improve-quality-of-care
#16
Yi-Hsuan Hu, Chien-Ying Wang, Mu-Shun Huang, Chen-Hsen Lee, Yi-Szu Wen
BACKGROUND: This study investigated surgery-related medical disputes and analyzed disease etiologies and the main causes of disputes in order to identify key points for the purpose of improving the quality of surgical patient care in Taiwan. METHODS: Reports on all surgery-related cases appraised by the Taiwan Witness Examiner Committee of the Department of Health between 2004 and 2008 were reviewed retrospectively by three senior physicians from the emergency department who specialize in both trauma and emergency general surgery...
August 28, 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/27555111/urine-intestinal-fatty-acid-binding-protein-predicts-acute-mesenteric-ischemia-in-patients
#17
Saad Y Salim, Pang Y Young, Thomas A Churchill, Rachel G Khadaroo
BACKGROUND: Acute mesenteric ischemia (AMI) has a high morbidity and mortality and often presents as a diagnostic challenge. Currently, there is no blood, urine, or radiologic tests that provide a definitive diagnosis of AMI. The aim of this study was to evaluate the clinical accuracy of urine intestinal fatty acid-binding protein (I-FABP) to diagnosis AMI. MATERIALS AND METHODS: Twenty patients referred to the Acute Care Surgery service at University of Alberta Hospital with suspected AMI taken to the operating room for definitive diagnosis were recruited...
July 16, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27552801/cerebral-perfusion-monitoring-in-acute-care-surgery-current-and-perspective-use
#18
Hsin-I Tsai, Peter Chi-Ho Chung, Chao-Wei Lee, Huang-Ping Yu
INTRODUCTION: The technology near infrared spectroscopy (NIRS) has been utilized extensively in several clinical settings and one of which is in cerebral oximetry. This review will provide information on the technology, clinical applications and algorithm to follow when desaturation occurs. AREAS COVERED: The review will cover the technology of near infrared spectroscopy, cerebral oximetry and the utilization of cerebral oximetry in each clinical setting. Expert commentary: Cerebral oximetry provides a noninvasive measure of cerebral oxygenation, which when persistently declining, can serve as a warning sign of hemodynamic or metabolic compromise intraoperatively or a predictor of postoperative cognitive dysfunction...
September 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27353030/changing-models-of-care-for-emergency-surgical-and-trauma-patients-in-singapore
#19
Sachin Mathur, Tiong Thye Goo, T'zu Jen Tan, Kok Yang Tan, Kenneth Seck Wai Mak
The last 15 years have seen changing patterns of injury in emergency surgery and trauma patients. The ability to diagnose, treat and manage these patients nonoperatively has led to a decline in interest in trauma surgery as a career. In addition, healthcare systems face multiple challenges, including limited resources, an ageing population and increasing subspecialisation of medical care, while maintaining government-directed standards and managing public expectations. In the West, these challenges have led to the emergence of a new subspecialty, 'acute care surgery', with some models of care providing dedicated acute surgical units or separating acute and elective streams with the existing manpower resources...
June 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27211577/the-use-of-massive-transfusion-protocol-for-trauma-and-non-trauma-patients-in-a-civilian-setting-what-can-be-done-better
#20
Ramesh Wijaya, Hui Min Gloria Cheng, Chee Keong Chong
INTRODUCTION: Massive transfusion protocol (MTP) is increasingly used in civilian trauma cases to achieve better haemostatic resuscitation in patients requiring massive blood transfusions (MTs), with improved survival outcomes. However, in non-trauma patients, evidence for MTP is lacking. This study aims to assess the outcomes of a newly established MTP in a civilian setting, for both trauma and non-trauma patients, in an acute surgical care unit. METHODS: A retrospective cohort analysis was performed on 46 patients for whom MTP was activated in Changi General Hospital, Singapore...
May 2016: Singapore Medical Journal
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