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Inspira General Surgery Journal Club

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5 papers 0 to 25 followers Monthly updated General Surgery journal club.
https://www.readbyqxmd.com/read/23659733/pacemaker-or-defibrillator-surgery-without-interruption-of-anticoagulation
#1
RANDOMIZED CONTROLLED TRIAL
David H Birnie, Jeff S Healey, George A Wells, Atul Verma, Anthony S Tang, Andrew D Krahn, Christopher S Simpson, Felix Ayala-Paredes, Benoit Coutu, Tiago L L Leiria, Vidal Essebag
BACKGROUND: Many patients requiring pacemaker or implantable cardioverter-defibrillator (ICD) surgery are taking warfarin. For patients at high risk for thromboembolic events, guidelines recommend bridging therapy with heparin; however, case series suggest that it may be safe to perform surgery without interrupting warfarin treatment. There have been few results from clinical trials to support the safety and efficacy of this approach. METHODS: We randomly assigned patients with an annual risk of thromboembolic events of 5% or more to continued warfarin treatment or to bridging therapy with heparin...
May 30, 2013: New England Journal of Medicine
https://www.readbyqxmd.com/read/26890472/long-term-results-of-stenting-versus-endarterectomy-for-carotid-artery-stenosis
#2
RANDOMIZED CONTROLLED TRIAL
Thomas G Brott, George Howard, Gary S Roubin, James F Meschia, Ariane Mackey, William Brooks, Wesley S Moore, Michael D Hill, Vito A Mantese, Wayne M Clark, Carlos H Timaran, Donald Heck, Pierre P Leimgruber, Alice J Sheffet, Virginia J Howard, Seemant Chaturvedi, Brajesh K Lal, Jenifer H Voeks, Robert W Hobson
BACKGROUND: In the Carotid Revascularization Endarterectomy versus Stenting Trial, we found no significant difference between the stenting group and the endarterectomy group with respect to the primary composite end point of stroke, myocardial infarction, or death during the periprocedural period or any subsequent ipsilateral stroke during 4 years of follow-up. We now extend the results to 10 years. METHODS: Among patients with carotid-artery stenosis who had been randomly assigned to stenting or endarterectomy, we evaluated outcomes every 6 months for up to 10 years at 117 centers...
March 17, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26616499/hemodialysis-access-in-the-elderly-outcomes-among-patients-older-than-seventy
#3
Caroline C Jadlowiec, Elizabeth M Mannion, Matthew Lavallee, Matthew G Brown
BACKGROUND: Arteriovenous fistulae (AVF) are the preferred access for hemodialysis, however, there continues to be limited data guiding the surgical management of primary dialysis access creation in elderly end-stage renal disease patients. METHODS: This is an 8-year retrospective institutional study evaluating the operative and clinical characteristics of patients 70 years or above who underwent primary, first-ever, AVF or arteriovenous graft (AVG) creation. RESULTS: There was no overall significant difference in AVF and AVG primary (P = 0...
February 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/26739769/in-the-superobese-weight-loss-and-resolution-of-obesity-comorbidities-after-biliopancreatic-bypass-and-or-duodenal-switch-vary-according-to-health-insurance-carrier-medicaid-vs-medicare-vs-private-insurance-vs-self-pay-in-1681-bariatric-outcomes-longitudinal
#4
Janette P Gomez, Michael A Davis, Gus J Slotman
BACKGROUND: Differences in Medicaid vs Medicare vs Private vs Self-Pay duodenal switch (DS) results are unknown. This study identified DS outcomes variations by health insurance. METHODS: Data from 1,681 DS patients were analyzed retrospectively: Medicaid (n = 138), Medicare (n = 313), Private insurance (n = 1,171), and Self-Pay (n = 59). General linear models included baseline and postoperative data and were modified for dichotomous variables. RESULTS: Hypertension, obstructive sleep apnea, abdominal hernia, diabetes, and 9 other hepatobiliary, and somatic conditions were lowest in Private (P < ...
March 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/26151506/minimally-invasive-is-maximally-effective-diagnostic-and-therapeutic-laparoscopy-for-penetrating-abdominal-injuries
#5
Paul J Chestovich, Timothy D Browder, Shawna L Morrissey, Douglas R Fraser, Nichole K Ingalls, John J Fildes
BACKGROUND: Laparoscopic techniques have evolved, allowing increased capabilities within most subspecialties of general surgery, but have failed to gain traction managing injured patients. We hypothesized that laparoscopy is effective in the diagnosis and treatment of penetrating abdominal injuries. METHODS: We retrospectively reviewed patients undergoing abdominal exploration following penetrating trauma at our Level 1 trauma center during a 6-year period from January 1, 2008, to December 31, 2013...
June 2015: Journal of Trauma and Acute Care Surgery
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