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Risk avoidance

Kenny Vlaemynck, Lies Lahousse, Aude Vanlander, Hubert Piessevaux, Pieter Hindryckx
BACKGROUND:  The first-line approach to the treatment of biliary leaks is endoscopic retrograde cholangiopancreatography. A variety of techniques can be used, including sphincterotomy, stenting, a combination of both techniques, or nasobiliary drainage. We performed a systematic review with meta-analysis to define the optimal strategy. METHODS:  We searched MEDLINE/PubMed, EMBASE, CENTRAL, Scopus, Google Scholar, and Web of Science until January 2018 for randomized clinical trials, case-control studies, and prospective cohort studies...
February 13, 2019: Endoscopy
Aisha Egolf, Christina Hartmann, Michael Siegrist
New food technologies have a high potential to transform the current resource-consuming food system to a more efficient and sustainable one, but public acceptance of new food technologies is rather low. Such an avoidance might be maintained by a deeply preserved risk avoidance system called disgust. In an online survey, participants (N = 313) received information about a variety of new food technology applications (i.e., genetically modified meat/fish, edible nanotechnology coating film, nanotechnology food box, artificial meat/milk, and a synthetic food additive)...
February 13, 2019: Risk Analysis: An Official Publication of the Society for Risk Analysis
Danielle Weiss, Sarah Ostrowski-Delahanty, Jason Van Allen, Paige Seegan, Meghan L Marsac
PURPOSE: Nurses are at the forefront of children's postinjury recovery; this unique role provides an opportunity for nurses to recognize and screen for symptoms that may interfere with children's quality of life (QOL). As such, aims of the present investigation were to explore selected variables (e.g., posttraumatic stress symptoms [PTSS], hope) that have the potential to impact QOL after pediatric injury, with a larger goal of contributing to recommendations for nursing practice to support children's full (physical and emotional) recovery during the peritrauma period following injury...
February 13, 2019: Journal for Specialists in Pediatric Nursing: JSPN
Leandro Cardoso Barchi, Marcus Fernando Kodama Pertille Ramos, André Roncon Dias, Osmar Kenji Yagi, Ulysses Ribeiro-Júnior, Bruno Zilberstein, Ivan Cecconello
BACKGROUND: Traditionally, total omentectomy is performed along with gastric resection and extended lymphadenectomy in gastric cancer (GC) surgery. However, solid evidences regarding its oncologic benefit is still scarce. AIM: To evaluate the incidence of metastatic omental lymph nodes (LN) in patients undergoing curative gastrectomy for GC, as well as its risk factors and patients' outcomes. METHODS: All consecutive patients submitted to D2/modified D2 gastrectomy due to gastric adenocarcinoma from March 2009 to April 2016 were retrospectively reviewed from a prospective collected database...
February 7, 2019: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Marcin Sniadecki, Dariusz Grzegorz Wydra, Szymon Wojtylak, Ewa Wycinka, Marcin Liro, Nikola Sniadecka, Agnieszka Mrozinska, Sambor Sawicki
OBJECTIVES: To assess the significance of pathologic ultrastaging (PU) of sentinel (SLN) and non-sentinel (nSLN) lymph nodes (LNs) and the influence on cancer staging in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IB1 cervical cancer. MATERIAL AND METHODS: A retrospective study was conducted with 54 patients divided into two equal-sized groups. In test group (n1), at least one SLN/patient was detected with blue dye. All excised LNs in this group were subjected to PU (4 μm slices/150 μm intervals) with hematoxylin-eosin staining and immunohistochemistry (AE1-AE3 antibodies)...
2019: Ginekologia Polska
Takuya Oyakawa, Nao Muraoka, Kei Iida, Masatoshi Kusuhara, Keita Mori
BACKGROUND: The efficacy of direct oral anti-coagulants (DOACs) for the treatment of venous thromboembolism (VTE) in Japanese patients with advanced cancer is largely unknown. METHODS: This prospective single-center observational study enrolled Japanese patients with unresectable advanced cancer who started DOAC treatment for new-onset VTE between December 2015 and May 2018. Patients were followed for 3 months to evaluate bleeding and VTE recurrences. The primary study endpoint was major and non-major bleeding...
February 12, 2019: International Journal of Clinical Oncology
Reza Deihimfard, Sajjad Rahimi-Moghaddam, Karine Chenu
In the semi-arid climatic conditions, water shortage is a key factor to generate crop production. Planting in autumn and winter and using precipitation can help cope with the problem. But in the semi-arid areas with cold winter, frost is another limited factor affecting crop production. For this purpose, in the present study, a simple and universal crop growth simulator (SUCROS) model was used to estimate the potential yield of sugar beets and frost damage from 1993 to 2009 for four autumn sowing dates (2 October, 17 October, 1 November, and 16 November) and two spring dates (6 March and 6 May) in eight locations (Birjand, Bojnord, Ghaen, Mashhad, Torbat-e Heydarieh, Neyshabor, Torbat-e Jam, and Ghochan) of the Khorasan province in northeastern Iran as a semi-arid and cold area...
February 13, 2019: International Journal of Biometeorology
Ayoub Innabi, Alok Surana, Bashar Alzghoul, Nikhil Meena
Background Complicated parapneumonic effusions empyema (CPEE) is fairly common and associated with increased morbidity and mortality. The Multicenter Intrapleural Sepsis Trial 2 (MIST 2) established the combination of intrapleural deoxyribonuclease (DNase) and tissue plasminogen activator (tPA) as an effective treatment for CPEE, thereby avoiding surgery and decreasing the length of hospitalization. MIST 2, however, used a labor-intensive protocol with some risk of bleeding. We hypothesize the simpler regimen of concurrent administration of intrapleural tPA and DNase (lower dose of tPA and a higher DNAse dose) to be equally effective with a decreased risk of bleeding...
February 21, 2018: Curēus
Juan-Carlos Gomez-Rosado, Yun-Hao Li, Javier Valdés-Hernández, Fernando Oliva-Mompeán, Luis-Cristobal Capitán-Morales
INTRODUCTION: The shortage of available beds and the increase in Emergency Department pressure can cause some patients to be admitted in wards with available beds assigned to other services (outlying patients). The aim of this study is to assess the frequency, types of complications and costs of outlying patients. METHODS: Using a retrospective cohort model, we analysed the 2015 general and digestive surgery records (source: Minimum Basic Data Set and economic database)...
February 9, 2019: Cirugía Española
Cecily M Begley, Gillian Ml Gyte, Declan Devane, William McGuire, Andrew Weeks, Linda M Biesty
BACKGROUND: Active management of the third stage of labour involves giving a prophylactic uterotonic, early cord clamping and controlled cord traction to deliver the placenta. With expectant management, signs of placental separation are awaited and the placenta is delivered spontaneously. Active management was introduced to try to reduce haemorrhage, a major contributor to maternal mortality in low-income countries. This is an update of a review last published in 2015. OBJECTIVES: To compare the effects of active versus expectant management of the third stage of labour on severe primary postpartum haemorrhage (PPH) and other maternal and infant outcomes...
February 13, 2019: Cochrane Database of Systematic Reviews
Sine Berntsen, Viveca Söderström-Anttila, Ulla-Britt Wennerholm, Hannele Laivuori, Anne Loft, Nan B Oldereid, Liv Bente Romundstad, Christina Bergh, Anja Pinborg
Worldwide, more than 7 million children have now been born after ART: these delivery rates are steadily rising and now comprise 2-6% of births in the European countries. To achieve higher pregnancy rates, the transfer of two or more embryos was previously the gold standard in ART. However, recently the practise has moved towards a single embryo transfer policy to avoid multiple births. The positive consequences of the declining multiple birth rates after ART are decreasing perinatal risks and overall improved health for the ART progeny...
February 12, 2019: Human Reproduction Update
Mario Pelle-Ceravolo, Matteo Angelini
Background: The main challenge of periocular fat grafting is the risk of contour irregularities, especially in the lower eyelid. Injection of diluted fat can decrease the likelihood of poor contour. Objectives: The authors developed a simple method of periocular fat grafting in which the fat was harvested through unconventional cannulas and diluted before the injection to avoid the risk of contour irregularities. Methods: A retrospective study was conducted on 200 patients who underwent fat grafting to the periocular region...
February 12, 2019: Aesthetic Surgery Journal
Maria Carliana Mota, Catarina Mendes Silva, Laura Cristina Tibiletti Balieiro, Bruna Fernandes Gonçalves, Walid Makin Fahmy, Cibele Aparecida Crispim
Chronic disruption of the synchronous relationship between endogenous and exogenous circadian timing is associated with the development of obesity and metabolic disease. Social jetlag is a measure of circadian misalignment and has been identified as a risk factor for overweight and related diseases. However, the mechanisms involved in this relationship remain underexplored. The objective of this study was to investigate the association between social jetlag and food consumption at late meal timing in patients with obesity-related chronic diseases...
2019: PloS One
Ingrid Miljeteig, Frehiwot Berhane Defaye, Paul Wakim, Dawit Neema Desalegn, Yemane Berhane, Ole Frithjof Norheim, Marion Danis
BACKGROUND: Out-of-pocket health expenditures can pose major financial risks, create access-barriers and drive patients and families into poverty. Little is known about physicians' role in financial protection of patients and families at the bedside in low-income settings and how they perceive their roles and duties when treating patients in a health care system requiring high out-of-pocket costs. OBJECTIVE: Assess physicians' concerns regarding financial welfare of patients and their families and analyze physicians' experiences in reducing catastrophic health expenditures for patients in Ethiopia...
2019: PloS One
Nikhil Crain, Talar Tejirian
Although inguinal herniorrhaphy is low risk, patients still return to the urgent care or ED. We performed a retrospective study on 19,296 inguinal hernia operations across 14 Southern California Kaiser Permanente medical centers over five years. Unplanned returns within the first postoperative week were evaluated focusing on four potentially avoidable diagnoses (AD): pain, constipation, urinary retention, and nausea/vomiting. Overall, 1370 (7%) patients returned to the urgent care/emergency department, of which 537 (39%) had an AD...
October 1, 2018: American Surgeon
Pridvi Kandagatla, Vahagn C Nikolian, Niki Matusko, Shayna Mason, Scott E Regenbogen, Karin M Hardiman
Because of the concern about risk of poor outcome, ileostomy creation is sometimes avoided in older adults. We sought to evaluate the effect of a rigorous postoperative pathway and checklist on readmission and self-efficiacy in older surgical patients. After implementing a self-care checklist and standardized care pathway at our institution, we performed a retrospective review of patients between June 2013 and June 2016 and compared characteristics and outcomes for patients aged <65 and ≥65 years. Using logistic regression, we identified independent predictors of readmission...
November 1, 2018: American Surgeon
Cristina Jardi, Núria Aranda, Cristina Bedmar, Victoria Arija
Adequate dietary intake is vital for infants' growth and development. The aim was to analyse food consumption and energy and nutrient intakes in a group of healthy Spanish infants and toddlers. Cross-sectional study. 154 infants were assessed at 6 months, and followed at 12 and 30 months. Clinical history, anthropometry, type of feeding, food consumption and energy and nutrient intakes (24-hours recall) were estimated. Advice about food consumed, estimated average requirements, the prevalence of inadequate intakes and percentage of adequacy of the recommended dietary allowance were applied...
February 12, 2019: International Journal for Vitamin and Nutrition Research. Journal International de Vitaminologie et de Nutrition
Lynn C Sadler, Vicki L Masson, Sue Belgrave, Hillary F Bennett, Jutta van den Boom, Suzanne Miller, Malcolm R Battin
BACKGROUND: In 25% of affected babies, neonatal encephalopathy results from acute peripartum events, but rigorous review of these cases for quality improvement is seldom reported. New Zealand has maintained a national database of all babies diagnosed with Sarnat moderate and severe neonatal encephalopathy since 2010 under the Perinatal and Maternal Mortality Review Committee. AIMS: To determine the rate of contributory factors, potentially avoidable mortality or morbidity, and to identify key areas for improvements to maternity and neonatal care among cases of neonatal encephalopathy following an acute peripartum event...
February 12, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Anna Serafini, Elizabeth Gerard, Pierre Genton, Arielle Crespel, Philippe Gelisse
Juvenile myoclonic epilepsy (JME) is both a frequent and a very characteristic epileptic syndrome with female preponderance. Treatment of JME in women of childbearing potential must consider multiple factors such as desire for pregnancy, use of contraception, seizure control and previously used antiepileptic drugs (AEDs). Approximately 85% of cases are well controlled with valproate, which remains the reference AED in JME but is nowadays considered unsafe for the expecting mother and her fetus. The prescription of valproate is now severely restricted in women of childbearing potential but may still be considered, at the lowest possible dose and when pregnancies can be reliably planned, with temporary alternatives to valproate prescribed before fertilization...
February 11, 2019: CNS Drugs
Caterina Offidani, Maria Lodise, Vittorio Gatto, Paola Frati, Stefano D'Errico, Marta Luisa Ciofi Degli Atti, Massimiliano Raponi
INTRODUCTION: Healthcare quality improvements are one of the most important goals to reach a better and safer healthcare system. Reviewing in-hospital mortality data is useful to identify areas for improvement, and to monitor the impact of actions taken to avoid preventable cases, such as those related to healthcare associated infections (HAI). METHODS: In this paper, we present the experience of the Mortality Committee of Bambino Gesù Children Hospital (OPBG)...
February 11, 2019: Current Pharmaceutical Biotechnology
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