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https://read.qxmd.com/read/30691821/familiarity-and-communication-in-the-operating-room
#1
Lane L Frasier, Sudha R Pavuluri Quamme, Yue Ma, Douglas Wiegmann, Glen Leverson, Eva H DuGoff, Caprice C Greenberg
BACKGROUND: Poor communication is implicated in many adverse events in the operating room (OR); however, many hospitals' scheduling practices permit unfamiliar operative teams. The relationship between unfamiliarity, team communication and effectiveness of communication is poorly understood. We sought to evaluate the relationship between familiarity, communication rates, and communication ineffectiveness of health care providers in the OR. MATERIALS AND METHODS: We performed purposive sampling of 10 open operations...
March 2019: Journal of Surgical Research
https://read.qxmd.com/read/30586100/use-of-closed-incision-negative-pressure-therapy-in-obstetrics
#2
Glen I Feinstein
BACKGROUND: Cesarean delivery is one of the most commonly performed surgeries in the United States. Compared with other surgical procedures, surgical site infection tends to be a relatively uncommon outcome after cesarean delivery in the general population with an incidence rate between 1.46 and 3.82% in the United States in 2006-2008. Despite this lower incidence, surgical site infections following cesarean delivery result in a 6-day increase in mean length of stay at an additional cost of $13,968...
January 2019: Plastic and Reconstructive Surgery
https://read.qxmd.com/read/30570517/opioid-prescribing-patterns-after-micrographic-surgery-a-follow-up-retrospective-chart-review
#3
Jessica M Donigan, Abigail I Franco, Gregory J Stoddard, Amanda Hedderman, Payam Tristani-Firouzi, Glen M Bowen, Eric A Millican, Keith L Duffy
BACKGROUND: The abuse of opioids has reached epidemic proportions in the United States, and leftover medications are a primary source for nonmedical pain relievers. A past study at the University of Utah showed that micrographic surgeons were likely overprescribing opioids, with 35% of patients receiving a postoperative prescription. OBJECTIVE: To examine the current opioid prescribing habits of the micrographic surgeons at the University of Utah compared with those in 2010...
December 18, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://read.qxmd.com/read/30564117/cost-utility-analysis-of-venous-thromboembolism-prophylaxis-strategies-for-people-undergoing-elective-total-hip-and-total-knee-replacement-surgeries-in-the-english-national-health-service
#4
Dalia M Dawoud, David Wonderling, Jessica Glen, Sedina Lewis, Xavier L Griffin, Beverley J Hunt, Gerard Stansby, Michael Reed, Nigel Rossiter, Jagjot Kaur Chahal, Carlos Sharpin, Peter Barry
Background: Major orthopedic surgery, such as elective total hip replacement (eTHR) and elective total knee replacement (eTKR), are associated with a higher risk of venous thromboembolism (VTE) than other surgical procedures. Little is known, however, about the cost-effectiveness of VTE prophylaxis strategies in people undergoing these procedures. Aim: The aim of this work was to assess the cost-effectiveness of these strategies from the English National Health Service perspective to inform NICE guideline (NG89) recommendations...
2018: Frontiers in Pharmacology
https://read.qxmd.com/read/30555849/repeat-infective-endocarditis-in-persons-who-inject-drugs-take-another-little-piece-of-my-heart
#5
Glen Huang, Erin W Barnes, James E Peacock
Background: Injection drug use (IDU) is a major risk factor for infective endocarditis (IE). Few data exist on repeat IE (rIE) in persons who inject drugs (PWID). Methods: Patients ≥18 years old seen at Wake Forest Baptist Medical Center from 2004 to 2017 who met Duke criteria for IE and who self-reported IDU in the 3 months before admission were identified. The subset of PWID who developed rIE, defined as another episode of IE at least 10 weeks after diagnosis of the first episode, was then reviewed...
December 2018: Open Forum Infectious Diseases
https://read.qxmd.com/read/30528813/the-influence-of-the-charlson-comorbidity-index-on-procedural-characteristics-varc-2-endpoints-and-30-day-mortality-among-patients-who-undergo-transcatheter-aortic-valve-implantation
#6
Sudhakar George, Chun Shing Kwok, Glen P Martin, Aswin Babu, Adrian Shufflebotham, James Nolan, Karim Ratib, Rodrigo Bagur, Mark Gunning, Mamas Mamas
BACKGROUND: Aortic stenosis (AS) is a common valvular abnormality and transcatheter aortic valve implantation (TAVI) is being increasingly used to treat patients considered too high risk for conventional surgery. We aimed to assess the prevalence of comorbid conditions in patients undergoing TAVI using the Charlson Comorbidity Index (CCI) and to assess their impact on clinical and procedural outcomes. METHODS: We analysed 158 patients who underwent a TAVI at our institution between June 2009 and September 2015 to define their co-morbid burden as measured with CCI, and study its impact on procedural characteristics and mortality at 30 days...
November 30, 2018: Heart, Lung & Circulation
https://read.qxmd.com/read/30511604/survey-of-multinational-surgical-management-practices-in-tetralogy-of-fallot
#7
Sara Hussain, Osman Al-Radi, Tae-Jin Yun, Zhongdong Hua, Budi Rahmat, Suresh Rao, An Qi, Charles Fraser, Yves d'Udekem, Quazi Ibrahim, Ingrid Copland, Richard Whitlock, Glen Van Arsdell
BACKGROUND: A wide variety of surgical strategies are used in tetralogy of Fallot repair. We sought to describe the international contemporary practice patterns for surgical management of tetralogy of Fallot. METHODS: Surgeons from 18 international paediatric cardiac surgery centres (representing over 1800 tetralogy of Fallot cases/year) completed a Research Electronic Data Capture-based survey. Participating countries include: China (4), India (2), Nepal (1), Korea (1), Indonesia (1), Saudi Arabia (3), Japan (1), Turkey (1), Australia (1), United States of America (2), and Canada (1)...
January 2019: Cardiology in the Young
https://read.qxmd.com/read/30511131/timed-stair-climbing-as-a-surrogate-marker-for-sarcopenia-measurements-in-predicting-surgical-outcomes
#8
Samantha Baker, Mary Glen Waldrop, Joshua Swords, Thomas Wang, Martin Heslin, Carlo Contreras, Sushanth Reddy
BACKGROUND: Estimating sarcopenia by measuring psoas muscle density (PMD) has been advocated as a method to accurately predict post-operative morbidity. The aim of the present study was to determine whether the Timed Stair Climb (TSC) could be used to replace PMD measurements in predicting morbidity. METHODS: Patients were prospectively enrolled from March 2014-2015 and were eligible if they were undergoing an abdominal operation. PMD was measured using pre-operative CT scans obtained within 90 days of surgery...
December 3, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://read.qxmd.com/read/30468997/analysis-of-the-drivers-of-cost-of-management-when-patients-with-brain-metastases-are-treated-with-upfront-radiosurgery
#9
Rachel F Shenker, Emory R McTyre, Glen B Taksler, Ralph B D'Agostino, Christina K Cramer, Jimmy Ruiz, Natalie K Alphonse-Sullivan, Michael Farris, Kounosuke Watabe, Fei Xing, Adrian W Laxton, Stephen B Tatter, Michael D Chan
OBJECTIVES: We aimed to assess the driving factors for increased cost of brain metastasis management when using upfront stereotactic radiosurgery (SRS). PATIENT AND METHODS: 737 patients treated with upfront SRS without whole brain radiotherapy (WBRT). Patients were evaluated for use of craniotomy, length of hospital stay, need for rehabilitation or facility placement, and use of salvage SRS or salvage WBRT. Costs of care of these interventions were estimated based on 2013 Medicare reimbursements...
November 13, 2018: Clinical Neurology and Neurosurgery
https://read.qxmd.com/read/30462279/continued-vs-interrupted-direct-oral-anticoagulants-at-the-time-of-device-surgery-in-patients-with-moderate-to-high-risk-of-arterial-thrombo-embolic-events-bruise-control-2
#10
David H Birnie, Jeff S Healey, George A Wells, Felix Ayala-Paredes, Benoit Coutu, Glen L Sumner, Giuliano Becker, Atul Verma, François Philippon, Eli Kalfon, John Eikelboom, Roopinder K Sandhu, Pablo B Nery, Nicholas Lellouche, Stuart J Connolly, John Sapp, Vidal Essebag
Aims: Guidelines recommend warfarin continuation rather than heparin bridging for pacemaker and defibrillator surgery, after the BRUISE CONTROL trial demonstrated an 80% reduction in device pocket haematoma with this approach. However, direct oral anticoagulants (DOACs) are now used to treat the majority of patients with atrial fibrillation. We sought to understand the best strategy to manage the DOACs at the time of device surgery and specifically hypothesized that performing device surgery without DOAC interruption would result in a reduced haematoma rate...
November 21, 2018: European Heart Journal
https://read.qxmd.com/read/30268174/gunshot-injuries-to-the-extremity-is-immediate-general-surgery-presence-needed
#11
Brian G Harbrecht, Keith R Miller, Amirreza T Motameni, Matthew V Benns, Matthew C Bozeman, Nicholas A Nash, Glen A Franklin, Jason W Smith
Gunshot wounds (GSW) are becoming increasingly prevalent in urban settings. GSW to the trunk mandate full trauma activation and immediate surgeon response because of the high likelihood of operative intervention. Extremity GSW proximal to the knee/elbow also require full trauma activation based on American College of Surgeons Committee on trauma standards. However, whether isolated extremity GSW require frequent operative intervention is unclear. We evaluated GSW at our Level I trauma center from January 2012 to December 2016...
September 1, 2018: American Surgeon
https://read.qxmd.com/read/30189006/use-of-gentamicin-impregnated-beads-or-sponges-in-the-treatment-of-early-acute-periprosthetic-joint-infection-a-propensity-score-analysis
#12
Marjan Wouthuyzen-Bakker, Claudia A M Löwik, Bas A S Knobben, Wierd P Zijlstra, Joris J W Ploegmakers, Glen Mithoe, Aziz Al Moujahid, Greetje A Kampinga, Paul C Jutte
Objectives: Early acute periprosthetic joint infections (PJIs) treated with debridement, antibiotics and implant retention (DAIR) have failure rates ranging from 10% to 60%. We determined the efficacy of applying local gentamicin-impregnated beads and/or sponges during debridement in early PJI. Methods: Patients with early acute PJI, defined as less than 21 days of symptoms and treated with DAIR within 90 days after index surgery, were retrospectively evaluated...
December 1, 2018: Journal of Antimicrobial Chemotherapy
https://read.qxmd.com/read/30054280/a-biological-signature-for-breast-ductal-carcinoma-in-situ-to-predict-radiotherapy-rt-benefit-and-assess-recurrence-risk
#13
Troy Bremer, Pat W Whitworth, Rakesh Patel, Jess Savala, Todd Barry, Stephen Lyle, Glen Leesman, Steven P Linke, Karin Jirström, Wenjing Zhou, Rose-Marie Amini, Fredrik Wärnberg
Purpose: Ductal carcinoma in situ (DCIS) patients and their physicians currently face challenging treatment decisions with limited information about the individual's subsequent breast cancer risk or treatment benefit. The DCISionRT biological signature developed in this study provides recurrence risk and predicts radiotherapy (RT) benefit for DCIS patients following breast-conserving surgery (BCS). Experimental Design: A biological signature that calculates an individualized Decision Score (DS) was developed and cross-validated in 526 DCIS patients treated with BCS ± RT...
July 27, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://read.qxmd.com/read/30039324/an-update-on-immunotherapy-for-solid-tumors-a-review
#14
REVIEW
Toan Pham, Sara Roth, Joseph Kong, Glen Guerra, Vignesh Narasimhan, Lloyd Pereira, Jayesh Desai, Alexander Heriot, Robert Ramsay
In recent years, it has been demonstrated that immunotherapy is an effective strategy for the management of solid tumors. The origins of immunotherapy can be traced back to the work of William Coley, who elicited an immune response against sarcoma by injecting patients with a mixture of dead bacteria. Significant progress has been made since, with immune markers within the tumor now being used as predictors of cancer prognosis and manipulated to improve patient survival. While surgery remains central to the management of most patients with solid malignancies, it is important that surgeons consider the different immunotherapy strategies that can be employed to manage disease...
October 2018: Annals of Surgical Oncology
https://read.qxmd.com/read/30019933/the-endocrine-disruptor-bisphenol-a-is-implicated-in-urinary-voiding-dysfunction-in-male-mice
#15
Tristan M Nicholson, Jalissa L Nguyen, Glen E Leverson, Julia A Taylor, Frederik S Vom Saal, Ronald W Wood, William A Ricke
Estrogens, acting synergistically with androgens, are known from animal experiments to be important in lower urinary tract symptoms (LUTS) and benign prostate enlargement. Human exposure to environmental estrogens occurs throughout the lifespan, but the urologic health risks in men are largely unknown. Bisphenol-A (BPA) is an endocrine disruptor implicated in male urogenital malformations. Given the role of estrogens in male LUTS, we studied the effects of BPA administered in combination with testosterone (T) on the urinary voiding behavior of adult male mice...
July 18, 2018: American Journal of Physiology. Renal Physiology
https://read.qxmd.com/read/30017301/pelvic-mri-staging-of-endometriosis-at-3-t-without-patient-preparation-or-anti-peristaltic-diagnostic-performance-outcomes
#16
Shaun Zheng Liang Yap, Sebastian Leathersich, Joy Lu, Laura Fender, Glen Lo
PURPOSE: Endometriosis is a disease of significant burden among pre-menopausal women characterised by the appearance of functional endometrial tissue in locations outside the uterus. Deep infiltrating endometriosis (DIE) is an invasion of the endometriotic lesion that exceeds 5 mm in depth into the peritoneum. In most cases, pelvic MRI is the imaging modality of choice for the pre-operative workup for DIE to guide surgery. The recommended standard for pelvic MRI images is at 1.5 T with patient preparations in the form of laxatives, anti-spasmodics and/or rectal contrast...
August 2018: European Journal of Radiology
https://read.qxmd.com/read/30003452/the-impact-of-hospital-neoadjuvant-therapy-utilization-on-survival-outcomes-for-pancreatic-cancer
#17
Alexander V Fisher, Daniel E Abbott, Manasa Venkatesh, Glen E Leverson, Stephanie A Campbell-Flohr, Sean M Ronnekleiv-Kelly, Caprice C Greenberg, Emily R Winslow, Sharon M Weber
BACKGROUND: Many surgeons advocate the use of neoadjuvant treatment for resectable pancreatic cancer, however little is known about variation in the utilization of neoadjuvant therapy (NAT) at the hospital level. METHODS: The National Cancer Data Base was used to identify patients undergoing resection for pancreatic cancer between 2006 and 2014 at high-volume centers. Hospitals were grouped by NAT utilization using standard deviations (SD) from the mean as follows: high neoadjuvant utilizers (> 2 SDs above the mean, > 40% of patients receiving NAT); medium-high (1-2 SDs, 27-40%), medium (0-1 SD, 14-26%); or low (- 1...
September 2018: Annals of Surgical Oncology
https://read.qxmd.com/read/29953883/long-term-natural-history-of-lower-urinary-tract-symptoms-following-radical-retropubic-prostatectomy-a-prospective-15-year-longitudinal-study
#18
Alex J Xu, Glen B Taksler, Elton Llukani, Herbert Lepor
OBJECTIVE: To provide insights into the long-term impact of radical retro-pubic prostatectomy (ORRP) on lower urinary tract symptoms (LUTS) which are age and prostate dependent and adversely impact quality of life. METHODS: 1995 men undergoing ORRP enrolled in a prospective longitudinal outcomes study. The American Urological Association Symptom Index was self-administered before ORRP and at predetermined time-points after surgery. A multivariate generalized linear model was used to evaluate the association of time since ORRP with American Urological Association symptom score (AUASS)...
October 2018: Urology
https://read.qxmd.com/read/29932208/treating-melanoma-in-situ-and-lentigo-maligna-with-mohs-micrographic-surgery-in-australia
#19
Glen C Foxton, Timothy G Elliott, Kelly A Litterick
BACKGROUND/OBJECTIVES: There is a paucity of Australian data on the use of Mohs micrographic surgery for treating melanoma in situ and lentigo maligna. We share an Australian centre's experience with the technique. METHODS: A total of 62 patients with 62 lesions of melanoma in situ and lentigo maligna referred for treatment between 2015 and 2017 comprised the study group. All melanomas were excised with Mohs micrographic surgery utilising melanoma-associated antigen recognised by T-cells (MART-1) immunostaining...
June 22, 2018: Australasian Journal of Dermatology
https://read.qxmd.com/read/29923226/yonsei-nomogram-a-predictive-model-of-new-onset-chronic-kidney-disease-after-on-clamp-partial-nephrectomy-in-patients-with-t1-renal-tumors
#20
Ali Abdel Raheem, Tae Young Shin, Ki Don Chang, Glen Denmer R Santok, Mohamed Jayed Alenzi, Young Eun Yoon, Won Sik Ham, Woong Kyu Han, Young Deuk Choi, Koon Ho Rha
OBJECTIVES: To develop a predictive nomogram for chronic kidney disease-free survival probability in the long term after partial nephrectomy. METHODS: A retrospective analysis was carried out of 698 patients with T1 renal tumors undergoing partial nephrectomy at a tertiary academic institution. A multivariable Cox regression analysis was carried out based on parameters proven to have an impact on postoperative renal function. Patients with incomplete data, <12 months follow up and preoperative chronic kidney disease stage III or greater were excluded...
July 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
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