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Elizabeth Palmer Kelly, Alexa Meara, Madison Hyer, Nicolette Payne, Timothy M Pawlik
The purpose of the current study was to characterize the experiences of cancer patients and their caregiver/family members around their relationship with their oncologist, health care team, and the hospital environment. Participants were recruited from The Ohio State University Comprehensive Cancer Center. Participant sociodemographic factors were assessed. Focus groups were moderated and recorded by two members of the research team using a semi-structured interview format. The audio recordings were transcribed and uploaded to NViVO 11 for analyses...
February 16, 2019: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Marie Meurer, A Floquet, I Ray-Coquard, F Bertucci, M Auriche, A Cordoba, S Piperno-Neumann, S Salas, M Delannes, T Chevalier, A Italiano, J Y Blay, Julien Mancini, P Pautier, F Duffaud
OBJECTIVE: High grade endometrial stromal sarcoma and undifferentiated uterine sarcomas are associated with a very poor prognosis. Although large surgical resection is the standard of care, the optimal adjuvant strategy remains unclear. METHODS: A retrospective analysis of patients with localized high grade endometrial stromal sarcoma and undifferentiated uterine sarcomas (stages I-III) treated in 10 French Sarcoma Group centers was conducted. RESULTS: 39 patients with localized high grade endometrial stromal sarcoma and undifferentiated uterine sarcomas treated from 2008 to 2016 were included...
February 16, 2019: International Journal of Gynecological Cancer
Christopher F Janowak, Suresh K Agarwal, Ben L Zarzaur
BACKGROUND: We previously demonstrated that unidentified aliased patients, John Doe's (DOEs), are one of the highest risk and most medically fragile populations of injured patients. Aliasing can result in misplaced information and confusion that must be overcome by health care professionals. DOE alias use is institutionally dependent and not uniform, which may lead to significant variation in perception of confusion and error. We sought to determine if health care practitioners experience confusion that may result in compromised care when caring for injured DOE patients...
February 14, 2019: Journal of Surgical Research
Lily Tung, Young Ju Jeong, Christianne Lane, Joseph N Carey, Richard Sposto, Naomi R Schechter, Stephen F Sener, Julie E Lang
BACKGROUND: This study was performed to determine if there was a difference in immediate breast reconstruction (IBR) rates between our public hospital and private cancer center, which share a common faculty with a consistent management philosophy in multidisciplinary care. We investigated the factors affecting postmastectomy reconstruction and IBR rates. MATERIALS AND METHODS: We retrospectively identified women with clinical stage I-II breast cancer who underwent mastectomy at our public hospital, Los Angeles County Medical Center, and our private cancer center, Keck Hospital of USC/Norris Comprehensive Cancer Center...
February 14, 2019: Journal of Surgical Research
Marketa Marvanova, Paul Jacob Henkel
OBJECTIVES: To summarize select continuing pharmacy education (CPE) topics and hours related to geriatric care completed by community, hospital/clinic, and long-term care (LTC)/consultant pharmacists in the previous 12 months, whether pharmacy workplace influenced topic selection or completion, and to describe CPE sources used by community versus hospital/clinic pharmacists. DESIGN: Cross-sectional survey (2017). SETTING AND PARTICIPANTS: Licensed pharmacists in North Dakota, South Dakota, Minnesota, Iowa, and Nebraska with primary practice settings in community pharmacies, hospitals, or clinics or those practicing as consultant pharmacists...
February 13, 2019: Journal of the American Pharmacists Association: JAPhA
Perel Baral, Elizabeth Cotter, Guangyi Gao, Jianghua He, Katy Wirtz, Akshit Sharma, Trip Zorn Iii, Gregory Muehlebach, Brigid Flynn
OBJECTIVE: Activated recombinant factor VII (rFVIIa) has been used to treat cardiac surgical bleeding in an off-label manner. This observational report analyzes the outcomes with use of a low dose and early administration of rFVIIa for cardiac surgical bleeding. DESIGN: A retrospective, observational study. SETTING: Single-center, tertiary care cardiothoracic surgical setting. PARTICIPANTS: A total of 6,862 patients underwent cardiac surgery from January 2012 to January 2018...
January 22, 2019: Journal of Cardiothoracic and Vascular Anesthesia
Joshua R Vest, Nir Menachemi, Shaun J Grannis, Jennifer L Ferrell, Suranga N Kasthurirathne, Ying Zhang, Yan Tong, Paul K Halverson
INTRODUCTION: Social determinants of health are critical drivers of health status and cost, but are infrequently screened or addressed in primary care settings. Systematic approaches to identifying individuals with unmet social determinants needs could better support practice workflows and linkages of patients to services. A pilot study examined the effect of a risk-stratification tool on referrals to services that address social determinants in an urban safety-net population. METHODS: An intervention that risk stratified patients according to the need for wraparound was evaluated in a stepped wedge design (i...
February 14, 2019: American Journal of Preventive Medicine
Vanessa Menut, Etienne Seigneur, Christèle Gras Leguen, Daniel Orbach, Estelle Thebaud
BACKGROUND: The use of complementary and alternative medicine (CAM) in children with cancer is commonly used. However, studies and data on this topic are still scarce in France. METHODS: Our aim was to investigate the prevalence of CAM usage in pediatric cancer patients and describe the modality of use. Our study population comprised children and young people treated from 2011 to 2012 in 2 French centers (Nantes, Paris). An anonymous self-administered questionnaire was addressed to families and data was collected from them and from the medical record...
February 13, 2019: Bulletin du Cancer
Ping Zhu, Xianglin L Du, Jay-Jiguang Zhu, Yoshua Esquenazi
OBJECTIVEThe present study was designed to explore the association between facility type (academic center [AC] vs non-AC), facility volume (high-volume facility [HVF] vs low-volume facility [LVF]), and outcomes of glioblastoma (GBM) treatment.METHODSBased on the National Cancer Database (NCDB), GBM patients were categorized by treatment facility type (non-AC vs AC) and volume [4 categories (G1-G4): < 5.0, 5.0-14.9, 15.0-24.9, and ≥ 25.0, cases/year]. HVF was defined based on the 90th percentile of annual GBM cases (≥ 15...
February 15, 2019: Journal of Neurosurgery
Steve Balian, David G Buckler, Audrey L Blewer, Abhishek Bhardwaj, Benjamin S Abella
AIM OF THE STUDY: Regionalization of care for out-of-hospital cardiac arrests (OHCA) may improve patient outcomes. We evaluated inter-hospital variations in post-arrest care provision and the relation between hospital case volume and survival in Pennsylvania. METHODS: This retrospective study (2013-2017) used data from adult OHCA cases in Pennsylvania from the Cardiac Arrest Registry to Enhance Survival. Analysis was performed on hospitals reporting greater than 40 cases/5 years with sustained return of spontaneous circulation upon emergency department arrival and survival to hospital admission...
February 13, 2019: Resuscitation
Lisette Dekker, Hansje M Heller, Jessica E van der Meij, Annelies E J Toor, Leo M G Geeraedts
BACKGROUND: A medical-psychiatric unit (MPU) is a special ward where staff is trained in caring for patients with psychiatric or behavioural problems that need hospitalisation for physical health problems. It is well known that these patients are at higher risk of complications and have a longer length of stay resulting in higher costs than patients without psychiatric comorbidity. The objective of this study was to analyse the trauma patient population of the first 10 years of existence of the MPU in a level I trauma center...
February 15, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
J Eschweiler, F Migliorini, H Siebers, M Tingart, B Rath
BACKGROUND: Providing the hip with an endoprosthesis is one of the most common orthopedic interventions in Germany. The long-term success of such a procedure depends on the consideration of the loads due to muscle and joint forces in the planning and operative care. Patient-specific information of forces acting in vivo is not available to the surgeon in clinical routine today. This is where biomechanical modeling comes in. PROCEDURES: A field of activity of biomechanical modeling is the development of methods and procedures for the precise analysis and simulation of endoprosthetic supplies...
February 15, 2019: Der Orthopäde
Emily M Bachner, Elaine C Schmidt, Matthew Chin, Surena Namdari, Josh R Baxter, Michael W Hast
BACKGROUND: Locked plating of displaced proximal humeral fractures is common, but rates of subacromial impingement remain high. This study used a multidisciplinary approach to elucidate the relationships between common surgical parameters, anatomic variability, and the likelihood of plate impingement. METHODS: The experiment was completed in 3 phases. First, a controlled in vitro experiment was conducted to simulate impingement. Second, a dynamic in silico musculoskeletal model modeled changes to implant geometry, surgical techniques, and acromial anatomy, where a collision detection algorithm was used to simulate impingement...
February 13, 2019: Journal of Shoulder and Elbow Surgery
Sophie Masmejan, David Baud, Greg Ryan, Tim Van Mieghem
In this review article, we discuss the most common fetal tumors, their prenatal management, and outcomes. Overall, the most important outcome predictors are tumor histology, size, vascularity, and location. Very large lesions, lesions causing cardiac failure, and hydrops and lesions obstructing the fetal airway have the poorest outcome, as they may cause fetal death or complications at the time of delivery. Fetal therapy has been developed to improve outcomes for the most severe cases and can consist of transplacental therapy (sirolimus for rhabdomyomas or steroids for hemangiomas and microcystic lung lesions) or surgical intervention (shunting of cystic masses, tumor ablation, occlusion of blood flow or airway exploration, and protection)...
January 14, 2019: Best Practice & Research. Clinical Obstetrics & Gynaecology
Aldo L Schenone, Kevin Chen, Bashaer Gheyath, Nyal Borges, Manshi Li Bs Mss, Xiaofeng Wang, Abhijit Duggal, Venu Menon
Most important prognostic factors in the postcardiac arrest patients who underwent targeted temperature management (TTM) derive from the periarrest period. Whether early invasive hemodynamics predict survival or neurologic outcomes remains unknown. We retrospectively reviewed all comatose survivors of cardiac arrest who underwent TTM at the Coronary Intensive Care Unit of a Quaternary Center between January 2015 and June 2017. Patients were required to have a set of invasive hemodynamics available at initiation of TTM to be included...
January 24, 2019: American Journal of Cardiology
Robert A Tessler, Steve Vanhoy, Katherine Bergus, Christine Fong, Eileen M Bulger, Frederick P Rivara, Monica S Vavilala
BACKGROUND: The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score may distinguish necrotizing soft tissue infection (NSTI) from non-NSTI. The association of higher preoperative LRINEC scores with escalations of intraoperative anesthesia care in NSTI is unknown and may be useful in communicating illness severity during patient handoffs. MATERIALS AND METHODS: We conducted a retrospective cohort study of first operative debridement for suspected NSTI in a single referral center from 2013 to 2016...
February 12, 2019: Journal of Surgical Research
Tony H Truong, Jason D Pole, Henrique Bittencourt, Tal Schechter, Geoff D E Cuvelier, Kristjan Paulson, Meera Rayar, David Mitchell, Kirk R Schultz, Debbie O'Shea, Randy Barber, Donna Wall, Lillian Sung
INTRODUCTION: Access to hematopoietic stem cell transplantation (HSCT) in pediatric acute lymphoblastic leukemia (ALL) is primarily dependent on disease-related factors but may be influenced by social and economic determinants. METHODS: We included all children < 15 years old with newly diagnosed ALL in Canada between 2001 and 2018 using the Cancer in Young People in Canada (CYP-C) national registry. We examined factors potentially associated with the likelihood of receiving HSCT using univariate and multivariable logistic regression models...
February 12, 2019: Biology of Blood and Marrow Transplantation
Aimée Wattiaux, Brittany Bettendorf, Laura Block, Andrea Gilmore-Bykovskyi, Edmond Ramly, Megan E Piper, Ann Rosenthal, Jane Sadusky, Elizabeth Cox, Betty Chewning, Christie M Bartels
OBJECTIVE: Although smoking is a risk factor for cardiovascular and rheumatic disease severity, only 10% of rheumatology visits document cessation counseling. After implementing a rheumatology clinic protocol that increased tobacco quitline referrals 20-fold, current objectives were to 1) examine patients' barriers and facilitators to smoking cessation based on prior rheumatology experiences, 2) solicit reactions to the new cessation protocol, and 3) identify patient-centered outcomes or "signs of cessation progress" following improved care...
February 15, 2019: Arthritis Care & Research
Dennis W Ashley, Robert F Mullins, Christopher J Dente, Tracy J Johns, Laura E Garlow, Regina S Medeiros, Elizabeth V Atkins, Gina Solomon, Dena Abston, Colville H Ferdinand
BACKGROUND: Readiness Costs are real expenses incurred by trauma centers to maintain essential infrastructure to provide emergent services on a 24/7 basis. Although the components for readiness are well described in the American College of Surgeon's Resources for Optimal Care of the Injured Patient, the cost associated with each component is not well defined. We hypothesized that meeting the requirements of the 2014 Resources for Optimal Care of the Injured Patient would result in significant costs for trauma centers...
February 13, 2019: Journal of Trauma and Acute Care Surgery
Jonathan Braun Bsc, S David Gertz, Ariel Furer, Tarif Bader, Hagay Frenkel, Jacob Chen, Elon Glassberg, Dean Nachman
Unmanned aerial vehicles (UAV), commonly referred to as drones, have been made widely available in recent years leading to an exponential growth in their roles and applications. The rapidly developing field of medical drones is on the verge of revolutionizing pre-hospital medicine enabling advanced healthcare delivery to once-inaccessible patients. The aim of this review is to clarify the basic technical properties of currently available medical drones and review recent advances and their usefulness in military and civilian healthcare missions...
February 13, 2019: Journal of Trauma and Acute Care Surgery
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