320 results match your criteria Outpatient Surgical Suite


Amending the fasting polemic: is fasting 1 h the answer?

Authors:
Jerrold Lerman

Paediatr Anaesth 2019 Feb 13. Epub 2019 Feb 13.

From the Department of Anesthesiology, Oishei Children's Outpatient Center, 1001 Main St. Suite K-3502, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, U.S.A.

I read with interest recent the APA-ESPA-ADARPEF joint consensus statement and the SPANZA endorsement to reduce the fasting interval after clear fluids in children to 1 hour. I am fully committed to re-examining fasting guidelines in children periodically. However, abbreviating the fasting interval to the point where flexibility to change the order of the surgical list in the face of an unexpected delay or cancellation occur is eliminated, would preclude our ability to run an efficient operating room schedule. Read More

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http://doi.wiley.com/10.1111/pan.13606
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http://dx.doi.org/10.1111/pan.13606DOI Listing
February 2019
1 Read

Overall survival according to immunotherapy and radiation treatment for metastatic non-small-cell lung cancer: a National Cancer Database analysis.

Radiat Oncol 2019 Jan 28;14(1):18. Epub 2019 Jan 28.

Department of Radiation and Cellular Oncology, The University of Chicago Medicine, 5758 S. Maryland Avenue, MC 9006, Chicago, IL, 60637, USA.

Background: Preclinical studies suggest enhanced anti-tumor activity with combined radioimmunotherapy. We hypothesized that radiation (RT) + immunotherapy would associate with improved overall survival (OS) compared to immunotherapy or chemotherapy alone for patients with newly diagnosed metastatic non-small-cell lung cancer (NSCLC).

Methods: The National Cancer Database was queried for patients with stage IV NSCLC receiving chemotherapy or immunotherapy from 2013 to 2014. Read More

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http://dx.doi.org/10.1186/s13014-019-1222-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348608PMC
January 2019
1 Read

Patient Preferences in Office-Based Orthopedic Care: A Prospective Evaluation.

Am J Orthop (Belle Mead NJ) 2018 Oct;47(10)

Midwest Orthopaedics at Rush, 1611 W. Harrison Street, Suite 300, Chicago, IL 60612, USA. Email:

Patient satisfaction has become a topic of interest within orthopedics as the landscape of provider reimbursement continues to evolve to reward value of care. Online internet physician rating sites are becoming increasingly popular ways for patients to subjectively express their provider experience. Understanding what patients value during their episode of care is important in the modern healthcare environment. Read More

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http://dx.doi.org/10.12788/ajo.2018.0090DOI Listing
October 2018
7 Reads

Glycemic Outcomes of Islet Autotransplantation.

Curr Diab Rep 2018 Sep 28;18(11):116. Epub 2018 Sep 28.

Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, 1830 East Monument Street, Suite 333, Baltimore, MD, 21287, USA.

Purpose Of Review: While there has been a growing utilization of total pancreatectomy with islet autotransplantation (TPIAT) for patients with medically refractory chronic pancreatitis over the past few decades, there remains a lack of consensus clinical guidelines to inform the counseling and management of patients undergoing TPIAT. In this article, we review the current clinical practice and published experience of several TPIAT centers, outline key aspects in managing patients undergoing TPIAT, and discuss the glycemic outcomes of this procedure.

Recent Findings: Aiming for lower inpatient glucose targets immediately after surgery (usually 100-120 mg/dl), maintaining all patients on subcutaneous insulin for at least 3 months to "rest" islets before an attempt is made to wean insulin, and close outpatient endocrinology follow-up after TPIAT particularly in the first year is common and related to better outcomes. Read More

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http://dx.doi.org/10.1007/s11892-018-1095-0DOI Listing
September 2018
20 Reads

Incidence, Risk Factors, and Clinical Implications of Postoperative Hematoma Requiring Reoperation Following Anterior Cervical Discectomy and Fusion.

Spine (Phila Pa 1976) 2018 Sep 21. Epub 2018 Sep 21.

Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT 06510, USA.

Study Design: Retrospective study of prospectively collected data.

Objective: To determine the incidence, timing, risk factors, and clinical implications of postoperative hematoma requiring reoperation following anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Postoperative hematomas requiring reoperation are rare but potentially catastrophic complications following ACDF. Read More

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http://dx.doi.org/10.1097/BRS.0000000000002885DOI Listing
September 2018
2 Reads

Home intravenous versus oral antibiotics following appendectomy for perforated appendicitis in children: a randomized controlled trial.

Pediatr Surg Int 2018 Dec 14;34(12):1257-1268. Epub 2018 Sep 14.

Levine Children's Hospital, Carolinas Healthcare System, 1000 Blythe Blvd., Charlotte, NC, 28203, USA.

Purpose: To compare the effect of home intravenous (IV) versus oral antibiotic therapy on complication rates and resource utilization following appendectomy for perforated appendicitis.

Methods: This was a randomized controlled trial of patients aged 4-17 with surgically treated perforated appendicitis from January 2011 to November 2013. Perforation was defined intraoperatively and divided into three grades: I-contained perforation, II-localized contamination to right gutter/pelvis, and III-diffuse contamination. Read More

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http://dx.doi.org/10.1007/s00383-018-4343-0DOI Listing
December 2018
2 Reads

Can time to healing in pediatric blunt splenic injury be predicted?

Pediatr Surg Int 2018 Nov 7;34(11):1195-1200. Epub 2018 Sep 7.

Division of Pediatric Surgery, Alpert Medical School of Brown University and Hasbro Children's Hospital, 2, Dudley Street, Suite 190, Providence, RI, 02905, USA.

Background: Current consensus guidelines do not recommend routine follow-up imaging for blunt splenic injury (BSI) in children. However, repeat imaging is recommended based on persistent symptoms. Wide variation of practice continues to exist among surgeons. Read More

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http://dx.doi.org/10.1007/s00383-018-4341-2DOI Listing
November 2018
1 Read

Symptomatic anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow concentrate and platelet products: a non-controlled registry study.

J Transl Med 2018 Sep 3;16(1):246. Epub 2018 Sep 3.

CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.

Background: Bone marrow concentrate (BMC) has shown promise in the treatment of several orthopedic conditions. This registry study investigated the use of autologous BMC and platelet products for percutaneous anterior cruciate ligament (ACL) treatment.

Methods: Twenty-nine patients presenting to a single outpatient interventional musculoskeletal and pain practice with symptomatic grade 1, 2, or 3 ACL tears with less than 1 cm retraction were enrolled. Read More

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http://dx.doi.org/10.1186/s12967-018-1623-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122476PMC
September 2018
8 Reads

Heterogeneity among hospitals statewide in percentage shares of the annual growth of surgical caseloads of inpatient and outpatient major therapeutic procedures.

J Clin Anesth 2018 Sep 18;49:126-130. Epub 2018 Apr 18.

Department of Anesthesiology, Perioperative Medicine & Pain Management, University of Miami, Miller School of Medicine, 1400 NW 12th Avenue, Suite 3075, Miami, FL 33136, United States. Electronic address:

Study Objective: Suppose that it were a generalizable finding, in both densely populated and rural states, that there is marked heterogeneity among hospitals in the percentage change in surgical caseload and/or in the total change in caseload. Then, individual hospitals should not simply rely on federal and state forecasts to infer their expected growth. Likewise, individual hospitals and their anesthesiology groups would best not rely on national or US regional surgical trends as causal reasons for local trends in caseload. Read More

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http://dx.doi.org/10.1016/j.jclinane.2018.04.003DOI Listing
September 2018

Safety and Efficacy of Arterial Closure Devices in an Office-Based Angiosuite.

Ann Vasc Surg 2018 Aug 13;51:10-17. Epub 2018 Apr 13.

DFW Vascular Group, Dallas, TX. Electronic address:

Introduction: We aimed to compare the safety and efficacy of 5 arterial closure devices in an outpatient endovascular surgery center.

Methods: We retrospectively reviewed all cases using femoral arterial access performed between January 2012 and December 2013. Five different arterial closure devices (AngioSeal, Perclose, StarClose, ExoSeal, and Mynx) were used by 7 endovascular surgeons. Read More

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http://dx.doi.org/10.1016/j.avsg.2018.02.011DOI Listing
August 2018
8 Reads

Preoperative Evaluation and Patient Selection for Office-Based Oral Surgery Anesthesia.

Authors:
Stuart Lieblich

Oral Maxillofac Surg Clin North Am 2018 May;30(2):137-144

University of Connecticut School of Dental Medicine, Farmington, CT, USA; Private Practice, Avon Oral and Maxillofacial Surgery, 34 Dale Road, Suite 105, Avon, CT 06001, USA. Electronic address:

Provision of an outpatient anesthetic requires careful review of the patient's medical history along with salient aspects of the physical examination. The oral and maxillofacial surgeon may need to consult with the patient's medical providers to gain an understanding of the patient's potential risks for an adverse event. This article reviews key aspects of the patient evaluation so that an informed determination of suitability for an office anesthetic can be made. Read More

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http://dx.doi.org/10.1016/j.coms.2018.01.001DOI Listing
May 2018
3 Reads

The development of facility standards for common outpatient procedures and implications for the context of abortion.

BMC Health Serv Res 2018 03 27;18(1):212. Epub 2018 Mar 27.

Advancing New Standards in Reproductive Health, University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA.

Background: In recent years, an increasing number of states have enacted laws that impose specific requirements for facilities in which abortions are performed. In this study, we sought to understand the processes used to develop facility standards in the context of other, less politically charged areas of health care and consider implications for the context of abortion.

Methods: We conducted key informant interviews with 20 clinicians and accreditation professionals involved in facility standards development for common outpatient procedures (endoscopy, gynecology, oral surgery, plastic surgery). Read More

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http://dx.doi.org/10.1186/s12913-018-3048-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870078PMC
March 2018
1 Read

First installation of a dual-room IVR-CT system in the emergency room.

Scand J Trauma Resusc Emerg Med 2018 Mar 5;26(1):17. Epub 2018 Mar 5.

Department of Emergency and Critical Care Medicine, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan.

Computed tomography (CT) embedded in the emergency room has gained importance in the early diagnostic phase of trauma care. In 2011, we implemented a new trauma workflow concept with a sliding CT scanner system with interventional radiology features (IVR-CT) that allows CT examination and emergency therapeutic intervention without relocating the patient, which we call the Hybrid emergency room (Hybrid ER). In the Hybrid ER, all life-saving procedures, CT examination, damage control surgery, and transcatheter arterial embolisation can be performed on the same table. Read More

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http://dx.doi.org/10.1186/s13049-018-0484-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836362PMC
March 2018
1 Read

Physician Assistants and Nurse Practitioners in Head and Neck Surgery.

Cancer Treat Res 2018 ;174:17-30

City of Hope National Medical Center, Duarte, CA, USA.

This chapter explores the role of advanced practice clinicians (APCs) and patient care coordinators in the head and neck cancer setting. APCs, which include physician assistants (PAs) and nurse practitioners (NPs), are licensed professional healthcare providers who diagnose and treat illnesses, order and interpret diagnostic tests, and prescribe pharmaceutical and non-pharmaceutical therapies. Although the training, education, and licensure differ between PAs and NPs, their roles are quite similar in head and neck surgery. Read More

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http://dx.doi.org/10.1007/978-3-319-65421-8_2DOI Listing
January 2018
1 Read

The outpatient total hip arthroplasty : a paradigm change.

Bone Joint J 2018 Jan;100-B(1 Supple A):31-35

Joint Implant Surgeons, 7277 Smith's Mill Road, Suite 200, New Albany, Ohio 43054, USA.

Aims: To examine incidence of complications associated with outpatient total hip arthroplasty (THA), and to see if medical comorbidities are associated with complications or extended length of stay.

Patients And Methods: From June 2013 to December 2016, 1279 patients underwent 1472 outpatient THAs at our free-standing ambulatory surgery centre. Records were reviewed to determine frequency of pre-operative medical comorbidities and post-operative need for overnight stay and complications which arose. Read More

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http://online.boneandjoint.org.uk/doi/10.1302/0301-620X.100B
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http://dx.doi.org/10.1302/0301-620X.100B1.BJJ-2017-0514.R1DOI Listing
January 2018
6 Reads

Outcomes and Direct Costs of Inferior Vena Cava Filter Placement and Retrieval within the IR and Surgical Settings.

J Vasc Interv Radiol 2018 02 6;29(2):170-175. Epub 2017 Dec 6.

Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio; Northwest Radiology, St. Vincent Health, 5901 Technology Center Dr., Indianapolis, IN 46278. Electronic address:

Purpose: To compare the outcomes and costs of inferior vena cava (IVC) filter placement and retrieval in the interventional radiology (IR) and surgical departments at a tertiary-care center.

Materials And Methods: Retrospective review was performed of 142 sequential outpatient IVC filter placements and 244 retrievals performed in the IR suite and operating room (OR) from 2013 to 2016. Patient demographic data, procedural characteristics, outcomes, and direct costs were compared between cohorts. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10510443173083
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http://dx.doi.org/10.1016/j.jvir.2017.09.005DOI Listing
February 2018
8 Reads

Lack of generalizability of observational studies' findings for turnover time reduction and growth in surgery based on the State of Iowa, where from one year to the next, most growth was attributable to surgeons performing only a few cases per week.

J Clin Anesth 2018 02 24;44:107-113. Epub 2017 Nov 24.

Department of Anesthesiology, Perioperative Medicine & Pain Management, University of Miami, Miller School of Medicine, 1400 NW 12th Avenue, Suite 3075, Miami, FL 33136, United States. Electronic address:

Study Objective: Three observational studies at large teaching hospitals found that reducing turnover times resulted in the surgeons performing more cases. We sought to determine if these findings are generalizable to other hospitals, because, if so, reducing turnover times may be an important mechanism for hospitals to use for growing caseloads.

Design: Observational cohort study. Read More

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http://dx.doi.org/10.1016/j.jclinane.2017.11.002DOI Listing
February 2018
3 Reads

Contraception Update: Sterilization.

FP Essent 2017 Nov;462:30-34

Christiana Care Health System Value Institute Ammon Center 2E55, 4755 Ogletown-Stanton Rd, Newark, DE 19718.

Female sterilization procedures include postpartum partial salpingectomy via cesarean or minilaparotomy incision, interval laparoscopic procedures, or hysteroscopic placement of microinserts. Rates of failure and serious complications are low and comparable among the various methods. A hysteroscopic procedure requires a 3-month confirmatory hysterosalpingogram before it is considered effective for contraception. Read More

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November 2017
5 Reads

Fast-Track Registration: A Way to Increase Efficiency in the IR Division.

J Vasc Interv Radiol 2018 Jan 21;29(1):125-131. Epub 2017 Nov 21.

Department of Radiology, University of Louisville Hospital, 530 South Jackson Street, CCB-C07, Louisville, KY 40202.

Purpose: To evaluate changes in patient registration process at an academic 2-suite IR Division to determine if moving registration from the waiting room to the vascular holding area decreased amount of time patients spent in the Radiology Department and improved start times.

Materials And Methods: A data collection sheet was created by evaluating patient-related processes; event timestamps were recorded on the sheet. The control group consisted of 33 patients who registered using the traditional process. Read More

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http://dx.doi.org/10.1016/j.jvir.2017.08.025DOI Listing
January 2018
4 Reads

Ambulatory anterior cervical discectomy and fusion is associated with a higher risk of revision surgery and perioperative complications: an analysis of a large nationwide database.

Spine J 2018 07 16;18(7):1180-1187. Epub 2017 Nov 16.

Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, 1250 16th St., Santa Monica, CA 90404. Electronic address:

Background Context: With the changing landscape of health care, outpatient spine surgery is being more commonly performed to reduce cost and to improve efficiency. Anterior cervical discectomy and fusion (ACDF) is one of the most common spine surgeries performed and demand is expected to increase with an aging population.

Purpose: The objective of this study was to determine the nationwide trends and relative complication rates associated with outpatient ACDF. Read More

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http://dx.doi.org/10.1016/j.spinee.2017.11.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291305PMC
July 2018
21 Reads

Outpatient Surgery.

Authors:
Frederick M Azar

Orthop Clin North Am 2018 01 23;49(1):xv. Epub 2017 Oct 23.

Campbell Clinic, Inc, University of Tennessee-Campbell Clinic, Department of Orthopaedic Surgery & Biomedical Engineering, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ocl.2017.10.001DOI Listing
January 2018

Outpatient Shoulder Arthroplasty.

Orthop Clin North Am 2018 Jan 26;49(1):73-79. Epub 2017 Oct 26.

Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA. Electronic address:

Health care policy makers have placed increased attention on the cost of health care making outpatient joint arthroplasty an attractive alternative to routine hospital admission. Recent studies have shown outpatient shoulder arthroplasty is a safe and cost-effective alternative to inpatient shoulder arthroplasty. Proper patient selection, patient education, effective pain management strategies, and attention to intraoperative blood loss are keys in the success of outpatient shoulder arthroplasty. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00305898173015
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http://dx.doi.org/10.1016/j.ocl.2017.08.011DOI Listing
January 2018
4 Reads

Hand Surgery in the Ambulatory Surgery Center.

Orthop Clin North Am 2018 Jan;49(1):69-72

Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA. Electronic address:

Outpatient surgery, especially in free-standing ambulatory surgery centers (ASC), provides a safe, cost-effective option for a variety of surgical procedures and has become the preferred choice over inpatient and hospital-based outpatient surgery for most hand and wrist procedures. Complication rates after ASC hand surgery are low (0.2%-2. Read More

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http://dx.doi.org/10.1016/j.ocl.2017.08.009DOI Listing
January 2018
3 Reads

Use of Wide-awake Local Anesthesia No Tourniquet in Hand and Wrist Surgery.

Orthop Clin North Am 2018 Jan;49(1):63-68

Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.

WALANT (wide-awake local anesthesia no tourniquet) appears to be a safe and effective anesthesia technique for many hand and wrist surgeries. Patient satisfaction is high because of the avoidance of preoperative testing and hospital admission. Postoperative recovery is rapid, and procedures can be done in outpatient settings, resulting in substantial savings in time and money. Read More

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http://dx.doi.org/10.1016/j.ocl.2017.08.008DOI Listing
January 2018
3 Reads

Outpatient Management of Ankle Fractures.

Orthop Clin North Am 2018 Jan;49(1):103-108

Foot and Ankle, Foot and Ankle Orthopedic Fellowship, Department of Orthopedic Surgery, Northwestern Memorial Hospital, Northwestern University, Feinberg School of Medicine, 676 North St. Clair, Suite 1350, Chicago, IL 60611, USA. Electronic address:

Interest in outpatient orthopedic surgery has been fueled by provider desire to control costs and development of rapid recovery protocols. Open reduction and internal fixation (ORIF) is a commonly elected treatment strategy for ankle fracture that may be performed in an outpatient setting. Lessons on cost-savings of the outpatient model in orthopedics can be learned in total joint replacement and spine surgery. Read More

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http://dx.doi.org/10.1016/j.ocl.2017.08.012DOI Listing
January 2018
2 Reads

A Radiologist's View of Tumor Ablation in the Radiology Suite.

Anesthesiol Clin 2017 Dec;35(4):617-626

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.

Image-guided percutaneous, minimally invasive ablation techniques offer a wide variety of new modalities to treat tumors in some of the most medically complicated patients coming to our hospitals. The use of computed tomography, PET, ultrasound imaging, and MRI to guide radiofrequency ablation, microwave ablation, and cryoablation techniques now makes it possible to treat patients on a short stay or outpatient basis with very good immediate outcomes. This rapid expansion of new tumor ablation techniques often presents challenges for the non-operating room anesthesia team. Read More

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http://dx.doi.org/10.1016/j.anclin.2017.07.007DOI Listing
December 2017
8 Reads

An Anesthesiologist's View of Tumor Ablation in the Radiology Suite.

Anesthesiol Clin 2017 Dec;35(4):611-615

Department of Anesthesiology, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.

The advent of radiology image-guided tumor ablation procedures has opened up a new era in minimally invasive procedures. Using CT, MRI, ultrasound, and other modalities, radiologists and surgeons can now ablate a tumor through percutaneous entry sites. What traditionally was done in an operating room via large open incisions, with multiple days in the hospital recovering, is now becoming an outpatient procedure via these new techniques. Read More

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http://dx.doi.org/10.1016/j.anclin.2017.07.006DOI Listing
December 2017
12 Reads

Open treatment of ankle fracture as inpatient increases risk of complication.

J Orthop Traumatol 2017 Dec 26;18(4):431-438. Epub 2017 Oct 26.

Vanderbilt Orthopaedic Institute Center for Health Policy, Department of Orthopaedics, Vanderbilt University Medical Center, 1215 21st Avenue South, Suite 4200, Medical Center East, South Tower, Nashville, TN, 37232, USA.

Background: Ankle fracture is one of the most common injuries treated by orthopaedic surgeons, and its incidence is only expected to rise with an aging population. It is also associated with often costly complications, yet there is little literature on risk factors, especially modifiable ones, driving these complications. The aim of this study is to reveal whether inpatient treatment after ankle fracture is associated with higher incidence of postoperative complications. Read More

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https://jorthoptraumatol.springeropen.com/articles/10.1007/s
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http://dx.doi.org/10.1007/s10195-017-0472-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685990PMC
December 2017
6 Reads

The digital divide in adoption and use of mobile health technology among caregivers of pediatric surgery patients.

J Pediatr Surg 2018 Aug 1;53(8):1478-1493. Epub 2017 Sep 1.

Department of Pediatric Surgery, The McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, Suite 5.258, Houston, TX 77030, United States; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United States; Department of Pediatric Patient Care, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler St., Unit 1406, Houston, TX 77030, United States. Electronic address:

Purpose: The purpose of this study was to identify mobile Health (mHealth) technology utilization among caregivers of pediatric surgery patients.

Methods: We provided a modified version of the 2012 mobile health survey from the Pew Research Center to English and Spanish-speaking caregivers of children aged <18years presenting to pediatric surgical outpatient clinics from June to July of 2016.

Results: A total of 171 caregivers completed the survey and included 57 (34%) whites, 30 (18%) blacks, 75 (44%) Hispanics, and 6 (4%) other races. Read More

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http://dx.doi.org/10.1016/j.jpedsurg.2017.08.023DOI Listing
August 2018
2 Reads

At most hospitals in the state of Iowa, most surgeons' daily lists of elective cases include only 1 or 2 cases: Individual surgeons' percentage operating room utilization is a consistently unreliable metric.

J Clin Anesth 2017 Nov 29;42:88-92. Epub 2017 Aug 29.

Department of Anesthesiology, Perioperative Medicine & Pain Management, University of Miami, Miller School of Medicine, 1400 NW 12th Avenue, Suite 3075, Miami, FL 33136, United States. Electronic address:

Study Objective: Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals. Read More

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http://dx.doi.org/10.1016/j.jclinane.2017.08.016DOI Listing
November 2017
5 Reads

Validity of a smartphone protractor to measure sagittal parameters in adult spinal deformity.

Spine J 2017 10 14;17(10):1559-1564. Epub 2017 Aug 14.

Department of Orthopedic Surgery, Yawkey Center for Outpatient Care, Massachusetts General Hospital, 55 Fruit St, Suite 3A, Boston, MA 02114, USA.

Background Context: Smartphones have become an integral tool in the daily life of health-care professionals (Franko 2011). Their ease of use and wide availability often make smartphones the first tool surgeons use to perform measurements. This technique has been validated for certain orthopedic pathologies (Shaw 2012; Quek 2014; Milanese 2014; Milani 2014), but never to assess sagittal parameters in adult spinal deformity (ASD). Read More

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http://dx.doi.org/10.1016/j.spinee.2017.06.014DOI Listing
October 2017
3 Reads

Patient with a total artificial heart maintained on outpatient dialysis while listed for combined organ transplant, a single center experience.

Hemodial Int 2017 10 11;21(4):E69-E72. Epub 2017 Aug 11.

Division of Nephrology, Department of Medicine, Ronald Regan Medical Center, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.

Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Read More

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http://dx.doi.org/10.1111/hdi.12580DOI Listing
October 2017
1 Read

Health resource utilization and costs during the first 90 days following robot-assisted hysterectomy.

Int Urogynecol J 2018 Jun 7;29(6):865-872. Epub 2017 Aug 7.

Obstetrics & Gynecology, University of Nevada School of Medicine, 1707 West Charleston Boulevard, Suite 120, Las Vegas, NV, 89102, USA.

Introduction And Hypothesis: To compare health resource utilization, costs and readmission rates between robot-assisted and non-robot-assisted hysterectomy during the 90 days following surgery.

Methods: The study used 2008-2012 Truven Health MarketScan data. All patients admitted as inpatients with a CPT code for hysterectomy between January 2008 and September 2012 were identified and the first hysterectomy-related admission in each patient was included. Read More

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http://dx.doi.org/10.1007/s00192-017-3432-2DOI Listing
June 2018
1 Read

Outcomes of Gartland type III supracondylar fractures treated using Blount's method.

Orthop Traumatol Surg Res 2017 11 3;103(7):1121-1125. Epub 2017 Aug 3.

Service d'orthopédie infantile, hôpitaux pédiatriques de Nice CHU-Lenval, 57, avenue de la Californie, 06000 Nice, France. Electronic address:

Background: Supracondylar fractures of the elbow with major displacement are usually treated by surgical pinning and less often non-operatively as described by Blount. The objective of this study was to assess the clinical and radiological outcomes of Gartland type III supracondylar fractures treated at least 3 years earlier using Blount's method.

Hypothesis: Blount's method produces good outcomes after more than 3 years when used to treat Gartland type III supracondylar fractures of the humerus. Read More

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http://dx.doi.org/10.1016/j.otsr.2017.06.011DOI Listing
November 2017
7 Reads

Pre-transplant depression as a predictor of adherence and morbidities after orthotopic heart transplantation.

J Cardiothorac Surg 2017 Jul 25;12(1):62. Epub 2017 Jul 25.

Cardiovascular and Thoracic Surgery, Rush University Medical Center, Rush University Medical Center, 1725 W Harrison, Suite 1156 POB, Chicago, IL, 60612, USA.

Background: Psychosocial factors are useful predictors of adverse outcomes after solid organ transplantation. Although depression is a known predictor of poor outcomes in patients who undergo orthotopic heart transplantation (OHT) and is actively screened for during pre-transplant evaluation, the effects of early identification of this entity on post-transplant outcomes are not clearly understood. The purpose of this study was to evaluate the impact of pre-transplant depression on outcomes after OHT. Read More

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http://cardiothoracicsurgery.biomedcentral.com/articles/10.1
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http://dx.doi.org/10.1186/s13019-017-0626-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526318PMC
July 2017
1 Read

A universal drug delivery catheter for the treatment of infrapopliteal arterial disease: Results from the multi-center first-in-human study.

Catheter Cardiovasc Interv 2018 02 14;91(2):296-301. Epub 2017 Jul 14.

Cardiovascular Associates of East Texas, Interventional Cardiologist and Peripheral Interventionalist, 1783 Troup Hwy, Tyler, TX, 75701.

Objective: The objective of this study was to assess the feasibility, safety and initial efficacy of paclitaxel administration using a novel drug delivery catheter for the prevention of restenosis in infrapopliteal de novo and restenotic lesions.

Background: Restenosis continues to be a great challenge after percutaneous revascularization procedures for peripheral arterial disease, particularly for below-the-knee applications.

Methods: A prospective, multicenter first-in-human registry of a novel delivery catheter delivering liquid paclitaxel was conducted in 10 patients. Read More

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http://doi.wiley.com/10.1002/ccd.27176
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http://dx.doi.org/10.1002/ccd.27176DOI Listing
February 2018
9 Reads

Type B Aortic Dissections: Current Guidelines for Treatment.

Cardiol Clin 2017 Aug 26;35(3):387-410. Epub 2017 May 26.

Division of Vascular Surgery, Department of Surgery, Keck School of Medicine of USC, University of Southern California, 1520 San Pablo Street, HCC II, Suite 4300, Los Angeles, CA 90033-5330, USA. Electronic address:

Stanford type B aortic dissections (TBADs) involve the descending aorta and can present with complications, including malperfusion syndrome or aortic rupture, which are associated with significant morbidity and mortality if left untreated. Clinical diagnosis is straightforward, typically confirmed using CT angiography. Treatment begins with immediate anti-impulse medical therapy. Read More

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http://dx.doi.org/10.1016/j.ccl.2017.03.007DOI Listing
August 2017
1 Read

Comparative outcomes of outpatient and inpatient total shoulder arthroplasty: an analysis of the Medicare dataset.

Bone Joint J 2017 Jul;99-B(7):934-938

Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 300, Chicago, IL 60612, USA.

Aims: The aim of the present study was to compare the 30- and 90-day re-admission rates and complication rates of outpatient and inpatient total shoulder arthroplasty (TSA).

Patients And Methods: The United States Medicare Standard Analytical Files database was questioned to identify patients who had undergone outpatient or inpatient TSA between 2005 and 2012. Patient characteristics were compared between the two groups using chi-squared analysis. Read More

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http://dx.doi.org/10.1302/0301-620X.99B7.BJJ-2016-0976.R1DOI Listing
July 2017
6 Reads

In-Hospital ST Elevation Myocardial Infarction: Clinical Characteristics, Management Challenges, and Outcome.

Interv Cardiol Clin 2016 10 5;5(4):471-480. Epub 2016 Aug 5.

Cedars-Sinai Heart Institute, 127 South San Vicente Boulevard, Suite A3100, Los Angeles, CA 90048, USA.

Timely reperfusion therapy reduces complications and improves survival in ST elevation myocardial infarction (STEMI). An effective chain of survival has been established for STEMIs occur in the community (outpatient STEMI). Recent studies have identified a subgroup of patients who develop STEMI while hospitalized for primary conditions, often not directly related to coronary artery disease (in-hospital STEMI or inpatient STEMI). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22117458163006
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http://dx.doi.org/10.1016/j.iccl.2016.06.005DOI Listing
October 2016
35 Reads

Social well-being is associated with less pro-inflammatory and pro-metastatic leukocyte gene expression in women after surgery for breast cancer.

Breast Cancer Res Treat 2017 Aug 30;165(1):169-180. Epub 2017 May 30.

Department of Psychology, University of Miami, 5665 Ponce De Leon Blvd., Coral Gables, FL, 33146, USA.

Purpose: Satisfaction with social resources, or "social well-being," relates to better adaptation and longer survival after breast cancer diagnosis. Biobehavioral mechanisms linking social well-being (SWB) to mental and physical health may involve inflammatory signaling. We tested whether reports of greater SWB were associated with lower levels of pro-inflammatory and pro-metastatic leukocyte gene expression after surgery for non-metastatic breast cancer. Read More

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http://link.springer.com/10.1007/s10549-017-4316-3
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http://dx.doi.org/10.1007/s10549-017-4316-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5528864PMC
August 2017
31 Reads

Preoperative risk stratification of critically ill patients.

J Clin Anesth 2017 Jun 7;39:122-127. Epub 2017 Apr 7.

David Geffen School of Medicine, Ronald Reagan Medical Center, UCLA, 757 Westwood Plz. Suite 3325, Los Angeles, CA 90095, United States.

Study Objective: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. Read More

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http://dx.doi.org/10.1016/j.jclinane.2017.03.044DOI Listing
June 2017
7 Reads

Outpatient treatment of osteomyelitis with telavancin.

Int J Antimicrob Agents 2017 Jul 26;50(1):93-96. Epub 2017 Apr 26.

Infectious Diseases Associates, 1425 S. Osprey Ave., Suite 1, Sarasota, FL 34239, USA.

Telavancin is a lipoglycopeptide antibiotic with bactericidal activity against Gram-positive pathogens including Staphylococcus aureus, the most frequent cause of osteomyelitis. Treatment is often challenging due to needs for surgical intervention along with prolonged administration of intravenous antimicrobials, frequently in an outpatient setting. This was a retrospective analysis of the efficacy and safety of telavancin for treatment of osteomyelitis provided as outpatient parenteral antimicrobial therapy (OPAT) in physician office infusion centres. Read More

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http://dx.doi.org/10.1016/j.ijantimicag.2017.01.034DOI Listing
July 2017
21 Reads

Outpatient Emergencies: Acute Heart Failure.

Med Clin North Am 2017 May 2;101(3):507-519. Epub 2017 Mar 2.

Department of Medicine, Jefferson Heart Institute, Sidney Kimmel Medical College of Thomas Jefferson University, 925 Chestnut Street, Suite 323A, Philadelphia, PA 19107, USA. Electronic address:

Heart failure is an epidemic in the United States and a major health problem worldwide. The syndrome of acute heart failure is marked by a recent onset of symptoms usually in terms of days to a few weeks of worsening fatigue, shortness of breath, orthopnea, swelling, and sudden onset of weight gain. Physicians caring for patients with heart failure must know the risk factors for this disease, pathophysiology, symptomatology, important examination findings, key diagnostic tests, and management approach so as to improve symptoms and reduce mortality. Read More

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http://dx.doi.org/10.1016/j.mcna.2016.12.010DOI Listing
May 2017
1 Read

Comparative analysis of overall cost and rate of healthcare utilization among apical prolapse procedures.

Int Urogynecol J 2017 Oct 31;28(10):1481-1488. Epub 2017 Mar 31.

Department of Obstetrics and Gynecology, University of Nevada School of Medicine, 1707 West Charleston Blvd, Suite 120, Las Vegas, NV, 89102, USA.

Introduction And Hypothesis: The annual cost of prolapse surgeries is expected to grow at twice the rate of population growth. Understanding the economic impact of apical prolapse procedures, including sacrospinous fixation (SSF), abdominal sacrocolpopexy (ASC), and laparoscopic sacrocolpopexy (LSC), is crucial. We aimed to compare overall cost of SSF versus ASC and LSC, as well as health resource utilization, up to 90-day follow-up. Read More

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http://dx.doi.org/10.1007/s00192-017-3324-5DOI Listing
October 2017
2 Reads

Complications and Outcomes After Gynecomastia Surgery: Analysis of 204 Pediatric and 1583 Adult Cases from a National Multi-center Database.

Aesthetic Plast Surg 2017 Aug 24;41(4):761-767. Epub 2017 Mar 24.

Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, 6560 Fannin Street, Scurlock Tower, Suite 2200, Houston, TX, 77030, USA.

Background: Gynecomastia is a common disease that is prevalent across all age groups of boys and men. Although benign in nature, it can lead to psychological and social distress, prompting affected patients to seek medical attention. Management strategies include observation and drug therapy, yet surgical procedures remain the hallmark of treatment. Read More

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http://dx.doi.org/10.1007/s00266-017-0833-zDOI Listing
August 2017
9 Reads

Two techniques for assessing postoperative voiding function, a randomized trial.

Int Urogynecol J 2017 Oct 11;28(10):1567-1572. Epub 2017 Mar 11.

The University of North Carolina, Chapel Hill, NC, USA.

Introduction And Hypothesis: Post-operative voiding dysfunction is common after sling placement and is assessed with a voiding trial (VT) before discharge. We hypothesized that an operating room (OR) initiated retrograde VT (OR-fill) would decrease time to discharge compared with a post-anesthesia care unit (PACU) initiated retrograde VT (PACU-fill).

Methods: This was a parallel non-blinded randomized trial, of women undergoing outpatient sling surgery at a university hospital. Read More

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http://dx.doi.org/10.1007/s00192-017-3310-yDOI Listing
October 2017
6 Reads

ST-segment elevation myocardial infarction, systems of care. An urgent need for policies to co-ordinate care in order to decrease in-hospital mortality.

Int J Cardiol 2017 Aug 15;240:82-86. Epub 2017 Feb 15.

University of Nevada School of Medicine, Division of Cardiovascular Medicine, United States. Electronic address:

Background: Regional trends for ST-segment elevation myocardial infarction (STEMI) treatment is not known in the state of Nevada.

Hypothesis: Great disparity exists for treatment for STEMI in different geographical areas of Nevada. There is a great potential to improve treatment and outcomes of STEMI patients in the State of Nevada. Read More

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http://dx.doi.org/10.1016/j.ijcard.2017.02.038DOI Listing
August 2017
4 Reads

Associations Between Pain Catastrophizing and Cognitive Fusion in Relation to Pain and Upper Extremity Function Among Hand and Upper Extremity Surgery Patients.

Ann Behav Med 2017 Aug;51(4):547-554

Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 1 Bowdoin Street, Boston, MA, 02114, USA.

Background: Patients who present to hand surgery practices are at increased risk of psychological distress, pain, and disability. Greater catastrophic thinking about pain is associated with greater pain intensity, and initial evidence suggest that, together, catastrophic thinking about pain and cognitive fusion (i.e. Read More

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http://dx.doi.org/10.1007/s12160-017-9877-1DOI Listing
August 2017
11 Reads

Flat detector CT and its applications in the endovascular treatment of wide-necked intracranial aneurysms-A literature review.

Eur J Radiol 2017 Mar 26;88:26-31. Epub 2016 Dec 26.

Microvention - Terumo, Tustin, CA, USA. Electronic address:

Flat detector CT (FDCT) provides cross sectional imaging within an angiographic suite and is increasingly gaining popularity in various areas of interventional radiology, as an alternative imaging modality. Its relatively high spatial resolution improves visualization of intraluminal devices such as intracranial stents or flow-diverters. Device deployment and positioning, in relation to the parent vessel and surrounding structures, are easily assessible with FDCT. Read More

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http://dx.doi.org/10.1016/j.ejrad.2016.12.027DOI Listing
March 2017
11 Reads

Risk associated with perioperative red blood cell transfusion in cranial surgery.

Neurosurg Rev 2017 Oct 3;40(4):633-642. Epub 2017 Feb 3.

The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, and Department of Neurosurgery, The Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

We assessed the impact of intra- and postoperative RBC transfusion on postoperative morbidity and mortality in cranial surgery. A total of 8924 adult patients who underwent cranial surgery were identified in the 2006-2011 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Patients undergoing a biopsy, radiosurgery, or outpatient surgery were excluded. Read More

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http://dx.doi.org/10.1007/s10143-017-0819-yDOI Listing
October 2017
5 Reads