154,321 results match your criteria hospital stays

Iatrogenic Ureteral Injury and Prophylactic Stent Use in Veterans Undergoing Colorectal.

J Surg Res 2021 May 5;265:272-277. Epub 2021 May 5.

Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine / Detroit Medical Center, Detroit, Michigan; John D. Dingell VA Medical Center, Detroit, Michigan. Electronic address:

Introduction: Iatrogenic ureteral injury (IUI) is an uncommon complication in colorectal surgery. Prophylactic ureteral stenting (PUS) gained acceptance to aid in intraoperative identification of the ureter. Despite its use, the benefit of pus to avoid IUI remains debatable. Read More

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EMS blood collection from patients with acute chest pain reduces emergency department length of stay.

Am J Emerg Med 2021 Apr 26;47:248-252. Epub 2021 Apr 26.

Department of Emergency Medicine, Wake Forest School of Medicine, USA.

Background: Expediting the measurement of serum troponin by leveraging EMS blood collection could reduce the diagnostic time for patients with acute chest pain and help address Emergency Department (ED) overcrowding. However, this practice has not been examined among an ED chest pain patient population in the United States.

Methods: A prospective observational cohort study of adults with non-traumatic chest pain without ST-segment elevation myocardial infarction was conducted in three EMS agencies between 12/2016-4/2018. Read More

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Sequence For Surgical Resection of Primary Lung Tumor For Oligometastatic Non-Small Cell Lung Cancer.

Ann Thorac Surg 2021 May 5. Epub 2021 May 5.

Division of Thoracic Oncology, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Background: Differing surgical series for the treatment of primary lung tumor with synchronous oligometastatic stage IV non-small cell lung cancer (NSCLC) have been published; however, outcomes remain ambiguous.

Methods: Patients with synchronous oligometastatic stage IV NSCLC treated from 2005 to 2017 were enrolled to identify the impact of treatment sequence (primary lung resection versus systemic treatment) on progression-free survival (PFS) and overall survival (OS).

Results: Fifty-one patients received tumor resection (84% adenocarcinoma, 55% non-smokers, and 65% driver gene mutation). Read More

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Is Outpatient Management of Mandibular Fractures Associated With Inflammatory Complications? An ACS-NSQIP Study.

J Oral Maxillofac Surg 2021 Mar 26. Epub 2021 Mar 26.

Assistant Professor, Oral & Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA. Electronic address:

Purpose: Timing of mandibular fracture repair has long been debated. The purpose of the present study was to assess the incidence of postoperative inflammatory complications (POICs) following open repair of mandibular fractures managed non-urgently in the outpatient setting versus urgently in the inpatient setting.

Methods: The authors utilized the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to enroll a sample of patients with mandibular fractures who underwent open repair. Read More

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Association between nutrition delivery, modified Nutrition Risk in Critically Ill score, and 28-day mortality.

Nutr Clin Pract 2021 May 8. Epub 2021 May 8.

Division of Biostatistics, National Institute of Nutrition, Hyderabad, Telangana, India.

Background: Nutrition delivery, is a key component in the management of critical illness. Traditional scoring systems are inadequate in the intensive care unit (ICU), as patients are sedated. Our study examines the associations between calorie and protein adequacy, 28-day mortality, and modified Nutrition Risk in Critically Ill (mNUTRIC) score and identify at-risk ICU patients who may benefit more from nutrition intervention. Read More

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Extracorporeal photopheresis vs standard therapies for steroid-refractory chronic graft-vs-host disease: Pharmacoeconomic assessment of hospital resource use in Spain.

J Clin Apher 2021 May 8. Epub 2021 May 8.

Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.

Background: This study assessed pharmacoeconomic costs associated with extracorporeal photopheresis (ECP) compared with other available second-line therapies for chronic graft-vs-host disease (cGvHD) in a tertiary Spanish institution.

Methods: Patients (≥18 years) diagnosed with steroid-refractory cGvHD were eligible. Data were collected retrospectively from index date until 1 year or relapse. Read More

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Does preoperative neoadjuvant chemotherapy impact short-term surgical outcomes in patients with locally advanced colon cancer?

Int J Colorectal Dis 2021 May 8. Epub 2021 May 8.

Department of Surgery, University of Arizona Medical Center, Tucson, AZ, USA.

Background: Preoperative neoadjuvant chemotherapy (NAC) for colon cancer in advanced stages is associated with improved outcomes and tumor regression. The aim of our study was to identify outcomes in patients with colon cancer who received preoperative NAC.

Methods: A 4-year analysis of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) was performed. Read More

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Magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) is a viable alternative to liver biopsy for steatosis quantification in living liver donor transplantation.

Clin Transplant 2021 May 8:e14339. Epub 2021 May 8.

Thomas E. Starzl Transplantation Institute, University of Pittsburgh, University of Pittsburgh Medical Center.

This study aimed to investigate whether magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) can be a viable noninvasive alternative to liver biopsy for the quantification of living liver donor steatosis. Hepatic steatosis for 143 donors was graded by MRI-PDFF. Study endpoints included liver volume regeneration in donors, recipient outcomes including length of hospital stay, deaths, primary non-function (PNF), early allograft dysfunction (EAD), and small for size syndrome (SFSS). Read More

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Perioperative Management Of Children With Neuromuscular Disorders Based On A Common Protocol: A Prospective, National Study In Italy.

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Department of Emergency Medicine, Anaesthesia and Intensive Care, University Hospital Agostino Gemelli IRCCS, Rome, Italy.

Background: Children with neuromuscular diseases (NMDs) often display respiratory muscle weakness which increases the risk of postoperative pulmonary complications (PPCs) after general anaesthesia. Non-invasive ventilation (NIV) associated with mechanical insufflation-exsufflation (MI-E) can reduce the incidence and severity of PPCs. The aim of this study was to report our experience with a shared peri-operative protocol that consists in using NIV combined with MI-E to improve the postoperative outcome of NMD children (IT-NEUMA-Ped). Read More

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Difference in postoperative opioid consumption after spinal vs. general anaesthesia for ankle fracture surgery - a retrospective cohort study.

Acta Anaesthesiol Scand 2021 May 8. Epub 2021 May 8.

Research Group of Surgery, Anaesthesiology and Intensive Care Medicine, Medical Research Center, Oulu University, Oulu University Hospital, Oulu, Finland.

Background: Surgical treatment of ankle fracture is associated with significant pain and high postoperative opioid consumption. The anaesthesia method may affect early postoperative pain. The main objective of the study was to compare postoperative opioid consumption after ankle-fracture surgery between patients treated with spinal anaesthesia and general anaesthesia. Read More

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Effective cleaning of endoscopic lenses to achieve visual clarity for minimally invasive abdominopelvic surgery: a systematic review.

Surg Endosc 2021 May 7. Epub 2021 May 7.

Department of Surgery and Cancer, Imperial College London, London, United Kingdom.

Objective: To review the recently available interventions to achieve optimal visual clarity in laparoscopic abdominopelvic surgery compared to conventional cleaning alternatives. Currently, there is no consensus on the most effective method for the cleaning of endoscopic lenses used in minimally invasive abdominopelvic surgery.

Methods: Literature searching for articles relevant to answering a predefined research question was performed in December 2019 and involved searching of the electronic databases of MEDLINE, the Cochrane Registry, and EMBASE. Read More

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Comparison of Clinical and Radiographic Outcomes After Standalone Versus Cage and Plate Constructs for Anterior Cervical Discectomy and Fusion.

Int J Spine Surg 2021 May 7. Epub 2021 May 7.

MedStar Georgetown University Hospital, Department of Neurosurgery, Washington, DC.

Background: Anterior cervical discectomy and fusion (ACDF) has conventionally been performed using an allograft cage with a plate-and-screw construct. Recently, standalone cages have gained popularity due to theorized decreases in operative time and postoperative dysphagia. Few studies have compared these outcomes. Read More

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Lordosis Restoration With Midline Minimally Invasive Cortical Trajectory Screws (MidLF) and Transforaminal Interbody Fusion: A Safe Technique With a Short Stay.

Int J Spine Surg 2021 May 7. Epub 2021 May 7.

Avon Orthopaedic Centre, Brunel Building, Southmead Hospital, Westbury-on-Trym, Bristol, United Kingdom.

Background: The minimally invasive cortical trajectory screw (MidLF) technique has been described accompanied with posterolateral interbody fusion (PLIF). We present our 2-year results of a hybrid technique to show that using transforaminal interbody fusion (TLIF) rather than PLIF in conjunction with MidLF is a less invasive and safe technique.

Methods: We retrospectively identified 25 patients who underwent MidLF with TLIF from July 2015 through September 2017. Read More

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Academy of Nutrition and Dietetics Nutrition Research Network: Rationale and Protocol for a Study to Validate the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Consensus-Derived Diagnostic Indicators For Adult And Pediatric Malnutrition and to Determine Optimal Registered Dietitian Nutritionist Staffing in Acute Care Hospital Settings.

J Acad Nutr Diet 2021 May 4. Epub 2021 May 4.

No systematic, universally accepted method of diagnosing malnutrition in hospitalized patients exists, which may contribute to underdiagnosis, undertreatment, and poorer patient outcomes. To address this issue, the Academy of Nutrition and Dietetics is conducting a cohort study to: assess the predictive validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition indicators for the diagnosis of adult and pediatric malnutrition in hospital settings; assess the interrater reliability of the indicators for the diagnosis of adult and pediatric malnutrition; and quantify the level of registered dietitian nutritionist care needed to improve patient outcomes. Up to 60 adult and 60 pediatric hospital sites will collect data to estimate level of registered dietitian nutritionist care, along with patient medical history and Malnutrition Screening Tool (adult) or STRONGkids (pediatric) results. Read More

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Antimicrobial stewardship solutions with a smart innovative tool.

J Am Pharm Assoc (2003) 2021 Apr 24. Epub 2021 Apr 24.

Background: Antimicrobial consumption has been increasing lately. Hence, effective strategies are required to control antimicrobial use and decrease the development of antimicrobial resistance.

Objective: To evaluate the impact of the use of a mobile app on the implementation of antimicrobial stewardship program (ASP) interventions. Read More

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Healthcare-associated carbapenem-resistant Klebsiella pneumoniae bloodstream infections: Risk factors, mortality, and antimicrobial susceptibility, 2017-2019.

J Formos Med Assoc 2021 May 5. Epub 2021 May 5.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:

Background: In Taiwan, carbapenem-resistant Klebsiella pneumoniae (CRKP) now became a leading cause of difficult-to-treat healthcare-associated infection, for which there are a lack of recent hospital epidemiological studies on risk factors, mortality, and antimicrobial susceptibility.

Methods: We prospectively enrolled patients with healthcare-associated CRKP monomicrobial bloodstream infection (mBSI) and matched patients with carbapenem susceptible K. pneumoniae (CSKP) mBSI at National Taiwan University Hospital (Taipei, Taiwan) from October 2017 through December 2019 in a 1:2 ratio. Read More

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Use of expedited post-operative protocol for children undergoing appendicostomy reduces length of hospitalization.

J Pediatr Surg 2021 Apr 5. Epub 2021 Apr 5.

Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, 100 N. Mario Ceppechi Drive, Suite 3800, Salt Lake City, UT 84113, United States.

Background: An appendicostomy (ACE) is a surgical option for antegrade enemas in children with severe constipation and/or fecal incontinence who have failed medical management.  In 2019, we initiated an expedited post-operative protocol and sought to examine our short-term outcomes compared with our historical cohort.

Methods: A retrospective review was performed of all children undergoing ACE between 2017 and 2020. Read More

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Monitoring of patients with microdialysis following pancreaticoduodenectomy-the MINIMUM study: study protocol for a randomized controlled trial.

Trials 2021 May 7;22(1):329. Epub 2021 May 7.

Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen, 0424, Oslo, Norway.

Background: Postoperative pancreatic fistula after pancreatoduodenectomy is a much-feared complication associated with substantial mortality and morbidity. The current standard for diagnosing postoperative pancreatic fistula, besides routine clinical examination, include radiological examinations, analysis of pancreatic drain amylase activity, and routine blood samples. Another promising method is by intraperitoneal microdialysis to monitor intraperitoneal metabolites measured at the pancreaticojejunostomy, thereby detecting what occurs locally, before chemical events can be reflected as measurable changes in systemic blood levels. Read More

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Repurposing existing medications for coronavirus disease 2019: protocol for a rapid and living systematic review.

Syst Rev 2021 May 7;10(1):143. Epub 2021 May 7.

University of Sydney, Sydney, NSW, Australia.

Background: Coronavirus disease 2019 (COVID-19) has no confirmed specific treatments. However, there might be in vitro and early clinical data as well as evidence from severe acute respiratory syndrome and Middle Eastern respiratory syndrome that could inform clinicians and researchers. This systematic review aims to create priorities for future research of drugs repurposed for COVID-19. Read More

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Enhanced Recovery After Surgery strategies for elective craniotomy: a systematic review.

J Neurosurg 2021 May 7:1-25. Epub 2021 May 7.

1Machine Intelligence in Clinical Neuroscience (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland.

Objective: Enhanced Recovery After Surgery (ERAS) has led to a paradigm shift in perioperative care through multimodal interventions. Still, ERAS remains a relatively new concept in neurosurgery, and there is no summary of evidence on ERAS applications in cranial neurosurgery.

Methods: The authors systematically reviewed the literature using the PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases for ERAS protocols and elements. Read More

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Comparing the inter-observer reliability of the Tada formula among neurosurgeons while estimating the intracerebral haematoma volume.

Clin Neurol Neurosurg 2021 May 1;205:106668. Epub 2021 May 1.

The First Affiliated Hospital of Xia'men University, 55# Zhenhai Road, Xia'men, Fujian 361003, China. Electronic address:

Objective: To compare the inter-observer reliability among neurosurgeons while estimating the intracerebral haematoma (ICH) volume by the Tada formula and assess its influence on predicting the severity and prognosis of various ICHs.

Methods: We obtained clinical data from 262 consecutive patients with spontaneous ICH. The haematoma volume was independently calculated and compared by 3D Slicer and eight neurosurgeons. Read More

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Extracorporeal support for trauma: A trauma quality improvement project (TQIP) analysis in patients with acute respiratory distress syndrome.

Am J Emerg Med 2021 Apr 30;48:170-176. Epub 2021 Apr 30.

Division of Acute Care Surgery, University of Southern California, Los Angeles, CA, United States of America.

Introduction: The use of extracorporeal membrane oxygenation (ECMO) in trauma patients with severe acute respiratory distress syndrome (ARDS) continues to evolve. The objective of this study was to perform a comparative analysis of trauma patients with ARDS who received ECMO to a propensity matched cohort of patients who underwent conventional management.

Methods: The Trauma Quality Improvement Program (TQIP) database was queried from 2013 to 2016 for all patients with ARDS and those who received ECMO. Read More

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Unplanned open conversion during radical or partial nephrectomy: Comparing outcomes and trends.

Urology 2021 May 4. Epub 2021 May 4.

Division of Urology, Department of Surgery, Saint Louis University, St Louis, MO. Electronic address:

Objectives: To compare perioperative outcomes between open conversion and planned open surgical approach and to investigate trends.

Materials And Methods: The National Cancer Database (NCDB) was queried for cT1 and cT2 RCC treated by radical (RN) or partial (PN) nephrectomy between 2010 and 2016. We retrospectively analyzed patient demographics, clinical tumor characteristics, and perioperative outcomes between unplanned open conversion and planned open approaches for RN and PN. Read More

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Cangrelor vs. Glycoprotein IIb/IIIa Inhibitors During Percutaneous Coronary Intervention.

Am Heart J 2021 May 4. Epub 2021 May 4.

Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC. Electronic address:

Background: To date, there are no real-world studies comparing cangrelor to glycoprotein IIb/IIIa inhibitors (GPI) during percutaneous coronary intervention (PCI). Thus, we performed this study to evaluate the safety and effectiveness of cangrelor compared to GPI during PCI.

Methods: We identified patients who underwent PCI at our institution who received either cangrelor or GPI during PCI. Read More

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[Economic evaluation of porous metal cones in total knee arthroplasty].

Ann Pharm Fr 2021 May 4. Epub 2021 May 4.

Hôpital Renée Sabran, Hospices Civils de Lyon. Electronic address:

Introduction: The use of porous metal cones (PMC) to fill bone loss during knee replacements is increasing, but these medical devices are not reimbursed in addition to diagnosis related tariffs (DRTs). The economic impact of PMC may be significant for hospitals.

Material And Methods: This multicenter observational study includes all patients who benefited of a total knee prosthesis, with reconstruction by PMC, between June 2014 and June 2019, in two French university hospitals. Read More

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Assessment of Magnet status and Textbook Outcomes among medicare beneficiaries undergoing hepato-pancreatic surgery for cancer.

J Surg Oncol 2021 May 7. Epub 2021 May 7.

Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Background: The relationship between hospital Magnet status recognition and postoperative outcomes following complex cancer surgery remains ill-defined. We sought to characterize Textbook Outcome (TO) rates among patients undergoing (HP) surgery for cancer in Magnet versus non-Magnet centers.

Methods: Medicare beneficiaries undergoing HP surgery between 2015 and 2017 were identified. Read More

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Use of a Multidisciplinary Mechanical Ventilation Weaning Protocol to Improve Patient Outcomes and Empower Staff in a Medical Intensive Care Unit.

Dimens Crit Care Nurs 2021 Mar-Apr 01;40(2):67-74

Background: Prolonged duration of mechanical ventilation is associated with higher mortality and increased patient complications; conventional physician-directed weaning methods are highly variable and permit significant time that weaning is inefficient and ineffective.

Objectives: The primary objective of this quality improvement project was to implement a registered nurse (RN)- and respiratory therapist (RT)-driven mechanical ventilation weaning protocol in a medical intensive care unit (ICU) at a tertiary care academic medical center.

Methods: This quality improvement project used a quasi-experimental design with a retrospective usual care group who underwent physician-directed (conventional) weaning (n = 51) and a prospective intervention group who underwent protocol-directed weaning (n = 54). Read More

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The impact of loco-regional anaesthesia on postoperative opioid use in elderly hip fracture patients: an observational study.

Eur J Trauma Emerg Surg 2021 May 7. Epub 2021 May 7.

Department of Anesthesiology, Luzerner Kantonsspital, Luzern, Switzerland.

Purpose: Hip fractures are a common health problem among the elderly with an increasing incidence. They are associated with high mortality and morbidity. Optimal pain management remains challenging and inadequate pain control is known for negatively affecting outcomes. Read More

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Imageless robotic-assisted total knee arthroplasty leads to similar 24-month WOMAC scores as compared to conventional total knee arthroplasty: a retrospective cohort study.

Knee Surg Sports Traumatol Arthrosc 2021 May 7. Epub 2021 May 7.

Department of Orthopedic Surgery, Columbia University Medical Center, 630 West 168th Street, PH-11, New York, NY, 10032, USA.

Purpose: Robotic-assisted total knee arthroplasty (RA-TKA) was introduced to improve limb alignment, component positioning, soft-tissue balance and to minimize surgical outliers. This study investigates perioperative outcomes, complications, and early patient-reported outcome measures (PROMs) of one imageless RA-TKA system compared to conventional method TKA (CM-TKA) at 24-month follow-up.

Methods: This multi-surgeon retrospective cohort analysis compared 111 imageless RA-TKA patients to 110 CM-TKA patients (n = 221). Read More

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Centers for Medicare & Medicaid Services' 2018 Removal of Total Knee Arthroplasty From the Inpatient-only List Led to Broad Changes in Hospital Length of Stays.

J Am Acad Orthop Surg 2021 May 5. Epub 2021 May 5.

From the Yale Department of Orthopedics and Rehabilitation, New Haven, CT.

Introduction: Centers for Medicare & Medicaid Services (CMS) removed total knee arthroplasty (TKA) from the "inpatient-only" list from January 1, 2018. The impact of this change on actual hospital length of stay (LOS) and patient coding is of interest.

Methods: Patients undergoing TKA were abstracted from the 2015 to 2018 National Surgical Quality Improvement Program database. Read More

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