37,676 results match your criteria performed tertiary

Major depressive disorder in detention officers.

Rev Saude Publica 2021 14;55:11. Epub 2021 Apr 14.

Universidade Federal da Bahia. Programa de Pós-Graduação em Saúde, Ambiente e Trabalho. Departamento de Medicina Preventiva e Social. Salvador, Bahia, Brasil.

Objective: To identify factors associated with major depressive disorder (MDD) in detention officers.

Methods: This cross-sectional study included all detention officers from the largest prison complex in the state of Bahia, Brazil. A self-reported questionnaire collected sociodemographic, occupational and health data. Read More

View Article and Full-Text PDF

Incidence of urinary retention and relations between patient's complaint, physical examination, and bladder ultrasound.

Rev Gaucha Enferm 2021 12;42:e20200014. Epub 2021 Mar 12.

Universidade Federal do Rio Grande do Sul (UFRGS), Escola de Enfermagem, Departamento de Assistência e Orientação Profissional. Porto Alegre, Rio Grande do Sul, Brasil.

Objective: To describe the frequency of urinary complaints, bladder globe, and need for bladder relief catheterization according to ultrasound; to investigate the relationship between the urinary volume estimated by ultrasound and the one drained in catheterization; and to describe the relationship of patient's complaints and detection of bladder globe with the diagnosis of urinary retention.

Method: A cross-sectional study with clinical patients with suspected urinary retention in a tertiary hospital, conducted from February to September 2018. Urinary volume ≥500 mL in ultrasound was considered urinary retention. Read More

View Article and Full-Text PDF

Trophoblast Cell Surface Antigen 2 (Trop-2) Protein is Highly Expressed in Salivary Gland Carcinomas and Represents a Potential Therapeutic Target.

Head Neck Pathol 2021 Apr 22. Epub 2021 Apr 22.

Department of Pathology, University of Cologne, Medical Faculty, Cologne, Germany.

Treatment options for unresectable, recurrent or metastatic salivary gland carcinomas (SGC) are scarce. Trophoblast cell surface antigen 2 (Trop-2) is a transmembrane glycoprotein that is involved in a variety of oncogenic cell signaling pathways. Its potential as a target for the antibody-drug conjugate sacituzumab govitecan has already been demonstrated in different tumor entities. Read More

View Article and Full-Text PDF

Completely resected stage III melanoma controversy - 15 years of national tertiary centre experience.

Radiol Oncol 2020 Oct 8;55(1):50-56. Epub 2020 Oct 8.

Department of Surgery, Institute of Oncology Ljubljana, Ljubljana, Slovenia.

Background: Two prospective randomized studies analysing cutaneous melanoma (CM) patients with sentinel lymph node (SLN) metastases and rapid development of systemic adjuvant therapy have changed our approach to stage III CM treatment. The aim of this study was to compare results of retrospective survival analysis of stage III CM patients' treatment from Slovenian national CM register to leading international clinical guidelines.

Patients And Methods: Since 2000, all Slovenian CM patients with primary tumour ≥ TIb are treated at the Institute of Oncology Ljubljana and data are prospectively collected into a national CM registry. Read More

View Article and Full-Text PDF
October 2020

Readmissions after cholecystectomy in a tertiary UK centre: Incidence, causes and burden.

J Minim Access Surg 2021 Apr 8. Epub 2021 Apr 8.

Department of General Surgery, Royal London Hospital, Barts Health NHS Trust, Whitechapel, London, United Kingdom.

Context: Although cholecystectomy is a widely performed procedure, post-operative readmissions place a heavy burden on healthcare facilities.

Aims: This study assesses the incidence, causes and burden of 30-day readmissions after cholecystectomy in a tertiary UK centre.

Settings And Design: This study was conducted at a university hospital, and the study design involves retrospective cohort study. Read More

View Article and Full-Text PDF

Thoracoscopic bilateral dorsal sympathectomy for primary palmo-axillary hyperhidrosis short- and mid-term results.

J Minim Access Surg 2021 Apr 8. Epub 2021 Apr 8.

Centre For Chest Surgery, Sir Ganga Ram Hospital, New Delhi, India.

Background: Thoracoscopic bilateral dorsal sympathectomy is the standard of care for primary palmo-axillary hyperhidrosis. This study aims at studying the surgical outcomes with special emphasis on the incidence of compensatory hyperhidrosis (CH) after thoracoscopic dorsal sympathectomy. Post-procedural patient satisfaction as well as quality of life was measured and analysed. Read More

View Article and Full-Text PDF

Laparoscopic hepaticojejunostomy for benign biliary stricture: A case series of 16 patients at a tertiary care centre in India.

J Minim Access Surg 2021 Mar 8. Epub 2021 Mar 8.

Department of General Surgery, SCBMCH, Cuttack, Odisha, India.

Background: Gallstone disease is common in India, and since primary management involves surgery, it is one of the most commonly performed surgeries by a general surgeon either laparoscopically or open. There are various factors which are responsible for intra- and post-operative complications. These factors result in significant injuries which cause serious post-operative complications. Read More

View Article and Full-Text PDF

Combined off pump coronary artery bypass graft and liver transplant.

Ann Card Anaesth 2021 Apr-Jun;24(2):197-202

Medanta Heart Institute, Medanta the Medicity, Rishikesh, Uttarakhand, India.

Background: Prospective recipients of liver transplant (LT) have a high prevalence rate of coronary artery disease (CAD) requiring revascularization. In patients of Child Turcot Pugh Class B and C performing LT prior to cardiac revascularization on cardiopulmonary bypass leads to a high risk of major adverse cardiovascular events (MACE). Whereas, isolated cardiac surgery prior to LT has perioperative risk of coagulopathy, sepsis, and hepatic decompensation. Read More

View Article and Full-Text PDF

Less is more: We are administering too much protamine in cardiac surgery.

Ann Card Anaesth 2021 Apr-Jun;24(2):178-182

Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.

Context: Protamine is routinely administered to neutralize the anticlotting effects of heparin, traditionally at a dose of 1 mg for every 100 IU of heparin-a 1:1 ratio protamine sparing effects-but this is based more on experience and practice than literature evidence. The use of Hemostasis Management System (HMS) allows an individualized heparin and protamine titration. This usually results in a decreased protamine dose, thus limiting its side effects, including paradox anticoagulation. Read More

View Article and Full-Text PDF

A Comparison Between Computer-Assisted Self-Triage by Patients and Triage Performed by Nurses in the Emergency Department.

Cureus 2021 Mar 19;13(3):e14002. Epub 2021 Mar 19.

Emergency Medicine, Sunnybrook Health Sciences Centre, Toronto, CAN.

Background and objective Emergency departments (EDs) often find the number of arriving patients exceeding their capacity and find it difficult to triage them in a timely manner. The potential risk to the safety of patients awaiting assessment by a triage professional has led some hospitals to consider implementing patient self-triage, such as using kiosks. Published studies about patient self-triage are scarce and information about patients' ability to accurately assess the acuity of their condition or predict their need to be hospitalized is limited. Read More

View Article and Full-Text PDF

Clinicians' Initial Experiences of Transition to Online Interdisciplinary Pain Rehabilitation During the Covid-19 Pandemic.

J Rehabil Med Clin Commun 2020 30;3:1000036. Epub 2020 Jun 30.

Department of Rehabilitation Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.

Objective: Public health legislation during the CO-VID-19 pandemic has resulted in forced transitioning to the use of remote care in order to continue the provision of pain rehabilitation worldwide. The objective of this study was to gain insight into clinicians' initial experiences with the provision of interdisciplinary pain rehabilitation via videoconferencing.

Design: Observational, cross-sectional design. Read More

View Article and Full-Text PDF

Person-Centered Care in a Tertiary Hospital Through Patient's Eyes: A Cross-Sectional Study.

Patient Prefer Adherence 2021 15;15:761-773. Epub 2021 Apr 15.

Department of Health System Management, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Background: The current trend in healthcare systems around the world is moving towards a person (or patient)-centered care (PCC) model. While some healthcare organizations have only recently embraced the PCC approach, there is no evidence of person-centered care in Saudi hospitals. This study aimed to assess patients' perspectives on the climate of person-centered care and its associated factors in a tertiary hospital in Saudi Arabia. Read More

View Article and Full-Text PDF

Diagnosis and management of extrahepatic oesophageal variceal bleed in children in a low resourced setting.

Ghana Med J 2020 Dec;54(4):274-278

Department of Child Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra.

Extrahepatic portal vein obstruction (EHPVO) is a major cause of portal hypertension (PH) in children. Portal vein thrombosis (PVT) is the most common cause accounting for up to 75% of cases in developing countries. Upper gastrointestinal bleeding is the most dreaded and commonest presentation of portal hypertension. Read More

View Article and Full-Text PDF
December 2020

Effects of prior exposure to a visual airway cognitive aid on decision-making in a simulated airway emergency: A randomised controlled study.

Eur J Anaesthesiol 2021 Apr 20. Epub 2021 Apr 20.

From the Departments of Anesthesia (FB-Z, M-M, E-W, KE-YT), Family Medicine-Emergency Medicine (VS-P), MiCcare Research Centre, Mount Sinai Hospital-Sinai Health System, University of Toronto, Toronto, Ontario, Canada (XY-Y), The Wilson Centre and Post-MD Education, Toronto, Ontario, Canada (W-T).

Background: Decision-making deficits in airway emergencies have led to adverse patient outcomes. A cognitive aid would assist clinicians through critical decision-making steps, preventing key actions omission.

Objective: We aimed to investigate the effects of a visual airway cognitive aid on decision-making in a simulated airway emergency scenario. Read More

View Article and Full-Text PDF

Reconstructive Management of Gunshot Wounds to the Frontal Sinus: An Urban Trauma Center's Perspective.

Ann Plast Surg 2021 Apr 21. Epub 2021 Apr 21.

From the University of Alabama at Birmingham, School of Medicine, Birmingham, AL Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL Ford Plastic and Reconstructive Surgery, Baton Rouge, LA Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL.

Introduction: In the last decade, we have seen a steady increase in the incidence of frontal sinus trauma due to gunshot wounds and a decrease in motor vehicle trauma. Penetrating gunshot wounds to the frontal sinus present a unique challenge to the reconstructive surgeon because they require careful consideration of the management principles of plastic surgery. Despite previous reviews on frontal sinus trauma, there are no studies examining the management techniques of frontal sinus fractures due specifically to gunshot wounds. Read More

View Article and Full-Text PDF

Fluid Responsiveness Predictability in Immediate Postoperative Pediatric Cardiac Surgery. Is the Old Slandered Central Venous Pressure Back Again?

Shock 2021 Apr 20. Epub 2021 Apr 20.

Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel, 4920235 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 6997801.

Objective: Acute low cardiac output (CO) is a frequent scenario in pediatric cardiac intensive care units (PCICU). While fluid responsiveness has been studied extensively, literature is scarce for the immediate postoperative congenital heart surgery population admitted to PCICUs. This study analyzed the utility of hemodynamic, bedside ultrasound and Doppler parameters for prediction of fluid responsiveness in infants and neonates in the immediate postoperative cardiac surgery period. Read More

View Article and Full-Text PDF

Outcomes following Craniosynostosis Surgery at a Tertiary Care Center in the Middle East.

Pediatr Neurosurg 2021 Apr 21:1-9. Epub 2021 Apr 21.

Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

Background: Despite advancements in craniosynostosis surgery, open surgical approaches remain crucial for the management of infants >6 months of age and in those with complex synostosis. The clinical features of craniosynostosis remain poorly characterized in the Middle East. This study sought to assess the clinical features and outcomes of infants undergoing craniosynostosis surgery at a tertiary care center in Lebanon. Read More

View Article and Full-Text PDF

Exploring caregiver burden and financial toxicity in caregivers of tracheostomy-dependent children.

Int J Pediatr Otorhinolaryngol 2021 Apr 18;145:110713. Epub 2021 Apr 18.

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Objective: Measure the prevalence of and factors associated with financial toxicity (FT) and caregiver burden in families of tracheostomy-dependent children. FT is defined as the objective and subjective patient-level impact of the costs of medical care and has been associated with lower quality of life, decreased compliance with treatment, and increased mortality.

Methods: A medical record review was performed on all children with a tracheostomy tube placed from 2009 to 2018 at a tertiary children's hospital to identify and include children younger than 18 years old, not deceased, and not decannulated at the time of review. Read More

View Article and Full-Text PDF

Artificial intelligence based writer identification generates new evidence for the unknown scribes of the Dead Sea Scrolls exemplified by the Great Isaiah Scroll (1QIsaa).

PLoS One 2021 21;16(4):e0249769. Epub 2021 Apr 21.

Department of Artificial Intelligence, Faculty of Science and Engineering, University of Groningen, Groningen, The Netherlands.

The Dead Sea Scrolls are tangible evidence of the Bible's ancient scribal culture. This study takes an innovative approach to palaeography-the study of ancient handwriting-as a new entry point to access this scribal culture. One of the problems of palaeography is to determine writer identity or difference when the writing style is near uniform. Read More

View Article and Full-Text PDF

Neuroimaging Findings of Hospitalized Covid-19 Patients: A Canadian Retrospective Observational Study.

Can Assoc Radiol J 2021 Apr 21:8465371211002815. Epub 2021 Apr 21.

University of Toronto, Toronto, Ontario, Canada.

Purpose: Coronavirus disease (COVID-19) has been associated with neurologic sequelae and neuroimaging abnormalities in several case series previously. In this study, the neuroimaging findings and clinical course of adult patients admitted with COVID-19 to a tertiary care hospital network in Canada were characterized.

Methods: This is a retrospective observational study conducted at a tertiary hospital network in Ontario, Canada. Read More

View Article and Full-Text PDF

The Role of Relaparoscopy in the Management of Early Bariatric Surgery Complications and 30-Day Outcome: a Tertiary Centre Experience.

Obes Surg 2021 Apr 21. Epub 2021 Apr 21.

Department of Surgery, Luton and Dunstable University Hospital, Luton, UK.

The laparoscopic approach for dealing with bariatric complications has become the gold standard of modern practice. The aim of this study is to assess the role of relaparoscopy as a diagnostic and therapeutic approach towards managing complications and improving 30-day outcome.

Materials And Methods: A retrospective review of a prospectively maintained database was conducted in a tertiary bariatric unit. Read More

View Article and Full-Text PDF

Accuracy of 18-F Fluorodeoxyglucose Positron Emission Tomographic/Computed Tomographic Imaging in Primary Staging of Squamous Cell Carcinoma of the Oral Cavity.

JAMA Netw Open 2021 Apr 1;4(4):e217083. Epub 2021 Apr 1.

Department of Nuclear Medicine, University Hospital of Würzburg, Würzburg, Germany.

Importance: Squamous cell carcinoma (SCC) of the oral cavity is one of the most common tumor entities worldwide. Precise initial staging is necessary to determine a diagnosis, treatment, and prognosis.

Objective: To examine the diagnostic accuracy of preoperative 18-F fluorodeoxyglucose (FDG) positron emission tomographic/computed tomographic (PET/CT) imaging in detecting cervical lymph node metastases. Read More

View Article and Full-Text PDF

Blood Usage at a Large Academic Center in Maryland in Relation to the COVID-19 Pandemic in 2020.

Transfusion 2021 Apr 20. Epub 2021 Apr 20.

Department of Pathology, University of Maryland School of Medicine.

Background: Blood usage and collections were impacted throughout 2020 both by the severity of the COVID-19 pandemic as well as public health decisions affecting hospital operations. We sought to understand the longer-term effects of the pandemic on blood usage via changes in case volume and clinical intensity as well as whether the blood needs of COVID-19 positive patients differed from other transfused patients.

Study Design And Methods: A single center retrospective study of blood use in 2020 as compared to 2014-2019 was conducted at a tertiary care center. Read More

View Article and Full-Text PDF

Hypoxemia during procedural sedation in adult patients: a retrospective observational study.

Can J Anaesth 2021 Apr 20. Epub 2021 Apr 20.

Section of vital functions, Department of Anesthesiology, UMC Utrecht, Heidelberglaan 100, Utrecht, The Netherlands.

Purpose: Since 2010, new guidelines for procedural sedation and the Helsinki Declaration on Patient Safety have increased patient safety, comfort, and acceptance considerably. Nevertheless, the administration of sedatives and opioids during sedation procedures may put the patient at risk of hypoxemia. However, data on hypoxemia during procedural sedation are scarce. Read More

View Article and Full-Text PDF

Effect of Perioperative Tranexamic Acid on Allogeneic Blood Transfusions for Total Knee Arthroplasty Patients at a Community Hospital.

Cureus 2021 Mar 17;13(3):e13951. Epub 2021 Mar 17.

Orthopedics, Lake Placid Sports Medicine, Lake Placid, USA.

Introduction Tranexamic acid (TXA) has been shown to be a cost-effective method for reducing blood loss and postoperative transfusions in patients undergoing total knee arthroplasty (TKA) at tertiary care centers. However, the efficacy of TXA has not been studied in community hospitals, and the potential cost savings may be especially beneficial for these institutions. The purpose of this study was to assess the effectiveness of TXA in reducing postoperative transfusions and blood loss following TKA at a community hospital. Read More

View Article and Full-Text PDF

Retinal Detachment After Endophthalmitis: Risk Factors and Outcomes.

Clin Ophthalmol 2021 13;15:1529-1537. Epub 2021 Apr 13.

Department of Ophthalmology and Visual Sciences, University of Michigan W.K. Kellogg Eye Center, Ann Arbor, MI, USA.

Purpose: To analyze the risk factors, clinical course, and visual and anatomic outcomes of retinal detachment (RD) after endophthalmitis.

Patients And Methods: This retrospective study included 108 patients diagnosed with endophthalmitis between August 2014 and May 2019 at a single tertiary referral center. Sixteen patients developed RD after endophthalmitis. Read More

View Article and Full-Text PDF

Repair of frontal sinus fractures: clinical and radiological long-term outcomes.

J Laryngol Otol 2021 Apr 21:1-4. Epub 2021 Apr 21.

Department of Otolaryngology and Head and Neck Surgery, Chaim Sheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel Aviv University, Israel.

Objective: The long-term clinical and radiological outcomes of patients surgically treated for frontal sinus fracture were assessed.

Methods: A retrospective, single-centre analysis was conducted of patients treated for frontal sinus fracture in a tertiary trauma centre between 2000 and 2017. Patients who underwent surgical repair for frontal sinus fracture followed by clinical and radiographical evaluation for at least six months were included. Read More

View Article and Full-Text PDF

Bariatric surgery in the treatment of adolescent obesity: current perspectives in the United States.

Expert Rev Endocrinol Metab 2021 Apr 21:1-12. Epub 2021 Apr 21.

Department of Medicine, MGH Weight Center, Boston, MA, USA.

: Rates of severe obesity in adolescents have increased at an alarming rate. Unfortunately, there are limited successful treatments for severe obesity in adolescents. Metabolic and bariatric surgery (MBS) is the most effective treatment available for adolescents with Class 2 and above severe obesity and has demonstrated variable degrees of sustained long-term weight loss which leads to resolution of multiple associated conditions and an improved quality of life. Read More

View Article and Full-Text PDF

Intermittent preventive treatment comparing two versus three doses of sulphadoxine pyrimethamine (IPTp-SP) in the prevention of anaemia in pregnancy in Ghana: A cross-sectional study.

PLoS One 2021 20;16(4):e0250350. Epub 2021 Apr 20.

Department of Global and International Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

In 2012 the World Health Organisation (WHO) revised the policy on Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPTp-SP) to at least three doses for improved protection against malaria parasitaemia and its associated effects such as anaemia during pregnancy. We assessed the different SP dosage regimen available under the new policy to determine the dose at which women obtained optimal protection against anaemia during pregnancy. A cross-sectional study was conducted among pregnant women who attended antenatal clinic at four different health facilities in Ghana. Read More

View Article and Full-Text PDF

The Detection of Hypermucoviscous Carbapenem-Resistant from a Tertiary Teaching Hospital in Malaysia and Assessment of Hypermucoviscous as Marker of Hypervirulence.

Microb Drug Resist 2021 Apr 20. Epub 2021 Apr 20.

Department of Medical Microbiology and Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Hypermucoviscous carbapenem-resistant (hmCRKp) is emerging globally and approaching the worst-case scenario in health care system. The main objective in this study was to determine the hypermucoviscous characteristics among the carbapenem-resistant (CRKp) isolated from a teaching hospital in Malaysia. The association of hypermucoviscous phenotype with the virulence traits and clinical presentations were also investigated. Read More

View Article and Full-Text PDF