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1. Following programmes to improve recovery after surgery linked to shorter hospital stays

Following programmes to improve recovery after surgery linked to shorter hospital stays Following programmes to improve recovery after surgery linked to shorter hospital stays Discover Portal Discover Portal Following programmes to improve recovery after surgery linked to shorter hospital stays Published on 24 January 2017 doi: Reduced compliance with enhanced recovery protocols was associated with more days in hospital after keyhole bowel surgery, an increased likelihood of readmission (...) and complications. Enhanced recovery, also known as fast track access, is considered standard practice but there is considerable variation in what this means and how this is implemented locally. This systematic review included 34 studies where protocols were used to enhance recovery after laparoscopic colorectal resection surgery. The review aimed to identify which elements of local protocols such as early walking or epidural anaesthesia, are associated with a successful outcome. However, because local

2019 NIHR Dissemination Centre

2. Following programmes to improve recovery after surgery linked to shorter hospital stays

Following programmes to improve recovery after surgery linked to shorter hospital stays Following programmes to improve recovery after surgery linked to shorter hospital stays Discover Portal Discover Portal Following programmes to improve recovery after surgery linked to shorter hospital stays Published on 24 January 2017 doi: Reduced compliance with enhanced recovery protocols was associated with more days in hospital after keyhole bowel surgery, an increased likelihood of readmission (...) and complications. Enhanced recovery, also known as fast track access, is considered standard practice but there is considerable variation in what this means and how this is implemented locally. This systematic review included 34 studies where protocols were used to enhance recovery after laparoscopic colorectal resection surgery. The review aimed to identify which elements of local protocols such as early walking or epidural anaesthesia, are associated with a successful outcome. However, because local

2018 NIHR Dissemination Centre

3. Gender-linked impact of epicardial adipose tissue volume in patients who underwent coronary artery bypass graft surgery or non-coronary valve surgery. (PubMed)

Gender-linked impact of epicardial adipose tissue volume in patients who underwent coronary artery bypass graft surgery or non-coronary valve surgery. Traditional and non-traditional risk factors for atherosclerotic cardiovascular disease (ASCVD) are different between men and women. Gender-linked impact of epicardial adipose tissue volume (EATV) in patients undergoing coronary artery bypass grafting (CABG) remains unknown.Gender-linked impact of EATV, abdominal fat distribution and other (...) traditional ASCVD risk factors were compared in 172 patients (men: 115; women: 57) who underwent CABG or non-coronary valvular surgery (non-CABG).In men, EATV, EATV index (EATV/body surface area) and the markers of adiposity such as body mass index, waist circumference and visceral fat area were higher in the CABG group than in the non-CABG group. Traditional ASCVD risk factors were also prevalent in the CABG group. In women, EATV and EATV index were higher in the CABG group, but other adiposity markers

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2017 PLoS ONE

4. Linking world bank development indicators and outcomes of congenital heart surgery in low-income and middle-income countries: retrospective analysis of quality improvement data. (PubMed)

Linking world bank development indicators and outcomes of congenital heart surgery in low-income and middle-income countries: retrospective analysis of quality improvement data. Many low-income and middle-income countries (LMICs) struggle to provide the health services investment required for life-saving congenital heart disease (CHD) surgery. We explored associations between risk-adjusted CHD surgical mortality from 17 LMICs and global development indices to identify patterns that might inform (...) investment strategies.Retrospective analysis: country-specific standardised mortality ratios were graphed against global development indices reflective of wealth and healthcare investment. Spearman correlation coefficients were calculated.The International Quality Improvement Collaborative (IQIC) keeps a volunteer registry of outcomes of CHD surgery programmes in low-resource settings. Inclusion in the IQIC is voluntary enrolment by hospital sites. Patients in the registry underwent congenital heart

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2019 BMJ open

5. Passing the fundamentals of endoscopic surgery (FES) exam: linking specialty choice and attitudes about endoscopic surgery to success. (PubMed)

Passing the fundamentals of endoscopic surgery (FES) exam: linking specialty choice and attitudes about endoscopic surgery to success. Previous work has shown that up to 30% of graduating surgery residents fail the fundamentals of endoscopic surgery (FES) exam. This study investigated the extent to which FES pass rates differ in a specific sample of individuals who have chosen a career in GI surgery and to examine the relationships between FES performance and confidence in performing flexible (...) examination scores. However, confidence performing EGDs (r = 0.57, p < 0.01), colonoscopies (r = 0.45, p < 0.05), polypectomy (r = 0.52, p < 0.01), and PEGs (r = 0.46, p < 0.05) did.These data support existing research suggesting that current flexible endoscopy training in residency may be insufficient for trainees to pass the FES examination, and that failure rates hold true even for this select group of trainees who have chosen a profession in GI surgery and intend to use endoscopy in practice.

2017 Surgical endoscopy

6. Strategies to link people with undiagnosed HIV infection to HIV testing, care, and prevention services

Strategies to link people with undiagnosed HIV infection to HIV testing, care, and prevention services Strategies to link people with undiagnosed HIV infection to HIV testing, care, and prevention services | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Strategies to link people with undiagnosed HIV infection to HIV testing, care, and prevention services Strategies to link people with undiagnosed HIV infection to HIV testing, care, and prevention services , , , , Questions (...) What strategies have been successful at linking people with undiagnosed HIV infection to HIV testing, care, and prevention services? Key take-home messages A variety of strategies have shown promise for identifying individuals with undiagnosed HIV and engaging them with HIV testing using clinical, community-based, network-based, and self-directed approaches. Various service delivery models for implementing rapid initiation of antiretroviral treatment have demonstrated benefits for linking the newly

2019 Ontario HIV Treatment Network

7. Reoperation after breast-conserving surgery for cancer in Australia: statewide cohort study of linked hospital data. (PubMed)

Reoperation after breast-conserving surgery for cancer in Australia: statewide cohort study of linked hospital data. To investigate between-hospital variation in the probability of reoperation within 90 days of initial breast-conserving surgery (BCS), and the contribution of health system-level and other factors.Population-based, retrospective cohort study.New South Wales (NSW), Australia.Linked administrative hospitalisation data were used to define a cohort of adult women undergoing initial (...) by reoperation type; the probability of re-excision increased alongside a concomitant decrease in the probability of mastectomy. Significant between-hospital variation was observed. Non-metropolitan location and surgery at low-volume hospitals were associated with a higher overall probability of reoperation, and of mastectomy specifically, after accounting for patient-level factors, calendar year and area-level socioeconomic status. The magnitude of association with geographical location and surgical volume

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2018 BMJ open

8. Linking late cognitive outcome with glioma surgery location using resection cavity maps (PubMed)

Linking late cognitive outcome with glioma surgery location using resection cavity maps Patients with a diffuse glioma may experience cognitive decline or improvement upon resective surgery. To examine the impact of glioma location, cognitive alteration after glioma surgery was quantified and related to voxel-based resection probability maps. A total of 59 consecutive patients (range 18-67 years of age) who had resective surgery between 2006 and 2011 for a supratentorial nonenhancing diffuse (...) glioma (grade I-III, WHO 2007) were included in this observational cohort study. Standardized neuropsychological examination and MRI were obtained before and after surgery. Intraoperative stimulation mapping guided resections towards neurological functions (language, sensorimotor function, and visual fields). Maps of resected regions were constructed in standard space. These resection cavity maps were compared between patients with and without new cognitive deficits (z-score difference >1.5 SD

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2018 Human brain mapping

9. Delirium, Frailty, and Fast-Track Surgery in Oncogeriatrics: Is There a Link? (PubMed)

Delirium, Frailty, and Fast-Track Surgery in Oncogeriatrics: Is There a Link? Postoperative delirium (POD) is more frequent in elderly patients undergoing major cancer surgery. The interplay between individual clinical vulnerability and a series of perioperative factors seems to play a relevant role. Surgery is the first-line treatment option for cancer, and fast-track surgery (FTS) has been documented to decrease postoperative complications. The study sought to assess, after comprehensive (...) of POD was 12.3%. Patients' prevalent clinical phenotype was pre-frail. The multivariate analysis indicated physical performance (TUG in seconds) as the most significant predictor of POD for each second of increase.Only few procedure-specific studies have examined the impact of FTS for colorectal cancer on POD. This is the first study to investigate the risk factors for POD, in a vulnerable octogenarian oncogeriatric population submitted to FTS surgery and frailty stratification.

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2018 Dementia and geriatric cognitive disorders extra

10. Clinical observations of vitreoretinal surgery for four different phenotypes of X-linked congenital retinoschisis (PubMed)

Clinical observations of vitreoretinal surgery for four different phenotypes of X-linked congenital retinoschisis To evaluate the outcomes of vitreoretinal surgery for four different phenotypes of X-linked retinoschisis (XLRS).This study included thirty-one eyes of 25 patients who developed XLRS with severe complications. Among the 31 eyes, there were 7 eyes with vitreous hemorrhage, 8 eyes with retinal detachment and vitreous hemorrhage, and 16 eyes with rhegmatogenous retinal detachment. All (...) of the patients underwent standard three-port pars plana vitrectomy. All of the eyes were divided into 4 groups before surgery according to a modified classification scheme, with the first three groups as follows: group A, with foveal cystic schisis; group B with macular lamellar schisis; and group C with foveolamellar changes. Peripheral schisis was not present in these 3 groups; however, group D was a complex group with both macular and peripheral changes. One year after surgery, we analyzed the best

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2018 International journal of ophthalmology

11. Characterizing Dehn surgeries on links via trisections (PubMed)

Characterizing Dehn surgeries on links via trisections We summarize and expand known connections between the study of Dehn surgery on links and the study of trisections of closed, smooth 4-manifolds. In particular, we propose a program in which trisections could be used to disprove the generalized property R conjecture, including a process that converts the potential counterexamples of Gompf, Scharlemann, and Thompson into genus four trisections of the standard 4-sphere that are unlikely

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2018 Proceedings of the National Academy of Sciences of the United States of America

12. Cross-Linked Polyethylene for Total Hip Arthroplasty Markedly Reduces Revision Surgery at 16 Years. (PubMed)

Cross-Linked Polyethylene for Total Hip Arthroplasty Markedly Reduces Revision Surgery at 16 Years. Total hip arthroplasty (THA) is an effective operation for the management of end-stage hip osteoarthritis, but long-term success can be limited by wear of the polyethylene bearing surface. Cross-linking conventional polyethylene has resulted in lower wear rates and a reduction in bone lysis in both laboratory and clinical studies. The aim of this study was to compare the rates of revision between (...) cross-linked polyethylene (XLPE) and conventional non-cross-linked polyethylene (CPE) at 16 years after THAs performed for the treatment of osteoarthritis.We performed an observational study of data, from a national registry, on all patients who underwent THA for osteoarthritis in Australia from 1999 through December 31, 2016. The outcomes of THAs performed with CPE were compared with those of THAs performed with XLPE, along with an analysis of the effect of age, sex, femoral head size, the method

2018 The Journal of Bone and Joint Surgery. American Volume

13. Genome-Wide Association Study Links Receptor Tyrosine Kinase Inhibitor Sprouty 2 to Thrombocytopenia after Coronary Artery Bypass Surgery. (PubMed)

Genome-Wide Association Study Links Receptor Tyrosine Kinase Inhibitor Sprouty 2 to Thrombocytopenia after Coronary Artery Bypass Surgery.  Thrombocytopenia after cardiac surgery independently predicts stroke, acute kidney injury and death. To understand the underlying risks and mechanisms, we analysed genetic variations associated with thrombocytopenia in patients undergoing coronary artery bypass grafting (CABG) surgery. Study subjects underwent isolated on-pump CABG surgery at Duke (...) platelet extracellular signal-regulated kinase (ERK) phosphorylation after agonist stimulation. We identified the association of a genetic polymorphism in the intergenic region of SPRY2 with a decreased incidence of thrombocytopenia after CABG surgery. Because SPRY2-an endogenous receptor tyrosine kinase inhibitor-is present in platelets and modulates essential signalling pathways, these findings support a role for SPRY2 as a novel modulator of platelet responses after cardiac surgery.Georg Thieme

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2018 Thrombosis and haemostasis

14. Prior Bariatric Surgery Is Linked to Improved Colorectal Cancer Surgery Outcomes and Costs: A Propensity-Matched Analysis. (PubMed)

Prior Bariatric Surgery Is Linked to Improved Colorectal Cancer Surgery Outcomes and Costs: A Propensity-Matched Analysis. Morbid obesity is associated with worse colorectal cancer (CRC) perioperative outcomes. The impact of bariatric surgery on these outcomes is unknown.The National Inpatient Sample Database (2006-2012) was used to identify adults with prior bariatric surgery (divided into BMI ≤35 kg/m2 and BMI >35 kg/m2) or morbid obesity that underwent CRC surgery. Main outcomes were (...) mortality, surgical complications and health care utilization.There were 1813 patients with prior bariatric surgery and 22,552 morbidly obese patients that underwent CRC surgery between 2006 and 2012. Prior bariatric surgery patients were younger, with fewer comorbidities, and had less emergency CRC surgery admissions (p < 0.05). Multivariate analyses revealed no adverse association (OR 0.54, 95 % CI = 0.16 to 1.79) between prior bariatric surgery and CRC perioperative mortality. Notably, multivariate

2016 Obesity Surgery

15. Bariatric Surgery to Reduce Mortality in US Adults. A Public Health Perspective from the Analysis of the American National Health and Nutrition Examination Survey Linked to the US Mortality Register. (PubMed)

Bariatric Surgery to Reduce Mortality in US Adults. A Public Health Perspective from the Analysis of the American National Health and Nutrition Examination Survey Linked to the US Mortality Register. Type II obesity represents a major pandemic and public health threat in high-income countries. Type II obesity increases the risk of all-cause and specific-cause mortality, and it is widely acknowledged that bariatric surgery represents the only effective therapeutic option in these patients (...) . The aim of the present study was to estimate US population attributable risk for all-cause and cause-specific mortality in type II obese subjects undergoing weight loss as resulting from bariatric surgery alone and supplemented with behavioral intervention.The American National Health and Nutrition Examination Survey linked to the US death registry updated to 2011 was used to estimate type II obesity prevalence and all-cause and specific cause of death for type II obese adults undergoing weight loss

2017 Obesity Surgery

16. Rapid Eating Is Linked to Emotional Eating in Obese Women Relieving from Bariatric Surgery. (PubMed)

Rapid Eating Is Linked to Emotional Eating in Obese Women Relieving from Bariatric Surgery. Eating rate is associated with BMI and weight gain in various populations, and is a factor modulating the risk of complications after bariatric surgery. The aim of the present study is to determine whether common difficulties to change eating rate in subjects with obesity candidate to bariatric surgery, could be due to more extensive abnormalities in eating behavior.A self-administered questionnaire (...) (r = 0.30, p = 0.001), but not with restrained eating score.These data show that rapid eating, by being potentially associated to emotional eating, must be considered as an important issue in bariatric surgery.

2017 Obesity Surgery

17. Outcomes of orthopedic surgery in a cohort of 49 patients with X-linked hypophosphatemic rickets (XLHR) (PubMed)

Outcomes of orthopedic surgery in a cohort of 49 patients with X-linked hypophosphatemic rickets (XLHR) X-linked hypophosphatemic rickets (XLHR) is due to mutations in PHEX leading to unregulated production of FGF23 and hypophosphatemia. XLHR is characterized by leg bowing of variable severity. Phosphate supplements and oral vitamin analogs, partially or, in some cases, fully restore the limb straightness. Surgery is the alternative for severe or residual limb deformities.To retrospectively (...) assess the results of surgical limb correction in XLHR (osteotomies and bone alignment except for 3 transient hemiepiphysiodesis).We analyzed the incidence of recurrence and post-surgical complications in 49 XLHR patients (29F, 20M) (mean age at diagnosis 6.0 years (± 7.1)).At first surgery, the mean age was 13.4 years (± 5.0). Recurrence was observed in 14/49 (29%) patients. The number of additional operations significantly decreased with age (2.0 (± 0.9), 1.7 (± 1.0) and 1.2 (± 0.4) in children <11

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2017 Endocrine connections

18. Navigation-Linked Heads-Up Display in Intracranial Surgery: Early Experience (PubMed)

Navigation-Linked Heads-Up Display in Intracranial Surgery: Early Experience The use of intraoperative navigation during microscope cases can be limited when attention needs to be divided between the operative field and the navigation screens. Heads-up display (HUD), also referred to as augmented reality, permits visualization of navigation information during surgery workflow.To detail our initial experience with HUD.We retrospectively reviewed patients who underwent HUD-assisted surgery from (...) incision (17.3%), craniotomy (23.1%), dural opening (26.9%), corticectomy (13.5%), arachnoid opening (36.5%), and intracranial drilling (13.5%). HUD was deactivated at some point during the surgery in 59.6% of cases. There were no complications related to HUD use.HUD can be safely used for a wide variety of vascular and oncologic intracranial pathologies and can be utilized during multiple stages of surgery.

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2017 Operative Neurosurgery

19. The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures

. Forbes, MD (Chair), Ali AbuRahma, MD, Kwame Amankwah, MD, Neal Barshes, MD, Ruth Bush, MD, Ronald L. Dalman, MD, Hans Henning Eckstein, MD, Anil Hingorani, MD, Eva Rzucidlo, MD, Marc Schermerhorn, MD. © 2018 by the Society for Vascular Surgery. Published by Elsevier Inc. Access this article on Visit ScienceDirect to see if you have access via your institution. Article Tools (100 minimum order) Article Related Video Article Related Audio Linked Articles DOI: Related Articles Searching for related (...) The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures - Journal of Vascular Surgery Email/Username: Password: Remember me Search JVS Journals Search Terms Search within Search Volume 68, Issue 1, Pages 256–284 To read this article in full, please review your options for gaining access at the bottom of the page. The Society

2018 Society for Vascular Surgery

20. Relative effectiveness assessment of Femtosecond laser-assisted cataract surgery (FLACS) compared to standard ultrasound phacoemulsification cataract surgery

Relative effectiveness assessment of Femtosecond laser-assisted cataract surgery (FLACS) compared to standard ultrasound phacoemulsification cataract surgery Dec2015 © EUnetHTA, 2015. Reproduction is authorised provided EUnetHTA is explicitly acknowledged 1 EUnetHTA Joint Action 3 WP4 Version 1.4 October 2018 Rapid assessment of other technologies using the HTA Core Model ® for Rapid Relative Effectiveness Assessment FEMTOSECOND LASER-ASSISTED CATARACT SURGERY (FLACS) FOR THE TREATMENT OF AGE (...) -RELATED CATARACT Project ID: OTCA07 Femtosecond Laser Assisted Surgery (FLACS) for age-related cataract Version 1.4. October 2018 EUnetHTA Joint Action 3 WP4 2 DOCUMENT HISTORY AND CONTRIBUTORS Version Date Description V1.0 07/05/2018 First draft. V1.1 04/06/2018 Input from co-author has been processed. V1.2 16/07/2018 Input from dedicated reviewers has been processed. V1.3 28/09/2018 Input from external experts and manufacturer(s) has been processed. V1.4 24/10/2018 Input from medical editor

2018 EUnetHTA

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