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Articles 1 - 30 of 167
Full-Text Articles in Medicine and Health Sciences
Trends In Patient Selection And Postoperative Outcomes After Pancreatoduodenectomy. A 10-Year Retrospective Acs Nsqip Database Analysis, Jan Grendar, Zelika Jutric, Shu-Ching Chang, L Wang, E Tang, P Newell, C Hammill
Trends In Patient Selection And Postoperative Outcomes After Pancreatoduodenectomy. A 10-Year Retrospective Acs Nsqip Database Analysis, Jan Grendar, Zelika Jutric, Shu-Ching Chang, L Wang, E Tang, P Newell, C Hammill
Shu-Ching Chang, PhD, MS
Objective: We aimed to assess trends in patient selection and outcomes to evaluate safety in current practice of pancreatoduodenectomy. Methods: NSQIP database from 2005 to 2014 was used to identify patients undergoing a pancreatoduodenectomy. Preoperative optimization measure was created using lack of >10% weight loss, albumin>3 and bilirubin<2. Annual trends in patient characteristics and outcomes were described in univariate and logistic or linear regression analyses for binary and continuous variables, respectively. Results: 23,295 pancreatoduodenectomies were identified. There was no significant trend of age (overall median 65 years, trend p=0.31), severity of systemic disease increased (ASA≥3 in 73% overall, trend OR=1.07, p<0.001), but so did the rate of preoperative optimization (52% overall, trend OR=1.03, p<0.001). Malignant indication percentage was increasing (75% overall, trend OR=1.04, p<0.001) as was rate of associated vascular resection (8% overall, trend OR=1.09, p<0.001), but not multivisceral resections (4% overall, trend p=0.10). The adjusted odds of minor and major complications increased over time (overall 31.2% and 27.7%, trend OR=1.32 and 1.11 respectively, p<0.001 for both). In contrast, unadjusted and adjusted length of stay was shortening (median 9 days, decrease by 1.60% and 1.44% respectively, p<0.001 for both) and mortality continued to decrease (2.5% overall, trend OR=0.95, p=0.002). Conclusion: There has been increasing severity of systemic disease as well as more advanced primary disease in patients undergoing pancreatoduodenectomy. Despite increasing complication rates, preoperative optimization and management of complications were likely improved, as suggested by shortening length of stay and decreasing mortality.
Bilateral Renal Artery Thrombosis Secondary To Blunt Trauma: Case Report And Review Of The Literature., P Frassinelli, Michael D. Pasquale Md, Facs, Fccm, C Reckard, J Goodreau, G Sherwin
Bilateral Renal Artery Thrombosis Secondary To Blunt Trauma: Case Report And Review Of The Literature., P Frassinelli, Michael D. Pasquale Md, Facs, Fccm, C Reckard, J Goodreau, G Sherwin
Michael D Pasquale MD, FACS, FCCM
No abstract provided.
Science And Pre-Health Networking Event: Invited Lecturer, Raymond L. Singer Md
Science And Pre-Health Networking Event: Invited Lecturer, Raymond L. Singer Md
Raymond L Singer MD
No abstract provided.
Value-Based Medicine: The Financial Impact Of A Pressure Ulcer Prevention Program On A Trauma Population, Jayme D. Lieberman Md, Patrick S. Duffy Md, Kai L. Bortz Rn, Rovinder S. Sandhu Md, Michael D. Pasquale Md, Facs, Fccm, Michael M. Badellino Md
Value-Based Medicine: The Financial Impact Of A Pressure Ulcer Prevention Program On A Trauma Population, Jayme D. Lieberman Md, Patrick S. Duffy Md, Kai L. Bortz Rn, Rovinder S. Sandhu Md, Michael D. Pasquale Md, Facs, Fccm, Michael M. Badellino Md
Michael D Pasquale MD, FACS, FCCM
No abstract provided.
Sentinel Lymph Node Mapping In Breast Cancer: A Community Hospital Experience, Chand Rohatgi Md, M Chang, M Espinosa
Sentinel Lymph Node Mapping In Breast Cancer: A Community Hospital Experience, Chand Rohatgi Md, M Chang, M Espinosa
Chand Rohatgi, MD
No abstract provided.
Practice Management Guidelines For The Appropriate Triage Of The Victim Of Trauma, Robert Barraco, William Chiu
Practice Management Guidelines For The Appropriate Triage Of The Victim Of Trauma, Robert Barraco, William Chiu
Robert D Barraco MD, MPH
No abstract provided.
Geriatric Psychology, Robert D. Barraco Md
Geriatric Psychology, Robert D. Barraco Md
Robert D Barraco MD, MPH
No abstract provided.
Does The Expression Of Ki-67, P16 And Cox-2 At Initial Diagnosis Of Breast Atypia Or Usual Ductal Hyperplasia Predict A Second Clinically Significant Event?, Judy Tjoe, Philippe Gascard, Jianxin Zhao, Gary Neitzel, Maharaj Singh, Brittany Last, James Marx, Thea Tlsty, Sanjay Kansra
Does The Expression Of Ki-67, P16 And Cox-2 At Initial Diagnosis Of Breast Atypia Or Usual Ductal Hyperplasia Predict A Second Clinically Significant Event?, Judy Tjoe, Philippe Gascard, Jianxin Zhao, Gary Neitzel, Maharaj Singh, Brittany Last, James Marx, Thea Tlsty, Sanjay Kansra
Judy Tjoe, MD
Background: Women diagnosed with atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH) have a fivefold increased risk of developing breast cancer. Because ADH/ALH can be precursors or predictive markers of a subsequent clinically significant event (SCSE), i.e. atypia, in situ or invasive carcinoma, the clinical outcome for these patients ranges anywhere from remission to invasive malignancy. Currently we cannot predict which atypical breast lesion is likely to be associated with future cancer, resulting in aggressive management and, possibly, overtreatment. Kerlikowske et al. reported that a combination of three biomarkers (cell cycle regulator p16INK4a, proliferation antigen Ki-67 and stress response …
Mortality, Mauling, And Maiming By Vicious Dogs, John Bini, Stephen Cohn, Shirley Acosta, Marilyn Mcfarland, Mark Muir, Joel Michalek
Mortality, Mauling, And Maiming By Vicious Dogs, John Bini, Stephen Cohn, Shirley Acosta, Marilyn Mcfarland, Mark Muir, Joel Michalek
John K. Bini
Objective: Maiming and death due to dog bites are uncommon but preventable tragedies. We postulated that patients admitted to a level I trauma center with dog bites would have severe injuries and that the gravest injuries would be those caused by pit bulls. Design: We reviewed the medical records of patients admitted to our level I trauma center with dog bites during a 15-year period. We determined the demographic characteristics of the patients, their outcomes, and the breed and characteristics of the dogs that caused the injuries. Results: Our Trauma and Emergency Surgery Services treated 228 patients with dog bite …
Perioperative Nonopioid Agents For Pain Control In Spinal Surgery., Anna Rivkin, Mark Rivkin
Perioperative Nonopioid Agents For Pain Control In Spinal Surgery., Anna Rivkin, Mark Rivkin
Mark Rivkin
PURPOSE: Commonly used nonopioid analgesic agents that are incorporated into multimodal perioperative pain management protocols in spinal surgery are reviewed. SUMMARY: Spinal procedures constitute perhaps some of most painful surgical interventions, as they often encompass extensive muscle dissection, tissue retraction, and surgical implants, as well as prolonged operative duration. Perioperative nonopioid analgesics frequently used in multimodal protocols include gabapentin, pregabalin, acetaminophen, dexamethasone, ketamine, and nonsteroidal antiinflammatory drugs (NSAIDs). There is evidence to suggest that gabapentin is safe and effective in reducing opioid consumption and pain scores at optimal doses of 600-900 mg orally administered preoperatively. Pregabalin 150-300 mg orally perioperatively …
Middle-Aged Man With Penetrating Trauma To The Pancreaticoduodenal Complex, Thomas Bening, John Bini, Brian Perry, Melanie Richards
Middle-Aged Man With Penetrating Trauma To The Pancreaticoduodenal Complex, Thomas Bening, John Bini, Brian Perry, Melanie Richards
John K. Bini
No abstract provided.
Governor Rendell's Prescription For Pennsylvania: A Bill Too Large To Swallow Whole, Raymond Singer
Governor Rendell's Prescription For Pennsylvania: A Bill Too Large To Swallow Whole, Raymond Singer
Raymond L Singer MD
No abstract provided.
So You're Not Lvpg? Gee, For A Second I Was Worried., Raymond Singer
So You're Not Lvpg? Gee, For A Second I Was Worried., Raymond Singer
Raymond L Singer MD
No abstract provided.
Live Television Interview On Barbara Walter's Valve Surgery, Raymond Singer
Live Television Interview On Barbara Walter's Valve Surgery, Raymond Singer
Raymond L Singer MD
No abstract provided.
Ron Swinfard's Legacy : Humble Leader Who Cares For People, Raymond Singer
Ron Swinfard's Legacy : Humble Leader Who Cares For People, Raymond Singer
Raymond L Singer MD
No abstract provided.
How To Make Par In Life, Raymond Singer
New Heart Valve Procedure Kindles Memory Of A Visonary Surgeon, Raymond Singer
New Heart Valve Procedure Kindles Memory Of A Visonary Surgeon, Raymond Singer
Raymond L Singer MD
No abstract provided.
Elliot Sussman Was A Visonary Who Inspired, Raymond Singer
Elliot Sussman Was A Visonary Who Inspired, Raymond Singer
Raymond L Singer MD
No abstract provided.
What You Need To Know About Valve Surgery, Raymond Singer
What You Need To Know About Valve Surgery, Raymond Singer
Raymond L Singer MD
No abstract provided.
Golf's Lessons Can Be Your Caddie To Help You Make Par In Life., Raymond Singer
Golf's Lessons Can Be Your Caddie To Help You Make Par In Life., Raymond Singer
Raymond L Singer MD
No abstract provided.
Careful Selection Of Candidates For Percutaneous Ventricular Assist Device Is Crucial, Raymond Singer
Careful Selection Of Candidates For Percutaneous Ventricular Assist Device Is Crucial, Raymond Singer
Raymond L Singer MD
No abstract provided.
Cardiac Surgery Report Cards Benefit Patients, Raymond Singer
Cardiac Surgery Report Cards Benefit Patients, Raymond Singer
Raymond L Singer MD
No abstract provided.
Letter To The Editor: Tort Reform Is A Must, Raymond Singer
Letter To The Editor: Tort Reform Is A Must, Raymond Singer
Raymond L Singer MD
No abstract provided.
A Worldly Rabbi Makes A World Of Difference At Home, Raymond Singer
A Worldly Rabbi Makes A World Of Difference At Home, Raymond Singer
Raymond L Singer MD
No abstract provided.
An Attitude Of Gratitude: A Positive Outlook Can Impact Your Health, Raymond Singer
An Attitude Of Gratitude: A Positive Outlook Can Impact Your Health, Raymond Singer
Raymond L Singer MD
No abstract provided.
Heart Health, Raymond Singer
The Comfort Of A Simple Crayon., Raymond Singer
The Comfort Of A Simple Crayon., Raymond Singer
Raymond L Singer MD
No abstract provided.
Measuring Quality Beyond The Sts Database: How Health Care Reform, Public Reporting, And Patient Satisfaction Will Impact Your Career., Raymond Singer
Measuring Quality Beyond The Sts Database: How Health Care Reform, Public Reporting, And Patient Satisfaction Will Impact Your Career., Raymond Singer
Raymond L Singer MD
No abstract provided.
Imagine If People Acknowledged We Are All The Same Inside., Raymond Singer
Imagine If People Acknowledged We Are All The Same Inside., Raymond Singer
Raymond L Singer MD
No abstract provided.
The Future Of Medicine: What You Need To Know About Health Care Reform, Ronald Swinfard, Raymond Singer, Joanne Judge, John Kristel, Christopher Molineaux, Gary St. Hilaire
The Future Of Medicine: What You Need To Know About Health Care Reform, Ronald Swinfard, Raymond Singer, Joanne Judge, John Kristel, Christopher Molineaux, Gary St. Hilaire
Raymond L Singer MD
No abstract provided.