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101.
Donna L. Berry Fangxin Hong Traci M. Blonquist Barbara Halpenny Christopher P. Filson Viraj A. Master Martin G. Sanda Peter Chang Gary W. Chien Randy A. Jones Tracey L. Krupski Seth Wolpin Leslie Wilson Julia H. Hayes Quoc-Dien Trinh Mitchell Sokoloff Prabhakara Somayaji 《The Journal of urology》2018,199(1):89-97
102.
Andrew M. Nunn Justin S. Hatchimonji Daniel N. Holena Mark J. Seamon Brian P. Smith Lewis J. Kaplan Niels D. Martin Patrick M. Reilly C. William Schwab Jose L. Pascual 《American journal of surgery》2018,215(4):669-674
Introduction
Surgical Intensive Care Unit (SICU) patients “boarding” in ICUs other than the designated home unit have been shown to suffer increased rates of complications. We hypothesized that ICU rounding practices are different when SICU patients are housed in home vs. boarding ICUs.Material and methods
SICU rounds were observed at an academic quaternary medical center. Individual patient rounding time and order seen on rounds along with patient data and demographics were recorded. Multivariable regression analysis was used for comparison between patients.Results
Non-boarders were older, observed on a later post ICU admission day and were more likely to be mechanically ventilated. Boarded patients were often seen at the end of rounds and for less time. Not being a boarder, age, APACHE II score on admission, vasopressor use, and positive pressure ventilation all predicted increased rounding time.Conclusions
Surgical ICU patients boarding in non-preferred units are often seen at the end of rounds, result in a greater reliance upon telephone communication, and receive less bedside attention from ICU provider teams. 相似文献103.
Effect of a hospital-associated urinary tract infection reduction policy on general surgery patients
Sheena K. Harris Erica L. Mitchell Michael R. Lasarev Fouad Attia John G. Hunter Brett C. Sheppard 《American journal of surgery》2018,215(4):658-662
Background
Hospital-associated UTI rates in surgery patients have not improved despite recommendations for reducing indwelling catheter days.Methods
We performed a retrospective review of institutional NSQIP general surgery patient data, 2006–2015. During this time, a UTI-reduction policy was implemented. Demographics, HA-UTI incidence, CA-UTI incidence, indwelling catheter days, straight catheterization rates, and mortality were examined.Results
Females had significantly higher risk of HA-UTI. There was no significant change in HA-UTI (X12?=?0.02, p?=?.878) or indwelling catheter days (5.18?±?1.12 days v 3.73?±?0.39 days, p?=?.23). Straight catheterizations among those with HA-UTI increased (0.04?±?0.04 v 0.32?±?0.12, p?=?.029). There was no change in CA-UTI (1.38 v 1.11 CAUTI/1000 patient hospital-days P?=?.555) or in initial indwelling catheter days of patients with CA-UTI (7.2 SD 8.89 v 47.0 SD 7.04 days P?=?.961) after policy implementation.Conclusions
The reduction policy increased the number of straight catheterizations for patients developing HA-UTI, but did not reduce the number of initial indwelling catheter days, HA-UTI rates, or CA-UTI rates. 相似文献104.
105.
106.
107.
Justin K. Lee Daniel D. Sjoberg Mariam Imnadze Miller Andrew J. Vickers John P. Mulhall Behfar Ehdaie 《European urology》2018,73(1):33-37
Background
Although active surveillance is increasingly used for the management of low-risk prostate cancer, many eligible patients are still nonetheless subject to curative treatment. One argument for considering surgery rather than active surveillance is that the probability of postoperative recovery of erectile function is age dependent, that is, patients who delay surgery may lose the window of opportunity to recover erectile function after surgery.Objective
To model erectile function over a 10-yr period for immediate surgery versus active surveillance.Design, setting, and participants
Data from 1103 men who underwent radical prostatectomy at a tertiary referral center were used.Outcome measurements and statistical analysis
Patients completed the International Index of Erectile Function (IIEF-6) pre- and postoperatively as a routine part of clinical care. Preoperative IIEF-6 scores were plotted against age to assess the natural rate of functional decline due to aging. Reported erectile scores in the 2-yr period following surgery were used to assess post-surgical recovery.Results and limitations
Each year increase in patient age resulted in a 0.27 reduction in IIEF scores. In addition to IIEF reducing with increased age, the amount of erectile function that is recovered from presurgery to 12-mo postsurgery also decreases (?0.16 IIF points/yr, 95% confidence interval ?0.27, ?0.05, p = 0.006). However, delayed radical prostatectomy increased the mean IIEF-6 score over a 10-yr period compared with immediate surgery (p = 0.001), even under the assumption that all men placed on active surveillance are treated within 5 yr.Conclusions
Small differences in erectile function recovery in younger men are offset by a longer period of time living with decreased postoperative function. Better erectile recovery in younger men should not be a factor used to recommend immediate surgery in patients suitable for active surveillance, even if crossover to surgery is predicted within a short period of time.Patient summary
Younger men have better recovery of erectile function after surgery for prostate cancer. This has led to the suggestion that delaying surgery for low-risk disease may lead patients to miss a window of opportunity to recover erectile function postoperatively. We conducted a modeling study and found that predicted erectile recovery was far superior on delayed treatment because slightly better recovery in younger men is offset by a longer period of time living with poorer postoperative function in those choosing immediate surgery. 相似文献108.
Gary R. Schooler Juan C. Infante Michael Acord Adina Alazraki Govind B. Chavhan James Christopher Davis Geetika Khanna Ajaykumar C. Morani Cara E. Morin HaiThuy N. Nguyen Mitchell A. Rees Raja Shaikh Abhay Srinivasan Judy H. Squires Elizabeth Tang Paul G. Thacker Alexander J. Towbin 《Pediatric blood & cancer》2023,70(Z4):e29965
Primary hepatic malignancies are relatively rare in the pediatric population, accounting for approximately 1%–2% of all pediatric tumors. Hepatoblastoma and hepatocellular carcinoma are the most common primary liver malignancies in children under the age of 5 years and over the age of 10 years, respectively. This paper provides consensus-based imaging recommendations for evaluation of patients with primary hepatic malignancies at diagnosis and follow-up during and after therapy. 相似文献
109.
110.
Mitchell A. Rees Cara E. Morin Gerald G. Behr J. Christopher Davis Hollie Lai Ajaykumar C. Morani Marguerite T. Parisi Gaurav Saigal Sudha Singh Sireesha Yedururi Alexander J. Towbin Barry L. Shulkin 《Pediatric blood & cancer》2023,70(Z4):e29973
Adrenal tumors other than neuroblastoma are uncommon in children. The most frequently encountered are adrenocortical carcinoma and pheochromocytoma. This paper offers consensus recommendations for imaging of pediatric patients with a known or suspected primary adrenal malignancy other than neuroblastoma at diagnosis and during follow-up. 相似文献