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Nelson Leung Morie Gertz Robert A. Kyle Fernando C. Fervenza Maria V. Irazabal Alfonso Eirin Shaji Kumar Stephen S. Cha S. Vincent Rajkumar Martha Q. Lacy Steve R. Zeldenrust Francis K. Buadi Suzanne R. Hayman Samih H. Nasr Sanjeev Sethi Marina Ramirez-Alvarado Thomas E. Witzig Sandra M. Herrmann Angela Dispenzieri 《Clinical journal of the American Society of Nephrology》2012,7(12):1964-1968
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Monica Sethi Karan Patel Jonathan Zagzag Manish Parikh John Saunders Aku Ude-Welcome Eduardo Somoza Bradley Schwack Marina Kurian George Fielding Christine Ren-Fielding 《Journal of gastrointestinal surgery》2016,20(2):244-252
Background
Thirty-day readmission post-bariatric surgery is used as a metric for surgical quality and patient care. We sought to examine factors driving 30-day readmissions after laparoscopic sleeve gastrectomy (LSG).Methods
We reviewed 1257 LSG performed between March 2012 and June 2014. Readmitted and nonreadmitted patients were compared in their demographics, medical histories, and index hospitalizations. Multivariable regression was used to identify risk factors for readmission.Results
Forty-five (3.6 %) patients required 30-day readmissions. Forty-seven percent were readmitted with malaise (emesis, dehydration, abdominal pain) and 42 % with technical complications (leak, bleed, mesenteric vein thrombosis). Factors independently associated with 30-day readmission include index admission length of stay (LOS) ≥3 days (OR 2.54, CI?=?[1.19, 5.40]), intraoperative drain placement (OR 3.11, CI?=?[1.58, 6.13]), postoperative complications (OR 8.21, CI?=?[2.33, 28.97]), and pain at discharge (OR?8.49, CI?=?[2.37, 30.44]). Patients requiring 30-day readmissions were 72 times more likely to have additional readmissions by 6 months (OR?72.4, CI?=?[15.8, 330.5]).Conclusions
The 30-day readmission rate after LSG is 3.6 %, with near equal contributions from malaise and technical complications. LOS, postoperative complications, drain placement, and pain score can aid in identifying patients at increased risk for 30-day readmissions. Patients should be educated on postoperative hydration and pain management, so readmissions can be limited to technical complications requiring acute inpatient management.86.
Eno powder (GlaxoSmithKline), an antacid preparation readily available over the counter, was used instead of a CO(2) generator for the growth of 15 strains of Neisseria gonorrhoeae obtained from men with urethritis. Due to its easy accessibility and low cost, Eno powder can be useful in developing countries for transporting clinical specimens from resource-poor peripheral labs to reference laboratories. 相似文献
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Chan Gek Cher Ho Peh Joo Li Jialiang Lee Evan Jon Choon Chua Horng Ruey Lau Titus Sethi Sunil Teo Boon Wee 《International urology and nephrology》2020,52(3):533-540
International Urology and Nephrology - Plasma galectin-3 (pG3) regulates inflammation. B-type natriuretic peptide (BNP), high-sensitivity Troponin I (hsTnI), and pG3 concentrations are elevated in... 相似文献
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Mark Christopher Snoddy Maximilian Frank Lang Thomas J. An Phillip Michael Mitchell William Jeffrey Grantham Benjamin Scoot Hooe Harrison Ford Kay Ritwik Bhatia Rachel V. Thakore Jason Michael Evans William Todd Obremskey Manish Kumar Sethi 《International orthopaedics》2014,38(8):1711-1716
Purpose
We evaluated factors influencing re-operation in tension band and plating of isolated olecranon fractures.Methods
Four hundred eighty-nine patients with isolated olecranon fractures who underwent tension band (TB) or open reduction internal fixation (ORIF) from 2003 to 2013 were identified at an urban level 1 trauma centre. Medical records were reviewed for patient information and complications, including infection, nonunion, malunion, loss of function or hardware complication requiring an unplanned surgical intervention. Electronic radiographs of these patients were reviewed to identify Orthopaedic Trauma Association (OTA) fracture classification and patients who underwent TB or ORIF.Results
One hundred seventy-seven patients met inclusion criteria of isolated olecranon fractures. TB was used for fixation in 43 patients and ORIF in 134. No statistical significance was found when comparing complication rates in open versus closed olecranon fractures. In a multivariate analysis, the key factor in outcome was method of fixation. Overall, there were higher rates of infection and hardware removal in the TB compared with the ORIF group.Conclusions
Our results demonstrate that the dominant factor driving re-operation in isolated olecranon fractures is type of fixation. When controlling for all variables, there is an increased chance of re-operation in patients with TB fixation. 相似文献89.
J Long H Vaughan-Williams J Moorhouse H Sethi N Kumar 《Annals of the Royal College of Surgeons of England》2014,96(1)
Simple liver cysts are common, rarely causing significant morbidity or mortality. Budd–Chiari syndrome (BCS) is caused by obstruction of hepatic venous outflow and is the leading cause of postsinusoidal liver failure. We present a rare case of BCS caused by a simple hepatic cyst.A 16cm × 16cm liver cyst was found on computed tomography of a 66-year-old woman presenting with abdominal pain. The cyst had become infected, thus enlarged, exerting mass effect with almost complete compression of the inferior vena cava. Shortly after admission, the patient developed acute liver failure, with deranged clotting and hepatic encephalopathy requiring full organ support on the intensive care unit. Cardiac output studies showed a low cardiac index of 1.4l/min/m2.An emergency laparotomy with fenestration of the cyst and drainage of 2l of purulent material led to a full recovery. Intraoperative cystic fluid aspirates later confirmed no evidence of Echinococcus. Histology confirmed a simple cyst. Liver biopsies showed severe, confluent, bridging necrosis, without background parenchymal liver disease.Acute BCS due to rapid compression of all major hepatic veins leading to fulminant hepatic failure is rare. Our case highlights a clinically significant complication of a simple liver cyst of which clinicians should be aware when managing these ‘innocent’ lesions. 相似文献
90.