Surgery
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Frail Older Patients Receiving Higher-Intensity End-of-Life Care
There is an opportunity for targeted interventions for all older patients, especially frail older adults, undergoing emergency general surgery to establish better prognostic understanding and discuss advance care planning before hospital discharge.
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Elderly Patients with Esophageal Cancers Might Tolerate Multimodal Therapy Well
Some clinicians shy away from complete therapy courses for these patients over concerns about frailty, quality of life.
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Papers Detail Hazards of Surgical Smoke
Researchers provide more detailed definitions, offer possible solutions to minimize risk.
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Managing Appendicitis Medically
A multicenter, randomized trial showed that 10 days of antibiotics results in comparable outcomes as surgery. Three in 10 patients treated with antibiotics required surgery within 90 days.
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Early Trial Results Suggest Many Acute Appendicitis Patients Could Safely Delay or Avoid Surgery
In a study, 70% of patients with appendicitis who were treated with antibiotics avoided surgery at 90 days. This creates possibilities for patients and providers for a common diagnosis in the ED.
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U.S. Readmission Rates for TAVR
An analysis of the Nationwide Readmission Database revealed one-fifth of transcatheter aortic valve replacement patients are readmitted a median of 31 days after discharge. Medical comorbidities are the most common reason.
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TAVR Outcomes in Patients on Chronic Corticosteroid Therapy
A 12-year experience with transcatheter aortic valve replacement at one Paris hospital demonstrated chronic systemic corticosteroid use increases the incidence of major 30-day complications and all-cause mortality at one year.
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When Is TAVR Futile?
A study of all patients who underwent transcatheter aortic valve replacement over eight years in France was used to develop a futility score that would help predict who would not live one year after the procedure. This simple clinical score based on comorbidities predicted who would live one year with 95% specificity.
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Lack of Health Literacy Tied to Higher Risk for Postoperative Infections
Limited knowledge is common in the United States, which is attributed to various factors.
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Can Antibiotics Sterilize an Infected Heart Valve Before Surgery?
In a study of the relationship between the duration of antibiotic therapy and a positive surgically excised heart valve culture in patients with infective endocarditis, researchers observed positive valve culture incidence decreases exponentially on antibiotic therapy for 14 days then plateaus with no effect after 21 days of therapy.