Journal of the American College of Surgeons
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Burn patients who require CPR before admission to a burn center are anecdotally known to suffer higher mortality than those who do not require pre-hospital CPR. ⋯ Patients who undergo CPR before transfer to a burn center are at high risk for early death. Predictors of death and early death after CPR may include elevated initial lactate and lower initial arterial pH.
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Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. ⋯ A phone-based transitional care protocol for surgical patients is feasible, with <1% refusals and 95% engagement. Medication management is a prominent issue. Future studies are needed to assess the impact of surgical C-TraC on post-discharge healthcare use.
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With triphasic, dynamic contrast-enhanced CT scan to identify benign and malignant gallbladder polypoid lesions, we hope to determine an accurate diagnosis before surgery. ⋯ In triphasic, dynamic contrast-enhanced CT scan, plain CT value, delayed phase CT value, and ΔCT value could detect malignant lesions of gallbladder polyps, with the highest sensitivity and specificity of ΔCT.
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Bowel length is an important factor in the management of patients with intestinal failure and short bowel syndrome. However, it is difficult to accurately measure the length of the small intestine. Our aim was to demonstrate the feasibility of a dedicated software algorithm for calculating small intestine length based on magnetic resonance enterography (MRE) images. ⋯ This study demonstrates the feasibility of a dedicated, computer-vision-based algorithm that can reliably and accurately calculate the length of the small intestine using MRE images. A validated, noninvasive approach to measuring small intestine length that can be implemented using available clinical imaging can have a dramatic clinical impact on management in patients with short bowel syndrome, Crohn's disease, and other intestinal disorders.