Journal of the American College of Surgeons
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Despite guideline directed opioid prescribing after surgery, many patients retain excess opioids. Leftover pills increase the risk for misuse, diversion, and dependency. It is unclear whether interventions applied in routine clinical practice can increase excess opioid disposal rates. ⋯ Interventions easily incorporated into the EMR as part of routine clinical practice can markedly increase excess opioid disposal rates after surgery. When information on opioid disposal and patient portal reminders are combined with disposal discussions with providers at the postoperative visit, opioid disposal rates of >90% can be achieved.
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Non-operative management (NOM) with antibiotics alone for pediatric uncomplicated appendicitis is accepted to be safe and effective. However, the relative cost-effectiveness of this approach compared to appendectomy remains unknown. We aimed to evaluate the cost-effectiveness of non-operative versus operative management for pediatric uncomplicated acute appendicitis. ⋯ NOM is cost-effective compared to laparoscopic appendectomy for pediatric uncomplicated appendicitis over 1 year.
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It has been proposed that more aggressive tumors trigger a stronger inflammatory response than less aggressive types. We hypothesize that systemic immune inflammatory index (SII) is associated with occult nodal disease (OND) in clinically node negative (cN0) patients undergoing lung resection for non-small cell lung cancer (NSCLC). ⋯ Increased SII is associated with OND in patients undergoing lung resection for NSCLC.