Annals of surgery
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To familiarize surgeons with the use of funnel plots as a control tool to assess quality in surgery. ⋯ More widespread application of funnel plots in surgery will help to overcome some of the existing difficulties in assessing and reporting performance and identifying evidence-based information. The assessment and changes in future healthcare delivery could be partly influenced by further development of funnel plot methodology.
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Evaluate outcomes of patients with an original diagnosis of ulcerative colitis (UC) who required partial or complete ileal pouch reconstruction due to poor function or infectious complications. ⋯ In UC patients with failing IPAA, partial or complete pouch reconstruction can be done safely with good functional results, and may avoid pouch excision and permanent ileostomy in carefully selected patients, especially those with definite UC.
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Comparative Study
Assessment of mortality in older trauma patients sustaining injuries from falls or motor vehicle collisions treated in regional level I trauma centers.
To compare mortality in elderly trauma patients sustaining fall or motor vehicle collision (MVC) related injuries and who are subsequently treated at regional Level I (tertiary) trauma centers. ⋯ Elderly patients sustaining fall-related injuries and treated at Level I trauma centers are at risk for excess mortality when compared with those injured in MVCs. Effective and efficient methods for treating this population must be determined.
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To examine whether case managers affect patient evaluation/treatment/outcome and staffing requirements during Multiple Casualty Incidents (MCIs). ⋯ During an MCI, case managers increase surge capacity by improving efficacy (workup/treatment times and use of resources) and may improve patient care via increased personal accountability, continuity of care, and involvement in treatment decisions.
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This study investigates the effect of lipid-rich nutrition on the local inflammatory response and gastrointestinal hypomotility in a rat model of postoperative ileus. ⋯ Our data demonstrate that nutritional stimulation of the autonomic nervous system with enteral lipids reduces postoperative ileus by inhibition of inflammation. Clinically, lipid-rich enteral nutrition may be a new therapeutic option in the treatment of postoperative ileus.