Annals of surgery
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To determine the optimal surgical strategy for performing tracheostomy in COVID-19 patients. ⋯ The rapid formation of a multi-disciplinary team allows for the efficient evaluation and performance of a large volume of tracheostomies in a resource-limited setting. Bedside tracheostomy in COVID-19 does not cause additional harm to patients if performed after 2 weeks from intubation. It also seems to be safe for proceduralists to perform in this timeframe. The manner of tracheostomy does not change outcomes significantly if it is performed safely and efficiently.
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To evaluate the mechanisms associated with reflux events after sleeve gastrectomy (SG). ⋯ We found reflux to be strongly associated with SG and identified 3 unique categories. Bolus-induced deglutitive and postprandial reflux occurred in most patients. Elevated fasting esophageal acid exposure mediated symptoms. Frequent, significant elevation in the gastro-esophageal pressure gradient was the mechanism of reflux and seemed to relate to the noncompliant proximal stomach.
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Analyze the impact of the Affordable Care Act (ACA) on trauma outcomes at a population level and within at-risk subgroups. ⋯ The ACA is associated with improved mortality and increased use of home health services. Discrepancies amongst racial groups and income quartiles are present.
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To implement and evaluate outcomes from a comprehensive, multi-disciplinary debulking program in the United States. ⋯ Debulking with power assisted liposuction is an effective treatment for patients with chronic extremity LE. The operation addresses patient goals and improves quality of life, and additionally reduces extremity volumes, infection rates and reliance on outpatient therapy. A comprehensive, multi-disciplinary debulking program can be successfully implemented in the United States healthcare system.
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To define benchmark cutoffs for redo liver transplantation (redo-LT). ⋯ This study shows that redo-LT achieves good outcome when looking at benchmark scenarios. However, this figure changes in high-risk redo-LT, as for example in PNF. This analysis objectifies for the first-time results and efforts for redo-LT and can serve as a basis for discussion about the use of scarce resources.