Classification of Surgical Complications

This landmark paper proposed a graded classification model for surgical complications and determined that there is a direct correlation between complication grade and patient length of stay. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.

The Surgical Safety System Checklist (SURPASS)

10.1093/med/9780199384075.003.0016 ◽

2017 ◽

Author(s):

Michael E. Hochman

Keyword(s):

Study Design ◽

Surgical Complications ◽

Clinical Case ◽

Safety System ◽

Design Study ◽

Safety Measures ◽

Surgical Safety ◽

Study Intervention ◽

This chapter provides a summary of the landmark study known as SURPASS (the Surgical Safety System Checklist). Can surgical complications be reduced by following a checklist of safety measures before, during, and after operations? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case on the use of SURPASS.

Heller Myotomy versus Heller Myotomy with Dor Fundoplication for Achalasia

10.1093/med/9780199384075.003.0040 ◽

2017 ◽

Author(s):

Jerald Borgella ◽

Michael Choi ◽

Miguel Burch

Keyword(s):

Gastroesophageal Reflux ◽

Study Design ◽

Heller Myotomy ◽

Clinical Case ◽

Partial Fundoplication ◽

Dor Fundoplication ◽

Design Study ◽

This chapter provides a summary of the management of patients with achalasia and how the addition of a fundoplication can affect outcomes. The primary question asked is could the addition of a Dor fundoplication to a Heller myotomy decrease the incidence of pathologic gastroesophageal reflux? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case regarding treating a patient with either Heller myotomy or Heller myotomy plus partial fundoplication.

Gastroesophageal Junction Tumors Does Location Determine Treatment?

10.1093/med/9780199384075.003.0028 ◽

2017 ◽

Author(s):

Emily L. Siegel ◽

Miguel Burch

Keyword(s):

Study Design ◽

Clinical Case ◽

Classification Scheme ◽

Treatment Approach ◽

Gastroesophageal Junction ◽

Design Study ◽

Appropriate Treatment ◽

Study Intervention ◽

This chapter summarizes a landmark study in treatment of gastroesophageal (GE) junction tumors. Should an anatomically based classification scheme of GE tumors define the appropriate treatment approach for these tumors? Starting with that question, it describes the basis of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving possible gastrectomy and esophagectomy.

Switching Antipsychotics to Reduce Metabolic Risk

10.1093/med/9780190625085.003.0043 ◽

2018 ◽

Author(s):

Eric Lin ◽

John Cahill

Keyword(s):

Study Design ◽

Clinical Case ◽

Population Characteristics ◽

Metabolic Risk ◽

Design Study ◽

Study Population ◽

Clinical Considerations ◽

Location Study ◽

This chapter provides a summary of the landmark Comparison of Antipsychotics for Metabolic Problems trial on schizophrenia treatment. This trial was designed to help clarify some of the clinical considerations in choosing antipsychotics. Does switching to aripiprazole from olanzapine, quetiapine, or risperidone confer metabolic benefits? Does the switch to aripiprazole cause clinical destabilization? Starting with these questions, it describes the basics of the study, including funding, study location, study population characteristics, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Mastectomy versus Lumpectomy for Invasive Breast Cancer

10.1093/med/9780199384075.003.0023 ◽

2017 ◽

Author(s):

Michael E. Hochman

Keyword(s):

Breast Cancer ◽

Study Design ◽

Invasive Breast Cancer ◽

Clinical Case ◽

Breast Conserving Therapy ◽

Total Mastectomy ◽

Design Study ◽

Study Intervention ◽

This chapter provides a summary of the landmark study known as the B-06 trial, which compared total mastectomy versus breast-conserving therapy (i.e., lumpectomy) for treating women with invasive breast cancer. Do all women with invasive breast cancer require a total mastectomy, or is breast conserving therapy (i.e., lumpectomy) appropriate in some women? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving total mastectomy versus lumpectomy.

North American Prodrome Longitudinal Study

10.1093/med/9780190625085.003.0045 ◽

2018 ◽

Author(s):

Nikhil Gupta ◽

Vinod H. Srihari

Keyword(s):

Longitudinal Study ◽

High Risk ◽

Psychotic Disorder ◽

Study Design ◽

North American ◽

Clinical Case ◽

Design Study ◽

Study Intervention ◽

This chapter provides a summary of a landmark study on schizophrenia. The question studied was “In patients identified clinically to be at high risk for psychosis, which variables (or their combinations) best predict conversion to schizophrenia or another psychotic disorder?” Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. This study demonstrates that presence of some characteristics can better prognosticate conversion of a prodromal state to a psychotic disorder. Finally, the chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Effectiveness of Clozapine versus Other Atypical Antipsychotics

10.1093/med/9780190625085.003.0041 ◽

2018 ◽

Author(s):

Eunice Yuen ◽

Cenk Tek

Keyword(s):

Study Design ◽

Clinical Case ◽

Atypical Antipsychotics ◽

Chronic Schizophrenia ◽

Intervention Effectiveness ◽

Design Study ◽

Study Intervention ◽

This chapter provides a summary of a landmark study on adult patients with schizophrenia. Discussion here is based on the investigation from the Clinical Antipsychotic Trials for Intervention Effectiveness (CATIE). What is the role of clozapine among patients with chronic schizophrenia who fail to respond to atypical antipsychotics? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

Accuracy of Focused Abdominal Sonography for Trauma (FAST)

10.1093/med/9780199384075.003.0031 ◽

2017 ◽

Author(s):

Rachel J. Kwon

Keyword(s):

Study Design ◽

Clinical Case ◽

Trauma Surgery ◽

Pericardial Fluid ◽

Trauma Patients ◽

Design Study ◽

Abdominal Sonography ◽

Study Intervention ◽

This chapter provides a summary of a landmark study in trauma surgery. It deals with focused abdominal sonography for trauma (FAST). How accurate is surgeon-performed ultrasound to assess hemoperitoneum and pericardial fluid in trauma patients? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case regarding when FAST might be applicable in a trauma situation.

Hydrocortisone Therapy for Patients with Septic Shock

50 Studies Every Intensivist Should Know ◽

10.1093/med/9780190467654.003.0049 ◽

2018 ◽

pp. 301-306

Author(s):

Ryan J. Horvath ◽

Edward Bittner

Keyword(s):

Septic Shock ◽

Study Design ◽

Steroid Therapy ◽

Clinical Case ◽

Low Dose ◽

Vasopressor Therapy ◽

Surviving Sepsis Campaign ◽

Number Of Patients ◽

This chapter provides a summary of the landmark study known as the CORTICUS trial. Among patients suffering from septic shock, does low dose hydrocortisone improve mortality? Starting with that question, it describes the basics of the study, including funding, study location, the population studies, number of patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The CORTICUS trial failed to demonstrate a benefit on mortality with steroid therapy among patients with septic shock. Based on CORTICUS and other studies, the Surviving Sepsis Campaign guidelines no longer recommend steroids for all patients with septic shock. Corticosteroids should be considered, however, for patients with septic shock who do not respond to fluids and vasopressor therapy.

Comparison of 8 versus 15 Days of Antibiotic Therapy for Ventilator-Associated Pneumonia in Adults

50 Studies Every Intensivist Should Know ◽

10.1093/med/9780190467654.003.0042 ◽

2018 ◽

pp. 257-262

Author(s):

Laurie O. Mark ◽

Jean Kwo

Keyword(s):

Antibiotic Therapy ◽

Randomized Trial ◽

Study Design ◽

Clinical Case ◽

Pulmonary Infection ◽

Ventilator Associated Pneumonia ◽

Icu Patients ◽

Study Intervention ◽

This chapter provides a summary of the landmark study “Comparison of 8 versus 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.” In adult patients with ventilator-associated pneumonia (VAP), is treatment with an 8-day course of antimicrobials as effective as a 15-day course? Starting with that question, the chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. In ICU patients who develop microbiologically proven VAP, an 8-day antimicrobial course is not inferior to a 15-day course with respect to all-cause mortality or recurrence of pulmonary infection. However, these findings may not apply to patients who are immunocompromised, and shorter or longer duration of antibiotics may sometimes be indicated.