scholarly journals 1017 Non-surgical aspects of minimising intraoperative haemorrhage in complex pelvic surgery – the multidisciplinary approach

Author(s):  
C Downing ◽  
SL Smyth ◽  
J Thompson ◽  
M Alazzam
2017 ◽  
Vol 10 (1_suppl) ◽  
pp. 29-33 ◽  
Author(s):  
Samer Jallad ◽  
Luke Hounsome ◽  
Julia Verne ◽  
Erik Mayer

Background: The volume–outcome relationship in surgery has been a focus of interest for over a decade. The National Institute for Health and Care Excellence (NICE) published their improving outcome guidance in 2002, which encouraged a regionalised multidisciplinary approach in managing urological cancer cases and recommended centralisation of urological pelvic surgery. The current study offers an updated view on the urological pelvic services in England with regard to radical cystectomy (RC) and radical prostatectomy (RP) and adherence to improving outcome guidance guidelines and patterns of services provision since its introduction in 2002. Methods: The data for inpatient elective RC and RP were taken from hospital episodes statistics for 2003–2013. The RC and RP cases were calculated separately per year for every trust to calculate the annual rates and then combined for every trust. The catchment areas for RC and RP were calculated using the proportionate-flow method. Results: The number of trusts performing RC and RP reduced significantly over the 10 years, while in the same period, the numbers of RC and RP performed increased significantly ( P<0.05). There has been a steady increase in the cases referred to another trust for their RC or RP surgery ( P<0.05). Overall, there has been a significant increase in the number of trusts achieving the improving outcome guidance recommended minimal case volume of 50 or more (RC + RP combined) over the 10-year analysis ( P=0.0006). Conclusion: There has been a shift in urological pelvic surgery provision in England since the publication of improving outcome guidance by NICE in 2002, with over 95% of cases being performed in improving outcome guidance compliant centres achieving 50 cases or more per year. Simultaneously, a significant reduction in postoperative mortality and the hospital length of stay has been seen over this period.


2015 ◽  
Vol 24 (3) ◽  
pp. 74-85
Author(s):  
Sandra M. Grether

Individuals with Rett syndrome (RS) present with a complex profile. They benefit from a multidisciplinary approach for diagnosis, treatment, and follow-up. In our clinic, the Communication Matrix © (Rowland, 1990/1996/2004) is used to collect data about the communication skills and modalities used by those with RS across the lifespan. Preliminary analysis of this data supports the expected changes in communication behaviors as the individual with RS ages and motor deficits have a greater impact.


Author(s):  
Oscar D. Guillamondegui

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.


2008 ◽  
Vol 18 (2) ◽  
pp. 87-98 ◽  
Author(s):  
Vinciya Pandian ◽  
Thai Tran Nguyen ◽  
Marek Mirski ◽  
Nasir Islam Bhatti

Abstract The techniques of performing a tracheostomy has transformed over time. Percutaneous tracheostomy is gaining popularity over open tracheostomy given its advantages and as a result the number of bedside tracheostomies has increased necessitating the need for a Percutaneous Tracheostomy Program. The Percutaneous Tracheostomy Program at the Johns Hopkins Hospital is a comprehensive service that provides care to patients before, during, and after a tracheostomy with a multidisciplinary approach aimed at decreasing complications. Education is provided to patients, families, and health-care professionals who are involved in the management of a tracheostomy. Ongoing prospective data collection serves as a tool for Quality Assurance.


1959 ◽  
Vol 36 (1) ◽  
pp. 19-25
Author(s):  
John M. Waugh
Keyword(s):  

1995 ◽  
Vol 40 (1) ◽  
pp. 7-8
Author(s):  
Heather Cecil ◽  
Melinda A. Stanley

1978 ◽  
Vol 23 (3) ◽  
pp. 181-182
Author(s):  
ELLEN R. GRITZ

1990 ◽  
Vol 35 (6) ◽  
pp. 577-578
Author(s):  
Amy Holtzworth-Munroe

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