scholarly journals Is Outpatient Thyroid Surgery for Everyone?

2017 ◽  
Vol 10 ◽  
pp. 117955061772442 ◽  
Author(s):  
Dale Butler ◽  
Sarah Oltmann
Keyword(s):  
Patient Outcomes ◽  
Postoperative Bleeding ◽  
Hospital Setting ◽  
Cost Effective ◽  
High Volume ◽  
Outpatient Setting ◽  
Current Trends ◽  
Surgeon Experience ◽  
Reduced Costs ◽  
Inpatient Basis

Thyroidectomy is a common surgical procedure. Traditionally, surgeons have performed thyroidectomy on an inpatient basis. However, consistent with current trends in surgery, some practices are transitioning thyroidectomy to an outpatient setting. Although concerns for hypocalcemia and postoperative bleeding exist regardless of surgeon experience, multiple studies demonstrate that outpatient thyroidectomy is safe in the hands of high-volume surgeons. Indeed, experienced thyroid surgeons who perform thyroidectomy in an outpatient setting experience excellent patient outcomes and reduced costs. However, outpatient thyroidectomy may not be suitable for all surgeons, hospitals, or patients. When evaluating whether to implement an outpatient thyroid program, a practice should consider a number of important factors including the team performing the procedure, the hospital, and the patient. With the appropriate staff education and experience, hospital setting, and patient selection, practices in a multitude of settings can successfully develop a safe, cost-effective outpatient thyroid program.

scholarly journals EFFECTIVENESS OF STRUCTURED ACTIVITY PROGRAMME ON COGNITIVE FUNCTION AMONG INMATES OF THE DESTITUTE HOME

2014 ◽  
Vol 04 (02) ◽  
pp. 110-113
Author(s):  
Anjali K. G. ◽  
Asha K. Nayak ◽  
Maxie Andrade
Keyword(s):  
Cognitive Function ◽  
Mentally Ill ◽  
Hospital Setting ◽  
Cost Effective ◽  
Care Practice ◽  
Optimum Level ◽  
Health Care Practice ◽  
Level Of Functioning ◽  
Current Trends ◽  
Post Test

Abstract:Current trends in health care practice emphasis on cost effective consolidative approach of pharmacological and life style modification. This can help mentally challenged individual and destitute to obtain the optimum level of functioning. The study aimed to determine the effectiveness of structured activity programme on cognitive function, self-esteem and behaviour among mentally ill destitute home inmates. Study was conceptualized based on Albert Bandura's Triadic reciprocity of determinism. An evaluative approach using pre-test post-test design was used for the study. The samples were selected based on the sampling criteria and a total of 50 samples were recruited for the study with the mean age of 41.98±13.13. Study findings revealed that structured activity programme was effective in improving the cognitive function of mentally ill destitute. This suggests structured activities can be used in institutionalized or hospital setting to improve the cognition of mentally ill clients.

Stapled Surgery for Hemorrhoidal Prolapse: From the Beginning to the Modern Times

2020 ◽  
Vol 15 ◽  
Author(s):  
Alessandro Sturiale ◽  
Bernardina Fabiani ◽  
Claudia Menconi ◽  
Danilo Cafaro ◽  
Felipe Celedon Porzio ◽  
...  
Keyword(s):  
Postoperative Bleeding ◽  
Invasive Procedure ◽  
High Volume ◽  
Normal Mucosa ◽  
Stapled Hemorrhoidopexy ◽  
Wound Complications ◽  
Rectal Intussusception ◽  
Stapler Technique ◽  
History Of ◽  
Hemorrhoidal Prolapse

Introduction: Hemorrhoidal disease is the most common proctologic condition in adults. Among the different surgical procedures, one of the greatest innovations is represented by the stapled hemorrhoidopexy. The history of this technique started with a single stapler use passing thorough a double stapler technique to resect the adequate amount of prolapse, finally arriving to the use of high volume devices. Methods: Nevertheless each device has its own specific feature, the stapler is basically made up with one or more circular lines of titanium staples whose height may be variable. The procedure is based on different steps: Introduction of the CAD, evaluation of the prolapse, fashioning purse string or parachute suture, introduction of the stapler head beyond the suture, pull the wires through the window, close the stapler and keep pulled the wires of the suture held together with a forcep, fire using two hands, open the stapler and remove it and check the staple line and then check the specimen. One of the latest innovations in stapled surgery the Tissue Selective Therapy. It is a minimally invasive procedure in which there is a partial circular stapled hemorrhoidopexy focused on the prolapsing piles with bridges of normal mucosa left. Results: Several studies have reported that SH is a safe and effective procedure to treat the hemorrhoidal prolapse. It is a quicker procedure with a shorter hospital stay and earlier return to work if compared with the conventional treatment. This is due to a less postoperative pain, postoperative bleeding, wound complications and constipation. Furthermore, the first generation devices had worse outcomes if compared with those of the new generation stapler that showed lower postoperative complication rate with better anatomical and symptomatic results. Conclusions: Stapled procedure for the treatment of symptomatic hemorrhoidal prolapse represents one of the most important innovations in proctology of the last century bringing with it the new revolutionary concept of the rectal intussusception as a determining factor involved in the natural history of the disease. Stapled hemorrhoidopexy marked an era in which the surgeon may to offer to the patients a safe, effective treatment with less pain and fast recovery.

scholarly journals Outcome of Acute Peritoneal Dialysis in Northern Tanzania

2012 ◽  
Vol 32 (3) ◽  
pp. 261-266 ◽  
Author(s):  
Kajiru Gad Kilonzo ◽  
Sudakshina Ghosh ◽  
Siya Anaeli Temu ◽  
Venance Maro ◽  
John Callegari ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Outcomes ◽  
Kidney Injury ◽  
Cost Effective ◽  
High Morbidity ◽  
Poor Countries ◽  
Resource Limited ◽  
Northern Tanzania ◽  
Nephrology Care ◽  
Technical Simplicity

Data on the burden of acute kidney injury (AKI) in resource-poor countries such as Tanzania are minimal because of a lack of nephrology services and an inability to recognize and diagnose AKI with any certainty. In the few published studies, high morbidity and mortality are reported. Improved nephrology care and dialysis may lower the mortality from AKI in these settings. Hemodialysis is expensive and technically challenging in resource-limited settings. The technical simplicity of peritoneal dialysis and the potential to reduce costs if consumables can be made locally, present an opportunity to establish cost-effective programs for managing AKI. Here, we document patient outcomes in a pilot peritoneal dialysis program established in 2009 at a referral hospital in Northern Tanzania.

Cost-effective, high-volume molecular beam epitaxy using a multi 6-in wafer reactor

2001 ◽  
Vol 227-228 ◽  
pp. 143-149
Author(s):  
Larry Leung ◽  
Damian Davison ◽  
Arthur Cornfeld ◽  
Frederick Towner ◽  
Dave Hartzell
Keyword(s):  
Molecular Beam Epitaxy ◽  
Molecular Beam ◽  
Cost Effective ◽  
High Volume

scholarly journals Future of Personalized Medicine in Oncology: A Systems Biology Approach

2010 ◽  
Vol 28 (16) ◽  
pp. 2777-2783 ◽  
Author(s):  
Ana Maria Gonzalez-Angulo ◽  
Bryan T.J. Hennessy ◽  
Gordon B. Mills
Keyword(s):  
Systems Biology ◽  
Patient Outcomes ◽  
Cost Effective ◽  
Molecular Medicine ◽  
Multidimensional Data ◽  
Data Sets ◽  
Therapeutic Modalities ◽  
Molecular Tests ◽  
Therapeutic Decision Making ◽  
The Masses

The development of cost-effective technologies able to comprehensively assess DNA, RNA, protein, and metabolites in patient tumors has fueled efforts to tailor medical care. Indeed validated molecular tests assessing tumor tissue or patient germline DNA already drive therapeutic decision making. However, many theoretical and regulatory challenges must still be overcome before fully realizing the promise of personalized molecular medicine. The masses of data generated by high-throughput technologies are challenging to manage, visualize, and convert to the knowledge required to improve patient outcomes. Systems biology integrates engineering, physics, and mathematical approaches with biologic and medical insights in an iterative process to visualize the interconnected events within a cell that determine how inputs from the environment and the network rewiring that occurs due to the genomic aberrations acquired by patient tumors determines cellular behavior and patient outcomes. A cross-disciplinary systems biology effort will be necessary to convert the information contained in multidimensional data sets into useful biomarkers that can classify patient tumors by prognosis and response to therapeutic modalities and to identify the drivers of tumor behavior that are optimal targets for therapy. An understanding of the effects of targeted therapeutics on signaling networks and homeostatic regulatory loops will be necessary to prevent inadvertent effects as well as to develop rational combinatorial therapies. Systems biology approaches identifying molecular drivers and biomarkers will lead to the implementation of smaller, shorter, cheaper, and individualized clinical trials that will increase the success rate and hasten the implementation of effective therapies into the clinical armamentarium.

Advanced Nursing Practice in Orthogeriatrics

2021 ◽  
Vol 05 (01) ◽  
pp. 29-34
Author(s):  
Anastasia Margioula ◽  
◽  
Stavroula Rizou ◽  
◽  
Keyword(s):  
Nursing Practice ◽  
Hospital Setting ◽  
Cost Effective ◽  
Term Care ◽  
Advanced Nursing Practice ◽  
Vein Thrombosis ◽  
Secondary Infections ◽  
Regular Care ◽  
Postoperative Constipation ◽  
Deep Vein

In the last few decades, all the countries aim to combine the improvement of the quality of health care with the reduction of health costs. In order to harmonize the above-mentioned contradictory goals, newly enhanced roles, as in the case of Advanced Nursing Practice, have been introduced, initially in the private sector and more recently in the public hospital setting. The orthogeriatric advanced nursing practitioners’ role is valuable for providing pain relief, diagnosing and treating postoperative delirium, deep vein thrombosis, and secondary infections, preventing subsequent injuries and pressure sores, helping patients deal with postoperative constipation, and assist them in early mobilizing. After patients’ discharge from the hospital, their role is essential for ensuring the patients are adhering to their osteoporotic treatment and have the adequate skills to prevent falls. Their role is significant for older adults living in nursing homes or long-term care facilities. Their care is cost-effective compared to regular care.

Addressing the Scottish burden of wounds through the Lens of Profound Knowledge

2021 ◽  
Vol 30 (Sup20) ◽  
pp. S34-S40
Author(s):  
Jenni MacDonald
Keyword(s):  
Patient Outcomes ◽  
Wound Care ◽  
Cost Effective ◽  
Theory Of Knowledge ◽  
Care Needs ◽  
Profound Knowledge ◽  
The Cost ◽  
Improve Patient ◽  
Growing Population

The prevalence of wounds and the cost of treating them are increasing year on year. Improving the quality of wound care will improve patient outcomes and is a financial necessity. The Lens of Profound Knowledge is a tool that can be used to support quality improvement and identify where action is needed. It allows exploration of an organisation through four aspects—appreciate the system, understanding variation, psychology, and theory of knowledge—and working on all four aspects simultaneously is believed to increase the likelihood of achieving improvement. Improvements at and between all levels—microsystem (such as frontline services), mesosystem (health boards) and macrosystem (NHS Scotland)—would reduce variation in practice and prove to be both clinically and cost-effective. Given the rapidly growing population of people with unhealed wounds, wound care needs to be valued at all system levels and be adequately resourced.

A COMPARATIVE STUDY OF EFFICACY, POTENCY AND RECOVERY OF INTRATHECAL 0.5% ROPIVACAINE WITH FENTANYLAND 0.5% LEVOBUPIVACAINE WITH FENTANYL IN LOWER ABDOMINAL SURGERIES IN PATIENTS OF 18-60YEARS OF AGE

2021 ◽  
pp. 74-76
Author(s):  
Payel Mitra ◽  
Archana Roy ◽  
Aamir Huda
Keyword(s):  
Comparative Study ◽  
Motor Block ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
Outpatient Setting ◽  
P Value ◽  
Equal Concentration ◽  
Medical College ◽  
Institutional Ethics ◽  
Care Surgery

INTRODUCTION:The recent trend in health care centres everywhere is to provide cost effective care to the patients. There is an increasing trend towards ambulatory day care surgery and rapid discharge of the patients. The operation of inguinal hernia or incisional hernia and even simple ligation surgeries are done without much complexities nowadays and can be completed in 60-90min without much intra or postoperative complications. Hence these have become an ideal procedure for outpatient setting and thereby reducing length of hospital stay. AIMS AND OBJECTIVE:A comparative study of efcacy, potency and recovery of intrathecal 0.5% ropivacaine with fentanyl and 0.5% levobupivacaine with fentanyl in lower abdominal surgeries in patients of 18-60years of age. MATERIALS AND METHOD: This is a prospective, comparative, observational study was conducted on 60 patients undergoing various lower abdominal surgeries under subarachnoid block (SAB) at Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal. This study was conducted over a period of 24-month. Approval of the Institutional Ethics Committee was taken. Awritten informed consent in the local language was taken from every patient. RESULT AND ANALYSIS: In RF 5 patients (17%) had onset at 3min, 17patients (57%) at 6min, 7 patients (23%) at 9min, 1 patient (3%) at 12min. In LBF 8 patients had onset at 0 min, 22 patients had onset at 3min. p value is less than 0.0001 which is statistically signicant. In RF, 23 patients (77%) had duration of motor block for 150min and 7 patients (23%) had for 180min. In LBF, 26 patients (87%) had duration of motor block for 210 min and 4 patients (13%) had for 180min. The p value is less than 0.0001, which is statistically signicant. SUMMARYAND CONCLUSION: This study was to compare potency, efcacy and recovery between the two groups of drugs. A potency of a drug is a measure of drug activity expressed in terms of the amount required to produce an effect of given intensity. Here both the drugs in comparison was given in equal concentration and found that levobupivacaine produced higher effect, reached Bromage 3 in lesser time than ropivacaine. So levobupivacaine was more potent drug. Efcacy is the ability to get a job done satisfactorily

scholarly journals Current trends in apple tree breeding (Malus Mill.)

2020 ◽  
pp. 5-11
Author(s):  
O. V. Kalinina ◽  
Yu. V. Burmenko ◽  
N. Yu. Svistunova
Keyword(s):  
Cost Effective ◽  
Tree Breeding ◽  
Industrial Sector ◽  
Crop Breeding ◽  
Relevant Today ◽  
Planting Material ◽  
Current Trends ◽  
Breeding Programmes ◽  
Apple Cultivars ◽  
Modern Breeding

Apples are among the most significant fruit crops in Russian horticulture. The wide variety, as well as the prominent economic potential of the crop, both enable its cultivation across many climate zones and bring orchard farming in general to the attention of investors in the agro-industrial sector. Breeders have met the rising challenges inherent in creating varieties that are superior in terms of productivity, abiotic- and biotic stress resistance, fruit quality and competitive fast-return capacity. In the present article, current research in apple breeding including methods for intensive selection is reviewed with a focus on breeding programmes for creating adaptive varieties having a high commercial and consumer value. Classical breeding can be complemented with modern techniques for an earlier selection of commercially valuable genotypes, identification of primary genotypes, as well as the creation of new donors and cultivars. The research achievements of leading national institutions in the development of apple varieties reflect additions to the Catalog of State-Permitted Cultivars of Agricultural Crops over the last decade. Most of the 422 permitted adapted apple cultivars are highly marketable due to having best-before-consumption dates in the winter. Despite current success in national orchard farming, further endeavours in crop breeding remain relevant today. Comprehensive research engaging genetics, physiology, phytopathology, virology, agrochemistry and nursery is essential for improving modern breeding programmes with the aim of supplying producers with high-quality planting material for a cost-effective, low pesticide, environmentallystable product.

Sign in / Sign up

Export Citation Format

Share Document