scholarly journals Total Thyroidectomy as an Ambulatory Procedure in Community Practice

OTO Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. 2473974X2095732
Author(s):  
Rebecca A. Compton ◽  
Jonathan C. Simmonds ◽  
Jagdish K. Dhingra
Keyword(s):  
New York ◽  
Total Thyroidectomy ◽  
National Database ◽  
Community Practice ◽  
Database Analysis ◽  
Time Period ◽  
Ambulatory Patients ◽  
Symptomatic Hypocalcemia ◽  
Ambulatory Procedure ◽  
Ambulatory Procedures

Objective Increasingly, total thyroidectomy is offered as an ambulatory procedure. Most of the relevant outcomes research derives from academic centers, but most thyroid surgeries are performed in the community. The goal of this study is to evaluate the safety of total thyroidectomy performed as an ambulatory procedure in a community otolaryngology practice. Study Design Retrospective review and national database analysis. Setting A single community otolaryngology practice. Methods Adult patients undergoing total thyroidectomy by a single otolaryngologist between 2013 and 2019 were divided into 2 cohorts: planned ambulatory and planned admission. Charts were reviewed for demographics and surgical outcomes in the 2 groups. The Healthcare Cost and Utilization Project databases for New York and Florida between 2015 and 2016 were also analyzed to compare outcomes of thyroidectomy as an ambulatory surgery between different practice settings. Results A total of 99 total thyroidectomies were performed during the study time period; 66 of 99 (67%) were planned as ambulatory procedures and 33 of 99 (33%) were planned admissions. Five of the 66 (8%) planned outpatient surgeries required admission. Complications of vocal fold dysfunction, symptomatic hypocalcemia, and seroma formation were more commonly seen in the inpatient cohort. Only 2 ambulatory patients required admission after discharge. Nationally, odds of complication were higher for ambulatory total thyroidectomy at nonteaching practice sites, which is not duplicated in our study. Conclusions Ambulatory total thyroidectomy can be undertaken safely in the community in carefully selected cases.

Regional, institutional and individual factors affecting selection of minimally invasive nephroureterectomy in Japan: A national database analysis

2012 ◽  
Vol 20 (7) ◽  
pp. 695-700 ◽  
Author(s):  
Toru Sugihara ◽  
Hideo Yasunaga ◽  
Hiromasa Horiguchi ◽  
Tetsuya Fujimura ◽  
Hiroaki Nishimatsu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
National Database ◽  
Individual Factors ◽  
Database Analysis ◽  
Factors Affecting ◽  
Selection Of

Proximal Aortic Repair in Dialysis Patients: A National Database Analysis

2021 ◽  
Author(s):  
Takuya Ogami ◽  
Eric Zimmermann ◽  
Roger Zhu ◽  
Yanling Zhao ◽  
Yuming Ning ◽  
...  
Keyword(s):  
National Database ◽  
Dialysis Patients ◽  
Database Analysis ◽  
Aortic Repair

scholarly journals IMPACT OF ANEMIA ON IN-HOSPITAL OUTCOMES OF MYOCARDIAL INFARCTION: A NATIONAL DATABASE ANALYSIS

2021 ◽  
Vol 77 (18) ◽  
pp. 123
Author(s):  
Aravdeep Jhand ◽  
Hyo Jung Tak ◽  
Arslan Ahmed ◽  
Eirini Apostolidou ◽  
S. Elissa Altin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
National Database ◽  
Database Analysis ◽  
Hospital Outcomes

scholarly journals DB1 Mortality Excess Due To Clostridium Difficile Infection - A National Database Analysis

2016 ◽  
Vol 19 (7) ◽  
pp. A354-A355
Author(s):  
S Bouee ◽  
L Levy Bachelot ◽  
H Ravonimbola ◽  
L Longepierre ◽  
C Godard ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
National Database ◽  
Database Analysis

Sick on the Frontlines:A Cross Sectional Study on COVID-19 Infection, Symptom Severity Amongst Emergency Medicine Residents and Fellows in Urban Academic Hospital Settings (Preprint)

2021 ◽  
Author(s):  
Stacey Frisch ◽  
Sarah Jones ◽  
James Willis ◽  
Richard Sinert
Keyword(s):  
New York ◽  
Emergency Medicine ◽  
Cross Sectional Study ◽  
The Novel ◽  
Academic Hospital ◽  
Cross Sectional ◽  
Time Period ◽  
High Infection ◽  
Novel Coronavirus ◽  
Specific Symptoms

BACKGROUND COVID-19, an illness caused by the novel coronavirus SARS-CoV-2, affected many aspects of healthcare worldwide in 2020. From March to May of 2020, New York City (NYC) experienced a large surge of cases. OBJECTIVE The authors aimed to characterize the amount of illness experienced by residents and fellows in 2 NYC hospitals during this time period. METHODS This was a cross-sectional observational study. An IRB-exempt survey was distributed to emergency medicine housestaff in May 2020 and submissions were accepted through August 2020. RESULTS 64 residents and fellows responded to our survey (a 62% response rate). 42% of responders tested positive for SARS-CoV-2 antibodies. Most residents experienced symptoms that could be consistent with COVID-19 however few received PCR testing. Fevers and/or chills along with loss of smell and/or taste were the most specific symptoms for COVID-19, with p-values <0.05. All 13 housestaff who reported no symptoms during the study period tested negative for SARS-CoV-2 antibodies. CONCLUSIONS Our study demonstrated that the rate of COVID-19 illness among emergency department housestaff is much higher than previously reported. Further studies are needed to characterize illness among medical staff in emergency departments across the nation. The high infection rate among emergency medicine trainees stresses the importance of supplying adequate PPE for healthcare professionals.

The Economic Effects on Acute Care Surgery in a New York City Public Hospital During the COVID Pandemic

2022 ◽  
pp. 000313482110697
Author(s):  
Zhobin Moghadamyeghaneh ◽  
Adedolapo Ojo ◽  
Murwarid Rahimi ◽  
Anthony Paul Kopatsis ◽  
Katherine Kopatsis ◽  
...  
Keyword(s):  
New York ◽  
Acute Care ◽  
Public Hospital ◽  
Economic Effects ◽  
Acute Care Surgery ◽  
Chi Square ◽  
Time Period ◽  
Before And After ◽  
Care Surgery ◽  
Hospital Center

Background Since the start of the COVID-19 pandemic, less acute care surgical procedures have been performed and consequently hospitals have experienced significant revenue loss. We aim to investigate these procedures performed before and after the start of the COVID-19 pandemic, as well as their effect on the economy. Methods This is a retrospective analysis of patients who underwent cholecystectomies and appendectomies during March–May 2019 compared to the same time period in 2020 using Chi-square and t-tests. Results There were 345 patients who presented with appendicitis or cholecystitis to Elmhurst Hospital Center during the March–May 2019 and 2020 time period. There were three times as many total operations, or about 75%, in 2019 (261) compared to 2020 (84). There was a decrease in the number of admissions from 2019 to 2020 for both acute cholecystitis (149 vs 43, respectively) and acute appendicitis (112 vs 41, respectively). The largest decrease in the number of admissions in 2020 compared to 2019 was observed in April 2020 (98 vs 9, P < .01) followed by May [69 vs 20, P < .01], and March [94 vs 55, P < .01]. Corresponding to the decrease in operative patterns was a noticeable six-time reduction in revenue for the procedures in 2019 ($187,283) compared to 2020 ($30,415). Conclusion We observed almost a triple reduction in the number of cholecystitis and appendicitis procedures performed during the 2020 pandemic surge as compared to the 2019 pre-pandemic data. Elmhurst hospital also experienced four times the loss of revenue during the same time period.

scholarly journals The impact of postoperative percent change of parathormone level from baseline value on the rate of hypocalcemia after total thyroidectomy

2017 ◽  
Author(s):  
Ismail Cem Sormaz ◽  
Ahmet Yalin Iscan ◽  
Ilker Ozgur ◽  
Seyma Karakus ◽  
Fatih Tunca ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Albumin Concentration ◽  
Postoperative Hypocalcemia ◽  
Percent Change ◽  
Number Of Patients ◽  
Increased Risk ◽  
Symptomatic Hypocalcemia ◽  
Postoperative Serum ◽  
Group 2 ◽  
The Impact

Background: To investigate the impact of the percent change of postoperative parathormone (PoPTH) level from baseline value (∆PTH) on the rate of hypocalcemia after total thyroidectomy. Methods: Assays of serum PTH and calcium (Ca) were performed preoperatively and at 24 hours postoperatively in 222 consecutive patients who underwent total thyroidectomy. Postoperative hypocalcemia was defined as serum calcium level corrected for albumin concentration (cCa) &lt;8.5mg/dl. Patients with postoperative hypocalcemia were classified as group1 (n=100) and those with normal Ca levels as group 2 (n=122). The PoPTH levels and ∆PTH were compared between the two groups. ROC analysis was performed to determine the cut off values for PoPTH and ∆PTH. Results: The mean PoPTH level was significantly lower in group 1 compared to group 2 (18.6±15.3 pg/ml vs 32.3±15.6 pg/ml, respectively; P&lt;0.0001). PoPTH values were within normal range in 54% of the patients with hypocalcemia and 35% of those with symptomatic hypocalcemia. PoPTH &lt;28pg/ml or ∆PTH &gt;45 were significantly associated with increased risk of post-thyroidectomy hypocalcemia (P=0.0001). A ∆PTH &gt;70% ,PoPTH ≤ 15.5pg/ml and postoperative serum cCa concentrations&lt;8.0mg/dl significantly predicted symptomatic hypocalcemia(P=0.009;P=0.006;andP=0.0001;respevtively).The sensitivities of ∆PTH,PoPTH level and postoperative serum cCa concentration to predict symptomatic hypocalcemia were 67%,64% and100, respectively. Conclusion: Although, PTH decline significantly correlate with symptomatic hypocalcemia, a considerable number of patients may experience hypocalcemic symptoms in spite of normal PoPTH levels. Analysis of serum Ca concentrations at 24 hours postoperatively help to achieve a more precise prediction of patients who bear a high risk for developing hypocalcemic symptoms.

scholarly journals Media and Foreign Policy on Pak-Afghan Relations (1997-2005): The Role of US and Pakistani Press

2020 ◽  
Vol Volume 4 (Issue 2) ◽  
pp. 454-477
Author(s):  
Ashraf Iqbal ◽  
Dr. Tanveer Hussain ◽  
Javed
Keyword(s):  
New York ◽  
Foreign Policy ◽  
American Foreign Policy ◽  
New York Times ◽  
Washington Post ◽  
War On Terrorism ◽  
Bilateral Relations ◽  
Time Period ◽  
The Us ◽  
Before And After

The main purpose of the present research is to investigate Pak-Afghan relations in the editorials of US newspapers, The Washington Post & The New York Times and Pakistani newspapers Dawn & The News related to the following issues during the period 1997-2005; A) US as a factor in Pak-Afghan relation, B) Coverage of Islam/Muslims regarding war on terrorism, C) Pakistan’s stance on Pak-Afghan bilateral relations, and D) US’s stance on Pak-Afghan bilateral relations. The time period to be examined in this proposed study spans over eight years regarding the editorial coverage of Pak-Afghan relations in the US and Pakistani leading English Press. Triangulation method based on qualitative and quantitative method was used to conduct the present research. The results show that the editorial contents of USA and Pakistani newspapers were not different regarding Pak-Afghan relations before and after 9/11. The incident of 9/11 changed the American foreign policy towards developing and least developing nations especially Muslims states like Pakistan, Afghanistan, Iraq, and Iran etc. Pakistani press highlighted the issues regarding the Pak-Afghan relations before and after 9/11 as a favorable and conducive, related to Muslim/Islam regarding war on terrorism. The study suggested that instead of the focus on military resolution of the different problems, rather social bilateral negations should be prioritized which would be long lasting and full of mutual respects and honor.

scholarly journals Promoting a Therapeutic Healing Environment: A Retrospective Examination of HCAHPS “Quiet at Night” Across a Large New York Health System

2021 ◽  
Vol 8 ◽  
pp. 237437352110565
Author(s):  
Agnes Barden ◽  
Amy E Loeb ◽  
Nicole Giammarinaro
Keyword(s):  
New York ◽  
Health System ◽  
National Database ◽  
Patient Centered ◽  
Healing Environment ◽  
Patient Feedback ◽  
Leadership Accountability ◽  
Percentile Rank ◽  
The Press ◽  
Adult Inpatient

Promoting respite and sleep impacts a patient's health and their inpatient experience. As New York State's largest health system, Northwell Health has been on a journey to create a healing and therapeutic healthcare environment. By establishing leadership accountability, leveraging patient feedback and adopting evidence-based interventions, system and individual adult inpatient hospital improvements have been noted. Between 2017 and 2020, Northwell's overall system HCAHPS “Quiet at Night” Top Box performance increased by 4.7, improving 30 percentile rank points when compared to the Press Ganey national database. This case study outlines Northwell's pragmatic patient-centered strategy and examines the unanticipated impact of limited visitation due to COVID-19 on this HCAHPS measure.

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