Beyond the AJR: Shorter Ultrasound Screening Intervals for Hepatocellular Carcinoma Improve Patient Outcomes

Introduction Percutaneous tracheostomy procedures are commonplace in intensive care units worldwide. Haemorrhagic complications, though potentially fatal, are thought to be under-reported. Ultrasonography use has not established itself in these procedures. This study assesses the prevalence and characteristics of pre-tracheal blood vessels, to aid intensivists on potential procedural hazards. Method A retrospective, observational study was performed in the UK. Computed tomography angiograms from January 2012 to October 2014 were randomly retrieved and analysed for vessel data. Results A total of 343 adult patients were included (mean age: 65 (inter-quartile range 52–79), male: 63%). Forty-one percent of patients demonstrated a vessel overlying percutaneous tracheostomy insertion sites (C6–T1); veins were more common than arteries (69%, p = 0.001). Males were more likely to display veins (78 vs. 53%, p < 0.001). Discussion A substantial proportion of patients exhibited pre-tracheal vessels. Front-of-neck ultrasonography has huge potential to identify these. Based on these data, we believe ultrasonography may be an effective screening tool for percutaneous tracheostomy procedures to reduce complications. Further research is required to study outcomes.

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State of the Art in Artificial Intelligence and Radiomics in Hepatocellular Carcinoma

Diagnostics ◽

10.3390/diagnostics11071194 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1194

Author(s):

Anna Castaldo ◽

Davide Raffaele De Lucia ◽

Giuseppe Pontillo ◽

Marco Gatti ◽

Sirio Cocozza ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Patient Outcomes ◽

State Of The Art ◽

Effective Management ◽

Lesion Segmentation ◽

Liver Malignancy ◽

Modeling And Prediction ◽

Imaging Characteristics ◽

Risk Patients ◽

Improve Patient

The most common liver malignancy is hepatocellular carcinoma (HCC), which is also associated with high mortality. Often HCC develops in a chronic liver disease setting, and early diagnosis as well as accurate screening of high-risk patients is crucial for appropriate and effective management of these patients. While imaging characteristics of HCC are well-defined in the diagnostic phase, challenging cases still occur, and current prognostic and predictive models are limited in their accuracy. Radiomics and machine learning (ML) offer new tools to address these issues and may lead to scientific breakthroughs with the potential to impact clinical practice and improve patient outcomes. In this review, we will present an overview of these technologies in the setting of HCC imaging across different modalities and a range of applications. These include lesion segmentation, diagnosis, prognostic modeling and prediction of treatment response. Finally, limitations preventing clinical application of radiomics and ML at the present time are discussed, together with necessary future developments to bring the field forward and outside of a purely academic endeavor.

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Combined Approaches to the Skull Base for Intracranial Extension of Tumors via Perineural Spread can Improve Patient Outcomes

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0036-1579796 ◽

2016 ◽

Vol 77 (S 01) ◽

Cited By ~ 1

Author(s):

Sheri Palejwala ◽

Jonnae Barry ◽

Crystal Rodriguez ◽

Chandni Parikh ◽

Stephen Goldstein ◽

...

Keyword(s):

Skull Base ◽

Patient Outcomes ◽

Intracranial Extension ◽

Perineural Spread ◽

Improve Patient

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Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures

US Cardiology Review ◽

10.15420/usc.2012.9.2.96 ◽

2012 ◽

Vol 9 (2) ◽

pp. 96-98

Author(s):

Brian A Bruckner ◽

Matthias Loebe

Keyword(s):

Patient Outcomes ◽

Surgical Procedures ◽

Systematic Approach ◽

Surgical Intervention ◽

Transfusion Requirement ◽

Cardiac Surgical Procedures ◽

Platelet Inhibitors ◽

Hemostatic Agents ◽

Surgical Field ◽

Improve Patient

Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.

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Which Decision Aids to Support Shared Decision Making Have the Potential to Improve Patient Outcomes in Palliative Lung- and Colorectal Cancer Care: Results from a Systematic Review

10.26226/morressier.5c76c8b3e2ea5a7237611f24 ◽

2019 ◽

Author(s):

Liesbeth van Vliet

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Decision Making ◽

Shared Decision Making ◽

Patient Outcomes ◽

Cancer Care ◽

Decision Aids ◽

Shared Decision ◽

Improve Patient

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Faculty Opinions recommendation of Sarcopenia in urologic oncology: Identification and strategies to improve patient outcomes.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.738032916.793579833 ◽

2020 ◽

Author(s):

Maria-José Molina-Garrido

Keyword(s):

Patient Outcomes ◽

Urologic Oncology ◽

Improve Patient

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How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study

BMJ Open ◽

10.1136/bmjopen-2020-041743 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041743

Author(s):

Christina Østervang ◽

Annmarie Touborg Lassen ◽

Charlotte Myhre Jensen ◽

Elisabeth Coyne ◽

Karin Brochstedt Dieperink

Keyword(s):

Patient Outcomes ◽

Participatory Design ◽

Hospital Admissions ◽

Phase 1 ◽

Family Needs ◽

Focus Group Interviews ◽

Phase 3 ◽

Ace Study ◽

Group Interviews ◽

Improve Patient

IntroductionThe development of acute symptoms or changes in diseases led to feelings of fear and vulnerability and the need for health professional support. Therefore, the care provided in the acute medical and surgical areas of the emergency department (ED) is highly important as it influences the confidence of patients and families in managing everyday life after discharge. There is an increase in short-episode (<24 hours) hospital admissions, related to demographic changes and a focus on outpatient care. Clear discharge information and inclusion in treatment decisions increase the patient’s and family’s ability to understand and manage health needs after discharge, reduces the risk of readmission. This study aims to identify the needs for ED care and develop a solution to improve outcomes of patients discharged within 24 hours of admission.Methods and analysisThe study comprises the three phases of a participatory design (PD). Phase 1 aims to understand and identify patient and family needs when discharged within 24 hours of admission. A qualitative observational study will be conducted in two different EDs, followed by 20 joint interviews with patients and their families. Four focus group interviews with healthcare professionals will provide understanding of the short pathways. Findings from phase 1 will inform phase 2, which aims to develop a solution to improve patient outcomes. Three workshops gathering relevant stakeholders are arranged in the design plus development of a solution with specific outcomes. The solution will be implemented and tested in phase 3. Here we report the study protocol of phase 1 and 2.Ethics and disseminationThe study is registered with the Danish Data Protection Agency (19/22672). Approval of the project has been granted by the Regional Committees on Health Research Ethics for Southern Denmark (S-20192000–111). Findings will be published in suitable international journals and disseminated through conferences.

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67 The Evolution of A Frailty Service

Age and Ageing ◽

10.1093/ageing/afab030.28 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

C Abbott ◽

K Bishop ◽

F Hill ◽

C Finlow ◽

R Maraj

Keyword(s):

Cost Effectiveness ◽

Patient Outcomes ◽

Local Population ◽

Management Team ◽

Pdsa Cycle ◽

North Wales ◽

Number Of Patients ◽

Constant State ◽

Clinical Resource ◽

Improve Patient

Abstract Introduction In September 2017 our frailty service was started within our medium sized DGH in North Wales. Working with our management team we secured a significant clinical resource including: We describe how resources, setting and staffing develop over a 2 year period in order to create a service which meets the needs of the local population. Method The service has been in a constant state of development since it has been in operation, utilising a PDSA model with regular meetings of clinical and managerial staff to analyse performance. Results With each new PDSA cycle the amount of patients reviewed has increased. With the move to AMU we increased the monthly number of patients reviewed from 29 to 172 patients reviewed, 97 of which were discharged directly from the unit. Conclusion Using QI methodology our Frailty Service has improved dramatically since its inception. We will continue to analyse how we work to improve patient outcomes and cost effectiveness.

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Cochlear Implant Research and Development in the Twenty-first Century: A Critical Update

Journal of the Association for Research in Otolaryngology ◽

10.1007/s10162-021-00811-5 ◽

2021 ◽

Vol 22 (5) ◽

pp. 481-508

Author(s):

Robert P. Carlyon ◽

Tobias Goehring

Keyword(s):

Research And Development ◽

Patient Outcomes ◽

Speech Processing ◽

Turn Of The Century ◽

First Century ◽

Directional Microphones ◽

Wide Range ◽

The Subject ◽

Processing Algorithms ◽

Improve Patient

AbstractCochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The review focuses on the processing, stimulation, and audiological methods that have been used to try to improve speech perception by human CI listeners, and on fundamental new insights in the response of the auditory system to electrical stimulation. The introduction of directional microphones and of new noise reduction and pre-processing algorithms has produced robust and sometimes substantial improvements. Novel speech-processing algorithms, the use of current-focusing methods, and individualised (patient-by-patient) deactivation of subsets of electrodes have produced more modest improvements. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of promising technologies that are currently being developed in animal models, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.

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