scholarly journals Making the case for spirometry as part of the perioperative multidisciplinary team assessment

2021 ◽  
pp. fhj.2021-0116
Author(s):  
Thomas Chambers ◽  
Mevan Gooneratne ◽  
Richa Singh ◽  
Ching Pang ◽  
Gayle McDonnell ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Team Assessment

Management of Velopharyngeal Insufficiency in Cleft Patients With and Without Multidisciplinary Team Care

2020 ◽  
pp. 105566562095406
Author(s):  
Vanessa Torrecillas ◽  
Sarah Hatch Pollard ◽  
Hilary McCrary ◽  
Helene M. Taylor ◽  
Alexandra Palmer ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Multidisciplinary Team ◽  
Speech Therapy ◽  
Fold Increase ◽  
Velopharyngeal Insufficiency ◽  
Team Care ◽  
Team Assessment ◽  
Hospital Patients ◽  
Cleft Palate Repair ◽  
Or Team

Objective: To evaluate the effect of an American Cleft Palate-Craniofacial Association (ACPA)–approved multidisciplinary team on velopharyngeal insufficiency (VPI) diagnosis and treatment. Design: Retrospective cohort setting; tertiary children’s hospital patients; children with cleft palate repair identified through procedure codes. Main Outcome Measures: Velopharyngeal insufficiency diagnosis was assigned based on surgeon or team assessment. Age at diagnosis and surgery was recorded. Difference in age and rate of VPI diagnosis and surgery was analyzed with t test. Multivariate linear and logistic regression adjusted for confounding variables. Results: Nine hundred forty patients were included with 71.5% cared for by an ACPA-approved multidisciplinary team. More (38.8% ) team care patients were found to have a diagnosis of VPI in comparison to 10% in independent care ( P < .001). Team care was associated with an almost 6-fold increase in VPI diagnosis ( P < .001). Team care was associated with a higher proportion of speech surgery (21% vs 10%, P < .001). Among children receiving team care, each visit was associated with 25% increased odds of being diagnosed with VPI ( P < .001) and 20% increased odds of receiving speech surgery ( P < .001). Age at VPI diagnosis and speech surgery were similar between groups ( P = .55 and .29). Discussion: Team care was associated with more accurate detection of VPI, resulting in more VPI speech therapy visits and surgical management. A higher number of team visits were similarly associated. Conclusion: Further studies of the clinical implication of timely and accurate VPI diagnosis, including quality of life assessments, are recommended to provide stronger guidance on team visit and evaluation planning.

scholarly journals Screening vs. non-screening detected colorectal cancer: Differences in pre-therapeutic work up and treatment

2016 ◽  
Vol 24 (2) ◽  
pp. 69-74 ◽  
Author(s):  
D Saraste ◽  
A Martling ◽  
PJ Nilsson ◽  
J Blom ◽  
S Törnberg ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Multidisciplinary Team ◽  
Primary Tumour ◽  
Preoperative Staging ◽  
Neoadjuvant Treatment ◽  
Stage I ◽  
Team Assessment ◽  
Assessment And Treatment ◽  
Emergency Interventions

Objectives To compare preoperative staging, multidisciplinary team-assessment, and treatment in patients with screening detected and non-screening detected colorectal cancer. Methods Data on patient and tumour characteristics, staging, multidisciplinary team-assessment and treatment in patients with screening and non-screening detected colorectal cancer from 2008 to 2012 were collected from the Stockholm–Gotland screening register and the Swedish Colorectal Cancer Registry. Results The screening group had a higher proportion of stage I disease (41 vs. 15%; p < 0.001), a more complete staging of primary tumour and metastases and were more frequently multidisciplinary team-assessed than the non-screening group ( p < 0.001). In both groups, patients with endoscopically resected cancers were less completely staged and multidisciplinary team-assessed than patients with surgically resected cancers ( p < 0.001). No statistically significant differences were observed between the screening and non-screening groups in the use of neoadjuvant treatment in rectal cancer (68 vs.76%), surgical treatment with local excision techniques in stage I rectal cancer (6 vs. 9%) or adjuvant chemotherapy in stages II and III disease (46 vs. 52%). Emergency interventions for colorectal cancer occurred in 4% of screening participants vs. 11% of non-compliers. Conclusions Screening detected cancer patients were staged and multidisciplinary team assessed more extensively than patients with non-screening detected cancers. Staging and multidisciplinary team assessment prior to endoscopic resection was less complete compared with surgical resection. Extensive surgical and (neo)adjuvant treatment was given in stage I disease. Participation in screening reduced the risk of emergency surgery for colorectal cancer.

scholarly journals Multidisciplinary Team Assessment

2020 ◽  
Author(s):  
Denine Northrup ◽  
Steven Northrup
Keyword(s):  
Multidisciplinary Team ◽  
Team Assessment

scholarly journals Multicentre study of multidisciplinary team assessment of pancreatic cancer resectability and treatment allocation

2019 ◽  
Vol 106 (6) ◽  
pp. 756-764 ◽  
Author(s):  
J. Kirkegård ◽  
E. K. Aahlin ◽  
M. Al‐Saiddi ◽  
S. O. Bratlie ◽  
M. Coolsen ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Multicentre Study ◽  
Multidisciplinary Team ◽  
Treatment Allocation ◽  
Team Assessment

scholarly journals Outcomes in Anomalous Aortic Origin of a Coronary Artery Following a Prospective Standardized Approach

2020 ◽  
Vol 13 (2) ◽  
Author(s):  
Silvana Molossi ◽  
Hitesh Agrawal ◽  
Carlos M. Mery ◽  
Rajesh Krishnamurthy ◽  
Prakash Masand ◽  
...  
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Multidisciplinary Team ◽  
Incidental Finding ◽  
Sudden Cardiac Arrest ◽  
Team Assessment ◽  
Long Term Prognosis ◽  
A Prospective Study ◽  
Sports Activities

Background: Anomalous aortic origin of a coronary artery (CA) is the second leading cause of sudden cardiac death in young athletes. Management is controversial and longitudinal follow-up data are sparse. We aim to evaluate outcomes in a prospective study of anomalous aortic origin of CA patients following a standardized algorithm. Methods: Patients with anomalous aortic origin of a CA were followed prospectively from December 2012 to April 2017. All patients were evaluated following a standardized algorithm, and data were reviewed by a dedicated multidisciplinary team. Assessment of myocardial perfusion was performed using stress imaging. High-risk patients (high-risk anatomy—anomalous left CA from the opposite sinus, presence of intramurality, abnormal ostium—and symptoms or evidence of myocardial ischemia) were offered surgery or exercise restriction (if deemed high risk for surgical intervention). Univariate and multivariable analyses were used to determine predictors of high risk. Results: Of 201 patients evaluated, 163 met inclusion criteria: 116 anomalous right CA (71%), 25 anomalous left CA (15%), 17 single CA (10%), and 5 anomalous circumflex CA (3%). Patients presented as an incidental finding (n=80, 49%), with exertional (n=31, 21%) and nonexertional (n=32, 20%) symptoms and following sudden cardiac arrest/shock (n=5, 3%). Eighty-two patients (50.3%) were considered high risk. Predictors of high risk were older age at diagnosis, black race, intramural course, and exertional syncope. Most patients (82%) are allowed unrestrictive sports activities. Forty-seven patients had surgery (11 anomalous left CA and 36 anomalous right CA), 3 (6.4%) remained restricted from sports activities. All patients are alive at a median follow-up of 1.6 (interquartile range, 0.7–2.8) years. Conclusions: In this prospective cohort of patients with anomalous aortic origin of a CA, most have remained free of exercise restrictions. Development of a multidisciplinary team has allowed a consistent approach and may have implications in risk stratification and long-term prognosis.

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