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Online Follow-Up Feasible for Most Surgery Patients

Posted on Sun, Oct 04, 2015
Online Follow-Up Feasible for Most Surgery Patients

Pros: convenience, surgeon efficiency gains; cons: liability, modified patient-provider relationships

Online postoperative care is preferred over in-person care by a majority of patients who have routine, uncomplicated surgery, according to research published online Sept. 22 in the Journal of the American College of Surgeons.

The study included 50 patients who had both online and in-person care visits after elective laparoscopic cholecystectomy, laparoscopic ventral hernia repair, umbilical hernia repair, or inguinal hernia repair by one of five surgeons. Patients in the study uploaded images of their incision sites to a secure, online portal, and their surgeons responded to the patients' photos and symptom reports. Patients and surgeons did not need to be online at the same time.

The researchers found that 76 percent of patients said online care was acceptable as the only form of follow-up. For 68 percent of the patients, online and in-person visits were deemed equally effective.

The researchers write that the study identified potential advantages of online care, "including convenient access for patients, decreased patient travel times, and surgeon efficiency gains." They added, however, that "these [benefits] must be carefully weighed against potential detriments of using patient-generated data to provide clinical assessment, including concerns about liability, provider work burden, and modified patient-provider relationships."

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Physician of the Year: Acute Care Surgery

Posted on Mon, Apr 13, 2015
Physician of the Year: Acute Care Surgery

 
2015 Acute Award Presented to Orange Park Surgeon
EmCare Honors Dr. Alexander Rose with National Recognition

 
ORLANDO, FLA. (April 7, 2015) – The medical director of surgery at Orange Park Medical Center in Orange Park, Fla., Alexander Rose, M.D., has been honored with the prestigious Acute Award for 2015. The award is presented by EmCare, a leading national provider of physician practice management services, and honors a single surgeon for the award each year.

 “It’s a tremendous honor,” said Dr. Rose of receiving the award. “These recognitions aren’t singular things. My wife, my staff, the administration at Orange Park and the staff at EmCare have been really created an environment where surgeons can thrive.”

“Dr. Rose is a great surgeon and a wonderful leader,” said John Josephs, M.D., CEO of EmCare Acute Care Surgery. “His work with robotic surgery has been innovative, and his collaboration with peers in helping to increase robotic surgery at his hospital has really been pioneering.”

Dr. Rose has been very involved in training and growing the types of robotic surgeries available at Orange Park Medical Center. The hospital’s administration praises his surgical skills, leadership skills and patient care. The hospital’s CEO, Chad Patrick, even drove from Charleston, S.C. to Orange Park while suffering from appendicitis so that Dr. Rose could personally perform the appendectomy.

Dr. Rose was honored with the Acute Award during EmCare’s annual Leadership Conference. The 2015 convention was held at the Coronado Springs Resort in Orlando, Fla. While the Acute Award recognizes a single surgeon from across the United States, EmCare also annually honors individuals from emergency medicine, hospital medicine and anesthesiology as its Physicians of the Year

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More Diverticulitis in Areas With Low-UV Light Exposure

Posted on Sat, Jan 31, 2015
More Diverticulitis in Areas With Low-UV Light Exposure

Low versus high UV areas have higher rate of diverticulitis admissions, diverticular abscess

THURSDAY, Jan. 22, 2015 (HealthDay News) -- Lower ultraviolet (UV) light is associated with increased rate of diverticulitis admissions, according to a study published online Jan. 21 in JAMA Surgery.

Noting that low circulating vitamin D levels are associated with diverticulitis, Lillias H. Maguire, M.D., from Massachusetts General Hospital in Boston, and colleagues examined the correlation between UV light and diverticulitis. Geographic and seasonal trends were assessed among 226,522 nonelective admissions for diverticulitis, identified in the Nationwide Inpatient Sample.

Compared with high-UV areas, the researchers found that low-UV areas had a higher rate of diverticulitis (751.8 versus 668.1 per 100,000 admissions; P < 0.001), diverticular abscess (12.0 versus 9.7 percent; P < 0.001), and colectomy (13.5 versus 11.5 percent; P < 0.001). Significant seasonal variation was observed, with a lower rate of diverticulitis in the winter versus the summer (645 versus 748 per 100,000; P < 0.001). In areas with the greatest UV fluctuation versus areas with the least UV fluctuation, the summer increase was more evident (120 versus 70 per 100,000; P = 0.01).

"Because UV exposure largely determines vitamin D status, these findings support a role for vitamin D in the pathogenesis of diverticulitis," the authors write.

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Heart Failure Survival Up in Obese, Overweight Patients

Posted on Sun, Jan 11, 2015
Heart Failure Survival Up in Obese, Overweight Patients

'Paradoxical' finding suggests excess pounds are protective

TUESDAY, Dec. 23, 2014 (HealthDay News) -- Obese heart-failure patients appear to live longer than people of normal weight who develop the condition, a new study suggests. The report appears in the Dec. 30 issue of theJournal of the American College of Cardiology.

Anita Deswal, M.D., a professor of medicine at the Baylor College of Medicine in Houston, and colleagues collected data on 1,487 people with heart failure who took part in the Atherosclerosis Risk in Communities study, an ongoing study conducted in four U.S. communities. Among these patients, 35 percent were overweight and 47 percent were obese about four years before their diagnosis.

Over a decade of follow-up, 43 percent of the patients died. The researchers found that 38 percent of obese and 45 percent of overweight patients died over 10 years, compared with 51 percent of normal-weight patients. The difference held even if they also had other health issues such as diabetes or hypertension.

"At this time, the reasons for this beneficial association are not clear," Deswal toldHealthDay.

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Good Long-Term Outcomes for Laparoscopic Radical Cystectomy

Posted on Sat, Jan 10, 2015
Good Long-Term Outcomes for Laparoscopic Radical Cystectomy

Recurrence-free survival of 66 percent at five years for patients with bladder cancer

FRIDAY, Dec. 19, 2014 (HealthDay News) -- For patients with bladder cancer, laparoscopic radical cystectomy (LRC) is associated with good long-term outcomes, according to research published online Dec. 18 in BJU International.

Simone Albisinni, M.D., from Hopital Erasme in Brussels, and colleagues reported the long-term outcomes for LRC in a multicenter European cohort. Data were collected from nine centers that enrolled 503 patients undergoing LRC for bladder cancer.

The researchers found that minor (Clavien I to II) and major (IIIa to IVb) complications occurred in 39 and 17 percent, respectively. Overall, there were 10 postoperative deaths (2 percent). The median lymph node retrieval was 14; 5.8 percent of patients had positive surgical margins. During a median follow-up of 50 months there were 134 (27 percent) recurrences. At five years, the actuarial recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were 66, 75, and 62 percent, respectively; at 10 years, RFS, CSS, and OS were 62, 55, and 38 percent, respectively. RFS, CSS, and OS varied significantly according to tumor stage, lymph node involvement, and margin status. Tumor stage and lymph node involvement were found to be significant predictors of RFS, CSS, and OS in multivariate analysis (both P < 0.001). Positive margins significantly predicted RFS (P = 0.016) and CSS (P = 0.043).

"In this European LRC multicenter study, the largest to date, long-term RFS, CSS, and OS rates after LRC appear comparable to those reported in current open RC series," the authors write.

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