Follow-Up Phone Calls After Colorectal Surgery
Ontology highlight
ABSTRACT:
DISEASE(S): Colitis, Ulcerative,Colonic Polyps,Diverticulitis,Colorectal Surgery,Crohn Disease,Colorectal Neoplasms,Colitis
PROVIDER: 2040038 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:The primary hypothesis is that a comprehensive transitional care program based on the premise of a patient-centered medical home versus routine care reduces emergency room visits and hospital readmissions without increasing costs among cancer patients undergoing surgery at a large safety-net hospital.
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Project description:Interventions: Group 1: The Remote Assist application allows discussion or collaboration in teams with a shared view of a patient-specific case. A post-market follow-up (PMCF) observation will confirm the safety as well as an acceptable benefit/risk ratio of the tool in different scenarios.
Instead of the telephone or other means of communication, remote assist via VSI HoloMedicine of the MS Team tool will be used in three different scenarios. The following scenarios are evaluated: Adding to the operating room (Whipple) (n=3), indication discussion with collegium (n=3), and emergency department support (ileus, cholelithiasis, appendicitis).
The purpose of this qualitative study is to evaluate the teams use of VSI HoloMedicine, in the context of surgery, physician on-call, and the emergency department for the following purposes.
Evaluate:
Confirm the performance of the teams integration of VSI HoloMedicine (remote assist / 3D hologram / streaming / voice quality).
Deployment in different scenarios (OR / emergency / on-call) in terms of remote collaboration.
Evaluation of usability, advantages and disadvantages
Confirmation of the safety of the medical device
Satisfaction of the users
Observation of any unforeseen risks related to the function,
Ensuring continued acceptance of the risk-benefit ratio.
Measurement of mental workload (NASA-TLX).
Primary outcome(s): The Remote Assist application enables discussion or collaboration in teams with a shared view of a patient-specific case. A post-market follow-up (PMCF) observation will confirm the safety as well as an acceptable benefit/risk ratio of the tool in different scenarios.
Instead of the telephone or other means of communication, remote assist via VSI HoloMedicine of the MS Team tool will be used in three different scenarios. The following scenarios are evaluated: Adding to the operating room (Whipple) (n=3), indication discussion with colleagues (n=3), and emergency support (ileus, cholelithiasis, appendicitis).
The aim is long-term post-marketing clinical follow-up (PMCF) of the performance, clinical utility, and safety of the product with respect to MS Teams use of VSI HoloMedicine.
Study Design: Allocation: ; Masking: ; Control: ; Assignment: ; Study design purpose: other
| 93683 | ecrin-mdr-crc
Project description:BackgroundTypically, in-person follow-up in clinic is utilized after outpatient inguinal hernia repair. Studies have shown that phone follow-up may be successfully used for the detection of postoperative hernia recurrences. However, no studies have evaluated the detection rates of other postoperative complications, such as emergency department visits and readmissions, with the utilization of phone follow-up after inguinal hernia repair. The objective of our study was to investigate the safety of a phone follow-up care pathway following elective, outpatient inguinal hernia repair.MethodsIn this retrospective cohort study, adult patients who underwent elective, outpatient inguinal hernia repair between 2013 and 2019 at a large academic health system in the Midwest United States were identified from the electronic health record. Patients were categorized by type of postoperative follow-up: in-person or phone follow-up. Baseline demographics, operative, and postoperative data were compared between follow-up groups. Multivariable logistic regression was performed to investigate predictors of having any related emergency department (ED) visit/readmission/reoperation within 90 days.ResultsWe included 2009 patients who underwent elective inguinal hernia repair during the study period. 321 patients had in-person follow-up only, while 1,688 patients had phone follow-up. There was a higher rate of laparoscopic repair in the phone follow-up group (85.4% vs. 53.0% for in-person follow-up). There were no differences in rates of related 90-day ED visits, readmissions, and reoperations between the phone and in-person follow-up groups. On multivariable logistic regression, receipt of phone follow-up was not a predictor of having 90-day ED visits, readmissions, or reoperations (OR 1.30, 95% CI [0.83, 2.05]).ConclusionsPatients who underwent phone follow-up had similarly low rates of adverse outcomes to those with in-person follow-up. Phone follow-up protocols may be implemented as an alternative for patients and provide a means to decrease healthcare utilization following inguinal hernia repair.
| S-EPMC7526072 | biostudies-literature
Project description:Acetaminophen can adversely affect the liver especially when overdosed. We used whole blood as a surrogate to identify genes as potential early indicators of an acetaminophen-induced response. In a clinical study, healthy human subjects were dosed daily with 4g of either acetaminophen or placebo pills for 7 days and evaluated over the course of 14 days. Alanine aminotransferase (ALT) levels for responders to acetaminophen increased between days 4 and 9 after dosing and 12 genes were detected with expression profiles significantly altered within 24hrs. The early responsive genes separated the subjects by class and dose period. In addition, the genes clustered patients who overdosed on acetaminophen apart from controls and also predicted the exposure classifications with 100% accuracy. The responsive genes serve as early indicators of an acetaminophen exposure and their gene expression profiles can potentially be evaluated as molecular indicators for further consideration. Overdosed patients admitted to the emergency room. Five male and female individuals from 19 - 59 years old were admitted to the emergency room following an overdose on acetaminophen. The patients presented 12hrs to 4 days after ingestion. ALT and AST elevated peaking beyond 400 U/I and 120 U/I. Blood was collected 2 or 5 days following ingestion.
2016-02-16 | E-GEOD-70786 | biostudies-arrayexpress
Project description:IntroductionThe American College of Obstetricians and Gynecologists recommends prompt postpartum follow-up. However, 40% of women do not attend postpartum visits. These rates are lower in populations with limited resources. In response, the Department of Obstetrics, Gynecology, and Reproductive Science in the Mount Sinai Health System created a postpartum follow-up phone call project that utilized medical students and was conducted at three health system hospitals from April 6 to May 30, 2020.MethodsThe number of patients contacted by medical students within 72 hours of hospital discharge was recorded. Students at two of the three sites also recorded the number of patients who needed (1) urgent evaluation and subsequent hospital readmission, (2) medications prescribed, and (3) referral for social work services. Students completed questionnaires at the project beginning and end regarding confidence in rendering of postpartum care. Confidence level was based on a 5-point Likert scale (1 = not confident at all, 5 = very confident).ResultsNine students participated. Overall, confidence on providing postpartum care significantly increased from 2.2 to 3.7 (p < .001). Three hundred eighty-seven patients were contacted. Four patients were advised to return to the hospital emergently; two were readmitted. Forty-seven patients needed medication prescribed. Two patients were referred for social work services.DiscussionOur medical student-driven postpartum follow-up phone call project was associated with a high number of patients called and management of significant postpartum issues. Students' confidence in managing postpartum issues was significantly higher after versus before project participation.
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Project description:To characterize the molecular signature of the choriodecidua remodeling in third trimestry of pregnancy before labour, we have employed whole genome microarray expression profiling. Fetal membranes were collected from women undergoing a emergency cesarean delivery before term (before 32 weeks of gestation and between 33-35 weeks of gestation), for preeclampsia and/or in utero growth retardation. During surgery, a Kocher's forceps was placed on membranes overlying the cervix and the area surrounding the forceps was dissected in the operating room under sterile conditions, the site, pinched by the forceps, being discarded. Fetal membranes in a remote zone were also sampled. Isolated RNAs were hybridized to the Aligent SurePrint G3 Human GE 8x60K Microarray.
2016-11-25 | GSE59686 | GEO
Project description:To describe the rheumatic and musculoskeletal symptoms at hospitalization as well as their persistence/severity after discharge with coronavirus disease 2019 (COVID-19) and to identify whether age, sex, body mass index (BMI), and length of hospital stay are associated with persistence of these symptoms. In this single-center cohort study, comprising 300 participants, two phone interviews were conducted (2-week and 1-month after hospitalization) and symptoms were queried with a standardized form. This form included musculoskeletal symptoms and other COVID-19 symptoms. Considering all symptoms (musculoskeletal and other), 100.0%, 86.7%, and 72.0% of patients reported one or more symptoms, at hospitalization, 2-week, and 1-month, respectively. Considering only musculoskeletal symptoms, 92.3%, 72.7%, and 56.3% of patients reported any musculoskeletal symptom at hospitalization, 2-week, and 1-month, respectively. The musculoskeletal symptoms were fatigue (44.3% of patients reported), back pain (22.7%), arthralgia (22.0%), myalgia (21.0%), low back pain (16.3%), and neck pain (10.3%); the other symptoms were shortness of breath (26.3%), loss of taste (15.0%), cough (14.0%), loss of smell (12.3%), loss of appetite (10.3%), headache (8.7%), sore throat (3.0%), diarrhea (1.3%), dizziness (1.3%), and fever (0.3%) at 1-month. Increasing BMI was associated with higher odds of persistence of fatigue (OR: 1.08, 1.03 to 1.13), myalgia (OR: 1.08, 1.01 to 1.14), and arthralgia (OR: 1.07, 1.02 to 1.14, p = 0.012) at 1-month. Nearly three-quarters reported one or more symptoms, with more than half of patients reported any musculoskeletal symptom at 1 month. The most common musculoskeletal symptom was fatigue, followed by back pain, arthralgia, myalgia, low back pain, and neck pain. The persistence of fatigue, myalgia, and arthralgia was related to BMI. The study results increase our understanding of the spectrum of COVID-19, which, in turn, may lead to more efficient and better care for COVID-19 survivors.
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