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Stefanescu B.M.,Vanderbilt University | Hetu C.,South Miami Hospital | Slaughter J.C.,Vanderbilt University
Contemporary Clinical Trials | Year: 2013

Background: Neonatal ventilator-associated pneumonia (VAP) is associated with increased morbidity and mortality. In adults on mechanical ventilation, timed oral care decreases the frequency of VAP, but this approach has not been studied in neonates. Objectives: To evaluate the feasibility of a randomized trial of timed oral care with Biotene OralBalance® gel and estimate the required sample size for such a trial. Methods: Infants were eligible for enrollment if they were born before 28. weeks of gestation, and were mechanically ventilated between 7 and 10 postnatal days. Infants were randomized to receive timed oral care with Biotene OralBalance® gel or sterile water. All subjects were treated with a standard bundle of procedures to reduce the risk of VAP. Results: We enrolled 41 of 46 eligible infants (89%). Compliance with timed oral care protocol was 97%. No local oral side effects of Biotene OralBalance® gel were observed. There were no significant group differences in mortality or short-term outcomes, except length of hospital stay which was significantly shorter in the Sterile water group (p=0.02). A lower rate of VAP was found in the Biotene group, although the difference was not statistically significant (9/1000 ventilator-days versus 17/1000 ventilator-days in the Sterile water group, respectively; p=0.16). Conclusions: The results of this pilot study support the feasibility of a randomized trial of timed oral care with Biotene OralBalance® gel for prevention of VAP in mechanically ventilated neonates. © 2013 Elsevier Inc..


News Article | October 28, 2016
Site: www.marketwired.com

MIAMI, FL--(Marketwired - October 28, 2016) - Dr. Sergio Gonzalez-Arias, chief of neurological surgery at Baptist Hospital and chair of the Department of Neuroscience at FIU's Herbert Wertheim College of Medicine, will join the College of Medicine's executive team as executive associate dean for clinical affairs. Gonzalez-Arias, who will begin his new position with the Herbert Wertheim College of Medicine in January 2017, will oversee all clinical functions at the College of Medicine, including the students' clinical experience; all strategic partnerships with hospitals and other clinical sites where students perform their clinical rotations; and development of Graduate Medical Education. "We have been fortunate to work with Dr. Gonzalez-Arias as a key member of our faculty since 2010. Now he brings to his new position a wealth of clinical experience that will add to the development of clinical programs to the College of Medicine," said Dr. John A. Rock, founding dean of the Herbert Wertheim College of Medicine and FIU senior vice president for health affairs. Wayne Brackin, executive vice president and chief operating officer for Baptist Health South Florida, said Gonzalez-Arias has made important contributions to the field of neuroscience. "Dr. Gonzalez-Arias is a well-respected neurosurgeon who has advanced his profession and expanded the comprehensive neuroscience offerings at Baptist Health," Brackin said. "As the founding medical director of Baptist Health Neuroscience Center he has developed and implemented surgical and technological advancements that have had a profound impact on our patients." Gonzalez-Arias is the founding and current medical director of Baptist Health Neuroscience Center. He has served as chief of Baptist Hospital's Department of Surgery and is a past president of the medical staff. He is a fellow of the American Association of Neurological Surgeons and the American College of Surgeons. He served as chair of the international committee of the Joint Council of State Neurosurgical Societies and is a past president of the Florida Neurological Society. "I am excited about this new opportunity at the FIU College of Medicine, which will allow me to continue building on its impressive growth, which I am honored to have been part of for several years," Gonzalez-Arias said. "In keeping with the best practice of a multidisciplinary approach to medicine, I look forward to collaborating with the university's hospital and community partners to research, innovate and continue making a significant positive impact on medical education and healthcare in our community." Dr. Gonzalez-Arias is a graduate of the University of Zaragoza (Spain) and completed his residencies at Rush-Presbyterian St. Luke's Medical Center and the University of Miami/Jackson Memorial Hospital. About Baptist Health South Florida: Baptist Health South Florida is the largest healthcare organization in the region, with seven hospitals (Baptist Hospital, Baptist Children's Hospital, Doctors Hospital, Homestead Hospital, Mariners Hospital, South Miami Hospital and West Kendall Baptist Hospital), nearly 50 outpatient and urgent care facilities, Baptist Health Medical Group, Baptist Health Quality Network and internationally renowned centers of excellence. The not-for-profit, faith-based Baptist Health has approximately 16,000 employees and 2,300 affiliated physicians. Baptist Health South Florida has been recognized as one of the 100 Best Companies to Work For in America and as one of the World's Most Ethical Companies. For more information, visit BaptistHealth.net and connect with us on Facebook at facebook.com/BaptistHealthSF and on Twitter and Instagram @BaptistHealthSF. About The FIU Herbert Wertheim College of Medicine: The Herbert Wertheim College of Medicine was approved in 2006 by the Florida Board of Governors and the Florida Legislature, and in February 2013 the medical degree program received full accreditation from the Liaison Committee for Medical Education. The College graduated its inaugural class on April 29, 2013. Among the innovative elements of the HWCOM is a program called Green Family Foundation NeighborhoodHELP™ that sends teams of medical students along with their counterparts in social work, nursing, and law into the community. The College of Medicine's mission is to lead the next generation of medical education and improve the quality of health care available to the South Florida community. For more information visit http://medicine.fiu.edu/ About FIU: Florida International University is classified by Carnegie as a "R1: Doctoral Universities - Highest Research Activity" and recognized as a Carnegie Community Engaged university. It is a public research university with colleges and schools that offers bachelor's, master's and doctoral programs in fields such as business engineering, computer science, international relations, architecture, law and medicine. As one of South Florida's anchor institutions, FIU contributes almost $9 billion each year to the local economy and is ranked second in Florida in Forbes Magazine's "America's Best Employers" list. FIU graduates are consistently among the highest paid college graduates in Florida and are among the leaders of public and private organizations throughout South Florida. FIU is Worlds Ahead in finding solutions to the most challenging problems of our time. FIU emphasizes research as a major component of its mission with multiple state-of-the-art research facilities including the Wall of Wind Research and Testing Facility, FIU's Medina Aquarius Program and the Advanced Materials Engineering Research Institute. FIU has awarded more than 220,000 degrees and enrolls more than 54,000 students in two campuses and centers including FIU Downtown on Brickell, FIU@I-75, the Miami Beach Urban Studios, and Tianjin, China. FIU also supports artistic and cultural engagement through its three museums: Patricia & Phillip Frost Art Museum, the Wolfsonian-FIU, and the Jewish Museum of Florida-FIU. FIU is a member of Conference USA and more than 400 student-athletes participating in 18 sports. For more information about FIU, visit http://www.fiu.edu/.


Alfonso B.,South Miami Hospital | Jacobson A.S.,New York University | Alon E.E.,The Chaim Sheba Medical Center | Via M.A.,Mount Sinai School of Medicine
Ear, Nose and Throat Journal | Year: 2015

Hypocalcemia is a well-known complication of total thyroidectomy. Patients who have previously undergone gastric bypass surgery may be at increased risk of hypocalcemia due to gastrointestinal malabsorption, secondary hyperparathyroidism, and an underlying vitamin D deficiency. We present the case of a 58-year-old woman who underwent a total thyroidectomy for the follicular variant of papillary thyroid carcinoma. Her history included Roux-en-Y gastric bypass surgery. Following the thyroid surgery, she developed postoperative hypocalcemia that required large doses of oral calcium carbonate (7.5 g/day), oral calcitriol (up to 4 μg/day), intravenous calcium gluconate (2.0 g/day), calcium citrate (2.0 g/day), and ergocalciferol (50,000 IU/day). Her serum calcium levels remained normal on this regimen after hospital discharge despite persistent hypoparathyroidism. Bariatric surgery patients who undergo thyroid surgery require aggressive supplementation to maintain normal serum calcium levels. Preoperative supplementation with calcium and vitamin D is strongly recommended. © 2015 Vendome Group.


News Article | March 2, 2017
Site: www.marketwired.com

MIAMI, FL--(Marketwired - March 02, 2017) - Miami Cardiac & Vascular Institute has completed its $120 million expansion project on the Baptist Hospital campus. The state-of-the-art facility includes additional space and cutting-edge technology, facilitating the creation of several new, specialized programs bringing together multidisciplinary teams of specialists to treat the cardiovascular system as a single entity. The expansion added 60,000 square feet of new space and included 40,000 square feet of renovations, nearly doubling the size of the Institute to 150,000 square feet in order to accommodate a growing number of patients and procedures. Since it was founded in 1987, Institute physicians have pioneered less-invasive techniques to treat aneurysms, stroke and heart disease, and have been part of many groundbreaking research trials. For 30 years, Miami Cardiac & Vascular Institute has been an integral innovation partner for Philips, a world leader in healthcare technologies, providing valuable clinical insights that have led to the development of industry-leading solutions such as the recently announced Philips Azurion Image Guided Therapy (IGT) system. The expansion includes a state-of-the-art Cath lab, representing the first North American installation of Azurion. The system is designed to anticipate what clinicians need, when they need it, to make procedures flow intuitively and support a superior patient experience. "This expansion allows us to be at the forefront of medical innovation and provides the most current treatment options for our patients, while at the same time, prepares us to be in the position to care for health problems we haven't even encountered yet," said Barry T. Katzen, M.D., Chief Medical Executive and founder of the Institute. "We are now able to conduct more research, offer new services and make discoveries that could transform how cardiovascular care is delivered." Throughout its history, the Institute's physicians have pioneered less-invasive techniques to treat aneurysms, stroke and heart disease, and have been part of many groundbreaking research trials. The newly expanded Institute, with its cutting-edge equipment and unique programs, allows our internationally respected physicians to continue their visionary work. One of the first elements of the three-year project was the expansion of Baptist Hospital's Surgery Center, which now includes six large operating rooms dedicated to neuroscience, cardiac, vascular and robotic surgery. The Institute also added four new advanced endovascular suites with enlarged gallery viewing areas for enhanced teaching and learning opportunities. "This is the centerpiece of the expansion, the Center for Advanced Endovascular Therapies," Dr. Katzen explained. "We wanted to create an environment in which we could do any type of predominantly image-guided procedure, where physicians of different disciplines could work together to create unique solutions for patients' problems." In designing interventional suites of the future, two of the new endovascular suites have glass walls and a video system that allow people to sit in a theater-style chair outside of the suite and control what they are watching using an iPad. Viewers from different disciplines or in training each can have their own unique user interface that allows them to pick and choose which parts of the procedure they want to watch, all with communication with the suites. Additionally, the Institute makeover created the National Center for Aneurysm Therapy -- the first in the world -- a Center for Structural Heart Therapy, Center for Critical Limb Ischemia and an Advanced Arrhythmia Therapy Center. It is here where physicians are doing research to discover more cardiovascular disease breakthroughs. "We are proud to open the doors of the new Miami Cardiac & Vascular Institute to our community," said Brian E. Keeley, President and CEO of Baptist Health South Florida. "This expansion now provides even greater promise to our patients, with new state-of-the-art interventional procedure suites; an expansive, high-tech gallery for observation, diagnostics and greater teaching opportunities; and, research space for more than 120 clinical trials." Miami Cardiac & Vascular Institute is the largest and most comprehensive cardiovascular facility in the region, consisting of 76 doctors and 1,100 employees system-wide serving 125,000 patients every year. "At Philips, we are committed to building a healthy society by creating solutions that are going to have a meaningful impact in improving human health, and this requires collaboration with pioneering organizations like Miami Cardiac & Vascular Institute," said Brent Shafer, CEO of Philips North America. "The Institute's clinical insights have been critical to the development of our Azurion technology, from understanding workflows and improving efficiencies, to understand how to improve the patient experience. Together, we are shaping the future of healthcare by making procedures safer and more efficient. This will not only help address the health issues in South Florida communities, it will allow us to apply those lessons globally to help tackle the challenges of rising healthcare costs and better access to care. Ultimately, we want to improve the patient experience and outcomes, one community at a time." Miami Cardiac & Vascular Institute is the largest and most comprehensive cardiovascular facility in the region. The team of multilingual, multidisciplinary specialists has pioneered the development of minimally invasive techniques used to treat aneurysms, blockages in veins and arteries and holes in the heart. Miami Cardiac & Vascular Institute is part of Baptist Health South Florida, the largest healthcare organization in the region, with seven hospitals (Baptist Hospital, Baptist Children's Hospital, Doctors Hospital, Homestead Hospital, Mariners Hospital, South Miami Hospital and West Kendall Baptist Hospital), nearly 50 outpatient and urgent care facilities, Baptist Health Medical Group, Baptist Health Quality Network and internationally renowned centers of excellence. The not-for-profit, faith-based Baptist Health has approximately 16,000 employees and 2,300 affiliated physicians. Baptist Health South Florida has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World's Most Ethical Companies. For more information, visit BaptistHealth.net and connect with us on Facebook at facebook.com/BaptistHealthSF and on Twitter and Instagram @BaptistHealthSF. Royal Philips (NYSE: PHG) (AEX: PHIA) is a leading health technology company focused on improving people's health and enabling better outcomes across the health continuum from healthy living and prevention, to diagnosis, treatment and home care. Philips leverages advanced technology and deep clinical and consumer insights to deliver integrated solutions. Headquartered in the Netherlands, the company is a leader in diagnostic imaging, image-guided therapy, patient monitoring and health informatics, as well as in consumer health and home care. Philips' health technology portfolio generated 2016 sales of EUR 17.4 billion and employs approximately 71,000 employees with sales and services in more than 100 countries. News about Philips can be found at www.philips.com/newscenter.


News Article | March 2, 2017
Site: www.businesswire.com

MIAMI--(BUSINESS WIRE)--Miami Cardiac & Vascular Institute has completed its $120 million expansion project on the Baptist Hospital campus. The state-of-the-art facility includes additional space and cutting-edge technology, facilitating the creation of several new, specialized programs bringing together multidisciplinary teams of specialists to treat the cardiovascular system as a single entity. The expansion added 60,000 square feet of new space and included 40,000 square feet of renovations, nearly doubling the size of the Institute to 150,000 square feet in order to accommodate a growing number of patients and procedures. Since it was founded in 1987, Institute physicians have pioneered less-invasive techniques to treat aneurysms, stroke and heart disease, and have been part of many groundbreaking research trials. For 30 years, Miami Cardiac & Vascular Institute has been an integral innovation partner for Philips, a world leader in healthcare technologies, providing valuable clinical insights that have led to the development of industry-leading solutions such as the recently announced Philips Azurion Image Guided Therapy (IGT) system. The expansion includes a state-of-the-art Cath lab, representing the first North American installation of Azurion. The system is designed to anticipate what clinicians need, when they need it, to make procedures flow intuitively and support a superior patient experience. “This expansion allows us to be at the forefront of medical innovation and provides the most current treatment options for our patients, while at the same time, prepares us to be in the position to care for health problems we haven’t even encountered yet,” said Barry T. Katzen, M.D., Chief Medical Executive and founder of the Institute. “We are now able to conduct more research, offer new services and make discoveries that could transform how cardiovascular care is delivered.” Throughout its history, the Institute’s physicians have pioneered less-invasive techniques to treat aneurysms, stroke and heart disease, and have been part of many groundbreaking research trials. The newly expanded Institute, with its cutting-edge equipment and unique programs, allows our internationally respected physicians to continue their visionary work. One of the first elements of the three-year project was the expansion of Baptist Hospital’s Surgery Center, which now includes six large operating rooms dedicated to neuroscience, cardiac, vascular and robotic surgery. The Institute also added four new advanced endovascular suites with enlarged gallery viewing areas for enhanced teaching and learning opportunities. “This is the centerpiece of the expansion, the Center for Advanced Endovascular Therapies,” Dr. Katzen explained. “We wanted to create an environment in which we could do any type of predominantly image-guided procedure, where physicians of different disciplines could work together to create unique solutions for patients’ problems.” In designing interventional suites of the future, two of the new endovascular suites have glass walls and a video system that allow people to sit in a theater-style chair outside of the suite and control what they are watching using an iPad. Viewers from different disciplines or in training each can have their own unique user interface that allows them to pick and choose which parts of the procedure they want to watch, all with communication with the suites. Additionally, the Institute makeover created the National Center for Aneurysm Therapy — the first in the world — a Center for Structural Heart Therapy, Center for Critical Limb Ischemia and an Advanced Arrhythmia Therapy Center. It is here where physicians are doing research to discover more cardiovascular disease breakthroughs. “We are proud to open the doors of the new Miami Cardiac & Vascular Institute to our community,” said Brian E. Keeley, President and CEO of Baptist Health South Florida. “This expansion now provides even greater promise to our patients, with new state-of-the-art interventional procedure suites; an expansive, high-tech gallery for observation, diagnostics and greater teaching opportunities; and, research space for more than 120 clinical trials.” Miami Cardiac & Vascular Institute is the largest and most comprehensive cardiovascular facility in the region, consisting of 76 doctors and 1,100 employees system-wide serving 125,000 patients every year. “At Philips, we are committed to building a healthy society by creating solutions that are going to have a meaningful impact in improving human health, and this requires collaboration with pioneering organizations like Miami Cardiac & Vascular Institute,” said Brent Shafer, CEO of Philips North America. “The Institute’s clinical insights have been critical to the development of our Azurion technology, from understanding workflows and improving efficiencies, to understand how to improve the patient experience. Together, we are shaping the future of healthcare by making procedures safer and more efficient. This will not only help address the health issues in South Florida communities, it will allow us to apply those lessons globally to help tackle the challenges of rising healthcare costs and better access to care. Ultimately, we want to improve the patient experience and outcomes, one community at a time.” Miami Cardiac & Vascular Institute is the largest and most comprehensive cardiovascular facility in the region. The team of multilingual, multidisciplinary specialists has pioneered the development of minimally invasive techniques used to treat aneurysms, blockages in veins and arteries and holes in the heart. Miami Cardiac & Vascular Institute is part of Baptist Health South Florida, the largest healthcare organization in the region, with seven hospitals (Baptist Hospital, Baptist Children’s Hospital, Doctors Hospital, Homestead Hospital, Mariners Hospital, South Miami Hospital and West Kendall Baptist Hospital), nearly 50 outpatient and urgent care facilities, Baptist Health Medical Group, Baptist Health Quality Network and internationally renowned centers of excellence. The not-for-profit, faith-based Baptist Health has approximately 16,000 employees and 2,300 affiliated physicians. Baptist Health South Florida has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World’s Most Ethical Companies. For more information, visit BaptistHealth.net and connect with us on Facebook at facebook.com/BaptistHealthSF and on Twitter and Instagram @BaptistHealthSF. Royal Philips (NYSE: PHG, AEX: PHIA) is a leading health technology company focused on improving people's health and enabling better outcomes across the health continuum from healthy living and prevention, to diagnosis, treatment and home care. Philips leverages advanced technology and deep clinical and consumer insights to deliver integrated solutions. Headquartered in the Netherlands, the company is a leader in diagnostic imaging, image-guided therapy, patient monitoring and health informatics, as well as in consumer health and home care. Philips' health technology portfolio generated 2016 sales of EUR 17.4 billion and employs approximately 71,000 employees with sales and services in more than 100 countries. News about Philips can be found at www.philips.com/newscenter.


Banet N.,Johns Hopkins Hospital | Gown A.M.,Urologic | Shih I.-M.,Johns Hopkins Hospital | Shih I.-M.,Johns Hopkins University | And 10 more authors.
American Journal of Surgical Pathology | Year: 2015

Immunohistochemical expression of GATA-3 is seen predominantly in non-neoplastic bladder and breast epithelium and their respective carcinomas; however, data on expression in normal and lesional trophoblastic tissues are limited. Immunohistochemical staining for GATA-3 was assessed in a range of normal/lesional trophoblastic tissues and tumors in the differential diagnosis (n=445), including nonmolar products of conceptions/second and third trimester placentas/ectopic pregnancies, hydatidiform moles, placental site nodules, normal/exaggerated implantation sites, choriocarcinomas, epithelioid trophoblastic tumors, placental site trophoblastic tumors, atypical smooth muscle tumors (including leiomyosarcoma), and cervical and pulmonary squamous cell carcinomas. The extent of expression (0 to 4+) and intensity (weak to strong) were recorded. All cases with developing trophoblast/non-neoplastic trophoblastic proliferation and 81% of trophoblastic neoplasms were positive. Of all non-neoplastic trophoblast cell types, expression was observed in cytotrophoblast in 89% of cases, syncytiotrophoblast in 50%, intermediate trophoblast in 100%, and villous trophoblastic columns in 100%. Increasing gestational age was associated with a decrease in extent/intensity of expression in non-neoplastic cytotrophoblast and syncytiotrophoblast, whereas intermediate trophoblast maintained diffuse and strong expression from early to late gestation (P<0.0001). Eighty-nine percent of normal/exaggerated implantation sites showed 3+ or 4+ expression, whereas staining in 55% of placental site nodules was 1+ or 2+. Staining for GATA-3 was present in 78% of choriocarcinomas, 95% of epithelioid trophoblastic tumors, and 71% of placental site trophoblastic tumors. Although the number of choriocarcinomas and placental site trophoblastic tumors that showed a spectrum of expression ranging from negative to diffuse was relatively evenly distributed, 81% of epithelioid trophoblastic tumors had 3+ or 4+ staining. None of the atypical smooth muscle tumors and 3% of squamous cell carcinomas were positive, all of which exhibited weak staining. We conclude that GATA-3 is frequently expressed in normal and lesional trophoblastic tissues. It is also differentially expressed in intermediate trophoblast and cytotrophoblast/syncytiotrophoblast, which varies according to time during pregnancy. This study expands the spectrum of neoplasms known to express GATA-3. Thus, recognition of expression in trophoblastic tumors is important, because it can present a diagnostic pitfall in the assessment of suspected metastatic bladder or breast carcinomas involving the gynecologic tract. In the evaluation of diagnostically problematic tumors for which trophoblastic neoplasms are in the differential diagnosis, such as leiomyosarcoma and squamous cell carcinoma, GATA-3 can be included as part of an immunohistochemical panel particularly when other trophoblastic markers are either not available or yield ambiguous results. Copyright © 2014 by Lippincott Williams & Wilkins.


Shammeri O.A.,Qassim University | Bitar F.,Tufts University | Ghitelman J.,South Miami Hospital | Soukas P.A.,The Miriam Hospital
Annals of Saudi Medicine | Year: 2012

Background and objectives: In-stent restenosis in the femoropopliteal artery is common (20%-40%). Treatment of in-stent restenosis is challenged by poor patency rate. An ePTFE-covered stent-graft (Viabahn) is inert with a very small pore size that does not allow for significant tissue in-growth. Use of a Viabahn stent-graft may improve the patency rate in the treatment of in-stent restenosis. DESIGN AND SETTING: A retrospective chart review of the use of Viabahn stent grafts implanted in patients with symptomatic femoropopliteal artery in-stent restenosis performed from January 2004 to December 2008. PATIENTS AND Methods: We measured the primary patency rate using duplex ultrasound at 1 year and 3 years. We also examined the rate of secondary patency, acute limb ischemia and amputation. Results: Twenty-seven cases with in-stent restenosis of the femoropopliteal artery treated by Viabahn stentgraft were identified. The average lesion length was 24.5 cm; 52% of the lesions were total occlusion and 37% had critical limb ischemia. The 1- and 3-year primary patency rates were 85.1% and 81.4%, respectively. The secondary patency rate was 96%. All recurrent in-stent restenoses were focal at the proximal and distal edges and none had stent fracture. Conclusion: Our single center experience in a small number of patients showed a favorable patency of ePTFE-covered stent-graft for treatment of patients with in-stent restenosis in the femoropopliteal artery.


Romero R.J.,South Miami Hospital | Kosanovic R.,South Miami Hospital | Rabaza J.R.,South Miami Hospital | Seetharamaiah R.,South Miami Hospital | And 3 more authors.
Obesity Surgery | Year: 2013

Background: Robotic technology has recently emerged in different surgical specialties, but the experience with robotic sleeve gastrectomy (RSG) is scarce in the literature. The purpose of this study is to compare our preliminary experience with RSG versus the descriptive results of a systematic review of the laparoscopic approach. Methods: Data from our RSG experience were retrospectively collected. Two surgeons performed all the cases in one single surgery center. Such information was compared with a systematic review of 22 selected studies that included 3,148 laparoscopic sleeve gastrectomy (LSG) cases. RSG were performed using the daVinci® Surgical System. Results: This study included 134 RSG vs 3,148 LSG. Mean age and mean BMI was 43 ± 12.6 vs 40.7 ± 11.6 (p = 0.022), and 45 ± 7.1 vs 43.6 ± 8.1 (p = 0.043), respectively. Leaks were found in 0 RSG vs 1.97 % LSG (p = 0.101); strictures in 0 vs 0.43 % (p = 0.447); bleeding in 0.7 vs 1.21 % (p = 0.594); and mortality in 0 vs 0.1 % (p = 0.714), respectively. Mean surgical time was calculated in 106.6 ± 48.8 vs 94.5 ± 39.9 min (p = 0.006); and mean hospital length of stay was 2.2 ± 0.6 vs 3.3 ± 1.7 days (p = <0.005), respectively. Four (2.9 %) complications were found in our robotic series. Conclusions: Our series shows that RSG is a safe alternative when used in bariatric surgery, showing similar results as the laparoscopic approach. Surgical time is longer in the robotic approach, while hospital length of stay is lower. No leaks or strictures were found in the robotic cases. However, further studies with larger sample size and randomization are warranted. © 2013 Springer Science+Business Media New York.


Lindgren C.L.,South Miami Hospital | Vidal E.C.,South Miami Hospital | Vasserman A.,South Miami Hospital
CIN - Computers Informatics Nursing | Year: 2010

In reaching the goal for standardized, quality care, a not-for-profit healthcare system consisting of seven institutional entities is transforming nursing practice guidelines, patient care workflow, and patient documents into electronic, online, real-time modalities for use across departments and all healthcare delivery entities of the system. Organizational structure and a strategic plan were developed for the 2-year Clinical Transformation Project. The Siemens Patient Care Document System was adopted and adapted to the hospitals' documentation and information needs. Two fast-track sessions of more than 100 nurses and representatives from other health disciplines were held to standardize assessments, histories, care protocols, and interdisciplinary plans of care for the top 10 diagnostic regulatory groups. Education needs of the users were addressed. After the first year, a productive, functional system is evidenced. For example, the bar-coded Medication Administration Check System is in full use on the clinical units of one of the hospitals, and the other institutional entities are at substantial stages of implementation of Patient Care Documentation System. The project requires significant allocation of personnel and financial resources for a highly functional informatics system that will transform clinical care. The project exemplifies four of the Magnet ideals and serves as a model for others who may be deciding about launching a similar endeavor. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.


OBJECTIVE: The purpose of this study was to compare the occupational stressors, the perceived stress levels, and coping styles of 3 generations of medicalsurgical (MS) nurses.BACKGROUND: The literature supports that the nurse's role is stressful based on a variety of factors including physical labor, human suffering, work hours, staffing, and interpersonal relationships. Data indicate that there are generational differences in the response to stress. The 3 predominant nursing generations coexisting in the nursing workforce add to the complexity of the recognition and coping skills to address stress.METHODS: A correlational design was used. A convenience sample ofMSnurses participated in this study by completing 4 questionnaires.RESULTS: Occupational stressors were found to be significant predictors for perceived stress among all generations of nurses in this sample. Also, the higher the level of stress perception among nurses, the higher the use of coping behaviors. Generation Y reported a higher level of perceived stress and higher use of escape avoidance coping behaviors, while baby boomers reported higher use of self-controlling coping behaviors.CONCLUSIONS: By identifying the needs of each of the generational cohorts, nurse leaders, nurse educators, and policy makers can better assist the nursing workforce to remain at the bedside, improve patient outcomes, andmaintain a positivework environment. Copyright © 2014 Wolters Kluwer Health.

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