ICU outcomes following a Central Line Associated Blood Stream Infections (CLABSI) reduction quality improvement project.

Background: Central Line Associated Blood Stream Infections (CLABSI) are significant complications for hospitalized patients. Several different approaches have been used to reduce CLABSI.

Objective: This study aimed to (1) describe a systematic approach used to analyze and reduce CLABSI rates in a surgical ICU (SICU) at a quaternary care medical facility (CLABSI reduction bundle) and (2) examine the association of the bundle on CLABSI rates in the SICU, compared to six unexposed health system ICUs.

The Quality Improvement Fellow: Educating on Making the Difference.

The critical care medicine (CCM) fellowship is an opportunity for advanced anesthesiology trainees to refine their quality improvement (QI) skills. However, the short training period and inconsistent curricula make this challenging. The QI fellow (QIF) is described as an education program to provide consistent QI training during the CCM fellowship.

An Analysis of Outcomes Following a Central Line Associated Blood Stream Infections (CLABSI) Reduction Quality Improvement Project in a Tertiary Care Center.

Central Line Associated Blood Stream Infections (CLABSI) continue to be a significant complication for hospitalized patients. Hospitals have used various strategies to reduce CLABSI events due to the significant complications and associated costs. In this QI analysis, we examined the impact of a CLABSI reduction quality improvement project within a single ICU at a tertiary care medical center.

Novel Airway and Ventilator Management of Tracheobronchial Disruption After Blunt Trauma.

Tracheobronchial injuries can be difficult to diagnose and manage, especially in the presence of polytrauma. A 50-year-old woman presented as a Level I trauma activation after being struck by a motor vehicle. Initial evaluation demonstrated intracranial hemorrhage and multiple chest injuries, including multilevel bilateral rib fractures, pneumomediastinum, and concern for tracheobronchial injury.

Postoperative Pulmonary Complications, Early Mortality, and Hospital Stay Following Noncardiothoracic Surgery: A Multicenter Study by the Perioperative Research Network Investigators.

Importance: Postoperative pulmonary complications (PPCs), a leading cause of poor surgical outcomes, are heterogeneous in their pathophysiology, severity, and reporting accuracy.

Objective: To prospectively study clinical and radiological PPCs and respiratory insufficiency therapies in a high-risk surgical population.

Design, Setting, And Participants: We performed a multicenter prospective observational study in 7 US academic institutions.

Lichen sclerosus in men is associated with elevated body mass index, diabetes mellitus, coronary artery disease and smoking.

Purpose: To elucidate disease associations and possible etiology of lichen sclerosus (LS), we identified comorbidities present in men with LS. LS is a chronic inflammatory disease of unknown etiology affecting genitals and urethra of men commonly resulting in strictures.

Methods: Men with LS of the urethra, penis, prepuce and scrotum were identified.

Distal urethroplasty for isolated fossa navicularis and meatal strictures.

Objective: • Urethral strictures located in the fossa navicularis are common and are often managed with meatotomy or meatoplasty. • Few data have described the outcomes for men after urethroplasty or patient satisfaction following these procedures.

Methods: • In all, 93 men at two different institutions underwent surgical repair of distal urethral stricture disease using meatotomy (73) or meatoplasty (20), with 13/20 (65%) of the latter group undergoing substitution urethroplasty.

Urethroplasty for radiotherapy induced bulbomembranous strictures: a multi-institutional experience.

Purpose: Radiotherapy induced urethral strictures are often difficult to manage due to proximal location, compromised vascular supply and poor wound healing. To determine the success of urethroplasty for radiation induced strictures we performed a multi-institutional review of men who underwent urethroplasty for urethral obstruction.

Materials And Methods: A total of 30 men (mean age 67 years) underwent urethroplasty at 3 separate institutions.

Developmental increases in effective connectivity to brain regions involved in phonological processing during tasks with orthographic demands.

Developmental differences (9- to 15-year-olds) in effective connectivity in left hemisphere regions were examined using dynamic causal modeling (DCM) of functional magnetic resonance imaging (fMRI) data. Children completed spelling tasks in the visual and auditory modalities in which they were asked to determine if two words were spelled the same from the first vowel onwards. Intrinsic (anatomical) connections were strongest from primary cortical regions to unimodal association areas - from Heschl's gyrus to superior temporal gyrus for the auditory spelling task and from calcarine to fusiform gyrus for the visual spelling task.