Implementation of the Spanish ERAS program in bariatric surgery.

The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish Fast Track Group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery, comparing it with a historical cohort receiving standard care.

Comparison of Mental Health Treatment Adequacy and Costs in Public Hospitals in Boston and Madrid.

Analyses of healthcare expenditures and adequacy are needed to identify cost-effective policies and practices that improve mental healthcare quality. Data are from 2010 to 2012 electronic health records from three hospital psychiatry departments in Madrid (n = 29,944 person-years) and three in Boston (n = 14,109 person-years). Two-part multivariate generalized linear regression and logistic regression models were estimated to identify site differences in mental healthcare expenditures and quality of care.

Effect of the Abdominal Fascial Closure with Triclosan-Coated Sutures in Fecal Peritonitis, on Surgical Site Infection, and Evisceration: A Retrospective Multi-Center Study.

Background: Surgical site infection (SSI) is a frequent complication in dirty surgery, reaching rates of up to 40%. The incidence of SSI might be influenced by the suture used for closure of the abdominal fascia. Sutures coated with antibacterial substances may reduce the bacterial load in the incision.

Axitinib treatment in advanced RAI-resistant differentiated thyroid cancer (DTC) and refractory medullary thyroid cancer (MTC).

Background: Axitinib, an antiangiogenic multikinase inhibitor (MKI), was evaluated in the compassionate use programme (CUP) in Spain (October 2012-November 2014).

Subjects And Methods: 47 patients with advanced radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC,  = 34) or medullary thyroid cancer (MTC,  = 13) with documented disease progression were treated with axitinib 5 mg b.i.

C-reactive protein, fibrinogen, and procalcitonin levels as early markers of staple line leak after laparoscopic sleeve gastrectomy in morbidly obese patients within an Enhanced Recovery After Surgery (ERAS) program.

Introduction: The performance of most bariatric procedures within an Enhanced Recovery After Surgery program has resulted in significant advantages, including a reduction in the length of hospital stay to 2-3 days. However, some postoperative complications may appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 h after a laparoscopic sleeve gastrectomy for predicting staple line leak in the postoperative course.

User profiles of an electronic mental health tool for ecological momentary assessment: MEmind.

Ecological momentary assessment (EMA) is gaining importance in psychiatry. This article assesses the characteristics of patients who used a new electronic EMA tool: the MEmind Wellness Tracker. Over one year, 13811 adult outpatients in our Psychiatry Department were asked to use MEmind.

Effect of Subcutaneous Sterile Vitamin E Ointment on Incisional Surgical Site Infection after Elective Laparoscopic Colorectal Cancer Surgery.

Background: Despite several interventions having been adopted to reduce the incidence of incisional surgical site infection (SSI), it still remains a challenge for surgeons, because incisional SSI is a common cause of health-care-associated infection, leading to increased morbidity, prolonged hospital stay, patient discomfort, and increased sanitary costs. The aim of this study was to evaluate the effect on incisional SSI of vitamin E ointment in the subcutaneous tissue of patients undergoing a laparoscopic colorectal surgical procedure.

Patients And Methods: A randomized study was performed.

Evolution of Liver Steatosis Quantified by MR Imaging and MR Spectroscopy, in Morbidly Obese Patients Undergoing Sleeve Gastrectomy: Short-Term Outcomes.

Background: Currently, the standard procedure used to evaluate hepatic steatosis is the liver biopsy. This is an invasive practice that presents inherent risks. Increasing evidence suggests that magnetic resonance imaging (MRI) and MR spectroscopy (MRS) may represent an accurate method to determine the hepatic lipid content.

Risk factors for bacteremia in urinary tract infections attended in the emergency department.

Urinary tract infections (UTI) are common in emergency departments (ED), and at least 15% of them are bacteremic. However, there are few data on how to predict which patients are at high risk of developing bacteremic UTI (b-UTI). We performed a retrospective observational cohort study including patients diagnosed with UTI who were admitted to the ED of a tertiary-care hospital in Spain.

Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications.

Purpose: The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS.

Method: A web application (www.

Intraperitoneal Ropivacaine Irrigation in Patients Undergoing Bariatric Surgery: a Prospective Randomized Clinical Trial.

Background: Despite most bariatric procedures are actually performed by laparoscopic approach, management of postoperative pain remains a major challenge. The aim of this study was to analyze the analgesic effect of intraperitoneal ropivacaine infusion in patients undergoing bariatric surgery.

Methods: A prospective randomized clinical trial of all the patients undergoing laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) between January and November 2015 was performed.

Implementation of the Spanish National Enhanced Recovery Program (ERAS) in Bariatric Surgery: A Pilot Study.

Introduction: The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish fast track group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery.

Portal Vein Thrombosis After Splenic and Pancreatic Surgery.

The portal vein is formed by the confluence of the splenic and superior mesenteric veins, which drain the spleen and small intestine respectively. Occlusion of the portal vein by thrombus typically occurs in patients with cirrhosis and/or prothrombotic disorders. However, portal vein thrombosis (PVT) can also happen after determined surgeries.

Thromboembolic Prophylaxis for Morbidly Obese Patients Undergoing Bariatric Surgery.

Obesity itself is associated with an increased risk of thromboembolic events. Moreover, most bariatric procedures actually are performed by laparoscopic approach, implying an increased intraabdominal pressure during the surgical procedure that may favor the development of thrombus. Therefore, bariatric surgery is considered a high-risk procedure for thromboembolic events.

Postoperative pain after laparoscopic sleeve gastrectomy: comparison of three analgesic schemes (isolated intravenous analgesia, epidural analgesia associated with intravenous analgesia and port-sites infiltration with bupivacaine associated with intravenous analgesia).

Introduction: Although bariatric surgery is actually mainly performed laparoscopically, analgesic optimization continues being essential to reduce complications and to improve the patients' comfort. The aim of this study is to evaluate the postoperative pain after analgesia iv exclusively, or associated with epidural analgesia or port-sites infiltration with bupivacaine.

Patients And Methods: A prospective randomized study of patients undergoing laparoscopic sleeve gastrectomy between 2012 and 2014 was performed.

Maintenance of Multivitamin Supplements After Sleeve Gastrectomy.

Introduction: After all bariatric procedures, multivitamin supplements are uniformly prescribed to minimize eventual deficiencies. These supplements are usually maintained long time, even during the whole life after malabsorptive techniques, while these are maintained at least during 1 year after restrictive procedures. Given that sleeve gastrectomy does not alter intestinal absorption, the supplements are possibly unnecessary, once the patient can take an adequate diet.

Preoperative Regular Diet of 900 kcal/day vs Balanced Energy High-Protein Formula vs Immunonutrition Formula: Effect on Preoperative Weight Loss and Postoperative Pain, Complications and Analytical Acute Phase Reactants After Laparoscopic Sleeve Gastrectomy.

Background: Between 2 and 8 weeks before surgery, most bariatric surgery groups establish strict dietary treatments with a total caloric intake of less than 1,000 kcal/day in order to maximize weight loss during this period of time.

Methods: A prospective randomized clinical trial of all the patients undergoing laparoscopic sleeve gastrectomy (LSG) was performed. Patients were randomly assigned into 3 groups: those patients receiving a preoperative regular diet of 900 kcal/day (group 1), those receiving a preoperative balanced energy high-protein formula (group 2) and those receiving preoperative Immunonutrition (group 3).

Experience with mandibular reconstruction using transport-disc-distraction osteogenesis.

The goal of transport-disc-distraction osteogenesis (TDDO) is to restore bone continuity by using in-situ bone. It may be useful following trauma, gunshot injuries, or tumor ablation, especially when there may be contraindications at the donor site or for prolonged surgery. To the best of the authors' knowledge, this is the first time TDDO has been used for mandibular reconstruction reporting additional procedures, which include osseointegrated dental implants rehabilitation and orthognathic surgery.