INTRODUCTION We sought to evaluate the cost effectiveness of perioperative use of alvimopan in cystectomy and urinary diversion. A recent randomized controlled trial demonstrated the efficacy of alvimopan in reducing postoperative ileus and length of stay in cystectomy; however, a major limitation was the exclusion of epidural analgesia. MATERIALS AND METHODS Eighty-six cystectomy and urinary...

ÐIn this paper, the Dynamic Trac Routing problem is de®ned as the real-time point diversion of trac during non-recurrent congestion. This dynamic trac routing problem is then formulated as a feedback control problem that determines the time-dependent split parameters at the diversion point for routing the incoming trac ̄ow onto the alternate routes in order to achieve a user-equilibrium tra...

This paper introduces the notion of policy as a basis for interaction for decision-support systems, and describes how policy was applied as the foundation of a decision-support tool to aid in diversion management in airline operations. A policy is an abstract, general, a priori statement of expressing a goal and an associated priority. Diversion management is the process of deciding which incom...

Prescription opioid abuse is at epidemic levels. Opioids diverted from friends and family members who have legitimate prescriptions are a major source of abused prescription opioids. Nurses are vital to any effort to combat this public health crisis because they have the opportunity to provide essential anticipatory guidance every time a patient receives prescription medication. The purpose of ...

Calculus formation in an ileal conduit following cystectomy is a known complication. Encrustation and formation of calculus may also occur over a DJ stent retained for a long period; but this is never reported in patients with conduit diversion because of close surveillance of these patients. Here we report first case of a large calculus encrusted over a forgotten DJ stent within an ileal condu...

Urinary diversion is a detour of the urinary tract. It may be necessary in different scenarios and can either be continent or incontinent, catheterisable or orthotopic. Pathological situations which may demand a urinary diversion are varied and include anatomical, physiological, congenital and traumatic causes, e.g. urethral stenosis and partial or complete urethral disruption; bladder dysfunct...

Spontaneous rupture of a continent cutaneous urinary diversion is uncommon and diagnosis of this situation requires a high degree of suspicion. In this paper we present a 66-year-old man with continent cutaneous pouch after radical cystoprostatectomy that presented with spontaneous perforation 25 years after surgery. Spontaneous pouch perforation in our case after 25 years emphasizes the need f...

In recent years, growth in the demand for emergency medical services along with decline in the number of hospitals with emergency departments (EDs) has raised concerns about the ability of the EDs to provide adequate service. Many EDs frequently report periods of overcrowding during which they are forced to divert incoming ambulances to neighboring hospitals, a phenomenon known as “ambulance di...

Purpose: The type of urinary diversion after radical cystectomies for bladder cancer does not influence survival substantially, but it may influence the quality of life very much. The aim of this study was to asses the Mainz II (sigma pouch) as a new modification of uretrosigmoidostomy in our patients in comparison to the more commonly used rectal bladder diversion. Material and Methods: Twenty...