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patient safety in surgery

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https://www.readbyqxmd.com/read/28526153/pharmacology-of-octreotide-clinical-implications-for-anesthesiologists-and-associated-risks
#1
REVIEW
Reza M Borna, Jonathan S Jahr, Susanna Kmiecik, Ken F Mancuso, Alan D Kaye
Many patients presenting with a history of foregut, midgut neuroendocrine tumors (NETs) or carcinoid syndrome can experience life-threatening carcinoid crises during anesthesia or surgery. Clinicians should understand the pharmacology of octreotide and appreciate the use of continuous infusions of high-dose octreotide, which can minimize intraoperative carcinoid crises. We administer a prophylactic 500-μg bolus of octreotide intravenously (IV) and begin a continuous infusion of 500 μg/h for all NET patients...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525682/secondary-sulcus-fixed-foldable-iol-implantation-with-25-g-infusion-in-patients-with-previous-ppv-after-open-globe-injury
#2
Tiangeng He, Caiyun You, Song Chen, Xiangda Meng, Yuanyuan Liu, Hua Yan
PURPOSE: To evaluate the safety and efficacy of secondary sulcus-fixed foldable intraocular lens (IOL) implantation through a clear corneal incision with 25-G infusion in patients with previous pars plana vitrectomy (PPV) after open-globe injury, and to analyze postoperative outcomes and prognostic factors of treatment. METHODS: Clinical data of 89 eyes of 89 patients with open-globe injury who underwent secondary sulcus-fixed foldable IOL implantation through a clear corneal incision with 25-G infusion after vitrectomy in our hospital between January 2008 and June 2015 were retrospectively analyzed...
May 16, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28525514/perineural-dexmedetomidine-is-more-effective-than-clonidine-when-added-to-local-anesthetic-for-supraclavicular-brachial-plexus-block-a-systematic-review-and-meta-analysis
#3
Kariem El-Boghdadly, Richard Brull, Herman Sehmbi, Faraj W Abdallah
BACKGROUND: Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#4
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525480/a-new-entrance-technique-for-c2-pedicle-screw-placement-and-the-use-in-patients-with-atlantoaxial-instability
#5
Jia-Ming Liu, Jian Jiang, Zhi-Li Liu, Xin-Hua Long, Wen-Zhao Chen, Yang Zhou, Song Gao, Lai-Chang He, Shan-Hu Huang
STUDY DESIGN: A prospective study and a technique note. OBJECTIVES: To introduce a new entrance technique for C2 pedicle screw placement and to measure the related linear and angular parameters about the entrance point on computed tomography (CT) images. The safety of this technique for patients with atlantoaxial instability was also evaluated. BACKGROUND DATA: Although earlier studies have introduced different methods for C2 pedicle screw placement, the entry points and the angular parameters may be variable...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525479/outcome-of-bilateral-c1-laminar-hooks-combined-with-c2-pedicle-screw-fixation-for-the-treatment-of-c1-c2-instability-a-report-of-18-cases-from-a-single-chinese-center
#6
Lifeng Lao, Guibin Zhong, Qianyi Li, Xinfeng Li, Bin Chen, Lie Qian, Zude Liu
STUDY DESIGN: A retrospective technical report. OBJECTIVE: To assess the effect of bilateral C1 laminar hooks combined with C2 pedicle screw fixation for the treatment of C1-C2 instability. SUMMARY OF BACKGROUND DATA: Various posterior atlantoaxial fixations for C1-C2 instability have been developed. However, due to anatomic anomalies of the vertebral artery, the smallness of the pedicle, trajectories of broken screws, or a lack of surgical experience, a simple atlantoaxial fixation technique with good safety and effectiveness is urgently needed...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525469/safety-and-efficacy-study-of-an-ozone-laser-combined-therapy-using-puncture-needle-in-the-treatment-of-patients-with-cervical-spondylosis
#7
Ke Gu, Yuqiu Yan, Wu Wei, Yan Li, Wenli Liu, Yang Guo, Long Yu
STUDY DESIGN AND METHODS: Fifty-eight patients with cervical spondylosis (CS) were treated with patented technology of ozone laser combined therapy using puncture needle between August 2008 and February 2010. Visual Analogue Scale (VAS) score changes before and 6 months after surgery and MacNab score criteria 6 months after surgery were analyzed. BACKGROUND AND OBJECTIVE: CS normally occurs over the age of 50 and broadly presents as either myelopathy or radiculopathy...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525401/glidescope-versus-airtraq-dl-for-double-lumen-tracheal-tube-insertion-in-patients-with-a-predicted-or-known-difficult-airway-a-randomised-study
#8
Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, Fabien Espitalier
BACKGROUND: Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE: Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN: Adult patients scheduled for elective thoracic surgery with a predicted risk (evaluated preoperatively using the Arné score) or history of difficult intubation were allocated randomly to one of two groups: a Glidescope group and an Airtraq group...
May 19, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28524884/assessment-of-conditions-affecting-surgical-success-of-ahmed-glaucoma-valve-implants-in-glaucoma-secondary-to-different-uveitis-etiologies-in-adults
#9
G Sungur, M Yakin, U Eksioglu, B Satana, F Ornek
PurposeThere is little known about the long-term efficacy and safety of Ahmed glaucoma valve (AGV) implant and about the conditions affecting surgical success in uveitic glaucoma (UG).Patients and methodsThe charts of adult patients with UG who underwent AGV implantation from 2006 to 2015 were reviewed retrospectively.ResultsData of 46 eyes of 39 patients were evaluated. Mean follow-up was 51.93±23.08 months. Mean preoperative IOP was 37.05±9.62 mm Hg and mean number of preoperative topical anti-glaucomatous medications was 2...
May 19, 2017: Eye
https://www.readbyqxmd.com/read/28524883/occurrence-rate-of-retinal-detachment-after-small-gauge-vitrectomy-for-idiopathic-epiretinal-membrane
#10
J Marie-Louise, E Philippakis, A Darugar, R Tadayoni, B Dupas
PurposeTo assess the occurrence rate of retinal detachment (RD) after small gauge vitrectomy for idiopathic epiretinal membrane (ERM).Patients and methodsRetrospective observational case series. The records of consecutive patients operated on for idiopathic ERM using small gauge pars plana vitrectomy between August 2012 and December 2014 with at least a 1-year follow-up were reviewed. All patients were contacted by phone to assess the occurrence of RD during the post-operative follow-up. The main outcome was the occurrence of RD...
May 19, 2017: Eye
https://www.readbyqxmd.com/read/28523526/iris-fixated-phakic-intraocular-lens-implantation-in-an-adult-with-retinopathy-of-prematurity-1-year-follow-up
#11
Young Shin Kim, Jin Kwon Chung, Sung Jin Lee
PURPOSE: To report a case of iris-fixated phakic intraocular lens (pIOL) implantation in a patient with an extremely steep cornea, shallow anterior chamber, and small corneal diameter caused by retinopathy of prematurity (ROP) and scleral encircling. METHODS: Case report. RESULTS: Iris-fixated pIOLs were implanted in a 19-year-old patient with refraction of -18.5 -0.75 × 180 in the right eye and -15.5 -1.25 × 180 in the left eye. The keratometric values were 53...
May 18, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#12
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28523181/surgery-after-drug-eluting-stent-implantation-it-s-not-all-doom-and-gloom
#13
EDITORIAL
Francesco Saia
Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. In fact, DES are associated with delayed vascular healing and require longer dual antiplatelet treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523161/the-safety-profile-of-preoperative-administration-of-heparin-for-thromboprophylaxis-in-chinese-patients-intended-for-thoracoscopic-major-thoracic-surgery-a-pilot-randomized-controlled-study
#14
Han-Yu Deng, Chang-Lin Shi, Gang Li, Jun Luo, Zhi-Qiang Wang, Yi-Dan Lin, Lun-Xu Liu, Qing-Hua Zhou
BACKGROUND: Patients undergoing major thoracic surgery especially for cancers are at a high risk of perioperative thromboembolism. Current guidelines recommended either heparin sodium (unfractionated heparin) or low-molecular-weight heparin (LMWH) for those patients at high risk of deep vein thrombosis (DVT). However, the rational timing of starting heparin has not yet been well established, because DVT can be caused by not only surgery but also comorbidities as well as prolonged hospital stay, and thoracic surgeons always concerned about heparin-related increased risk of intra- or post-operative bleeding...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522221/comparative-efficacy-and-safety-of-different-circumcisions-for-patients-with-redundant-prepuce-or-phimosis-a-network-meta-analysis
#15
REVIEW
Chuiguo Huang, Pan Song, Changbao Xu, Ruofan Wang, Lei Wei, Xinghua Zhao
BACKGROUND: Phimosis and redundant prepuce are defined as the inability of the foreskin to be retracted behind the glans penis in uncircumcised males. To synthesize the evidence and provide the hierarchies of different circumcisions for phimosis and redundant prepuce, we performed an overall network meta-analysis (NMA) based on their comparative efficacy and safety. MATERIAL AND METHODS: Electronic databases including PubMed, Embase, Wan Fang, VIP, CNKI and CBM database were researched from randomized controlled trials (RCTs) for redundant prepuce or phimosis...
May 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28522184/is-fluorescence-guided-surgery-with-5-ala-in-eloquent-areas-for-malignant-gliomas-a-reasonable-and-useful-technique
#16
T Picart, X Armoiry, J Berthiller, C Dumot, I Pelissou-Guyotat, F Signorelli, J Guyotat
INTRODUCTION: High-grade gliomas surgery in eloquent areas must achieve two pivotal aims: oncological efficacy and preservation of unimpaired neurological functions or improvement of impaired neurological functions. Here, we evaluated the safety and the usefulness of 5-ALA fluorescence-guided surgery in eloquent areas. MATERIAL AND METHODS: Single center, retrospective and consecutive series of adult patients operated on for a supratentorial glioblastoma between November 2012 and November 2015...
May 15, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28521921/1-year-results-in-patients-undergoing-transcatheter-aortic-valve-replacement-with-failed-surgical-bioprostheses
#17
G Michael Deeb, Stanley J Chetcuti, Michael J Reardon, Himanshu J Patel, P Michael Grossman, Theodore Schreiber, John K Forrest, Tanvir K Bajwa, Daniel P O'Hair, George Petrossian, Newell Robinson, Stanley Katz, Alan Hartman, Harold L Dauerman, Joseph Schmoker, Kamal Khabbaz, Daniel R Watson, Steven J Yakubov, Jae K Oh, Shuzhen Li, Neal S Kleiman, David H Adams, Jeffrey J Popma
OBJECTIVES: This study evaluated the safety and effectiveness of self-expanding transcatheter aortic valve replacement (TAVR) in patients with surgical valve failure (SVF). BACKGROUND: Self-expanding TAVR is superior to medical therapy for patients with severe native aortic valve stenosis at increased surgical risk. METHODS: The CoreValve U.S. Expanded Use Study was a prospective, nonrandomized study that enrolled 233 patients with symptomatic SVF who were deemed unsuitable for reoperation...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28521184/one-stage-posterior-grade-4-osteotomy-and-bone-graft-fusion-at-pseudarthrosis-for-the-treatment-of-kyphotic-deformity-with-andersson-lesions-in-ankylosing-spondylitis
#18
Tingxian Ling, Bangjian Zhou, Ce Zhu, Xi Yang, Yueming Song, Zhe Qiang, Limin Liu
OBJECTIVES: The optimal surgical procedure for treating kyphotic deformity with Andersson lesions (ALs) in ankylosing spondylitis (AS) patients is controversial. The one-stage posterior osteotomy and bone graft fusion approach is rarely reported. The aim of the present study was to report a new surgical procedure involving one-stage posterior grade 4 osteotomy and bone graft fusion for the treatment of kyphotic deformity with ALs in AS. PATIENTS AND METHODS: Eleven patients with ALs in AS were enrolled...
May 11, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28516968/preliminary-experience-with-4k-ultra-high-definition-endoscope-analysis-of-pros-and-cons-in-skull-base-surgery
#19
M Rigante, G La Rocca, L Lauretti, G Q D'Alessandris, A Mangiola, C Anile, A Olivi, G Paludetti
During the last two decades endoscopic skull base surgery observed a continuous technical and technological development 3D endoscopy and ultra High Definition (HD) endoscopy have provided great advances in terms of visualisation and spatial resolution. Ultra-high definition (UHD) 4K systems, recently introduced in the clinical practice, will shape next steps forward especially in skull base surgery field. Patients were operated on through transnasal transsphenoidal endoscopic approaches performed using Olympus NBI 4K UHD endoscope with a 4 mm 0° Ultra Telescope, 300 W xenon lamp (CLV-S400) predisposed for narrow band imaging (NBI) technology connected through a camera head to a high-quality control unit (OTV-S400 - VISERA 4K UHD) (Olympus Corporation, Tokyo, Japan)...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28515354/clinical-application-and-outcomes-of-sentinel-node-navigation-surgery-in-patients-with-early-gastric-cancer
#20
Takaaki Arigami, Yoshikazu Uenosono, Shigehiro Yanagita, Keishi Okubo, Takashi Kijima, Daisuke Matsushita, Masahiko Amatatsu, Takahiko Hagihara, Naoto Haraguchi, Yuko Mataki, Katsuhiko Ehi, Sumiya Ishigami, Shoji Natsugoe
Sentinel node navigation surgery (SNNS) has been recognized as a minimally invasive tool for individualized lymphadenectomy in patients with early gastric cancer (EGC). The aim of this study was to compare clinicopathological factors, adverse events, and clinical outcomes between sentinel node mapping (SNM) and SN dissection (SND) groups and assess the clinical utility of SNNS in patients with EGC. The clinical data of 157 patients with EGC, diagnosed as clinical T1N0M0 with tumors ≤ 40 mm, undergoing SNNS between March 2004 and April 2016 were retrospectively reviewed...
May 3, 2017: Oncotarget
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