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https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#1
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28919125/multi-institution-analysis-of-infection-control-practices-identifies-the-subset-associated-with-best-surgical-site-infection-performance-a-texas-alliance-for-surgical-quality-collaborative-project
#2
Catherine H Davis, Lillian S Kao, Jason B Fleming, Thomas A Aloia
BACKGROUND: In an effort to reduce surgical site infection (SSI) rates, a large number of infection control practices (ICPs), including operating room attire policies, have been recommended. However, few have proven benefits and many are costly, time-consuming, and detrimental to provider morale. The goal of this multi-institution study was to determine which ICPs are associated with lower postoperative SSI rates. STUDY DESIGN: Twenty American College of Surgeons NSQIP and Texas Alliance for Surgical Quality-affiliated hospitals completed this Quality Improvement Assessment Board-approved study...
August 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28914701/elevated-postvoid-residual-urine-volume-identifying-risk-factors-and-predicting-resolution-in-women-with-pelvic-organ-prolapse
#3
Amanda Ulrich, Patricia Davis, Paul Tulikangas, David M OʼSullivan, Katie Propst
OBJECTIVES: This study aims to identify risk factors for elevated preoperative postvoid residual (PVR) and persistently elevated postoperative PVR and to evaluate the resolution rate of elevated PVR urine volume in patients undergoing reconstructive surgery for pelvic organ prolapse (POP). METHODS: This was a retrospective cohort study comparing 50 women with elevated preoperative PVR (≥100 mL) and 50 women with normal PVR (<100 mL). Preoperative demographic, physical examination, urodynamic data, type of surgery performed, and postoperative trial of void data were collected...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28901936/advances-in-paediatric-urology
#4
REVIEW
David A Diamond, Ivy H Y Chan, Andrew J A Holland, Michael P Kurtz, Caleb Nelson, Carlos R Estrada, Stuart Bauer, Paul K H Tam
Paediatric urological surgery is often required for managing congenital and acquired disorders of the genitourinary system. In this Series paper, we highlight advances in the surgical management of six paediatric urological disorders. The management of vesicoureteral reflux is evolving, with advocacy ranging from a less interventional assessment and antimicrobial prophylaxis to surgery including endoscopic injection of a bulking agent and minimally invasive ureteric reimplantation. Evidence supports early orchidopexy to improve fertility and reduce malignancy in boys with undescended testes...
September 9, 2017: Lancet
https://www.readbyqxmd.com/read/28889781/intrauterine-cleaning-after-placental-delivery-at-cesarean-section-a-randomized-controlled-trial
#5
Ahizechukwu C Eke, Sheila Drnec, Andrea Buras, Joanna Woo, Denny Martin, Steven Roth
OBJECTIVE: To evaluate whether omission of intrauterine cleaning increases intraoperative and postoperative complications among women who deliver via cesarean section. METHODS: We randomized 206 women undergoing primary elective cesarean deliveries to intrauterine cleaning or omission of cleaning. Postpartum endomyometritis rates across groups was the primary outcome. We also examined secondary outcomes. To detect a 20% difference in infection rate between the cleaned and the noncleaned groups (two-tailed [alpha] = 0...
September 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28836242/-discussion-on-standardized-implementation-of-laparoscopic-radical-lymphadenectomy-for-distal-gastric-cancer
#6
Zejian Lyu, Junjiang Wang, Yong Li
Laparoscopic radical gastrectomy for gastric cancer has been widely applied in clinical practice, and its indications have been extended from early gastric cancer to advanced gastric cancer. It is acknowledged that laparoscopic radical gastrectomy is technically challenging because of the complexity of anatomy, rich blood supply, and extensive lymph node dissection. This paper primarily intends to share the experience of laparoscopic radical D2 gastrectomy for distal gastric cancer with details of choosing the location of Trocar, surgical approaches and the sequence of lymph node dissection...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28820031/elimination-of-mycobacterium-chimaera-in-a-heater-cooler-device-used-during-on-pump-cardiothoracic-surgery
#7
Conny Nielsen, Conni L Winther, Philip K Thomsen, Jan J Andreasen
Since 2014, several infections with non-tuberculous mycobacteria (NTM) belonging to the species Mycobacterium ( M.) chimaera have been associated with the use of heater-cooler devices during on-pump cardiothoracic surgery both in European countries and the United States of America. Infections have been detected after surgery, with a delay of a few months and up to five years. Bacterial contamination of heater-cooler devices has also been described without any associated infections. In many centres, it has been a challenging task to eliminate NTM from the heater-cooler devices in order to reduce the risk to patients...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28817132/plasma-of-argon-cleaning-treatment-on-implant-abutments-in-periodontally-healthy-patients-six-years-postloading-results-of-a-randomized-controlled-trial
#8
Luigi Canullo, Marco Tallarico, Miguel Penarrocha, Giuseppe Corrente, Joseph Fiorellini, David Penarrocha
The aim of this randomized, match-paired, triple-blinded, controlled clinical trial was to assess the 6-year radiographic changes around customized platform-switched abutments placed according to the one abutment-one time concept, with and without plasma of argon cleaning treatment. A total of 20 periodontally healthy patients received one maxillary implant between the premolars. Immediately before stage 2 surgery and abutment connection, patients were randomly assigned to the control (cleaning protocol by steam) or test group (plasma of argon treatment)...
September 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/28801924/foramen-epiploicum-mesh-closure-femc-through-a-ventral-midline-laparotomy
#9
T van Bergen, A Rötting, P Wiemer, S Schauvliege, K Vanderperren, F Ugahary, A Martens
BACKGROUND: Preventive laparoscopic closure of the epiploic foramen (EF) has previously been described, but methods for EF closure during laparotomy for treatment of colic are lacking. OBJECTIVES: To describe the Foramen Epiploicum Mesh Closure (FEMC) technique through a ventral midline laparotomy in horses under general anaesthesia and its outcome. STUDY DESIGN: Terminal surgical experiment and in vivo study. METHODS: In a pilot study a standard ventral midline laparotomy was performed under general anaesthesia in 10 experimental horses and a three-dimensional expandable diabolo-shaped mesh construct was manually introduced through the EF into the omental vestibule...
August 12, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28795891/experience-using-closed-incision-negative-pressure-wound-therapy-in-sternotomy-patients
#10
B Philip, P McCluskey, J Hinchion
OBJECTIVE: Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28790295/-perioperative-management-team-in-esophageal-cancer-surgery
#11
Akihiko Okamura, Masayuki Watanabe
Esophagectomy for patients with esophageal cancer is one of the most invasive surgery. Despite advances in surgical techniques and perioperative management, both morbidity and mortality rates after esophagectomy still remains high. Recently, it was suggested that perioperative care bundle is effective for preventing postoperative complications after esophagectomy. Then, we introduced a perioperative multidisciplinary management team, which aimed at systematic perioperative care for patients undergoing esophagectomy...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28776131/pure-distraction-injury-of-t1-2-with-quad-fever
#12
Jun-Yeong Seo, Chae-Moon Lim, Young-Hoon Kim, Kee-Yong Ha
INTRODUCTION: We report a pure distraction injury of the upper thoracic spine and uncontrolled hyperthermia without an infectious cause. Quad fever appears in the first several weeks to months after a cervical or upper thoracic SCI and is characterized by an extreme elevation in body core temperature beyond 40 °C without an infectious cause. Discriminating between infectious and noninfectious causes is important, and a thorough clinical assessment is required. MATERIALS AND METHODS: A 52-year-old male visited the emergency room complaining of back pain with complete paralysis [American Spinal Injury Association (ASIA) A] of both lower extremities after a pedestrian-motor vehicle accident...
August 3, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28763180/-improving-operating-room-efficiency-an-observational-and-multidimensional-approach-in-the-san-camillo-forlanini-hospital-rome
#13
Lucia Mitello, Fabrizio D'Alba, Francesca Milito, Cinzia Monaco, Daniela Orazi, Daniela Battilana, Anna Rita Marucci, Angelo Longo, Roberto Latina
AIM: The management of operating rooms (ORs) is a complex process which requires an effective organizational scheme. In order to amore convinient allocation of resources a rigorous monitoring plan is needed to ensure operating rooms performances. All the necessary actions should be taken to improve the quality of the planning and scheduling procedure. METHODS: Between April-December, 2016 an organizational analysis has been carried out on the performances of the A...
April 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28762900/-the-problem-of-minimally-changed-coronary-arteries-at-elective-coronary-angiography
#14
A N Sumin, E V Korok, M A Sinkov, O A Nagirnyak, L S Barbarash
AIM: to study rates and possible causes of detecting "clean" coronary arteries at elective coronary angiography. MATERIAL AND METHODS: Medical records of 711 patients who had undergone elective coronary angiography (ECAG) between 01/04 and 31/05 2014 were retrospectively reviewed. Four groups were distinguished: group 1 - patients with normal coronary arteries (n=234), group 2 - patients with coronary artery stenoses (CAS) <60% (n=94), group 3 - patients with 60-69% CAS (n=22), group 4 - patients with CAS more or equal 70% (n=361)...
April 2017: Kardiologiia
https://www.readbyqxmd.com/read/28756683/factors-influencing-clinical-consistency-and-variability-in-voice-prosthesis-management
#15
Kelli L Hancock, Elizabeth C Ward, Robyn A Burnett, Peta K Graciet, Priscilla J Lenne, Julia C F MaClean, Felicity J Megee
PURPOSE: Anecdotally it is recognised that management of tracheoesophageal speech (TES) post-laryngectomy varies between speech language pathology (SLP) services and clinicians. This study reviewed patterns of practice for TES management to examine patterns of practice and explore factors influencing variability. METHOD: A national survey was completed by SLP's from clinical services which manage TES. This online survey examined demographic and caseload information, initial voice prosthesis (VP) placement and procedures, VP cleaning and care recommendations, humidification management, equipment and service provision, and service delivery options at each site...
July 31, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28736320/comparison-of-urinary-tract-infection-rates-associated-with-transurethral-catheterization-suprapubic-tube-and-clean-intermittent-catheterization-in-the-postoperative-setting-a-network-meta-analysis
#16
Christopher S Han, Sinae Kim, Kushan D Radadia, Philip T Zhao, Sammy E Elsamra, Ephrem O Olweny, Robert E Weiss
PURPOSE: We performed a network meta-analysis of available randomized, controlled trials to elucidate the risks of urinary tract infection associated with transurethral catheterization, suprapubic tubes and intermittent catheterization in the postoperative setting. MATERIALS AND METHODS: PubMed®, EMBASE® and Google Scholar™ searches were performed for eligible randomized, controlled trials from January 1980 to July 2015 that included patients who underwent transurethral catheterization, suprapubic tube placement or intermittent catheterization at the time of surgery and catheterization lasting up to postoperative day 30...
July 20, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28718012/implant-decontamination-with-phosphoric-acid-during-surgical-peri-implantitis-treatment-a-rct
#17
Diederik F M Hentenaar, Yvonne C M De Waal, Hans Strooker, Henny J A Meijer, Arie-Jan Van Winkelhoff, Gerry M Raghoebar
BACKGROUND: Peri-implantitis is known as an infectious disease that affects the peri-implant soft and hard tissue. Today, scientific literature provides very little evidence for an effective intervention protocol for treatment of peri-implantitis. The aim of the present randomized controlled trial is to evaluate the microbiological and clinical effectiveness of phosphoric acid as a decontaminating agent of the implant surface during surgical peri-implantitis treatment. METHODS: Peri-implantitis lesions were treated with resective surgical treatment aimed at peri-implant granulation tissue removal, bone recontouring, and pocket elimination...
December 2017: International Journal of Implant Dentistry
https://www.readbyqxmd.com/read/28716327/surgical-management-of-neurogenic-lower-urinary-tract-dysfunction
#18
REVIEW
Ronak A Gor, Sean P Elliott
Surgery for patients with neurogenic urinary tract dysfunction (nLUTD) is indicated when medical therapy fails, to correct conditions affecting patient safety, or when surgery can enhance the quality of life better than nonoperative management. Examples include failure of maximal medical therapy, inability to perform or aversion to clean intermittent catheterization, refractory incontinence, and complications from chronic, indwelling catheters. Adults with nLUTD have competing risk factors, including previous operations, obesity, poor nutritional status, complex living arrangements, impaired dexterity/paralysis, and impaired executive and cognitive function...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28716129/current-knowledge-on-feline-injection-site-sarcoma-treatment
#19
REVIEW
Katarzyna Zabielska-Koczywąs, Anna Wojtalewicz, Roman Lechowski
Feline injection-site sarcomas (FISS) are malignant skin tumours of mesenchymal origin, the treatment of which is a challenge for veterinary surgeons. The role of surgery, radiotherapy and chemotherapy in FISS treatment has been studied, and a correlation between "clean" surgical margins and disease-free survival has been shown. In addition, clean surgical margins are one of the most important factors for achieving a low recurrence rate. The most effective method of FISS treatment includes combining radical surgery with pre- or postoperative radiotherapy...
July 17, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28714784/the-management-of-paediatric-neurogenic-bladder-an-approach-in-a-resource-poor-setting
#20
Patrick Opoku Manu Maison, John Lazarus
BACKGROUND: If untreated, paediatric neurogenic bladder can cause renal failure and urinary incontinence. It is usually caused by neural tube defects such as myelomeningocele. Children with a neurogenic bladder should be monitored from birth and management should aim to preserve renal function and achieve social continence. This article outlines the management options appropriate for these children in resource-poor settings. ASSESSMENT: In most low- and middle-income countries, a general lack of awareness of the neurological effects on the urinary tract results in late presentation, usually with urological complications even when spina bifida is diagnosed early...
July 17, 2017: Paediatrics and International Child Health
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