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https://www.readbyqxmd.com/read/29676943/impact-of-preoperative-thrombocytopenia-on-the-outcome-after-coronary-artery-bypass-grafting
#1
Wail Nammas, Magnus Dalén, Stefano Rosato, Riccardo Gherli, Daniel Reichart, Giuseppe Gatti, Francesco Onorati, Giuseppe Faggian, Marisa De Feo, Ciro Bancone, Sidney Chocron, Sorosh Khodabandeh, Giuseppe Santarpino, Antonino S Rubino, Daniele Maselli, Saverio Nardella, Antonio Salsano, Tiziano Gherli, Francesco Nicolini, Marco Zanobini, Matteo Saccocci, Karl Bounader, Paola D'Errigo, Tuomas Kiviniemi, Eeva-Maija Kinnunen, Andrea Perrotti, Juhani Airaksinen, Giovanni Mariscalco, Vito G Ruggieri, Fausto Biancari
The impact of thrombocytopenia on postoperative bleeding and other major adverse events after cardiac surgery is unclear. This issue was investigated in a series of patients who underwent isolated coronary artery bypass grafting (CABG) from the prospective, multicenter E-CABG registry. Preoperative thrombocytopenia was defined as preoperative platelet count <150 × 109 /L and it was considered moderate-severe when preoperative platelet count was <100 × 109 /L. Multilevel mixed-effects regression analysis was performed to adjust the effect of thrombocytopenia on outcomes for baseline and operative covariates as well as for interinstitutional differences in patient-blood management...
April 20, 2018: Platelets
https://www.readbyqxmd.com/read/29675898/implementation-of-the-who-surgical-safety-checklist-at-a-teaching-hospital-in-india-and-evaluation-of-the-effects-on-perioperative-complications
#2
Raghavendra Shankar
BACKGROUND: The WHO Surgical Safety Checklist was developed to help operating teams reduce the occurrence of patient harm. The Checklist is a simple, practical tool that any surgical team in the world can use to ensure that the preoperative, intraoperative, and postoperative steps that have been shown to benefit patients are undertaken in a timely and efficient way. METHODS: This study was carried out at Rajarajeswari Medical College Hospital, Bangalore, India, to study the effects of the WHO Surgical Safety Checklist on mortality and morbidity in surgical patients, to identify the potential problems in the long-term implementation of the same, and to document the complications in patients undergoing a major surgery during the study period...
April 20, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29668717/using-the-normalization-process-theory-to-qualitatively-explore-sense-making-in-implementation-of-the-enhanced-recovery-after-surgery-programme-it-s-not-rocket-science
#3
Eileen Sutton, Georgia Herbert, Sorrel Burden, Stephen Lewis, Steve Thomas, Andy Ness, Charlotte Atkinson
INTRODUCTION: The Enhanced Recovery After Surgery programme (ERAS) is an approach to the perioperative care of patients encompassing multiple interventions and involving a wide range of different actors. It can thus be defined as a complex intervention. Despite the strength of the evidence-base in its support, the implementation of ERAS has been slow. This paper specifically explores the utility of Normalization Process Theory (NPT) as a methodological framework to aid exploration of ERAS implementation, with a focus on the core NPT construct coherence...
2018: PloS One
https://www.readbyqxmd.com/read/29666832/structure-and-function-analysis-in-circulating-tumor-cells-using-nanotechnology-to-study-nuclear-size-in-prostate-cancer
#4
REVIEW
Nu Yao, Yu-Jen Jan, Shirley Cheng, Jie-Fu Chen, Leland Wk Chung, Hsian-Rong Tseng, Edwin M Posadas
Professor Donald Coffey and his laboratory pioneered studies showing the relationships between nuclear shape and cellular function. In doing so, he and his students established the field of nuclear morphometry in prostate cancer. By using perioperative tissues via biopsies and surgical sampling, Dr. Coffey's team discovered that nuclear shape and other pathologic features correlated with clinical outcome measures. Cancer cells also exist outside of solid tumor masses as they can be shed from both primary and metastatic lesions into the circulatory system...
2018: American Journal of Clinical and Experimental Urology
https://www.readbyqxmd.com/read/29649614/missing-data-treatments-matter-an-analysis-of-multiple-imputation-for-anterior-cervical-discectomy-and-fusion-procedures
#5
Nathaniel T Ondeck, Michael C Fu, Laura A Skrip, Ryan P McLynn, Jonathan J Cui, Bryce A Basques, Todd J Albert, Jonathan N Grauer
BACKGROUND CONTEXT: The presence of missing data is a limitation of large datasets, including the National Surgical Quality Improvement Program (NSQIP). In addressing this issue, most studies utilize complete case analysis, which excludes cases with missing data, thus potentially introducing selection bias. Multiple imputation, a statistically rigorous approach that approximates missing data and preserves sample size, may be an improvement over complete case analysis. PURPOSE: To evaluate the impact of using multiple imputation in comparison to complete case analysis for assessing the associations between preoperative laboratory values and adverse outcomes following anterior cervical discectomy and fusion (ACDF) procedures...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29643968/gastric-wall-thickness-and-stapling-in-laparoscopic-sleeve-gastrectomy-a-literature-review
#6
REVIEW
Krzysztof Barski, Artur Binda, Emilia Kudlicka, Paweł Jaworski, Wiesław Tarnowski
Despite the growing experience of bariatric surgeons in performing laparoscopic sleeve gastrectomy, the number of complications involving staple line leaks remains constant. Hence a solution to avoid such complications is still sought. A defect of the staple line may be the consequence of an inappropriate choice of staple size in relation to gastric wall thickness. Due to the variable nature of gastric wall thickness, the choice of proper staple height is not obvious. In the few studies in which gastric wall thickness was measured, it was observed to decrease gradually from the antrum to the fundus...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29643629/intraoperative-neurophysiological-monitoring-team-s-communiqu%C3%A3-with-anesthesia-professionals
#7
Anurag Tewari, Lisa Francis, Ravi N Samy, Dean C Kurth, Joshua Castle, Tiffany Frye, Mohamed Mahmoud
Background and Aims: Intraoperative neurophysiological monitoring (IONM) is the standard of care during many spinal, vascular, and intracranial surgeries. High-quality perioperative care requires the communication and cooperation of several multidisciplinary teams. One of these multidisciplinary services is intraoperative neuromonitoring (IONM), while other teams represent anesthesia and surgery. Few studies have investigated the IONM team's objective communication with anesthesia providers...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29616499/incidence-of-complications-following-thermocautery-assisted-circumcisions
#8
Ahmet Ali Tuncer, Mutlu Deger
PURPOSE: This study aimed to examine the short- and long-term complications of thermocautery-assisted circumcisions. MATERIALS AND METHODS: A total of 1780 children who consecutively underwent thermocautery-assisted circumcisions from  May 2014 to May 2016 in Yuksekova State Hospital in Turkey were included in this study. Thesechildren were classified into perioperative, early postoperative, and long-term complication groups. In addition, the age groups were compared in terms of complications...
April 4, 2018: Urology Journal
https://www.readbyqxmd.com/read/29602551/relationship-between-perioperative-blood-transfusion-and-surgical-site-infections-in-pediatric-general-and-thoracic-surgical-patients
#9
Jason Fawley, Thomas H Chelius, Marjorie J Arca
BACKGROUND: Recently, perioperative transfusions were demonstrated to be associated with higher rate of surgical site infections (SSIs) in neonates. We sought to examine whether a similar relationship exists between perioperative blood transfusions and SSI among non-neonatal pediatric general surgical patients. METHODS: We conducted an IRB-approved retrospective study reviewing non-neonatal patients (age greater than 28days and less than 18years) who underwent a general or thoracic surgical procedure in 2012, 2013, 2014, in the American College of Surgeons National Safety and Quality Improvement Project-Pediatric (ACS-NSQIP-P) Participant User Files...
March 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29595892/pediatric-perioperative-nurses-and-the-ethics-of-organ-donation-after-cardiac-death
#10
Elizabeth A Austin, Pamela Lovett, Wendy C Moore, Ingrid Zuzarte
Pediatric perioperative nurses are experiencing increased opportunities to participate in donations after cardiac death. An increased public awareness regarding transplantation has inspired more people to donate than in previous years. The demand for transplantable organs has led to opportunities that have increased donor candidates including living donors and cardiac death donors. Cardiac death in children is often sudden and unexpected, and is an emotional time not only for the family members but also for the hospital staff members, including perioperative nurses...
April 2018: AORN Journal
https://www.readbyqxmd.com/read/29595528/effect-of-methylprednisolone-on-pain-management-in-total-knee-or-hip-arthroplasty-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
Guoming Liu, Min Gong, Youcui Wang, Zhou Xiang
BACKGROUND: Total joint arthroplasty has been reported to be a successful strategy for patients with advanced osteoarthritis, however, early postoperative pain has become an unresolved issue. Perioperative methylprednisolone administration in total joint arthroplasty is an important and controversial topic. This study was conducted to assess the efficacy and safety of methylprednisolone for pain management after total knee or hip arthroplasty. METHODS: PubMed, Embase and the Cochrane Library were searched for randomized controlled trials comparing methylprednisolone versus placebo for patients undergoing total knee or hip arthroplasty...
March 27, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29589795/ethical-considerations-with-regard-to-adolescent-consent-in-the-perioperative-setting-talking-points-for-anaesthetic-practitioners
#12
Daniel Morgan
The legal and ethical issues surrounding the care of children and young people in the perioperative setting are often vague and an anaesthetic practitioner could find themselves inadequately prepared for any issues that may arise. This paper details the case of an adolescent who withdrew her consent to surgery whilst in the anaesthetic room. It raises questions about Gillick Competency and whether the use of restraint is ever justified.
January 1, 2018: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29576105/perioperative-management-of-patients-with-congenital-or-acquired-disorders-of-the-qt-interval
#13
REVIEW
M O'Hare, Y Maldonado, J Munro, M J Ackerman, H Ramakrishna, D Sorajja
QT prolongation can be attributable to various causes that can be categorised as acquired or congenital. Arrhythmias related to QT prolongation can result in clinical presentations, such as syncope and sudden cardiac death. The perioperative period presents a number of issues that may affect a patient's risk of developing polymorphic ventricular tachycardia or torsades de pointes. Although most patients may have an unremarkable perioperative course, some may have complications; this review article aims to help clinicians avoid potential complications, and to help them address treatment for perioperative issues that may occur...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29571983/coronary-artery-abnormalities-current-clinical-issues
#14
Helena Sousa, Jorge Casanova
INTRODUCTION AND OBJECTIVE: Patients with anomalous coronary arteries arising from the opposite sinus of Valsalva (ACAOS), the left coronary artery (LCA) arising from the right sinus or the right coronary artery (RCA) from the left sinus with an interarterial course, may present from complete absence of symptoms to sudden cardiac death. Although there are guidelines on indications for surgery, controversy remains. METHODS: A retrospective review was performed of all adult patients diagnosed with ACAOS in our hospital between 2007 and 2016...
March 20, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29565953/unique-complications-of-percutaneous-endoscopic-lumbar-discectomy-and-percutaneous-endoscopic-interlaminar-discectomy
#15
Chuanli Zhou, Guoqing Zhang, Ripul R Panchal, Xianfeng Ren, Hongfei Xiang, Ma Xuexiao, Xiaoliang Chen, Gu Tongtong, Wang Hong, Alana D Dixson
BACKGROUND: Percutaneous endoscopic discectomy (PED) includes 2 main procedures: percutaneous endoscopic lumbar discectomy (PELD) and percutaneous endoscopic interlaminar discectomy (PEID), both of which are minimally invasive surgical procedures that effectively deal with lumbar degenerative disorders. Because of the challenging learning curve for the surgeon and the individual characteristics of each patient, preventing and avoiding complications is difficult. The most common complications, such as nucleus pulposus omission, nerve root injury, dural tear, visceral injury, nerve root induced hyperalgesia or burning-like nerve root pain, postoperative dysesthesia, posterior neck pain, and surgical site infection, are difficult to avoid; however, more focus on these issues perioperatively may be in order...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29564904/-perioperative-palliative-care-the-role-of-multidisciplinary-consult-team-in-perioperative-period-and-intensive-care-setting
#16
Kateřina Rusinová, Markéta Červenková, Zuzana Čepelíková, Ondřej Kopecký
Palliative care is an important constituent of widely accepted quality care standard in seriously ill patients. The needs of these patients in perioperative setting or in intensive care are considerable for attending teams. Principal issues discussed include excellent communication skills during decision making before a high-risk surgery, and risk-benefit weighting in order to respect patients values and preferences. This article, based on examples of interventions in both perioperative care and in intensive care units, aims to demonstrate a complex integrated palliative approach...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29564862/-anesthetic-care-of-patient-with-heroin-addiction-a-case-report
#17
Wen-Yi Lee, Shu-Yu Kuo
The use of illegal drugs in Taiwan is on the rise. Drug addicts often have complex physical, psychological, and social problems. In addition, they often avoid disclosing their illicit drug use by deceit, concealment, or under-reporting. Building and maintaining relationships of trust with drug-addict patients has become a critical issue in achieving better care quality. In this case report, we report on an anesthesia care process for a heroin addict who was admitted for open reduction and internal fixation surgery for the femur and patella fractures after a car accident...
April 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29548354/preoperative-anesthesia-evaluation
#18
Joseph D Tobias
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29542366/placement-issues-of-hemodialysis-catheters-with-pre-existing-central-lines-and-catheters
#19
Afsha Aurshina, Anil Hingorani, Ahmad Alsheekh, Pavel Kibrik, Natalie Marks, Enrico Ascher
OBJECTIVE: It has been a widely accepted practice that a previous placed pacemaker, automatic implantable cardioverter defibrillators, or central line can be a contraindication to placing a hemodialysis catheter in the ipsilateral jugular vein. Fear of dislodging pacing wires, tunneling close to the battery site or causing venous obstruction has been a concern for surgeons and interventionalists alike. We suggest that this phobia may be unfounded. METHODS: A retrospective review was conducted of patients in whom hemodialysis catheters were placed over a period of 10 years...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29537348/ethics-of-liver-transplantation-the-role-of-the-anesthesiologist
#20
James M West
Anesthesiologists have clearly established their place in the history of medical ethics. Our involvement goes back to 1966 when Henri Beecher published his landmark paper on research and informed consent. Participation in the ethics of transplantation is no less important than our previous work. Organ transplant has been life saving for many but also has given rise to many misunderstandings not just from the public but also among our own colleagues. These include methods of allocation and donation, the role that affluence may play in receiving an organ, the definition of death and donation after circulatory death...
March 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
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