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https://www.readbyqxmd.com/read/28817531/bias-confounding-and-interaction-lions-and-tigers-and-bears-oh-my
#1
Thomas R Vetter, Edward J Mascha
Epidemiologists seek to make a valid inference about the causal effect between an exposure and a disease in a specific population, using representative sample data from a specific population. Clinical researchers likewise seek to make a valid inference about the association between an intervention and outcome(s) in a specific population, based upon their randomly collected, representative sample data. Both do so by using the available data about the sample variable to make a valid estimate about its corresponding or underlying, but unknown population parameter...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28803771/perioperative-management-of-patients-with-end-stage-renal-disease
#2
REVIEW
Hirotsugu Kanda, Yuji Hirasaki, Takafumi Iida, Megumi Kanao-Kanda, Yuki Toyama, Takashi Chiba, Takayuki Kunisawa
End-stage renal disease (ESRD) is associated with significant alterations in cardiovascular function; homeostasis of body fluid, electrolytes, and acid-base equilibrium; bone metabolism, erythropoiesis; and blood coagulation. The prevalence of ESRD is increasing rapidly worldwide, as is the number of patients requiring surgery under general anesthesia. Patients with ESRD have significantly higher risks of perioperative morbidity and mortality due to multiple comorbidities. The perioperative management of patients with ESRD under general anesthesia therefore requires special considerations and a careful multidisciplinary approach...
April 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28795019/safe-and-ethical-living-kidney-donation-in-qatar-a-national-health-system-s-approach
#3
Muhammad Asim, Yousuf Al-Maslamani, Hassan Al-Malki
The increasing incidence of end-stage kidney disease in Qatar has led to growing demand for donor kidneys. The deceased donor kidney program has yet to achieve its full potential; hence, living kidney donation has been widely adopted as an appropriate alternative. The reliance on living kidney donors however, raises a number of social, ethical, and legal concerns surrounding informed consent, voluntarism, psychosocial evaluation, perioperative care, and long-term follow-up of living kidney donors. Many of these concerns become heightened in a multicultural, multilingual society within a Gulf country such as Qatar...
2017: Qatar Medical Journal
https://www.readbyqxmd.com/read/28794832/perioperative-management-and-monitoring-of-antiplatelet-agents-a-focused-review-on-aspirin-and-p2y12-inhibitors
#4
REVIEW
Michael A Mazzeffi, Khang Lee, Bradley Taylor, Kenichi A Tanaka
Platelets play pivotal roles in hemostasis as well as pathological arterial thrombosis. The combination of aspirin and a P2Y12 inhibitor has become the mainstay therapy in the ageing population with cardiovascular conditions, particularly during and after percutaneous coronary intervention. A number of novel P2Y12 inhibitors has become available in the recent years, and they markedly vary in pharmacokinetic and pharmacodynamic properties. Perioperative physicians today face a challenge of preventing hemorrhage due to platelet inhibitors, while minimizing thrombotic risks...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28790279/-perioperative-management-of-fontan-operation
#5
Koichi Sughimoto, Kagami Miyaji
Surgical results of Fontan operation has been improved over the decades due to the introduction of the staged operations and some modifications of Fontan route from the classical atrio-pulmonary connection to total cavo-pulmonary connection. However, issues remain because of the single ventricular physiology of Fontan circulation. This article explains about the preoperative checklist for Fontan operation and tips on the postoperative management including an early extubation, use of inhaled nitric oxide after extubation, anticoagulation therapy, and efficacy of angiotensin converting enzyme inhibitor, supported by the cutting-edge evidence...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28780224/does-multiple-sclerosis-affect-the-inpatient-perioperative-outcomes-after-total-hip-arthroplasty
#6
Jared M Newman, Qais Naziri, Morad Chughtai, Anton Khlopas, Thomas J Kryzak, Suparna M Navale, Carlos A Higuera, Michael A Mont
BACKGROUND: There is a paucity of studies evaluating the short-term perioperative outcomes of total hip arthroplasty (THA) in multiple sclerosis (MS) patients. Therefore, this study evaluated (1) patient factors; and (2) patient outcomes in MS THA patients compared to non-MS THA patients. METHODS: The Nationwide Inpatient Sample from 2002 to 2013 identified 5899 MS and 2,723,652 non-MS THA patients. Yearly trends, demographics, and comorbidities were compared, and then non-MS THA patients were matched (3:1) to MS THA patients by age, gender, race, comorbidity score, and surgery year...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28770553/perioperative-technical-complications-in-deep-brain-stimulation-surgeries
#7
Onur Alptekin, Ersoy Kocabicak, Felix S Gubler, Linda Ackermans, Pieter L Kubben, Yasin Temel
AIM: Deep brain stimulation (DBS) surgeries are multi-faceted and the various steps are interconnected. Since its first implementation, the method of DBS surgery has undergone changes. We have encountered several expected and also non-expected perioperative technical complications in the past seventeen years. Here, we describe the stereotactic frame, stereotactic localizer and planning station related complications and how we have managed them as much as possible. MATERIAL AND METHODS: This study is a retrospective qualitative analysis of the documented technical events encountered during DBS surgeries from 1999 onwards...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28763154/best-practices-in-peri-operative-management-of-patients-with-skeletal-dysplasias
#8
Klane K White, Viviana Bompadre, Michael J Goldberg, Michael B Bober, Tae-Joon Cho, Julie E Hoover-Fong, Melita Irving, William G Mackenzie, Shawn E Kamps, Cathleen Raggio, Gregory J Redding, Samantha S Spencer, Ravi Savarirayan, Mary C Theroux
Patients with skeletal dysplasia frequently require surgery. This patient population has an increased risk for peri-operative complications related to the anatomy of their upper airway, abnormalities of tracheal-bronchial morphology and function; deformity of their chest wall; abnormal mobility of their upper cervical spine; and associated issues with general health and body habitus. Utilizing evidence analysis and expert opinion, this study aims to describe best practices regarding the peri-operative management of patients with skeletal dysplasia...
August 1, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28757921/the-impact-of-magnesium-sulfate-as-adjuvant-to-intrathecal-bupivacaine-on-intra-operative-surgeon-satisfaction-and-postoperative-analgesia-during-laparoscopic-gynecological-surgery-randomized-clinical-study
#9
Khaled Salah Mohamed, Sayed Kaoud Abd-Elshafy, Ali Mahmoud El Saman
BACKGROUND: Surgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia. METHODS: Sixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study...
July 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28752003/approach-to-perioperative-hypothermia-by-anaesthesiology-and-reanimation-specialist-in-turkey-a-survey-investigation
#10
Meltem Aktay İnal, Sedef Gülçin Ural, Hamiyet Şenol Çakmak, Mahmut Arslan, Reyhan Polat
OBJECTIVE: The aim is to investigate the attitudes of anaesthesiologists working in Turkey on perioperative temperature monitoring. METHODS: The questionnaire comprised 25 questions. Data were obtained through the completion of the questionnaire by hand or via the web. RESULTS: Two hundred and four questionnaires were evaluated. Most physicians were working in government hospitals. We determined that 26% of physicians often use temperature monitoring and that physicians who works in university hospitals are significantly more common monitor the body temperature...
June 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28749248/update-in-perioperative-medicine-practice-changing-evidence-published-in-2016
#11
Dennis W Regan, Deanne Kashiwagi, Brian Dougan, Karna Sundsted, Karen Mauck
This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change...
July 28, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28738809/surgical-frailty-assessment-a-missed-opportunity
#12
Gilgamesh Eamer, Jennifer A Gibson, Chelsia Gillis, Amy T Hsu, Marian Krawczyk, Emily MacDonald, Reid Whitlock, Rachel G Khadaroo
BACKGROUND: Preoperative frailty predicts adverse postoperative outcomes. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical healthcare professionals' use of frailty assessment for perioperative care. METHODS: Healthcare professionals caring for patients enrolled at a Canadian teaching hospital were surveyed to assess their perceptions of frailty, as well as attitudes towards and practices for frail patients...
July 24, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28738797/tibiotalocalcaneal-ttc-arthrodesis-with-reverse-philos-plate-and-medial-cannulated-screws-with-lateral-approach
#13
Jian Fan, X Zhang, Y Luo, G W You, W K Ng, Y F Yang
BACKGROUND: Tibiotalocalcaneal arthrodesis is most common and effective surgical treatment for severe hindfoot pathology, but the fusion rate is often lower than the ordinary tibiotalar arthrodesis because of the more serious joint disease associated with obvious deformity and osteoporosis. Recent literature describe tibiotalocalcaneal arthrodesis with reverse PHILOS plate with good clinical outcome result, though some patients non-union, due to eccentric force of the plate may be hidden...
July 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28737843/non-steroidal-anti-inflammatory-drugs-nsaids-for-cancer-related-pain-in-children-and-adolescents
#14
REVIEW
Tess E Cooper, Lauren C Heathcote, Brian Anderson, Marie-Claude Grégoire, Gustaf Ljungman, Christopher Eccleston
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for persisting pain in children acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28735683/pain-management-in-penile-prosthetic-surgery-a-review-of-the-literature
#15
REVIEW
Lael Reinstatler, Kevin Shee, Martin S Gross
INTRODUCTION: The literature on perioperative pain control and management in inflatable penile prosthesis placement is not firmly established. Because inflatable penile prosthesis placement is an elective procedure, pain can be one of the many issues that influence patient decision making. Pain control also presents a unique challenge to providers in an era of widespread opiate abuse. AIM: To review published data on pain management before, during, and after penile prosthetic surgery...
July 20, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28730640/2016-updated-thai-rheumatism-association-recommendations-for-the-use-of-biologic-and-targeted-synthetic-disease-modifying-anti-rheumatic-drugs-in-patients-with-rheumatoid-arthritis
#16
Worawit Louthrenoo, Nuntana Kasitanon, Wanruchada Katchamart, Duangkamol Aiewruengsurat, Parawee Chevaisrakul, Praveena Chiowchanwisawakit, Pornchai Dechanuwong, Punchong Hanvivadhanakul, Ajanee Mahakkanukrauh, Siriporn Manavathongchai, Chayawee Muangchan, Pongthorn Narongroeknawin, Veerapong Phumethum, Boonjing Siripaitoon, Anawat Suesuwan, Siraphop Suwannaroj, Parichat Uea-Areewongsa, Sittichai Ukritchon, Paijit Asavatanabodee, Ajchara Koolvisoot, Ratanavadee Nanagara, Kitti Totemchokchyakarn, Kanokrut Nuntirooj, Tasanee Kitumnuaypong
AIM: In June 2015, the Thai Rheumatism Association (TRA) approved an update of its recommendation for the use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) and targeted synthetic (tsDMARD) in the treatment of rheumatoid arthritis (RA) to cover those currently available in Thailand (etanercept, infliximab, golimumab, rituximab, tocilizumab, abatacept and tofacitinib). METHOD: A search of the literature was performed between January 2000 and June 2015...
July 21, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28719459/coagulation-management-in-patients-undergoing-neurosurgical-procedures
#17
Chiara Robba, Rita Bertuetti, Frank Rasulo, Alessando Bertuccio, Basil Matta
PURPOSE OF REVIEW: Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures...
July 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28709169/the-challenge-of-liver-resection-in-benign-solid-liver-tumors-in-modern-times-in-which-cases-should-surgery%C3%A2-be-done
#18
Hans-Michael Hau, Anne Kloss, Georg Wiltberger, Nora Jahn, Felix Krenzien, Christian Benzing, Moritz Schmelzle, Daniel Seehofer, Georgi Atanasov, Michael Bartels
Background Due to improved diagnostical and therapeutical approaches, benign liver tumors represent a challenge in clinical management. We here report our experience with patients undergoing liver resection for benign liver tumors. Methods 188 One hundred eighty-eight consecutive patients, who underwent surgery for solid benign liver tumors from 1992 - 2014, were analyzed retrospectively. The focus was on diagnostic pathways, indications for surgery, and perioperative and postoperative quality of life (QoL)...
July 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28701185/case-report-perioperative-management-of-caesarean-section-for-a-parturient-with-mitochondrial-myopathy
#19
Qiang Zheng, Penghui Wei, Jinfeng Zhou, Haipeng Zhou, Fucheng Ji, Wenxi Tang, Jianjun Li
BACKGROUND: Mitochondrial myopathies represent a group of disorders caused by mitochondrial defects that disrupt energy production. Most patients have issues from infancy to early childhood. Pregnancy in women with mitochondrial myopathy is uncommon and the management for these parturients is full of challenges. CASE PRESENTATION: A 36-year-old woman with mitochondrial myopathy was scheduled for caesarean section under a combined spinal-epidural anaesthesia and multi-model analgesia...
July 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28699150/effect-of-insulin-infusion-line-on-glycaemic-variability-in-a-perioperative-high-dependency-unit-hdu-a-prospective-randomised-controlled-trial
#20
Stéphanie Genay, Bertrand Décaudin, Sabine Ethgen, Arnaud Alluin, Elodie Babol, Julien Labreuche, Hélène Behal, Marie-Christine Vantyghem, Pascal Odou, Gilles Lebuffe
BACKGROUND: Glucose control is an important issue in post-operative patients. The objective here was to compare two insulin infusion lines by syringe pumps to assess the impact of medical devices on glycaemic variability in surgical patients under intensive insulin therapy. This open, prospective, single-centre randomised study was conducted in a fifteen-bed perioperative high dependency unit (HDU) in a university hospital. In total, 172 eligible patients receiving insulin therapy agreed to participate in the study...
December 2017: Annals of Intensive Care
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