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https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#1
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28317227/trends-in-the-surgical-treatment-of-benign-prostatic-hyperplasia-in-a-tertiary-hospital
#2
Darren Ow, Nathan Papa, Marlon Perera, Peter Liodakis, Shomik Sengupta, Stephen Clarke, Damien M Bolton, Nathan Lawrentschuk
BACKGROUND: To assess current treatment trends and perioperative outcomes of transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) in a tertiary institution. METHODS: We prospectively collected a database of all patients undergoing TURP and PVP for benign prostatic hyperplasia (BPH) at a tertiary hospital between January 2011 and December 2013. Patient characteristics such as length of stay, readmission, anticoagulation status, American Society of Anesthesiologists (ASA) score and need for blood transfusion were recorded and analysed...
March 19, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28304415/vaginal-obliterative-procedures-for-pelvic-organ-prolapse-a-systematic-review
#3
REVIEW
Gunhilde M Buchsbaum, Toy Gee Lee
Importance: Pelvic organ prolapse is a common condition, the prevalence of which is likely to increase with the aging of our population. Also changing are parameters by which outcomes are assessed, shifting toward patient-centered care. Objective: To review vaginal obliterative procedures for surgical treatment of advanced pelvic organ prolapse historically and to discuss evidence on indications for colpocleisis, outcomes, and complications, as well as review pros and cons for concomitant vaginal hysterectomy and anti-incontinence procedures...
March 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28293332/systemic-therapy-for-early-stage-breast-cancer-what-the-plastic-surgeon-should-know
#4
Chad M Teven, Daniel B Schmid, Mark Sisco, James Ward, Michael A Howard
Objective: We review the types, indications, and common regimens of systemic forms of therapy offered in early-stage breast cancer. We further detail the mechanism of action, approved uses, major toxicities, and relevance to breast reconstruction of specific agents. Methods: A review of the literature on PubMed and Cochrane databases was undertaken to define the indications and common regimens of systemic therapy in early-stage breast cancer. In addition, literature describing relevant information regarding specific systemic agents was reviewed...
2017: Eplasty
https://www.readbyqxmd.com/read/28262568/a-bleeding-assessment-tool-correlates-with-intraoperative-blood-loss-in-children-and-adolescents-undergoing-major-spinal-surgery
#5
Jennifer M Anadio, Peter F Sturm, Johan M Forslund, Sunil Agarwal, Adam Lane, Cristina Tarango, Joseph S Palumbo
Screening laboratory studies for bleeding disorders are of little predictive value for operative bleeding risk in adults. Predicting perioperative bleeding in pediatric patients is particularly difficult as younger patients often have not had significant hemostatic challenges. This issue is distinctly important for high bleeding risk surgeries, such as major spinal procedures. The aim of this study was to determine if the score of a detailed bleeding questionnaire (BQ) correlated with surgical bleeding in pediatric patients undergoing major spinal surgery...
February 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28262449/impact-of-the-zika-virus-for-anesthesiologists-a-review-of-current-literature-and-practices
#6
REVIEW
Benjamin J Heller, Menachem M Weiner, Joshua A Heller
Zika virus disease is of growing concern to all clinicians. There is a growing concern with regards to the neurologic sequela of the virus, particularly for infants born to women infected while pregnant. The continued spread of this virus throughout North and South America requires all anesthesiologists to maintain vigilance on this issue. This article addresses some of the key issues that pertain to anesthesiologists with regards to the Zika virus including the risks of perioperative management of patients with Zika virus...
December 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28257986/totally-extraperitoneal-laparoscopic-inguinal-hernia-repair-using-a-self-expanding-nitinol-framed-hernia-repair-device-a-prospective-case-series
#7
Mathieu D'Hondt, Frederiek Nuytens, Emi Yoshihara, Els Adriaens, Franky Vansteenkiste, Hans Pottel
BACKGROUND: The use of a self-expanding nitinol framed prosthesis (ReboundHRD(®)) for totally extraperitoneal laparoscopic inguinal hernia repair (TEP-IHR) could solve issues of mesh shrinkage and associated pain. We prospectively evaluated the use of the ReboundHRD(®) mesh for TEP-IHR. MATERIALS AND METHODS: All patients who underwent a TEP-IHR using the ReboundHRD(®) Large mesh from April 2014 till May 2015, were included. No mesh fixation was performed. Follow-up assessments were performed at the day of surgery, 1, 2, and 7 days, 1, 3, 6, and 12 months...
February 28, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28241949/promoting-resilience-in-new-perioperative-nurses
#8
Teresa M Stephens, Pamela Smith, Caitlin Cherry
New nursing graduates experience many challenges when transitioning from the academic environment to the practice setting. For many, the period of transition from student to employee is less than optimal, with many still experiencing reality shock, cognitive dissonance, and theory-practice gaps. The Stephens Model of Nursing Student Resilience addresses the unique issues faced by new graduate nurses to assist them in developing healthy coping strategies and to promote resilience. This model forms the basis of the RN Personal Resilience Enhancement Plan, a supplemental onboarding program created to assist new nurses in confidently facing challenges encountered during orientation and successfully moving forward as nursing professionals...
March 2017: AORN Journal
https://www.readbyqxmd.com/read/28237537/neurocognitive-and-psychiatric-issues-post-cardiac-surgery
#9
REVIEW
Ben Indja, Michael Seco, Richard Seamark, Jason Kaplan, Paul G Bannon, Stuart M Grieve, Michael P Vallely
Neurocognitive and psychiatric complications are common following cardiac surgery and impact on patient quality of life, recovery from surgery, participation in rehabilitation and long-term mortality. Postoperative cognitive decline, depressive disorders, post-traumatic stress disorder and neurocognitive impairment related to silent brain infarcts have all been linked to the perioperative period of cardiac surgery, and potentially have serious consequences. The accurate assessment of these conditions, particularly in determining the aetiology, and impact on patients is difficult due to the poorly recognised nature of these complications as well as similarities in presentation with postoperative delirium...
February 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28236867/medication-errors-in-anesthesia-unacceptable-or-unavoidable
#10
Ira Dhawan, Anurag Tewari, Sankalp Sehgal, Ashish Chandra Sinha
Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28231380/perioperative-medications-for-preventing-temporarily-increased-intraocular-pressure-after-laser-trabeculoplasty
#11
REVIEW
Linda Zhang, Jennifer S Weizer, David C Musch
BACKGROUND: Glaucoma is the international leading cause of irreversible blindness. Intraocular pressure (IOP) is the only currently known modifiable risk factor; it can be reduced by medications, incisional surgery, or laser trabeculoplasty (LTP). LTP reduces IOP by 25% to 30% from baseline, but early acute IOP elevation after LTP is a common adverse effect. Most of these IOP elevations are transient, but temporarily elevated IOP may cause further optic nerve damage, worsening of glaucoma requiring additional therapy, and permanent vision loss...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28219595/comparison-of-post-liver-transplantation-outcomes-in-portopulmonary-hypertension-and-pulmonary-venous-hypertension-a-single-center-experience
#12
P Rajaram, A Parekh, M Fisher, J Kempker, R Subramanian
BACKGROUND: In potential liver transplant candidates, pulmonary vascular diseases, including portopulmonary hypertension (PoPH) and pulmonary venous hypertension (PVH), can be associated with high morbidity and mortality. Although there are clear guidelines regarding management and transplant listing criteria for patients with PoPH, the listing criteria for PVH are not well defined. OBJECTIVE: The aim of this study was to describe and compare the perioperative and postoperative morbidity and mortality associated with PoPH and PVH in patients undergoing liver transplantation...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28219273/noteworthy-literature-published-in-2016-for-thoracic-organ-transplantation-anesthesiologists
#13
Kathirvel Subramaniam, Soheyla Nazarnia
This article is first in the series to review the published literature on perioperative issues in patients undergoing thoracic solid organ transplantations. We present recent literature from 2016 on preoperative considerations, organ preservation, intraoperative anesthesia management, surgical techniques, postoperative complications, and the impact of perioperative management on short- and long-term outcomes that are pertinent to thoracic transplantation anesthesiologists.
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28214316/pre-and-perioperative-aspects-of-dermatosurgery
#14
Cornelia S L Müller, Wakiko Hubner, Sigrid Thieme-Ruffing, Claudia Pföhler, Thomas Vogt, Thomas Volk, Barbara C Gärtner, Patric Bialas
Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri- and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that - in larger surgical specialties - would be attended to by a host of various specialists working in concert...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28205299/perioperative-hypothermia-during-hip-fracture-surgery-an-observational-study
#15
Usha Gurunathan, Christopher Stonell, Paul Fulbrook
RATIONALE: Elderly patients are at high risk of accidental perioperative hypothermia. The primary objective of this study was to measure the changes in body temperature and the incidence of hypothermia in elderly patients undergoing hip fracture surgery. METHODS: We conducted a prospective observational study on all adult patients undergoing surgery for fractured neck of femur between December 2013 and July 2014. We monitored their temperatures in different perioperative areas at multiple time points and also noted the warming methods used...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28195824/sleep-surgery-in-the-elderly
#16
Christopher J Gouveia, John D Cramer, Stanley Yung-Chuan Liu, Robson Capasso
Objective Assess the frequency and nature of postoperative complications following sleep surgery. Examine these issues specifically in elderly patients to provide guidance for their perioperative care. Study Design Retrospective cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program. Methods We identified patients with obstructive sleep apnea undergoing sleep surgery procedures from 2006 to 2013 in the American College of Surgeons National Surgical Quality Improvement Program, a multi-institutional outcomes program designed to improve surgical quality...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28192644/perioperative-antibiotics-for-prevention-of-acute-endophthalmitis-after-cataract-surgery
#17
REVIEW
Emily W Gower, Kristina Lindsley, Samantha E Tulenko, Afshan A Nanji, Ilya Leyngold, Peter J McDonnell
BACKGROUND: Endophthalmitis is a severe inflammation of the anterior or posterior (or both) chambers of the eye that may be sterile or associated with infection. It is a potentially vision-threatening complication of cataract surgery. Prophylactic measures for endophthalmitis are targeted against various sources of infection. OBJECTIVES: To evaluate the effects of perioperative antibiotic prophylaxis for endophthalmitis following cataract surgery compared with no prophylaxis or other form of prophylaxis...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#18
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28181385/hemodynamic-profile-and-behavioral-characteristics-during-induction-of-anesthesia-in-pediatric-patients-with-attention-deficit-hyperactivity-disorder
#19
Richard S Cartabuke, Joseph D Tobias, Julie Rice, Dmitry Tumin
AIM: There is no consensus regarding the administration of stimulant drugs preoperatively, particularly in pediatric patients diagnosed with ADHD. The primary objective of the current study was to assess differences in blood pressure and heart rate before and after induction of anesthesia between patients on chronic amphetamine or methylphenidate therapy who receive their normal dose preoperatively compared to patients in whom the prescribed medication was withheld. Secondary objectives were to assess the anxiety level during the induction of anesthesia and the effect of premedication with midazolam...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28159560/are-bariatric-operations-performed-by-residents-safe-and-efficient
#20
Piotr Major, Michał Wysocki, Jadwiga Dworak, Michał Pędziwiatr, Piotr Małczak, Andrzej Budzyński
BACKGROUND: The growing need for surgeons who are educated and trained in bariatric surgery has raised many issues related to training in this field. OBJECTIVES: This study was performed to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) performed by doctors-in-training during their residency in general surgery. SETTING: Tertiary referral university teaching hospital, Poland...
November 23, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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