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Tests before elective surgery

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https://www.readbyqxmd.com/read/28731000/appropriateness-based-reimbursement-of-elective-invasive-coronary-procedures-in-low-and-middle-income-countries-preliminary-assessment-of-feasibility-in-india
#1
Ganesan Karthikeyan, Umesh Shirodkar, Meeta Rajiv Lochan, Stephen Birch
BACKGROUND: Elective coronary interventional procedures are often overused and sometimes inappropriately used. The incentives for overuse are greater in low- and middle-income countries, where much of healthcare is provided by poorly regulated, fee-for-service systems. Overuse and inappropriate use increase healthcare costs and are potentially harmful to patients. Linking appropriate use of elective procedures to their reimbursement might deter overuse. METHODS: We explored the feasibility of introducing appropriateness criteria as a precondition to settling reimbursement claims in a publicly funded health insurance scheme in Maharashtra, India...
January 2017: National Medical Journal of India
https://www.readbyqxmd.com/read/28712704/impact-of-perioperative-voice-therapy-on-outcomes-in-the-surgical-management-of-vocal-fold-cysts
#2
Kathleen M Tibbetts, Laura M Dominguez, C Blake Simpson
INTRODUCTION: Vocal fold cysts are benign mid-membranous lesions of the true vocal fold, classified as mucus retention or epidermal inclusion cysts. Treatment is surgical excision with or without postoperative voice therapy. METHODS: A retrospective review was performed of the demographics, treatment approach, and outcomes of patients treated for vocal fold cysts between 2009 and 2014. Voice Handicap Index (VHI)-10 scores before and after treatment were compared using the Wilcoxon Rank-Sum test and the two-tailed Student's t test...
July 13, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28695674/foetal-pulmonary-maturity-in-dogs-estimated-from-bubble-tests-in-amniotic-fluid-obtained-via-amniocentesis
#3
T Bonte, A Del Carro, J Paquette, A Charlot Valdieu, S Buff, E Rosset
The goal of this study was to evaluate the reliability of amniocentesis during late pregnancy to assess lung maturity in puppies using a bubble test as described by Gunston and Davey (South African Medical Journal, 54, 1978, 495). Thirty-five bitches from eight different breeds were followed during late pregnancy before undergoing elective Caesarean (C)-section on days 61-62 after ovulation. Bubble tests were performed the day before the C-section (n = 11 bitches) and before the administration of aglepristone on amniotic fluid samples obtained via amniocentesis and were repeated the day of the surgery on amniotic fluid samples collected via puncture of the amniotic bags before they were opened (n = 35 bitches)...
July 10, 2017: Reproduction in Domestic Animals, Zuchthygiene
https://www.readbyqxmd.com/read/28671879/feasibility-of-protective-ventilation-during-elective-supratentorial-neurosurgery-a-randomized-crossover-clinical-trial
#4
Francesco Ruggieri, Luigi Beretta, Laura Corno, Valentina Testa, Enrico A Martino, Marco Gemma
BACKGROUND: Traditional ventilation approaches, providing high tidal volumes (Vt), produce excessive alveolar distention and lung injury. Protective ventilation, employing lower Vt and positive end-expiratory pressure (PEEP), is an attractive alternative also for neuroanesthesia, when prolonged mechanical ventilation is needed. Nevertheless, protective ventilation during intracranial surgery may exert dangerous effects on intracranial pressure (ICP). We tested the feasibility of a protective ventilation strategy in neurosurgery...
June 30, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28663639/anesthesiologist-s-role-in-relieving-patient-s-anxiety
#5
Brij Mohan, Rajan Kumar, Joginder Pal Attri, Veena Chatrath, Neeru Bala
INTRODUCTION: Anesthesia and surgery have proved to be highly anxiety provoking and with the rise of elective surgery, its aspect of patient's experience has become prominent in time. However, our fault as anesthesiologists is that we have not made people get versed with what we people as anesthesiologist do in the operating room. Hence, keeping in view all this, a study was carried out, in which video information/images regarding anesthesia and surgical procedure was shown to patients on PowerPoint Presentation...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663624/the-effect-of-preemptive-ankle-block-using-ropivacaine-and-dexamethasone-on-postoperative-analgesia-in-foot-surgery
#6
Ashraf Elsayed Alzeftawy, Nabil Aly Elsheikh
BACKGROUND: Peripheral nerve blocks have become an increasingly popular form of anesthesia. Preemptive analgesia reduces central sensitization, postoperative pain, and analgesic consumption. Different additive has been used to prolong regional blockade and improve postoperative analgesia. AIM: This study was conducted to evaluate whether preemptive ankle block using combination of ropivacaine and dexamethasone would succeed in improving the postoperative analgesia after foot surgery in patients receiving general anesthesia...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663608/comparison-of-usefulness-of-ketamine-and-magnesium-sulfate-nebulizations-for-attenuating-postoperative-sore-throat-hoarseness-of-voice-and-cough
#7
Sunil Rajan, George Jacob Malayil, Rekha Varghese, Lakshmi Kumar
CONTEXT: Postoperative sore throat (POST) is a complication that is unresolved in patients undergoing endotracheal intubation. AIM: To compare the effects of ketamine and magnesium sulfate nebulizations in two strengths, on the incidence and severity of POST, hoarseness, and cough. SETTINGS AND DESIGN: Sixty surgical patients undergoing elective abdominal and lower limb surgeries under combined epidural and general anesthesia were included in this prospective, randomized, double-blinded study...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28655949/peri-operative-blood-management
#8
REVIEW
Alex Eeles, Ravishankar Rao Baikady
Anaemia and allogeneic blood transfusions in surgical patients are associated with poor outcomes. Patient blood management (PBM) has been developed as an evidence-based clinical tool, by which clinicians can optimise anaemia, manage peri-operative bleeding, avoid unnecessary blood transfusion and improve patient outcome. This article aims to highlight the recent updates regarding evidence-based PBM in the perioperative period, following a thorough literature review involving original research articles, published guidelines and consensus documents discovered through an extensive PubMed and Medline search...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28648116/emboli-and-cognitive-state-in-surgical-vs-transcatheter-aortic-valve-replacement
#9
Tom Friedman, Oved Cohen, Avishai Ziser, Arthur Kerner, Keren Bitton-Worms, Gil Bolotin
Background Neurologic complications and neurocognitive impairment due to cerebral emboli are common following heart surgery. This study aimed to compare the number of emboli detected in the middle cerebral artery in open aortic valve replacement, apical and femoral transcatheter aortic valve replacement, and also to test for an association between the number of emboli captured in each procedure and changes in the patient's cognitive state. Methods Forty-four patients were enrolled in the study, 36 of whom were included in the final analyses: 14 underwent open aortic valve replacement, 2 had femoral transcatheter aortic valve replacement, and 10 had apical transcatheter aortic valve replacement...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28643079/similar-clinical-outcomes-with-preoperative-and-postoperative-start-of-thromboprophylaxis-in-tha-a-register-based-study
#10
Pål O Borgen, Are H Pripp, Eva Dybvik, Lilian Leistad, Ola E Dahl, Olav Reikerås
BACKGROUND: Elective THA is associated with a high risk of thromboembolic events. Although these events may be less common now than they were in the past, they can be serious, and most patients undergoing the procedure therefore still receive thromboprophylaxis. However, controversy remains regarding whether to begin thromboprophylaxis before THA or after to best balance the risks of clotting and bleeding. QUESTIONS/PURPOSES: We asked the following questions: (1) Is there a difference in bleeding events with pre- versus postoperative thromboprophylaxis? (2) Is there a difference in thromboembolic episodes after THA between the two regimens? (3) How do the two approaches of thromboprophylaxis influence mortality, readmissions, and other complications? METHODS: We used a population-based followup design with predefined data based on international health codification to assess clinical effects of LMWH prophylaxis initiated before or after THA...
June 22, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28638356/how-can-smoking-cessation-be-induced-before-surgery-a-systematic-review-and-meta-analysis-of-behavior-change-techniques-and-other-intervention-characteristics
#11
REVIEW
Andrew Prestwich, Sally Moore, Alwyn Kotze, Luke Budworth, Rebecca Lawton, Ian Kellar
Background: Smokers who continue to smoke up to the point of surgery are at increased risk of a range of complications during and following surgery. Objective: To identify whether behavioral and/or pharmacological interventions increase the likelihood that smokers quit prior to elective surgery and which intervention components are associated with larger effects. Design: Systematic review with meta-analysis. Data sources: MEDLINE, Embase, and Embase Classic, CINAHL, CENTRAL. Study selection: Studies testing the effect of smoking reduction interventions delivered at least 24 h before elective surgery were included...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28601642/comparison-of-citrated-and-fresh-whole-blood-for-viscoelastic-coagulation-testing-during-elective-neurosurgery
#12
E Silverberg, F Tornqvist, T Kander, J Bengzon, C Solomon, J Bonnevier, U Schött
BACKGROUND: Previous viscoelastic haemostatic tests studies have often indicated a hypercoagulative test signal with citrated blood, which could influence clinical decision makings. PURPOSE: The aim of this study was to compare fresh and citrated whole blood using two non-automated viscoelastic ROTEM and Sonoclot tests. Our hypothesis was that citrated blood would demonstrate a hypercoagulative response in this setting, not tested before. METHODS: Perioperative viscoelastic coagulation changes were evaluated with a ROTEM and Sonoclot in 38 patients undergoing elective brain tumor surgery...
June 3, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28575906/-preoperative-evaluation-of-adult-patients-before-elective-non-cardiothoracic-surgery
#13
(no author information available yet)
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e.g. blood chemistry, ECG, spirometry, chest x-ray) can contribute to a reduction of perioperative risk is often not very well known or controversial. Similarly, there is considerable uncertainty among anaesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28573343/-preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#14
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e. g. blood chemistry, ECG, spirometry, chest x‑ray) can contribute to a reduction of perioperative risk is often not very well known or is controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication...
June 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28564674/association-of-a-policy-mandating-physician-patient-communication-with-racial-ethnic-disparities-in-postmastectomy-breast-reconstruction
#15
Elham Mahmoudi, Yiwen Lu, Allan K Metz, Adeyiza O Momoh, Kevin C Chung
Importance: With the stabilization of breast cancer incidence and substantial improvement in survival, more attention has focused on postmastectomy breast reconstruction (PBR). Despite its demonstrated benefits, wide disparities in the use of PBR remain. Physician-patient communication has an important role in disparities in health care, especially for elective surgical procedures. Recognizing this, the State of New York enacted Public Health Law (NY PBH Law) 2803-o in 2011 mandating that physicians communicate about reconstructive surgery with patients undergoing mastectomy...
May 31, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28556611/defining-the-minimal-clinically-important-difference-for-olfactory-outcomes-in-the-surgical-treatment-of-chronic-rhinosinusitis
#16
Joshua M Levy, Jess C Mace, Todd E Bodner, Jeremiah A Alt, Timothy L Smith
BACKGROUND: Olfactory dysfunction is a common and defining symptom of chronic rhinosinusitis (CRS). Many measures of olfactory dysfunction in CRS are limited by scoring criteria defined within general populations with interpretations of statistical significance to infer clinically meaningful improvement. In this investigation we define a minimal clinically important difference (MCID) for the Brief Smell Identification Test (BSIT) in CRS patients electing endoscopic sinus surgery (ESS)...
May 26, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28533571/local-infiltration-of-tramadol-versus-bupivacaine-for-post-cesarean-section-pain-control-a-double-blind-randomized-study
#17
Mohammad Ali Sahmeddini, Simin Azemati, Ehsan Masoudi Motlagh
BACKGROUND: Postoperative pain control after cesarean section (C/S) is important because inadequate postoperative pain control can result in a prolonged hospital stay. In this study, we compared postoperative somatic wound pain control between patients receiving tramadol and bupivacaine, infiltrated at the wound site. METHODS: In this randomized clinical trial, 98 patients, eligible for elective C/S under general anesthesia, were randomly allocated to 2 groups. Before wound closure, 20 cc of 0...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28530777/clinicopathological-analysis-of-patients-operated-for-appendiceal-mucocele
#18
Hasan Abuoğlu, Mehmet Kamil Yıldız, Bülent Kaya, Mehmet Odabaşı
BACKGROUND: The term mucocele refers to the dilatation of the appendix due to mucus, and it is an uncommon disorder with an estimated incidence of 0.2%-0.3% of all appendectomies performed and 8%-10% of all appendiceal tumors. It is often asymptomatic, but may manifest appendicitis-like symptoms. METHODS: Twenty-six patients (14 females and 12 males) were operated on due to mucocele of the appendix. Sixteen patients exhibiting the characteristics of clinically acute appendicitis required an emergency operation...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28510737/total-haemoglobin-mass-but-not-haemoglobin-concentration-is-associated-with-preoperative-cardiopulmonary-exercise-testing-derived-oxygen-consumption-variables
#19
J M Otto, J O M Plumb, D Wakeham, E Clissold, L Loughney, W Schmidt, H E Montgomery, M P W Grocott, T Richards
Background: Cardiopulmonary exercise testing (CPET) measures peak exertional oxygen consumption ( V˙O2peak ) and that at the anaerobic threshold ( V˙O2 at AT, i.e. the point at which anaerobic metabolism contributes substantially to overall metabolism). Lower values are associated with excess postoperative morbidity and mortality. A reduced haemoglobin concentration ([Hb]) results from a reduction in total haemoglobin mass (tHb-mass) or an increase in plasma volume. Thus, tHb-mass might be a more useful measure of oxygen-carrying capacity and might correlate better with CPET-derived fitness measures in preoperative patients than does circulating [Hb]...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28492701/short-term-intensive-training-attenuates-the-exercise-induced-interaction-of-mono-1-2-cells-and-platelets-after-coronary-bypass-in-cardiac-patients
#20
Shu-Chun Huang, Mei-Kuen Wong, Pyng-Jing Lin, Feng-Chun Tsai, Jaw-Ji Chu, Meng-Yu Wu, Tieh-Cheng Fu, Jong-Shyan Wang
The interaction between platelets and monocytes plays a critical role in the pathogenesis and progression of cardiovascular diseases. This study investigated how short-term intensive training (SIT) influences monocyte subset characteristics and exercise-induced monocyte and platelet aggregates (MPAs) following elective coronary bypass (CABG) in cardiac patients. Forty-nine patients hospitalised for CABG were randomised into SIT (N=26) and conventional training (CT, N=23) groups. The SIT subjects underwent supervised aerobic training at 80~120 % of the ventilatory anaerobic threshold based on sub-maximal exercise tests performed 7 days post-CABG for 20 sessions with two sessions/day and 30 min/session, which were completed within four weeks after surgery...
May 11, 2017: Thrombosis and Haemostasis
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