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the association of perioperative practice

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https://www.readbyqxmd.com/read/27922894/antimicrobial-prophylaxis-practice-patterns-in-breast-augmentation-a-national-survey-of-current-practice
#1
Karan Chopra, Arvind U Gowda, Colton H L McNichols, Emile N Brown, Sheri Slezak, Yvonne Rasko
BACKGROUND: Breast augmentation is one of the most commonly performed aesthetic surgery procedures worldwide. Bacterial contamination is of paramount concern due to its role in biofilm formation and capsular contracture. Plastic surgeons have adopted a variety of perioperative interventions in efforts to reduce implant contamination, however definitive evidence supporting these practices is lacking. OBJECTIVE: The goal of this study was to assess current practice patterns aimed at reducing implant-related infections in breast augmentation and comparing them to current evidence-based medicine recommendations...
December 5, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27913536/reversal-of-direct-oral-anticoagulants-a-practical-approach
#2
Andrew W Shih, Mark A Crowther
Direct oral anticoagulants (DOACs) have at least noninferior efficacy compared with other oral anticoagulants and have ancillary benefits, including overall better safety profiles, lack of the need for routine monitoring, rapid onset of action, and ease of administration. Reversal of these agents may be indicated in certain situations such as severe bleeding and for perioperative management. DOAC-associated bleeding should be risk stratified: patients with moderate or severe bleeding should have the DOAC discontinued and reversal strategies should be considered...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#3
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#4
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27902502/zika-virus-and-patient-blood-management
#5
Lawrence T Goodnough, Marisa B Marques
Sporadic Zika virus infections had only occurred in Africa and Asia until an outbreak in Micronesia (Oceania) in 2007. In 2013 to 2014, several outer Pacific Islands reported local outbreaks. Soon thereafter, the virus was likely introduced in Brazil from competing athletes from French Polynesia and other countries that participated in a competition there. Transmission is thought to have occurred through mosquito bites and spread to the immunologically naive population. Being also a flavivirus, the Zika virus is transmitted by the Aedes mosquito that is endemic in South and Central America that is also the vector of West Nile virus, dengue, and chikungunya...
November 29, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27896656/pancreatitis-after-pancreatoduodenectomy-predicts-clinically-relevant-postoperative-pancreatic-fistula
#6
C M Kühlbrey, N Samiei, O Sick, F Makowiec, U T Hopt, U A Wittel
BACKGROUND: Morbidity after pancreas resection is still high with postoperative pancreatic fistulas (POPF) being the most frequent complication. However, exocrine insufficiency seems to protect from POPF. In clinical practice, patients showing increased postoperative systemic amylase concentrations appear to frequently develop POPF. We therefore retrospectively examined the occurrence of systemic amylase increase after pancreas resections and its association with the clinical course. PATIENTS AND METHODS: Perioperative data from 739 consecutive pancreas resections were assessed in a prospectively maintained SPSS database...
November 28, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27884218/the-current-state-of-perioperative-pain-management-challenges-and-potential-opportunities-for-nurses
#7
Melanie H Simpson, Patricia Bruckenthal
Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27879419/tympanoplasty-outcomes-for-blast-induced-perforations-from-iraq-and-afghanistan-2007-2012
#8
Sungjin A Song, Shankar K Sridhara, Philip D Littlefield
OBJECTIVE: To describe characteristics of blast-induced tympanic membrane perforations that do not spontaneously heal, evaluate the outcomes of tympanoplasty techniques, and understand the factors associated with surgical success. SETTING: Two tertiary military health care institutions. STUDY DESIGN: Case series with chart review. SUBJECTS AND METHODS: This study reviewed the practice of 1 military neurotologist and included all tympanoplasties for combat blast-induced perforations from 2007 to 2012, which comprised a total of 55 patients...
November 22, 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27869063/screening-patients-undergoing-total-hip-or-knee-arthroplasty-with-perioperative-urinalysis-and-the-effect-of-a-practice-change-on-antimicrobial-use
#9
Samuel Bailin, Nicolas Noiseux, Jean M Pottinger, Birgir Johannsson, Ambar Haleem, Sarah Johnson, Loreen A Herwaldt
OBJECTIVE To identify predictors of treatment for urinary tract infections (UTI) among patients undergoing total hip (THA) or knee (TKA) arthroplasties and to assess an intervention based on these predictors. DESIGN We conducted a retrospective cohort study of 200 consecutive patients undergoing THA/TKA between February 21, 2011, and June 30, 2011, to identify predictors of treatment for UTI and a prospective cohort study of 50 patients undergoing these procedures between May 21, 2012, and July 17, 2012, to assess the association of signs or symptoms and UTI treatment...
November 21, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27854111/the-risk-of-hypotension-and-seizures-in-patients-receiving-prophylactic-anti-epileptic-drugs-for-supratentorial-craniotomy
#10
Julius Höhne, Karl M Schebesch, Christian Ott, Alexander Brawanski, Max Lange
BACKGROUND: Perioperative seizure prophylaxis with antiepileptic drugs (AED) has been advocated in patients undergoing supratentorial craniotomy. The practice remains controversial. The reasoning presupposes that the possibility of an adverse drug reaction from the AED is lower than the probability of harm from a seizure. Even short periods of hypotension during the operation can lead to acute kidney and myocardial injury. We retrospectively evaluated cardiovascular effects and tolerability of Levetiracetam (LEV) alone, LEV and Lacosamid (LCM) as compared to Phenytoin (PHT)...
November 17, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27829093/postoperative-pulmonary-complications-early-mortality-and-hospital-stay-following-noncardiothoracic-surgery-a-multicenter-study-by-the-perioperative-research-network-investigators
#11
Ana Fernandez-Bustamante, Gyorgy Frendl, Juraj Sprung, Daryl J Kor, Bala Subramaniam, Ricardo Martinez Ruiz, Jae-Woo Lee, William G Henderson, Angela Moss, Nitin Mehdiratta, Megan M Colwell, Karsten Bartels, Kerstin Kolodzie, Jadelis Giquel, Marcos Francisco Vidal Melo
Importance: Postoperative pulmonary complications (PPCs), a leading cause of poor surgical outcomes, are heterogeneous in their pathophysiology, severity, and reporting accuracy. Objective: To prospectively study clinical and radiological PPCs and respiratory insufficiency therapies in a high-risk surgical population. Design, Setting, and Participants: We performed a multicenter prospective observational study in 7 US academic institutions...
November 9, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27828796/perioperative-anesthesia-care-and-tumor-progression
#12
Mir W Sekandarzad, André A J van Zundert, Philipp B Lirk, Chris W Doornebal, Markus W Hollmann
This narrative review discusses the most recent up-to-date findings focused on the currently available "best clinical practice" regarding perioperative anesthesia care bundle factors and their effect on tumor progression. The main objective is to critically appraise the current literature on local anesthetics, regional outcome studies, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) and their ability to decrease recurrence in patients undergoing cancer surgery. A brief discussion of additional topical perioperative factors relevant to the anesthesiologist including volatile and intravenous anesthetics, perioperative stress and anxiety, nutrition, and immune stimulation is included...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27818590/preoperative-therapy-in-locally-advanced-esophageal-cancer
#13
REVIEW
Pankaj Kumar Garg, Jyoti Sharma, Ashish Jakhetiya, Aakanksha Goel, Manish Kumar Gaur
Esophageal cancer is an aggressive malignancy associated with dismal treatment outcomes. Presence of two distinct histopathological types distinguishes it from other gastrointestinal tract malignancies. Surgery is the cornerstone of treatment in locally advanced esophageal cancer (T2 or greater or node positive); however, a high rate of disease recurrence (systemic and loco-regional) and poor survival justifies a continued search for optimal therapy. Various combinations of multimodality treatment (preoperative/perioperative, or postoperative; radiotherapy, chemotherapy, or chemoradiotherapy) are being explored to lower disease recurrence and improve survival...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27785761/using-physiological-monitoring-data-for-performance-feedback-an-initiative-using-thermoregulation-metrics
#14
Matthias Görges, Nicholas C West, Simon D Whyte
BACKGROUND: Feedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist's mind, thereby improving perioperative temperature management...
October 26, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27785357/perioperative-regional-anaesthesia-and-postoperative-longer-term-outcomes
#15
REVIEW
Jan Jakobsson, Mark Z Johnson
Regional anaesthesia provides effective anaesthesia and analgesia in the perioperative setting. Central neuraxial blocks-that is, spinal and epidural blocks-are well established as an alternative or adjunct to general anaesthesia. Peripheral blocks may be used as part of multimodal anaesthesia/analgesia in perioperative practice, reducing the need for opioid analgesics and enhancing early recovery. Furthermore, regional anaesthesia has increased in popularity and may be done with improved ease and safety with the introduction of ultrasound-guided techniques...
2016: F1000Research
https://www.readbyqxmd.com/read/27763895/low-versus-standard-urine-output-targets-in-patients-undergoing-major-abdominal-surgery-a-randomized-noninferiority-trial
#16
Jevon R Puckett, John W Pickering, Suetonia C Palmer, John L McCall, Michal T Kluger, Janak De Zoysa, Zoltan H Endre, Mattias Soop
OBJECTIVE: To determine whether a low perioperative minimum urine output target is safe and fluid sparing when compared with the standard target. BACKGROUND: A minimum hourly urine output of 0.5 mL/kg is a key target guiding perioperative fluid therapy. Few data support this standard practice, which may contribute to perioperative fluid overloading. METHODS: We randomized patients without significant risk factors for acute kidney injury undergoing elective colectomy to a minimum urine output target of 0...
October 19, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27762249/an-update-on-transesophageal-echocardiography-views-2016-2d-versus-3d-tee-views
#17
Poonam Malhotra Kapoor, Kanchi Muralidhar, Navin C Nanda, Yatin Mehta, Naman Shastry, Kalpana Irpachi, Aditya Baloria
In 1980, Transesophageal Echocardiography (TEE) first technology has introduced the standard of practice for most cardiac operating rooms to facilitate surgical decision making. Transoesophageal echocardiography as a diagnostic tool is now an integral part of intraoperative monitoring practice of cardiac anaesthesiology. Practice guidelines for perioperative transesophageal echocardiography are systematically developed recommendations that assist in the management of surgical patients, were developed by Indian Association of Cardiac Anaesthesiologists (IACTA)...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27739942/improved-outcomes-for-patients-with-cerebrovascular-malformations-at-high-volume-centers-the-impact-of-surgeon-and-hospital-volume-in-the-united-states-2000-2009
#18
Jason M Davies, Michael T Lawton
OBJECTIVE Treatment of cerebrovascular malformations has grown in complexity with the development of multimodal approaches, including microsurgery, endovascular treatments, and radiosurgery. In spite of this changing standard of care, the provision of care continues across a variety of settings. The authors sought to determine the risk of adverse outcome after treatment of patients with vascular malformations in the US. Patient, surgeon, and hospital characteristics, including volume, were tested as potential outcome predictors...
October 14, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27720420/perioperative-thromboprophylaxis-in-severely-obese-patients-undergoing-bariatric-surgery-insights-from-a-french-national-survey
#19
Pierre-Antoine Moulin, Anne Dutour, Patricia Ancel, Pierre-Emmanuel Morange, Thierry Bege, Olivier Ziegler, Stéphane Berdah, Corinne Frère, Bénédicte Gaborit
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of death in obese patients undergoing bariatric surgery (BS), but there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. OBJECTIVE: We aimed to evaluate patterns of BS perioperative thromboprophylaxis practices. SETTING: French obesity specialized care centers (CSO), which are tertiary care referral hospitals for the most severe cases of obesity METHODS: A detailed questionnaire survey (11 opened, 15 closed questions) investigating their prophylactic schemes of anticoagulation (molecule, dose, weight-adjustment, duration, associated measures, follow-up) was sent to the 37 CSO...
September 1, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27716695/variations-of-transesophageal-echocardiography-practices-in-india-a-survey-by-indian-college-of-cardiac-anaesthesia
#20
Deepak Prakash Borde, Antony George, Shreedhar Joshi, Suresh Nair, Thomas Koshy, Uday Gandhe, Murali Chakravarthy
CONTEXT: Use of perioperative transesophageal echocardiography (TEE) has expanded in India. Despite attempts to standardize the practice of TEE in cardiac surgical procedures, variation in practice and application exists. This is the first online survey by Indian College of Cardiac Anaesthesia, research and academic wing of the Indian Association of Cardiovascular Thoracic Anaesthesiologists (IACTA). AIMS: We hypothesized that variations in practice of intraoperative TEE exist among centers and this survey aimed at analyzing them...
October 2016: Annals of Cardiac Anaesthesia
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