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the association of perioperative practice

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https://www.readbyqxmd.com/read/29349482/-esophageal-diverticula-excluding-cricopharyngeal-diverticula
#1
C A Gutschow, H Schmidt
Diverticula of the middle and lower third of the esophagus are commonly associated with esophageal motility disorders. The increase of intraluminal pressure leads to an outpouching of the mucosal and submucosal layers through the esophageal muscle coat. These pouches are also called false diverticula, because they only consist of the mucosal and submucosal esophageal layers. In contrast, the more rarely encountered true diverticula that retain the complete esophageal wall are generally associated with periesophageal granulomatous lymph node disease...
January 18, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29343024/-hypopituitarism-mode-in-patients-with-craniopharyngioma-in-relation-to-tumor-growth-pattern
#2
S T Qi, J X Peng, J Pan, J Fan, S C Zhang, Y Liu, Y Bao, B H Qiu, X Y Wu
Objective: To investigate the pituitary hormone changes of patients with craniopharyngioma of different growth patterns during perioperative period and follow up time. Methods: Retrospective studies were performed on 212 cases of primary craniopharyngioma patient who received total tumor excision surgery in our hospital from January 2001 to May 2012. The characteristics of pituitary hormone and associated clinical manifestation during preoperative, perioperative and postoperative periods were analyzed according to the QST surgical classification...
January 2, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29334432/antibiotic-use-patterns-in-endoscopic-sinus-surgery-a-survey-of-the-american-rhinologic-society-membership
#3
Christina H Fang, Judd H Fastenberg, Marvin P Fried, Elina Jerschow, Nadeem A Akbar, Waleed M Abuzeid
BACKGROUND: There is a paucity of data supporting antibiotic use in endoscopic sinus surgery (ESS). The objective of this study is to determine perioperative antibiotic use patterns and factors which influence use in ESS. METHODS: An online-based survey was distributed to members of the American Rhinologic Society (ARS). Outcomes included timing of perioperative antibiotic use, practice environment, years of experience, and patient factors that influenced antibiotic use...
January 15, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29327184/efficacy-of-forced-air-warming-to-prevent-perioperative-hypothermia-in-morbidly-obese-versus-non-obese-patients
#4
Raphael Okoué, Daniela Calabrese, Pascal Nzé, Simon Msika, Hawa Keita
BACKGROUND: Hypothermia is associated with an increased postoperative morbidity and mortality. Forced-air warming systems are the most effective methods for its prevention. When using a mattress, a reduction in the area of diffusion of warm air by crushing due to excess weight cannot be ruled out. METHODS: We designed a prospective study to compare the efficacy of a forced-air warming mattress (Bair Hugger® 585) to prevent hypothermia (core temperature (CT°) < 36 °C) in morbidly obese (group MO, body mass index (BMI) ≥ 40 kg/m2) and non-obese patients (group NO, BMI < 30 kg/m2)...
January 11, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29322987/complications-related-to-sitting-position-during-pediatric-neurosurgery-an-institutional-experience-and-review-of-literature
#5
Priyanka Gupta, Girija P Rath, Hemanshu Prabhakar, Parmod K Bithal
BACKGROUND: Sitting position is preferred during posterior fossa surgeries as it provides better anatomical orientation and a clear surgical field. However, its use has been declining due to its propensity to cause life-threatening complications. This study was carried out to analyze the perioperative complications and postoperative course of children who underwent neurosurgery in sitting position. MATERIALS AND METHODS: Medical records of 97 children (<18 years) who underwent neurosurgery in sitting position over a period of 12 years, were retrospectively analyzed...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29321066/perioperative-management-of-antiplatelet-therapy-in-patients-undergoing-non-cardiac-surgery-following-coronary-stent-placement-a-systematic-review
#6
Christopher P Childers, Melinda Maggard-Gibbons, Jesus G Ulloa, Ian T MacQueen, Isomi M Miake-Lye, Roberta Shanman, Selene Mak, Jessica M Beroes, Paul G Shekelle
BACKGROUND: The correct perioperative management of antiplatelet therapy (APT) in patients undergoing non-cardiac surgery (NCS) is often debated by clinicians. American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend postponing elective NCS at least 3 months after stent implantation. Regardless of the timing of surgery, ACC/AHA guidelines recommend continuing at least ASA throughout the perioperative period and ideally continuing dual APT (DAPT) therapy "unless surgery demands discontinuation...
January 10, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29319482/perioperative-chemotherapy-for-bladder-cancer-a-qualitative-study-of-physician-knowledge-attitudes-and-behaviour
#7
Melanie Walker, R Christopher Doiron, Simon D French, Deb Feldman-Stewart, D Robert Siemens, William J Mackillop, Christopher M Booth
INTRODUCTION: Use of chemotherapy for muscle-invasive bladder cancer (MIBC) is known to be low. To understand factors driving practice we use the Theoretical Domains Framework (TDF) to identify barriers and enablers of chemotherapy use. METHODS: A convenience sample of Canadian urologists, medical oncologists (MOs) and radiation oncologists (ROs) participated in individual, semi-structured, one-hour telephone interviews. An interview guide was developed using the TDF to assess potential barriers and enablers of chemotherapy use...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29317806/profile-of-sugammadex-for-reversal-of-neuromuscular-blockade-in-the-elderly-current-perspectives
#8
REVIEW
Michele Carron, Francesco Bertoncello, Giovanna Ieppariello
The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29304787/factors-associated-with-prolonged-length-of-stay-for-elective-hepatobiliary-and-neurosurgery-patients-a-retrospective-medical-record-review
#9
Siu Yin Lee, Soo-Hoon Lee, Jenny H H Tan, Howard S L Foo, Phillip H Phan, Alfred W C Kow, Sein Lwin, Penelope M Y Seah, Siti Zubaidah Mordiffi
BACKGROUND: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29303803/postoperative-eras-interventions-have-the-greatest-impact-on-optimal-recovery-experience-with-implementation-of-eras-across-multiple-hospitals
#10
Mary-Anne Aarts, Ori D Rotstein, Emily A Pearsall, J Charles Victor, Allan Okrainec, Marg McKenzie, Stuart A McCluskey, Lesley Gotlib Conn, Robin S McLeod
BACKGROUND: Enhanced recovery after surgery (ERAS) programs incorporate evidence-based practices to minimize perioperative stress, gut dysfunction, and promote early recovery. However, it is unknown which components have the greatest impact. OBJECTIVE: This study aims to determine which components of ERAS programs have the largest impact on recovery for patients undergoing colorectal surgery. METHODS: An iERAS program was implemented in 15 academic hospitals...
January 4, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29282510/changes-in-clinical-practice-reduce-the-rate-of-anastomotic-leakage-after-colorectal-resections
#11
Henrik Iversen, Madelene Ahlberg, Marja Lindqvist, Christian Buchli
BACKGROUND: Anastomotic leakage is a serious clinical problem after colorectal resections and is associated with a significantly increased length of stay, morbidity and mortality. The aim of the present study was to evaluate the effect of changes in clinical practice on anastomotic leakage rate after colorectal resections. METHODS: Retrospective cohort study based on prospectively collected data. All 894 patients with primary anastomosis after colorectal resection at a tertiary referral center between 2006 and 2013 were analyzed...
December 28, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29274837/dedicated-operating-room-teams-and-clinical-outcomes-in-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#12
Michael C Grant, Andrew Hanna, Andrew Benson, Deborah Hobson, Christopher L Wu, Christina T Yuan, Michael Rosen, Elizabeth C Wick
INTRODUCTION: To determine if the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery After Surgery (ERAS). ERAS programs involve the application of bundled best-practices to improve value of the perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. METHODS: Development of dedicated teams of anesthesia providers was a component of the ERAS implementation...
December 21, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29258391/trends-and-patterns-of-corticosteroid-use-during-coronary-artery-bypass-grafting-surgery-in-the-united-states
#13
Macarius M Donneyong, Alexander Kulik, Joshua J Gagne
BACKGROUND: Several clinical trials have documented clinical benefits associated with prophylactic corticosteroid administration at the time of coronary artery bypass graft (CABG) surgery, including a reduction in the risk of atrial fibrillation and hospital length of stay. Despite the published data, the extent to which providers have adopted the perioperative use of corticosteroids remains unknown. OBJECTIVES: To assess temporal trends, between-hospital variation, and determinants of perioperative intravenous corticosteroid use during CABG surgery...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29246276/nutrition-management-for-head-and-neck-cancer-patients-improves-clinical-outcome-and-survival
#14
REVIEW
Urs Müller-Richter, C Betz, S Hartmann, R C Brands
Up to 80% of patients with head and neck cancers are malnourished because of their lifestyle and the risk factors associated with this disease. Unfortunately, nutrition management systems are not implemented in most head and neck cancer clinics. Even worse, many head and neck surgeons as well as hospital management authorities disregard the importance of nutrition management in head and neck cancer patients. In addition, the often extensive resection and reconstruction required for tumors in the upper aerodigestive tract pose special challenges for swallowing and sufficient food intake, placing special demands on nutrition management...
December 2017: Nutrition Research
https://www.readbyqxmd.com/read/29228960/cross-sectional-survey-on-the-use-and-impact-of-the-danish-national-antibiotic-use-guidelines-for-companion-animal-practice
#15
Lisbeth Rem Jessen, Tina Møller Sørensen, Zenia Littau Lilja, Maja Kristensen, Tine Hald, Peter Damborg
BACKGROUND: The Danish antibiotic use guidelines for companion animal practice were published by the Danish Veterinary Association in 2012. Since then, national surveillance data indicate a 10% reduction in the total use of antibiotics for companion animals, particularly a marked reduction in the use of third generation cephalosporins. The aim of the study was to assess if and how the guidelines have impacted diagnostic and antibiotic prescription habits of the users, and to identify user perceived barriers to implementation...
December 11, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/29223421/a-prospective-multi-institutional-cohort-study-of-mediastinal-infections-after-cardiac-operations
#16
Louis P Perrault, Katherine A Kirkwood, Helena L Chang, John C Mullen, Brian C Gulack, Michael Argenziano, Annetine C Gelijns, Ravi K Ghanta, Bryan A Whitson, Deborah L Williams, Nancy M Sledz-Joyce, Brian Lima, Giampaolo Greco, Nishit Fumakia, Eric A Rose, John D Puskas, Eugene H Blackstone, Richard D Weisel, Michael E Bowdish
BACKGROUND: Mediastinal infections are a potentially devastating complication of cardiac operations. This study analyzed the frequency, risk factors, and perioperative outcomes of mediastinal infections after cardiac operations. METHODS: In 2010, 5,158 patients enrolled in a prospective study evaluating infections after cardiac operations and their effect on readmissions and mortality for up to 65 days after the procedure. Clinical and demographic characteristics, operative variables, management practices, and outcomes were compared for patients with and without mediastinal infections, defined as deep sternal wound infection, myocarditis, pericarditis, or mediastinitis...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29206698/surgery-and-discontinuation-of-angiotensin-converting-enzyme-inhibitors-current-perspectives
#17
Nikola Bradic, Zdenko Povsic-Cevra
PURPOSE OF REVIEW: The current article reviews the current evidence for continuing or discontinuing angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) during the perioperative period. RECENT FINDINGS: In patients undergoing treatment of hypertension with ACEIs or ARBs, there are both benefits associated with continuing these medications during the perioperative period and higher risk for perioperative hypotension and its complications...
December 4, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29201359/rationale-for-and-approach-to-preoperative-opioid-weaning-a-preoperative-optimization-protocol
#18
REVIEW
Heath McAnally
The practice of chronic opioid prescription for chronic non-cancer pain has come under considerable scrutiny within the past several years as mounting evidence reveals a generally unfavorable risk to benefit ratio and the nation reels from the grim mortality statistics associated with the opioid epidemic. Patients struggling with chronic pain tend to use opioids and also seek out operative intervention for their complaints, which combination may be leading to increased postoperative "acute-on-chronic" pain and fueling worsened chronic pain and opioid dependence...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29200065/cardiac-arrest-in-the-operating-room-part-2-special-situations-in-the-perioperative-period
#19
Matthew D McEvoy, Karl-Christian Thies, Sharon Einav, Kurt Ruetzler, Vivek K Moitra, Mark E Nunnally, Arna Banerjee, Guy Weinberg, Andrea Gabrielli, Gerald A Maccioli, Gregory Dobson, Michael F O'Connor
As noted in part 1 of this series, periprocedural cardiac arrest (PPCA) can differ greatly in etiology and treatment from what is described by the American Heart Association advanced cardiac life support algorithms, which were largely developed for use in out-of-hospital cardiac arrest and in-hospital cardiac arrest outside of the perioperative space. Specifically, there are several life-threatening causes of PPCA of which the management should be within the skill set of all anesthesiologists. However, previous research has demonstrated that continued review and training in the management of these scenarios is greatly needed and is also associated with improved delivery of care and outcomes during PPCA...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29200062/is-compliance-with-surgical-care-improvement-project-cardiac-scip-card-2-measures-for-perioperative-%C3%AE-blockers-associated-with-reduced-incidence-of-mortality-and-cardiovascular-related-critical-quality-indicators-after-noncardiac-surgery
#20
Miklos D Kertai, Mary Cooter, Richard J Pollard, William Buhrman, Solomon Aronson, Joseph P Mathew, Mark Stafford-Smith
BACKGROUND: While continuation of β-blockers (BBs) perioperatively has become a national quality improvement measure, the relationship between BB withdrawal and mortality and cardiovascular-related critical quality indicators has not been studied in a contemporary cohort of patients undergoing noncardiac surgery. METHODS: For this retrospective study, the quality assurance database of a large community-based anesthesiology group practice was used to identify 410,288 surgical cases, 18 years of age or older, who underwent elective or emergent noncardiac surgical procedures between January 1, 2009, and December 31, 2014...
November 30, 2017: Anesthesia and Analgesia
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