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Safety protocols in surgery

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https://www.readbyqxmd.com/read/28350685/inadequate-enoxaparin-dosing-predicts-90-day-venous-thromboembolism-risk-among-plastic-surgery-inpatients-an-examination-of-enoxaparin-pharmacodynamics
#1
Christopher J Pannucci, W Bradford Rockwell, Maureen Ghanem, Kory I Fleming, Arash Momeni, Jayant Agarwal
BACKGROUND: Evidence-based plastic surgery guidelines support the effectiveness of once-daily enoxaparin prophylaxis. Despite prophylaxis, one in 25 highest risk patients has a venous thromboembolism event. The authors examined the pharmacodynamics of standard enoxaparin doses in plastic surgery patients to examine whether patient-level factors predict enoxaparin metabolism, whether inadequate enoxaparin dose predicts downstream venous thromboembolism events, and whether a pharmacist-driven dose-adjustment protocol was effective...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28336738/single-stage-osseointegrated-reconstruction-and-rehabilitation-of-lower-limb-amputees-the-osseointegration-group-of-australia-accelerated-protocol-2-ogaap-2-for-a-prospective-cohort-study
#2
Munjed Al Muderis, William Lu, Kevin Tetsworth, Belinda Bosley, Jiao Jiao Li
INTRODUCTION: Lower limb amputations have detrimental influences on the quality of life, function and body image of the affected patients. Following amputation, prolonged rehabilitation is required for patients to be fitted with traditional socket prostheses, and many patients experience symptomatic socket-residuum interface problems which lead to reduced prosthetic use and quality of life. Osseointegration has recently emerged as a novel approach for the reconstruction of amputated limbs, which overcomes many of the socket-related problems by directly attaching the prosthesis to the skeletal residuum...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28330522/passive-range-of-motion-exercise-to-enhance-growth-in-infants-following-the-norwood-procedure-a-safety-and-feasibility-trial
#3
Linda M Lambert, Felicia L Trachtenberg, Victoria L Pemberton, Janine Wood, Shelley Andreas, Robin Schlosser, Teresa Barnard, Kaitlyn Daniels, Ann T Harrington, Nicholas Dagincourt, Thomas A Miller
OBJECTIVE: The aim of this study was to evaluate the safety and feasibility of a passive range of motion exercise programme for infants with CHD. Study design This non-randomised pilot study enrolled 20 neonates following Stage I palliation for single-ventricle physiology. Trained physical therapists administered standardised 15-20-minute passive range of motion protocol, for up to 21 days or until hospital discharge. Safety assessments included vital signs measured before, during, and after the exercise as well as adverse events recorded through the pre-Stage II follow-up...
March 23, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28329584/reusing-surgical-instruments-during-mohs-micrographic-surgery-safe-from-infection-but-not-free-from-risk
#4
Tatyana A Petukhova, Thomas H King, Kenny J Omlin, Daniel B Eisen
We report several scenarios of compromise in patient safety owing to the re-use of mis-assigned patient's surgical instruments in Mohs micrographic surgery.We discuss the breaks in universal protocols that others may experience in their practices and describe corrective measures that our institutions employed to avoid such future events.There is a lack of publication in the literature on the topic of mis-assigned instrument use in Mohs surgery. We believe that the  practice of re-using instruments is cost-effective and therefore common...
October 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28327089/uniform-fdg-pet-guided-gradient-dose-prescription-to-reduce-late-radiation-toxicity-upgrade-rt-study-protocol-for-a-randomized-clinical-trial-with-dose-reduction-to-the-elective-neck-in-head-and-neck-squamous-cell-carcinoma
#5
Sven van den Bosch, Tim Dijkema, Martina C Kunze-Busch, Chris H J Terhaard, Cornelis P J Raaijmakers, Patricia A H Doornaert, Frank J P Hoebers, Marije R Vergeer, Bas Kreike, Oda B Wijers, Wim J G Oyen, Johannes H A M Kaanders
BACKGROUND: In definitive radiation therapy for head and neck cancer, clinically uninvolved cervical lymph nodes are irradiated with a so-called 'elective dose' in order to achieve control of clinically occult metastases. As a consequence of high-resolution diagnostic imaging, occult tumor volume has significantly decreased in the last decades. Since the elective dose is dependent on occult tumor volume, the currently used elective dose may be higher than necessary. Because bilateral irradiation of the neck contributes to dysphagia, xerostomia and hypothyroidism in a dose dependent way, dose de-escalation to these regions can open a window of opportunity to reduce toxicity and improve quality of life after treatment...
March 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28319532/evaluation-of-a-protocol-for-same-day-discharge-after-radial-lounge-monitoring-in-a-southern-swiss-referral-percutaneous-coronary-intervention-centre
#6
Luigi Biasco, Giovanni B Pedrazzini, Marco Araco, Francesco Petracca, Daniele Del Monte, Daniel Sürder, Fulvio Bomio, Martina Boscolo Berto, Giulia Montrasio, Alessandro Del Bufalo, Elena Pasotti, Tiziano Moccetti, Marco Moccetti
AIMS: The aim of the study was to retrospectively evaluate safety and patient satisfaction of same-day discharge after elective radial coronary angiography/percutaneous coronary intervention (PCI) after the implementation of a radial lounge facility. METHODS: All patients admitted to our radial lounge with a planned same-day discharge after an uncomplicated coronary angiography/PCI, having a co-living caregiver, were day enrolled in the study. Rates of same-day discharge, unplanned overnight stay, and in-hospital and first complications [death, myocardial infarction (MI), unplanned coronary angiography, access site hematoma, bleedings requiring hospitalization] were analysed; satisfaction was also evaluated through a questionnaire...
March 17, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28319448/rationale-and-design-of-a-phase-1-clinical-trial-to-evaluate-hsv-g207-alone-or-with-a-single-radiation-dose-in-children-with-progressive-or-recurrent-malignant-supratentorial-brain-tumors
#7
Alicia M Waters, James M Johnston, Alyssa T Reddy, John Fiveash, Avi Madan-Swain, Kara Kachurak, Asim K Bag, G Yancey Gillespie, James M Markert, Gregory K Friedman
Primary central nervous system tumors are the most common solid neoplasm of childhood and the leading cause of cancer-related death in pediatric patients. Survival rates for children with malignant supratentorial brain tumors are poor despite aggressive treatment with combinations of surgery, radiation, and chemotherapy, and survivors often suffer from damaging lifelong sequelae from current therapies. Novel innovative treatments are greatly needed. One promising new approach is the use of a genetically engineered, conditionally replicating herpes simplex virus (HSV) that has shown tumor-specific tropism and potential efficacy in the treatment of malignant brain tumors...
March 2017: Human Gene Therapy. Clinical Development
https://www.readbyqxmd.com/read/28316307/fast-track-pancreaticoduodenectomy-in-the-elderly
#8
Efstratios Zouros, Theodoros Liakakos, Anastasios Machairas, Paulos Patapis, Helen Tzerbinis, Dimitrios K Manatakis, Matthaios Papadimitriou-Olivgeris, Christos Dervenis
It remains uncertain whether enhanced recovery after surgery (ERAS) protocols can be safely implemented for elderly patients, especially after highly complex surgery such as pancreaticoduodenectomy (PD). The present study was designed to assess the feasibility and safety of an ERAS protocol in elderly patients undergoing PD. Starting January 2010 to February 2015, we prospectively collected data from 85 consecutive patients who underwent PD with a fast-track program. Data of patients older and younger than 70 years were compared...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28302178/laser-peripheral-iridotomy-versus-laser-peripheral-iridotomy-plus-laser-peripheral-iridoplasty-in-the-treatment-of-multi-mechanism-angle-closure-study-protocol-for-a-randomized-controlled-trial
#9
Shida Chen, Jianhua Lv, Sujie Fan, Hong Zhang, Lin Xie, Ling Xu, Bing Jiang, Huipin Yuan, Yuanbo Liang, Shuning Li, Pingyan Chen, Xiulan Zhang, Ningli Wang
BACKGROUND: China has the largest burden of primary angle-closure glaucoma (PACG) worldwide. The mechanism of the angle closure is complex and includes pupillary block and non-pupillary block. Currently, opinion is that laser peripheral iridotomy (LPI) alone is not sufficient to prevent disease progression. Laser peripheral iridoplasty (LPIP) is an alternative and effective way of widening the angle recess in eyes that are affected by primary angle closure (PAC). However, it is not known if greater benefit would be achieved using LPI plus LPIP for PAC with multiple mechanisms (MAC)...
March 17, 2017: Trials
https://www.readbyqxmd.com/read/28279391/the-effectiveness-of-thyme-honey-for-the-management-of-treatment-induced-xerostomia-in-head-and-neck-cancer-patients-a%C3%A2-feasibility-randomized-control-trial
#10
Andreas Charalambous, Ekaterini Lambrinou, Nicos Katodritis, Dimitrios Vomvas, Vasilios Raftopoulos, Morpho Georgiou, Lefkios Paikousis, Melanie Charalambous
PURPOSE: Radiation-induced xerostomia is one of the most common side effects that head and neck cancer patients experience during and after treatment. Despite the various methods for the prevention and treatment of radiation-induced xerostomia, it remains highly prevalent among patients treated for head and neck cancers negatively influencing their lives. The purpose of this study was to evaluate the effectiveness of thyme honey as a means for managing radiation-induced xerostomia. METHOD: This was a parallel randomised controlled trial with two equal arms, the experimental arm (thyme honey) and the control arm (saline)...
April 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/28277485/flexible-co2-laser-treatment-for-subglottic-stenosis
#11
Rasit Cevizci, Alper Dilci, Ilknur Haberal Can, Burak Kersin, Yildirim Bayazit
OBJECTIVES: To assess the efficacy and safety of flexible fiber CO2 laser surgery for subglottic stenosis and to present retrospective experience of 14 patients treated with flexible fiber CO2 laser system. To determine the characteristics, management protocols, prognostic factors, and postoperative outcomes of the sample. METHODS: Retrospective review of patients with subglottic stenosis undergoing flexible fiber CO2 laser surgery at the tertiary medical center...
March 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28266145/safety-and-efficacy-of-microwave-ablation-for-medically-inoperable-colorectal-pulmonary-metastases-single-centre-experience
#12
Craig D Ferguson, Chris R Luis, Karin Steinke
INTRODUCTION: To evaluate the safety and therapeutic efficacy of percutaneous microwave ablation (MWA) for colorectal pulmonary metastases. METHODS: Retrospective review of CT-guided lung MWA at a single tertiary institution. Adverse events within 30 days of MWA were considered procedure-related complications. Imaging follow-up was with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT and contrast-enhanced CT. Response of index tumours was assessed using modified response evaluation criteria in solid tumours (mRECIST)...
March 7, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28262914/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#13
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28257392/prehospital-hypertonic-fluid-resuscitation-for-trauma-patients-a-systematic-review-and-meta-analysis
#14
Claire de Crescenzo, Farzam Gorouhi, Edgardo S Salcedo, Joseph M Galante
BACKGROUND: Prehospital assessment of a patient's circulation status and appropriate resuscitation with intravenous fluids plays a critical role in patients with obvious hemorrhage or systolic blood pressure below 90 mmHg. OBJECTIVES: We assessed the efficacy and safety of prehospital administration of crystalloids, or colloids to improve the survival rate of trauma patients with acceptable safety profile. DATA SOURCES: We searched SCOPUS, Embase, TRIP database, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and PubMed as per search protocol from 1 January 1900 to 12 February 2015...
March 2, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28253733/rationale-and-design-of-a-phase-i-clinical-trial-to-evaluate-hsv-g207-alone-or-with-a-single-radiation-dose-in-children-with-progressive-or-recurrent-malignant-supratentorial-brain-tumors
#15
Alicia M Waters, James M Johnston, Alyssa T Reddy, John Fiveash, Avi Madan-Swain, Kara Kachurak, Asim K Bag, G Yancey Gillespie, James M Markert, Gregory K Friedman
Primary central nervous system tumors are the most common solid neoplasm of childhood and the leading cause of cancer related death in pediatric patients. Survival rates for children with malignant supratentorial brain tumors are poor despite aggressive treatment with combinations of surgery, radiation, and chemotherapy; and survivors often suffer from damaging lifelong sequelae from current therapies. Novel innovative treatments are greatly needed. One promising new approach is the use of a genetically engineered, conditionally replicating herpes simplex virus (HSV) that has shown tumor specific tropism and potential efficacy in the treatment of malignant brain tumors...
February 24, 2017: Human Gene Therapy. Clinical Development
https://www.readbyqxmd.com/read/28248410/low-permanent-pacemaker-rates-following-lotus-device-implantation-for-transcatheter-aortic-valve-replacement-due-to-modified-implantation-protocol
#16
Florian Krackhardt, Behrouz Kherad, Maximilian Krisper, Burkert Pieske, Michael Laule, Carsten Tschöpe
BACKGROUND: Conduction disturbances requiring permanent pacemaker implantation following transcatheter aortic valve replacement (TAVR) are a common problem. Pacemaker implantation rates after TAVR appear to be higher compared to conventional aortic valve replacement. The aim of this study was to analyze whether a high annulus implantation conveys the benefit of a decreased rate of permanent pacemaker implantation while being safe and successful according to VAR2-criteria. METHODS: A total of 23 patients with symptomatic severe aortic valve stenosis, an aortic annulus of 19-27mm and at high risk for surgery were treated with the Lotus valve...
March 1, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28245853/a-neuromuscular-exercise-programme-versus-standard-care-for-patients-with-traumatic-anterior-shoulder-instability-study-protocol-for-a-randomised-controlled-trial-the-sinex-study
#17
Henrik Eshoj, Sten Rasmussen, Lars Henrik Frich, Inge Hvass, Robin Christensen, Steen Lund Jensen, Jens Søndergaard, Karen Søgaard, Birgit Juul-Kristensen
BACKGROUND: Anterior shoulder dislocation is a common injury and may have considerable impact on shoulder-related quality of life (QoL). If not warranted for initial stabilising surgery, patients are mostly left with little to no post-traumatic rehabilitation. This may be due to lack of evidence-based exercise programmes. In similar, high-impact injuries (e.g. anterior cruciate ligament tears in the knee) neuromuscular exercise has shown large success in improving physical function and QoL...
February 28, 2017: Trials
https://www.readbyqxmd.com/read/28236348/fixed-time-interval-compared-with-on-demand-oral-analgesia-protocols-for-post-caesarean-pain-a-randomised-controlled-trial
#18
E Yefet, H Taha, R Salim, J Hasanein, Y Carmeli, N Schwartz, Z Nachum
OBJECTIVES: To compare the efficacy, safety and satisfaction from two modes of oral analgesia administration for the treatment of post-caesarean pain in the first 48 h following surgery: on-demand versus fixed time interval administration. DESIGN: Open label parallel-group, randomised-controlled trial from February to December 2013. SETTING: University-affiliated hospital in Israel. POPULATION: Two-hundred women who underwent caesarean delivery with regional anaesthesia...
February 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28229607/therapeutic-impact-of-colon-capsule-endoscopy-with-pillcam%C3%A2-colon-2-after-incomplete-standard-colonoscopy-a-spanish-multicenter-study
#19
Óscar Nogales, Javier García-Lledó, Marisol Luján, David Nicolás, José Francisco Juanmartiñena, Begoña González-Suárez, Francisco Sánchez Ceballos, Ignacio Couto, José Olmedo, Cristina Garfia, Cristina Carretero, Ignacio Fernández Urién, Sarbelio Rodríguez, Matilde Asteinza, Pilar Olivencia, Ángeles Masedo, Miguel Muñoz-Navas, Beatriz Merino, Cecilia González Asanza
INTRODUCTION: Colon capsule endoscopy (CCE) is an alternative approach for the examination of the colon in patients who refuse colonoscopy or after incomplete colonoscopy (IC). We conducted a study to determine the frequency of complete colonoscopy after IC, the diagnostic yield of CCE, the therapeutic impact of lesions found in CCE, the level of colon cleanliness and the safety of the procedure. METHODS: We performed a prospective, multicenter study involving ten Spanish hospitals...
February 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28222779/magnetic-resonance-imaging-for-cerebral-lesions-during-minimal-invasive-mitral-valve-surgery-study-protocol-for-a-randomized-controlled-trial
#20
Cristina Barbero, Davide Ricci, Erik Cura Stura, Augusto Pellegrini, Giovanni Marchetto, Suad ElQarra, Massimo Boffini, Roberto Passera, Maria Consuelo Valentini, Mauro Rinaldi
BACKGROUND: Recent data have highlighted a higher rate of neurological injuries in minimal invasive mitral valve surgery (MIMVS) compared with the standard sternotomy approach; therefore, the role of specific clamping techniques and perfusion strategies on the occurrence of this complication is a matter of discussion in the medical literature. The purpose of this trial is to prospectively evaluate major, minor and silent neurological events in patients undergoing right mini-thoracotomy mitral valve surgery using retrograde perfusion and an endoaortic clamp or a transthoracic clamp...
February 21, 2017: Trials
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