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https://www.readbyqxmd.com/read/27869630/a-prospective-evaluation-of-opioid-utilization-after-upper-extremity-surgical-procedures-identifying-consumption-patterns-and-determining-prescribing-guidelines
#1
REVIEW
Nayoung Kim, Jonas L Matzon, Jack Abboudi, Christopher Jones, William Kirkpatrick, Charles F Leinberry, Frederic E Liss, Kevin F Lutsky, Mark L Wang, Mitchell Maltenfort, Asif M Ilyas
BACKGROUND: Although adequate management of postoperative pain with oral analgesics is an important aspect of surgical procedures, inadvertent overprescribing can lead to excess availability of opioids in the community for potential diversion. The purpose of our study was to prospectively evaluate opioid consumption following outpatient upper-extremity surgical procedures to determine opioid utilization patterns and to develop prescribing guidelines. METHODS: All patients undergoing outpatient upper-extremity surgical procedures over a consecutive 6-month period had the following prospective data collected: patient demographic characteristics, surgical details, anesthesia type, and opioid prescription and consumption patterns...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27849672/beyond-infrastructure-understanding-why-patients-decline-surgery-in-the-developing-world-an-observational-study-in-cameroon
#2
Benjamin J Lerman, Marcella Alsan, Ngew J Chia, James A Brown, Sherry M Wren
OBJECTIVE: The aim of this study was to quantify and describe a population of patients in rural Cameroon who present with a surgically treatable illness but ultimately decline surgery, and to understand the patient decision-making process and identify key socioeconomic factors that result in barriers to care. BACKGROUND: An estimated 5 billion people lack access to safe, affordable surgical care and anesthesia when needed, and this unmet need resides disproportionally in low-income countries (LICs)...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27833245/buccal-mucosal-graft-urethroplasty-for-proximal-bulbar-urethral-stricture-a-revisit-of-the-surgical-technique-and-analysis-of-eleven-consecutive-cases
#3
Irekpita Eshiobo, Esezobor Ehizomen, F Omosofe, V Onuora
BACKGROUND: Urethral stricture disease is prevalent, and many surgical techniques have been developed to treat it. Currently, urethroplasty for bulbar strictures implies ventral or dorsal stricturotomy and a buccal mucosa graft (BMG) patch. OBJECTIVE: To describe the surgical approach of the ventral patch BMG urethroplasty for proximal bulbar urethral stricture and to analyze 11 consecutive cases for whom the technique was used. PATIENTS AND METHODS: The diagnosis of urethral stricture was confirmed with a combined retrograde urethrography and micturating cystourethrography...
September 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
https://www.readbyqxmd.com/read/27822394/giant-cell-fibroma-in-a-two-year-old-child
#4
Anna Carolina Volpi Mello-Moura, Ana Maria Antunes Santos, Gabriela Azevedo Vasconcelos Cunha Bonini, Cristina Giovannetti Del Conte Zardetto, Cacio Moura-Netto, Marcia Turolla Wanderley
The giant cell fibroma is a benign nonneoplastic fibrous tumor of the oral mucosa. It occurs in the first three decades of life in the mandibular gingiva, predominantly, showing predilection for females. This article reports a case of giant cell fibroma in a 2-year-old girl, which is an uncommon age for this lesion. The patient was brought for treatment at the Research and Clinical Center of Dental Trauma in Primary Teeth, where practice for the Discipline of Pediatric Dentistry (Faculty of Dentistry, University of São Paulo, Brazil) takes place...
2016: Case Reports in Dentistry
https://www.readbyqxmd.com/read/27768086/a-non-invasive-and-technically-non-intensive-method-for-induction-and-phenotyping-of-experimental-bacterial-pneumonia-in-mice
#5
Jennifer H Madenspacher, Michael B Fessler
Although community-acquired pneumonia remains a major public health problem, murine models of bacterial pneumonia have recently facilitated significant preclinical advances in our understanding of the underlying cellular and molecular pathogenesis. In vivo mouse models capture the integrated physiology and resilience of the host defense response in a manner not revealed by alternative, simplified ex vivo approaches. Several methods have been described in the literature for intrapulmonary inoculation of bacteria in mice, including aerosolization, intranasal delivery, peroral endotracheal cannulation under 'blind' and visualized conditions, and transcutaneous endotracheal cannulation...
September 28, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27757002/therapeutic-interchange-of-clevidipine-for-sodium-nitroprusside-in-cardiac-surgery
#6
Joseph E Cruz, Zachariah Thomas, David Lee, David M Moskowitz, Jeff Nemeth
BACKGROUND: Generic price inflation has resulted in rising acquisition costs for sodium nitroprusside (SNP), an agent historically described as the drug of choice for the treatment of perioperative hypertension in cardiac surgery. PURPOSE: To describe the implementation and cost avoidance achieved by utilizing clevidipine as an alternative to SNP in cardiac surgery patients at a 520-bed community teaching hospital that performs more than 300 cardiac surgeries each year...
October 2016: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/27738950/patterns-of-intra-arterial-blood-pressure-monitoring-for-patients-undergoing-total-shoulder-arthroplasty-under-general-anesthesia-a-retrospective-analysis-of-23-073-patients
#7
Rodney A Gabriel, Anair Beverly, Richard P Dutton, Richard D Urman
Total shoulder arthroplasty (TSA) is typically performed in the beach-chair position. Maintenance of adequate mean arterial pressure is required to provide appropriate cerebral perfusion pressure and prevent cerebral ischemia. Placement of an arterial line to facilitate invasive monitoring is discretionary, based on clinical judgment. We aimed to describe patient, surgical and institutional factors associated with the current use of blood pressure monitoring via an arterial line for TSA. We used de-identified patient data from the National Anesthesia Clinical Outcomes Registry between 2010 and 2015 to identify patients undergoing TSA under general anesthesia...
October 13, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27650453/a-simple-tool-to-predict-development-of-delirium-after-elective-surgery
#8
Andy Dworkin, David S H Lee, Amber R An, Sarah J Goodlin
OBJECTIVES: To identify a quick clinical tool to assess the risk of delirium after elective surgery. DESIGN: Prospective observational study. SETTING: Preoperative assessment clinic at the Veterans Affairs Portland Health Care System. PARTICIPANTS: Community-living veterans aged 65 and older scheduled for elective surgery requiring general or major anesthesia. MEASUREMENTS: Confusion Assessment Method (CAM) or Family Confusion Assessment Method (FAM-CAM)...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27635768/dose-dependent-protective-effect-of-inhalational-anesthetics-against-postoperative-respiratory-complications-a-prospective-analysis-of-data-on-file-from-three-hospitals-in-new-england
#9
Stephanie D Grabitz, Hassan N Farhan, Katarina J Ruscic, Fanny P Timm, Christina H Shin, Tharusan Thevathasan, Anne K Staehr-Rye, Tobias Kurth, Matthias Eikermann
OBJECTIVES: Inhalational anesthetics are bronchodilators with immunomodulatory effects. We sought to determine the effect of inhalational anesthetic dose on risk of severe postoperative respiratory complications. DESIGN: Prospective analysis of data on file in surgical cases between January 2007 and December 2015. SETTING: Massachusetts General Hospital (tertiary referral center) and two affiliated community hospitals. PATIENTS: A total of 124,497 adult patients (105,267 in the study cohort and 19,230 in the validation cohort) undergoing noncardiac surgical procedures and requiring general anesthesia with endotracheal intubation...
September 15, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27579265/the-role-of-plastic-surgeons-in-advancing-development-global
#10
REVIEW
P Niclas Broer, Hillary E Jenny, Joshua S Ng-Kamstra, Sabrina Juran
In September 2015, the international community came together to agree on the 2030 Agenda for Sustainable Development, a plan of action for people, the planet, and prosperity. Ambitious and far-reaching as they are, they are built on three keystones: the elimination of extreme poverty, fighting climate change, and a commitment to fighting injustice and inequality. Critical to the achievement of the Agenda is the global realization of access to safe, affordable surgical and anesthesia care when needed. The landmark report by the Lancet Commission on Global Surgery estimated that between 28 and 32 percent of the global burden of disease is amenable to surgical treatment...
May 2016: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/27548666/treating-early-childhood-caries-under-general-anesthesia-a-national-review-of-canadian-data
#11
Robert J Schroth, Carlos Quiñonez, Luke Shwart, Brandon Wagar
INTRODUCTION: Many Canadian children are affected by early childhood caries (ECC) and require treatment under general anesthesia. The purpose of this study was to determine the burden of day surgery for children with ECC in Canada. METHODS: Day surgery abstracts for children 6 years of age with ECC were extracted from the Canadian Institute for Health Information Discharge Abstract Database and National Ambulatory Care Reporting System for 4 years, 2010/11 to 2013/14...
July 2016: Journal—Canadian Dental Association, Journal de L'Association Dentaire Canadienne
https://www.readbyqxmd.com/read/27543009/higher-body-mass-index-associated-with-severe-early-childhood-caries
#12
Katherine Davidson, Robert J Schroth, Jeremy A Levi, Aaron B Yaffe, Betty-Anne Mittermuller, Elizabeth A C Sellers
BACKGROUND: Severe Early Childhood Caries (S-ECC) is an aggressive form of tooth decay in preschool children affecting quality of life and nutritional status. The purpose was to determine whether there is an association between Body Mass Index (BMI) and S-ECC. METHODS: Children with S-ECC were recruited on the day of their slated dental surgery under general anesthesia. Age-matched, caries-free controls were recruited from the community. All children were participating in a larger study on nutrition and S-ECC...
2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27509370/unilateral-absence-of-vas-deferens-prevalence-among-23-013-men-seeking-vasectomy
#13
Sarah Miller, Sophie Couture, Gareth James, Simon Plourde, Jacky Rioux, Michel Labrecque
PURPOSE: To determine the prevalence of unilateral absence of vas deferens (UAVD) in men with both testes seeking vasectomy. MATERIALS AND METHODS: Computerized charts of 23.013 patients encountered between January 1994 and December 2013 in one university hospital and two community clinics of Quebec City, Canada, were searched. Pre-vasectomy consultation, operative reports and semen analysis results were reviewed to identify cases of UAVD. Cases were categorized as confirmed (unilateral vasectomy and success confirmed by semen analysis) or possible congenital UAVD further sub-categorized according to whether or not a scrotal anomaly was present...
August 10, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27497043/the-use-of-endo-vascular-balloon-tamponade-technique-for-the-removal-of-a-misplaced-nephrostomy-tube-in-the-inferior-vena-cava-a-case-report
#14
Yousof Al Zahrani, Sultan R AlHarbi, Daniele Wiseman
INTRODUCTION: Inadvertent placement of a nephrostomy tube into the inferior vena cava (IVC) is an extremely rare complication with few reported cases in the literature. CASE PRESENTATION: We present a lady with obstructive uropathy in a solitary kidney in whom an attempt by the community radiologist to place a nephrostomy tube was complicated by wrong insertion into the IVC. This report illustrates how a safe non- surgical removal of this tube using an intravenous balloon tamponade technique was successfully applied...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27443131/hospitalist-co-management-of-pediatric-orthopaedic-surgical-patients-at-a-community-hospital
#15
Karan Dua, William C McAvoy, Sybil A Klaus, David I Rappaport, Rebecca E Rosenberg, Joshua M Abzug
PURPOSE: The benefits of hospitalist co-management of pediatric surgical patients include bettering patient safety, decreasing negative patient outcomes, providing comprehensive medical care, and establishing a dedicated resource to patients for postoperative care. The purpose of this study was to characterize the nature of patients co-managed by a pediatric hospitalist. The authors hypothesize that hospitalist co-management is safe and efficacious in pediatric orthopaedic surgical patients who are admitted to a community hospital...
2016: Maryland Medicine: MM: a Publication of MEDCHI, the Maryland State Medical Society
https://www.readbyqxmd.com/read/27417174/the-history-of-acupuncture-anesthesia-for-pneumonectomy-in-shanghai-during-the-1960s
#16
Li-Gong Liu, Arthur Yin Fan, Hong Zhou, Jun Hu
The success of acupuncture anesthesia (AA) for pneumonectomy in Shanghai in 1960 was a key event for AA gaining practical clinical application. The effort was a close collaboration between the Shanghai First Tuberculosis Hospital and the Shanghai Institute of Acupuncture and Moxibustion. One of the most important factors of AA success was the great financial and political support provided by the Chinese central government and Shanghai local government. In December1965 the State Science and Technology Commission of China issued a formal document acknowledging AA as an important first-level national achievement of the integration of Chinese and Western medicine, and a collaborative effort of the whole scientific community in China...
July 2016: Journal of Integrative Medicine
https://www.readbyqxmd.com/read/27411333/a-novel-multivariate-steady-state-index-during-general-anesthesia-stan
#17
Ana Castro, Fernando Gomes de Almeida, Pedro Amorim, Catarina S Nunes
The assessment of the adequacy of general anesthesia for surgery, namely the nociception/anti-nociception balance, has received wide attention from the scientific community. Monitoring systems based on the frontal EEG/EMG, or autonomic state reactions (e.g. heart rate and blood pressure) have been developed aiming to objectively assess this balance. In this study a new multivariate indicator of patients' steady-state during anesthesia (STAN) is proposed, based on wavelet analysis of signals linked to noxious activation...
July 13, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27272759/robotic-assisted-laparoscopic-radical-nephrectomy-using-the-da-vinci-si-system-how-to-improve-surgeon-autonomy-our-step-by-step-technique
#18
Hugo H Davila, Raul E Storey, Marc C Rose
Herein, we describe several steps to improve surgeon autonomy during a Left Robotic-Assisted Laparoscopic Radical Nephrectomy (RALRN), using the Da Vinci Si system. Our kidney cancer program is based on 2 community hospitals. We use the Da Vinci Si system. Access is obtained with the following trocars: Two 8 mm robotic, one 8 mm robotic, bariatric length (arm 3), 15 mm for the assistant and 12 mm for the camera. We use curved monopolar scissors in robotic arm 1, Bipolar Maryland in arm 2, Prograsp Forceps in arm 3, and we alternate throughout the surgery with EndoWrist clip appliers and the vessel sealer...
September 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27236993/dental-hygienist-led-chronic-disease-management-system-to-control-early-childhood-caries
#19
Man Wai Ng, Zameera Fida
UNLABELLED: Management of the complex chronic disease of early childhood caries requires a system of coordinated health care interventions which can be led by a dental hygienist and where patient self-care efforts are paramount. BACKGROUND AND PURPOSE: Even after receiving costly surgical treatment under general anesthesia in the operating room, many children develop new and recurrent caries after only 6-12 months, a sequela that can be prevented. This article describes the chronic disease management (CDM) of dental caries, a science-based approach that can prevent and control caries...
June 2016: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/27230890/barriers-to-essential-surgical-care-experienced-by-women-in-the-two-northernmost-regions-of-ghana-a-cross-sectional-survey
#20
Adam Gyedu, Francis Abantanga, Godfred Boakye, Shailvi Gupta, Easmon Otupiri, Anita Eseenam Agbeko, Adam Kushner, Barclay Stewart
BACKGROUND: Women in developing countries might experience certain barriers to care more frequently than men. We aimed to describe barriers to essential surgical care that women face in five communities in Ghana. METHODS: Questions regarding potential barriers were asked during surgical outreaches to five communities in the northernmost regions of Ghana. Responses were scored in three dimensions from 0 to 18 (i.e., 'acceptability,' 'affordability,' and 'accessibility'; 18 implied no barriers)...
2016: BMC Women's Health
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