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https://www.readbyqxmd.com/read/29454125/management-of-skull-base-tumors-in-the-obstetric-population-a-case-series
#1
Blake H Priddy, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
BACKGROUND: Neoplasms rarely present during pregnancy. However, increase in plasma volume, hormone release induced growth, and tumor hypervascularity, can cause rapid symptoms. These range from not requiring intervention to necessitating emergent operations. OBJECTIVE: We describe an algorithm for the management of symptomatic neoplasm in the obstetric population, and provide recommendations regarding surgical indications and timing. METHODS: Patients who presented to a skull base clinic from 2010-2016 at large tertiary care hospital were reviewed to identify patients who presented with a skull base tumor during pregnancy...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29452805/perioperative-cardiopulmonary-exercise-testing-cpet-consensus-clinical-guidelines-on-indications-organization-conduct-and-physiological-interpretation
#2
D Z H Levett, S Jack, M Swart, J Carlisle, J Wilson, C Snowden, M Riley, G Danjoux, S A Ward, P Older, M P W Grocott
The use of perioperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative events and inform the perioperative management of patients undergoing surgery has increased over the last decade. CPET provides an objective assessment of exercise capacity preoperatively and identifies the causes of exercise limitation. This information may be used to assist clinicians and patients in decisions about the most appropriate surgical and non-surgical management during the perioperative period...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29450530/screening-for-ovarian-cancer-updated-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#3
Jillian T Henderson, Elizabeth M Webber, George F Sawaya
Importance: Ovarian cancer is relatively rare but the fifth-leading cause of cancer mortality among United States women. Objective: To systematically review evidence on benefits and harms of ovarian cancer screening among average-risk women to inform the United States Preventive Services Task Force. Data Sources: MEDLINE, PubMed, Cochrane Collaboration Registry of Controlled Trials; studies published in English from January 1, 2003, through January 31, 2017; ongoing surveillance in targeted publications through November 22, 2017...
February 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29449161/ultrasound-training-in-surgical-critical-care-fellowship-a-survey-of-program-directors
#4
Thomas W Carver
OBJECTIVE: Surgical critical care (SCC) fellows are expected to receive training in critical care ultrasound (CCUS) but training is sporadic and there is no standardized curriculum to guide educators. Previous studies show wide variation in CCUS training during fellowship across specialties but SCC has been underrepresented. This study was performed to assess SCC program directors' views regarding CCUS during fellowship training. DESIGN: Adult SCC program directors were surveyed regarding the role of CCUS in fellowship training...
February 12, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29449026/validity-of-a-single-ptsd-checklist-item-to-screen-for-insomnia-in-survivors-of-critical-illness
#5
Elizabeth C Parsons, Catherine L Hough, Michael V Vitiello, Brian Palen, Douglas Zatzick, Dimitry S Davydow
BACKGROUND: There is no insomnia screening tool validated in intensive care unit (ICU) survivors. OBJECTIVES: To examine the validity of a single item from the PTSD checklist-Civilian version (PCL-C) to detect insomnia by Insomnia Severity Index (ISI) METHODS: We performed a secondary analysis of data from a longitudinal investigation in 120 medical-surgical ICU survivors. At 1 year post-ICU, patients completed ISI, PCL-C, and Medical Short-Form 12 (SF-12) by telephone...
February 12, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29446038/preoperative-evaluation-of-the-elderly-surgical-patient-and-anesthesia-challenges-in-the-xxi-century
#6
Gabriella Bettelli
Universally recognized goals of preoperative anesthesia assessment are the evaluation of patient's health status to define the entity of the surgical risk, and the anticipation of possible complications while optimizing and planning preventive strategies. Data obtained by Comprehensive Geriatric Assessment (CGA) and frailty evaluation are of extreme usefulness in surgical risk evaluation in older patients and in the decision about surgery. It is from the team-based discussion of such results that the most appropriate treatment can be individuated, surgery invasiveness and duration critically analyzed and if needed modified, and the best perioperative strategy carefully tailored...
February 14, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29445884/acute-kidney-injury-epidemiology-risk-factors-and-outcomes-in-critically-ill-patients-16-25-years-of-age-treated-in-an-adult-intensive-care-unit
#7
Dana Y Fuhrman, Sandra Kane-Gill, Stuart L Goldstein, Priyanka Priyanka, John A Kellum
BACKGROUND: Most studies of acute kidney injury (AKI) have focused on older adults, and little is known about AKI in young adults (16-25 years) that are cared for in an adult intensive care unit (ICU). We analyzed data from a large single-center ICU database and defined AKI using the Kidney Disease Improving Global Outcomes criteria. We stratified patients 16-55 years of age into four age groups for comparison and used multivariable logistic regression to identify associations of potential susceptibilities and exposures with AKI and mortality...
February 14, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29445882/procedure-rates-performed-by-emergency-medicine-residents-a-retrospective-review
#8
Joshua T Bucher, Christopher Bryczkowski, Grant Wei, Renee L Riggs, Anoop Kotwal, Brian Sumner, Jonathan V McCoy
BACKGROUND: The purpose of our study is to investigate rates of individual procedures performed by residents in our emergency medicine (EM) residency program. Different programs expose residents to different training environments. Our hypothesis is that ultrasound examinations are the most commonly performed procedure in our residency. METHODS: The study took place in an academic level I trauma center with multiple residency and fellowship programs including surgery, surgical critical care, trauma, medicine, pulmonary/critical care, anesthesiology and others...
February 14, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29440801/a-retrospective-study-of-end-of-life-care-decisions-in-the-critically-ill-in-a-surgical-intensive-care-unit
#9
Yi Lin Lee, Yee Yian Ong, Sze Ying Thong, Shin Yi Ng
Aim: Progress in medical care and technology has led to patients with more advanced illnesses being admitted to the Intensive Care Unit (ICU). The practice of approaching end-of-life (EOL) care decisions and limiting care is well documented in Western literature but unknown in Singapore. We performed a retrospective cohort study to describe the practice of EOL care in patients dying in a Singapore surgical ICU (SICU). The surgical critical care population was chosen as it is unique because surgeons are frequently involved in the EOL process...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29435839/surgical-perspectives-in-head-and-neck-cancer
#10
Allen S Ho, Ellie Maghami
Head and neck cancer treatment is a complex multidisciplinary undertaking. Cancer cure and survival is a primary goal, yet safe-guarding appearance and function to preserve the quality of life are similarly critical. The head and neck surgeon remains central to multidisciplinary cancer care, with deep knowledge of operative technique and an even deeper understanding of cancer biology. The surgeon models practice based on the highest levels of scientific evidence, but also takes into consideration the approaches that may best suit an individual patient...
2018: Cancer Treatment and Research
https://www.readbyqxmd.com/read/29433853/identifying-the-low-risk-patient-in-surgical-intensive-and-intermediate-care-units-using-continuous-monitoring
#11
Holly N Blackburn, Matthew T Clark, J Randall Moorman, Douglas E Lake, J Forrest Calland
BACKGROUND: Continuous predictive monitoring has been employed successfully to predict subclinical adverse events. Should low values on these models, however, reassure us that a patient will not have an adverse outcome? Negative predictive values of such models could help predict safe patient discharge. The goal of this study was to validate the negative predictive value of an ensemble model for critical illness (using previously developed models for respiratory instability, hemorrhage, and sepsis) based on bedside monitoring data in the intensive care units and intermediate care unit...
February 9, 2018: Surgery
https://www.readbyqxmd.com/read/29431046/intermediate-care-units-a-survey-of-organization-practices-across-the-united-states
#12
Blair Wendlandt, Thomas Bice, Shannon Carson, Lydia Chang
PURPOSE: Intermediate care units (IMCUs) represent an alternative care setting with nurse staffing levels between those of the general ward and the intensive care unit (ICU). Despite rising prevalence, little is known about IMCU practices across US hospitals. The purpose of this study is to characterize utilization patterns and assess for variation. MATERIALS AND METHODS: A 14-item survey was distributed to a random nationwide sample of pulmonary and critical care physicians between January and April 2017...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29423967/suvorexant-is-associated-with-a-low-incidence-of-delirium-in-critically-ill-patients-a-retrospective-cohort-study
#13
Tomoyuki Masuyama, Masamitsu Sanui, Naoto Yoshida, Yusuke Iizuka, Kunio Ogi, Satoko Yagihashi, Kanae Nagatomo, Yusuke Sasabuchi, Alan K Lefor
BACKGROUND: Benzodiazepine use is a risk factor for the development of delirium in adult intensive care unit (ICU) patients. Suvorexant is an alternative to benzodiazepines to induce sleep, but the incidence of delirium in critically ill patients is unknown. We undertook this retrospective study to investigate the incidence of delirium in patients who receive suvorexant in the ICU. METHODS: This retrospective cohort study was conducted in a closed 12-bed ICU at a tertiary teaching hospital...
February 8, 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/29422726/audit-of-postoperative-surgical-intensive-care-unit-admissions
#14
Shaili K Patel, Samir M Kacheriwala, Dipesh D Duttaroy
Objective: The objective of this study was to conduct an audit of Surgical Intensive Care Unit (SICU) for identifying the admission risk factors and evaluating the outcomes of postoperative surgical patients. Design: This was a prospective, observational study. Setting: This study was conducted at SICU of a 1500-bedded tertiary care university hospital in Western India. Subject and Methods: Two hundred and forty patients admitted to the SICU postoperatively over a period of 15 months...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29422404/new-challenges-for-a-core-procedure-development-of-a-faculty-workshop-for-skills-maintenance-for-abdominal-hysterectomy
#15
Lori R Berkowitz, Kaitlyn James, Emil Petrusa, Carey York-Best, Anjali J Kaimal
OBJECTIVE: To describe the development of a low-cost educational module for OB/GYN faculty skills maintenance for total abdominal hysterectomy (TAH), a low frequency core procedure in obstetrics and gynecology. DESIGN: After review of existing educational tools and utilization of a modified Delphi method to establish consensus regarding key procedural components for skills maintenance, a 2-hour workshop was developed to review knowledge and participate in a simulation focused on the critical steps in performing TAH...
February 5, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29415634/too-long-to-wait-obstetric-fistula-and-the-sociopolitical-dynamics-of-the-fourth-delay-in-soroti-uganda
#16
Bonnie Ruder, Melissa Cheyney, Alice Aturo Emasu
Uganda has one of the highest obstetric fistula rates in the world with approximately 200,000 women currently suffering. Surgical closure successfully treats fistula in the majority of cases, yet there is a severe shortage of facilities and trained surgeons in low-resource countries. The purpose of this study was to examine Ugandan women's experiences of obstetric fistula with the aim of adding narrative depth to the clinical literature on this devastating birth injury. Data were collected through semistructured interviews, focus groups, and participant observation...
February 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29413719/role-of-ulinastatin-a-trypsin-inhibitor-in-severe-acute-pancreatitis-in-critical-care-setting-a-retrospective-analysis
#17
Jui Yeshavant Lagoo, Moses Charles D'Souza, Anandajith Kartha, Appanervanda Muthanna Kutappa
PURPOSE: To evaluate the clinical utility of Ulinastatin, a multifunctional serine protease inhibitor, in the management of severe acute pancreatitis. MATERIALS AND METHODS: We conducted a retrospective analysis of the archived data of adult patients diagnosed with acute pancreatitis and admitted to surgical intensive care unit with one or more end organ dysfunction. The patients were divided into two groups depending on whether they did or did not receive ulinastatin...
January 25, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29409044/intensive-care-unit-wastewater-interventions-to-prevent-transmission-of-multi-species-klebsiella-pneumoniae-carbapenemase-kpc-producing-organisms
#18
Amy J Mathers, Kasi Vegesana, Ian German Mesner, Katie E Barry, Aaron Pannone, Josh Baumann, Derrick W Crook, Nicole Stoesser, Shireen Kotay, Joanne Carroll, Costi D Sifri
Background: Increasing prevalence of nosocomial carbapenemase-producing Enterobacteriaceae is a concern; however, the role of the environment in multispecies outbreaks remains poorly understood. There is increasing recognition that hospital wastewater plumbing may play a role. Methods: Covers were installed on all hoppers in adult intensive care units (ICUs) of a university hospital; in the surgical ICU (SICU) both hopper covers and sink trap heating/vibration devices were installed...
February 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29406374/cerebral-oxygen-metabolism-before-and-after-rbc-transfusion-in-infants-following-major-surgical-procedures
#19
Felix Neunhoeffer, Michael Hofbeck, Martin Ulrich Schuhmann, Jörg Fuchs, Christian Schlensak, Martin Esslinger, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Matthias Kumpf, Jörg Michel
OBJECTIVE: Although infants following major surgery frequently require RBC transfusions, there is still controversy concerning the best definition for requirement of transfusion in the individual patient. The aim of this study was to determine the impact of RBC transfusion on cerebral oxygen metabolism in noncardiac and cardiac postsurgical infants. DESIGN: Prospective observational cohort study. SETTING: Pediatric critical care unit of a tertiary referral center...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29405803/prehospital-rapid-sequence-intubation-by-intensive-care-flight-paramedics
#20
Ashleigh Delorenzo, Toby St Clair, Emily Andrew, Stephen Bernard, Karen Smith
OBJECTIVE: Rapid sequence intubation (RSI) is an advanced airway procedure for critically ill or injured patients. Paramedic-performed RSI in the prehospital setting remains controversial, as unsuccessful or poorly conducted RSI is known to result in significant complications. In Victoria, intensive care flight paramedics (ICFPs) have a broad scope of practice including RSI in both the adult and pediatric population. We sought to describe the success rates and characteristics of patients undergoing RSI by ICFPs in Victoria, Australia...
February 6, 2018: Prehospital Emergency Care
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