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https://www.readbyqxmd.com/read/29137835/venous-thromboembolism-risk-and-prophylaxis-in-the-portuguese-hospital-care-setting-the-arte-study
#1
Daniel Ferreira, Joaquim Abreu de Sousa, Paulo Felicíssimo, Ana França
INTRODUCTION: Venous thromboembolism (VTE) is a relatively common complication during hospital stay and determination of VTE risk is critical to choosing the best prophylactic strategy for each patient. OBJECTIVES: In the present study we studied the risk profile for VTE in hospitalized patients in a group of hospitals in Portugal. METHODS: Based on an open cohort of 4248 patients hospitalized in surgical, internal medicine, orthopedic or oncology departments, we determined thromboembolic risk at admission by applying a new score, modified from the Caprini and Khorana scores...
November 11, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29136259/risk-factors-for-surgical-site-infections-in-dermatological-surgery
#2
Xiaomeng Liu, Melissa Sprengers, Patty J Nelemans, Klara Mosterd, Nicole W J Kelleners-Smeets
Current literature on risk factors for surgical site infection (SSI) in dermatological surgery in the absence of antibiotic prophylaxis is limited. The aim of this study was to retrospectively evaluate patients presenting for dermatological surgery. A total of 1,977 procedures were reviewed. SSI was clinically suspected in 79 (4.0%) patients and confirmed by culture in 38 (1.9%). Using the strictest definition of SSI (clinical symptoms with positive culture) significantly higher risk of SSI was found for location on the ear (odds ratio (OR) 6...
November 14, 2017: Acta Dermato-venereologica
https://www.readbyqxmd.com/read/29135476/thrombogenicity-evaluation-in-221-patients-with-haemophilia-b-treated-with-nonacog-alfa
#3
Pablo Rendo, Janice Lamb, Lynne Smith, Joanne Fuiman, Joan M Korth-Bradley
: Risk for thrombotic events with factor IX replacement therapy in patients with haemophilia B remains a concern for patients, those who treat them, and regulatory agencies, based on experience with early use of prothrombin complex concentrates. The current post hoc analysis assessed the incidence of thrombotic events and changes in prothrombin fragment 1 + 2, thrombin-antithrombin complex, and D-dimer in 221 patients with haemophilia B who received nonacog alfa in clinical studies. Thrombotic event and coagulation marker data were collected from 8 interventional studies utilizing on-demand, prophylactic, and preventive regimens in patients with haemophilia B...
November 10, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29126330/-management-of-complications-of-pancreatic-anastomoses
#4
Georg F Weber, Axel Schmid, Michael Uder, Robert Grützmann
Background The pancreatic anastomosis may be the Achilles heel in pancreatic surgery. When a postoperative pancreatic fistula develops, be it mild or severe, in some cases life-threatening, POPF-associated complications can occur. Objectives Possibilities for the prophylaxis, diagnosis and therapy of POPF and POPF-associated complications in an interdisciplinary setting. Results Differentiated diagnostic and therapeutic management of POPF grade A - C is supported by recent studies to reduce morbidity and mortality...
November 10, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29122393/how-do-professional-relationships-influence-surgical-antibiotic-prophylaxis-decision-making-a-qualitative-study
#5
Jennifer K Broom, Alex F Broom, Emma R Kirby, Jeffrey J Post
BACKGROUND: Surgical antibiotic prophylaxis (SAP) is a critical area to optimize to reduce the escalation of antimicrobial resistance. This article explores the ways by which interpersonal relationships influence SAP decision making. METHODS: Twenty surgeons and anesthetists participated in in-depth semistructured interviews on SAP prescribing. Results were analyzed using the framework approach. RESULTS: Analysis revealed 3 ways by which interpersonal relationships influence SAP: relationship dynamics between the surgeon and the anesthetist determine appropriateness of SAP, particularly operative risk ownership; perceived hierarchies within, and between, surgical and anesthetist specialties influence antibiotic prescribing decisions; and surgical distance from the antimicrobial stewardship team, which influences use of antimicrobial stewardship principles...
November 7, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29120136/postoperative-atrial-fibrillation-prophylaxis-and-lung-resection-%C3%A2-our-experience-with-608-consecutive-patients
#6
Vjekoslav Karadža, Dinko Stančić-Rokotov, Jasna Špiček Macan, Nevenka Hodoba, Nevenka Kolarić, Sanja Sakan
Postoperative atrial fibrillation is a common complication after lung resection. It is burdened by increased mortality and morbidity, prolonged hospitalization, and higher resource utilization in thoracic surgery patients. Therefore, some kind of pharmacological prophylaxis is recommended. In our patients, diltiazem, a calcium antagonist, is administered. We collected data on all 608 patients having undergone lung resection (no less than lobectomy) between November 2012 and May 2015. This period included patients having received diltiazem during their postoperative stay in our Intensive Care Unit and surgical ward, and those that did not receive it...
March 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29118862/thromboprophylaxis-and-mortality-among-patients-who-developed-venous-thromboembolism-in-seven-major-hospitals-in-saudi-arabia
#7
Fahad M Al-Hameed, Hasan M Al-Dorzi, Abdulelah I Qadhi, Amira Shaker, Farjah H Al-Gahtani, Fawzi F Al-Jassir, Galila F Zahir, Tarig S Al-Khuwaitir, Mohammed H Addar, Mohamed S Al-Hajjaj, Mohamed A Abdelaal, Essam Y Aboelnazar
INTRODUCTION: Venous thromboembolism (VTE) during hospitalization is a serious and potentially fatal condition. Despite its effectiveness, evidence-based thromboprophylaxis is still underutilized in many countries including Saudi Arabia. OBJECTIVE OF THE STUDY: Our objectives were to determine how often hospital-acquired VTE patients received appropriate thromboprophylaxis, VTE-associated mortality, and the percentage of patients given anticoagulant therapy and adherence to it after discharged...
October 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29116559/perioperative-antiemetic-therapy-for-fast-track-laparoscopic-bariatric-surgery
#8
Olumuyiwa A Bamgbade, Oluwafemi Oluwole, Rong R Khaw
BACKGROUND: Postoperative nausea and vomiting (PONV) is problematic in bariatric surgery patients and has negative impacts on perioperative outcome. Antiemetic prophylaxis may reduce PONV. Perioperative antiemetic prophylaxis or therapy is crucial and may enhance fast-track bariatric surgery. This study examined the impact of intraoperative multimodal antiemetic prophylaxis on fast-track bariatric surgery. METHODS: This prospective observational clinical study explored the perioperative data of 400 consecutive laparoscopic bariatric surgery patients, over a 6-year period...
November 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29113840/extended-venous-thromboembolism-prophylaxis-after-radical-cystectomy-a-call-for-adherence-to-current-guidelines
#9
REVIEW
Zachary Klaassen, Karan Arora, Hanan Goldberg, Thenappan Chandrasekar, Christopher J D Wallis, Rashid K Sayyid, Neil E Fleshner, Antonio Finelli, Alexander Kutikov, Philippe D Violette, Girish S Kulkarni
PURPOSE: Radical cystectomy (RC) is an inherently morbid procedure. The purpose of this review is to assess the timing and incidence of venous thromboembolism (VTE), review current guideline recommendations, and provide evidence for considering extended VTE prophylaxis among all patients undergoing RC. MATERIALS AND METHODS: We conducted a PubMed search of available literature for RC and VTE, focusing on: incidence and timing, evidence supporting extended VTE prophylaxis (among RC and abdominal surgical oncology patients), current guideline recommendations, safety considerations, and direct oral anticoagulants...
November 4, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29113671/predictors-of-venous-thromboembolism-in-patients-with-primary-sarcoma-of-bone
#10
Courtney L Kaiser, Micayla K Freehan, Daniel A Driscoll, Joseph H Schwab, Karen De Amorim Bernstein, Santiago A Lozano-Calderon
Venous thromboembolism (VTE) is known to be independently associated with both orthopaedic surgery and malignancy. Patients undergoing surgery for musculoskeletal malignancies are at an increased risk for thromboembolic events. Although VTE can lead to serious morbidity and mortality, the potential complications of prophylactic anticoagulation call for a greater understanding of a patient's risk factors, as well as more rigorous guidelines for prophylactic anticoagulation regimens. The aims of this study were to 1) Analyze the rate of VTE in patients surgically treated for primary bone sarcoma; 2) Identify risk factors for VTE in patients with primary bone sarcoma; 3) Discuss the complications associated with prophylactic anticoagulation in patients with primary bone sarcoma...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/29112546/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-obese-patient
#11
Linas Venclauskas, Almantas Maleckas, Juan I Arcelus
: A systematic literature search was performed and patients were selected as obese patients undergoing bariatric surgery or obese patients undergoing nonbariatric surgical procedures. In addition, patients were stratified according to low risk of venous thromboembolism and high risk of venous thromboembolism (age >55 years, BMI >55 kg m, history of venous thromboembolism, venous disease, sleep apnoea, hypercoagulability or pulmonary hypertension). Prophylaxis of venous thromboembolism was analysed depending on the type of modality: compression devices of the lower extremities (including intermittent pneumatic compression and graduated compression stockings), pharmacological prophylaxis or inferior vena cava filters...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112544/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-day-surgery-and-fast-track-surgery
#12
Linas Venclauskas, Juan V Llau, Jean-Yves Jenny, Per Kjaersgaard-Andersen, Øivind Jans
: In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient management...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112543/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-during-pregnancy-and-the-immediate-postpartum-period
#13
Anne-Sophie Ducloy-Bouthors, Andrea Baldini, Rezan Abdul-Kadir, Jacky Nizard
: Thromboembolic events in the pregnant and postpartum patient remain rare but potentially fatal complications. The aim of this section was to analyse the few prospective studies addressing the issue of thromboprophylaxis following a surgical procedure during and immediately after pregnancy, as well as national guidelines, and to propose European guidelines on this specific condition. Thromboprophylaxis is broadly recommended due to the combined risks of surgery and pregnancy or the postpartum period, regardless of the mode of delivery...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112542/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-neurosurgery
#14
David Faraoni, Raquel Ferrandis, William Geerts, Matthew D Wiles
: Although there are numerous publications addressing venous thromboembolism and its prevention in neurosurgery, there are relatively few high-quality studies to guide decisions regarding thromboprophylaxis. In patients undergoing craniotomy, we recommend that if intermittent pneumatic compression (IPC) is used, it should be applied before the surgical procedure or on admission (Grade 1C). In craniotomy patients at particularly high risk for venous thromboembolism, we suggest considering the initiation of mechanical thromboprophylaxis with IPC preoperatively with addition of low molecular weight heparin (LMWH) postoperatively when the risk of bleeding is presumed to be decreased (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112541/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-cardiovascular-and-thoracic-surgery
#15
Aamer B Ahmed, Andreas Koster, Marcus Lance, David Faraoni
: None of the predictive models for venous thromboembolism (VTE) prophylaxis have been designed for and validated in patients undergoing cardiothoracic and vascular surgery. The presence of one or more risk factors [age over 70 years old, transfusion of more than 4 U of red blood cells/fresh frozen plasma/cryoprecipitate, mechanical ventilation lasting more than 24 h, postoperative complication (e.g. acute kidney injury, infection/sepsis, neurological complication)] should place the cardiac population at high risk for VTE...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29109576/baseline-competency-assessment-of-pharmacists-prescribing-and-managing-vancomycin-therapy-in-the-regina-qu-appelle-health-region
#16
Kirsten Tangedal, Jennifer Bolt, Suzanne Len, Ali Bell
Background: Pharmacists in the Regina Qu'Appelle Health Region (RQHR), Saskatchewan, independently dose, monitor, and adjust vancomycin therapy. No framework exists for ongoing competency assessment of pharmacists. Objectives: The primary objective was to determine pharmacists' overall level of competency for all components of the vancomycin prescribing procedure. The secondary objectives were to determine competency for individual prescribing phases, to stratify overall competency in relation to pharmacist and patient factors, and to identify the 3 most frequent errors...
September 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29108420/inhibitor-risk-stratification-and-individualized-treatment-in-patients-with-nonsevere-hemophilia-a-a-single-institution-practice-audit
#17
Haowei Linda Sun, Stella Chan, Paul Yenson, Shannon Jackson
Inhibitor risk in nonsevere hemophilia A increases with cumulative factor VIII (FVIII) exposure days and high-risk mutations. A standardized approach to minimize inhibitor risk is warranted. Following establishment of a systematic approach to reduce inhibitor risk in nonsevere hemophilia, we evaluated the uptake of these strategies into clinical practice. All adult males with nonsevere hemophilia A followed by British Columbia Adult Hemophilia Program from 2004 to 2016 were included in this retrospective audit...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29105078/a-systematic-review-of-the-incidence-of-and-risk-factors-for-postoperative-atrial-fibrillation-following-general-surgery
#18
REVIEW
R Chebbout, E G Heywood, T M Drake, J R L Wild, J Lee, M Wilson, M J Lee
Atrial fibrillation is a common cardiac arrhythmia and can occur de novo following a surgical procedure. It is associated with increased inpatient and long-term mortality. There is limited evidence concerning new-onset atrial fibrillation following abdominal surgery. This study aimed to identify the prevalence of and risk factors for postoperative atrial fibrillation in the general surgical population. A systematic search of the Embase, MEDLINE and Cochrane (CENTRAL) databases was conducted. Studies were included in the review if they reported cases of new-onset atrial fibrillation within 30 days of the index operation...
November 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29102205/a-multi-institutional-cohort-study-confirming-the-risks-of-clostridium-difficile-infection-associated-with-prolonged-antibiotic-prophylaxis
#19
Katherine A Kirkwood, Brian C Gulack, Alexander Iribarne, Michael E Bowdish, Giampaolo Greco, Mary Lou Mayer, Karen O'Sullivan, Annetine C Gelijns, Nishit Fumakia, Ravi K Ghanta, Jesse M Raiten, Anuradha Lala, Joseph S Ladowski, Eugene H Blackstone, Michael K Parides, Alan J Moskowitz, Keith A Horvath
OBJECTIVES: The incidence and severity of Clostridium difficile infection (CDI) have increased rapidly over the past 2 decades, particularly in elderly patients with multiple comorbidities. This study sought to characterize the incidence and risks of these infections in cardiac surgery patients. METHODS: A total of 5158 patients at 10 Cardiothoracic Surgical Trials Network sites in the US and Canada participated in a prospective study of major infections after cardiac surgery...
September 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29102076/prevention-of-surgical-site-infection-analysis-and-narrative-review-of-clinical-practice-guidelines
#20
Francisco Javier Gómez-Romero, Maria Fernández-Prada, Juan Francisco Navarro-Gracia
Surgical site infection is one of the most prevalent healthcare-associated infections and presents a considerable morbidity. The aim of this comprehensive narrative review is to describe the evidence and grade of recommendation of the preventive measures developed in the three phases of the surgical process (preoperative, perioperative and postoperative phases), as well as coincidences and divergences between selected Clinical Practice Guidelines (CPG). Four preventive measures were recommended with similar high grade evidence in all CPG: Hair removal, antibiotic prophylaxis, surgical site preparation and normothermia...
October 25, 2017: Cirugía Española
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