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Perioperative Home

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https://www.readbyqxmd.com/read/29114413/perioperative-factors-affecting-ambulatory-outcomes-following-laparoscopic-adjustable-gastric-banding
#1
Mirsad Dupanovic, Ron Krebill, Iris Dupanovic, John Nachtigal, Melissa Rockford, Walter Orr
Objective: Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes. Methods: Medical records of 201 consecutive LAGB patients performed at the University of Kansas Medical Centre during a 3-y period were reviewed...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29111798/perioperative-medicine-a-new-model-of-care
#2
Lena Al-Shammari, Deborah Douglas, Geetha Gunaratnam, Chris Jones
The discipline of perioperative medicine provides a foundation for the consistent delivery of safe and good quality care to surgical patients. Its goals include the identification and optimal care of the high-risk surgical patient, fostering patient-centred decision making throughout the surgical perioperative pathway, and reducing unwarranted variation in practice. In turn, this should reduce preventable complications and improve patient satisfaction, long-term morbidity and survival. This review concludes a series of articles which have described the epidemiology of surgical disease, the growth in the objective means of risk assessment, and novel outcome measures...
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29106872/design-and-validation-of-key-text-messages-tonsil-text-to-me-to-improve-parent-and-child-perioperative-tonsillectomy-experience-a-modified-delphi-study
#3
Jin Soo A Song, Lori Wozney, Jill Chorney, Stacey L Ishman, Paul Hong
OBJECTIVE: Parents can struggle while providing perioperative tonsillectomy care for their children at home. Short message service (SMS) technology is an accessible and direct modality to communicate timely, evidence-based recommendations to parents across the perioperative period. This study focused on validating a SMS protocol, Tonsil-Text-To-Me (TTTM), for parents of children undergoing tonsillectomy. METHODS: This study used a modified Delphi expert consensus method...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29103572/practical-management-of-the-opioid-tolerant-patient-in-the-perioperative-surgical-home
#4
REVIEW
John-Paul J Pozek, Stephen F Goldberg, Jaime L Baratta, Eric S Schwenk
No abstract text is available yet for this article.
2017: Advances in Anesthesia
https://www.readbyqxmd.com/read/29067198/an-extended-release-local-anaesthetic-potential-for-future-use-in-veterinary-surgical-patients
#5
REVIEW
B Duncan X Lascelles, Kristin Kirkby Shaw
One of the most effective means of preventing the transduction and transmission of acute and perioperative pain is through the use of local anaesthetics. However, local anaesthetics currently available have a relatively short duration of action. Although there are several tools available to treat perioperative pain in companion animals, overall, there is an unmet need for products that can be administered in the clinic, and provide pain relief for the crucial first few days following surgery in the home environment...
November 2016: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/29054214/robotic-assisted-video-assisted-thoracoscopic-and-open-lobectomy-propensity-matched-analysis-of-recent-premier-data
#6
COMPARATIVE STUDY
Daniel S Oh, Rishindra M Reddy, Madhu Lalitha Gorrepati, Shilpa Mehendale, Michael F Reed
BACKGROUND: Robotic-assisted lobectomy (RL) is becoming a popular alternative technique to video-assisted thoracoscopic lobectomy (VL), although open lobectomy (OL) remains the most common approach. The objective of this study is to provide a comparative analysis of perioperative clinical outcomes from elective RL, VL, and OL. METHODS: The Premier Healthcare Database was analyzed for lobectomies performed from January 1, 2011, to September 30, 2015. International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis and procedure codes were used to identify surgical approaches, complications, and mortality...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29049108/the-perioperative-surgical-home-is-not-just-a-name
#7
Edward R Mariano, Thomas R Vetter, Zeev N Kain
No abstract text is available yet for this article.
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#8
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29025089/oral-ketamine-for-acute-pain-management-after-amputation-surgery
#9
Asokumar Buvanendran, Jeffrey S Kroin, Arvind Rajagopal, Sherry J Robison, Mario Moric, Kenneth J Tuman
Objective: Intravenous ketamine has been shown to provide postoperative analgesia in many clinical trials, in particular to reduce opioid consumption. The primary objective of this pilot study is to determine if multiple dosing over a three-day perioperative period with oral ketamine is a safe treatment method for acute pain after amputation surgery. Methods: Three consented subjects (age 57-60 years) undergoing elective amputation of the lower extremity were included in the study (Institutional Review Board and Food and Drug Administration Investigational New Drug approved)...
September 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29021511/overcoming-sleep-disordered-breathing-and-ensuring-sufficient-good-sleep-time-for-a-healthy-life-expectancy
#10
Kazuo Chin
Recent advances in basic and clinical medicine have resulted in major improvements in human health. Currently sleep has been considered an essential factor in maintaining and promoting a healthy life expectancy. Sleep disorders include more than 60 diseases. Sleep disordered breathings (SDB) have 17 disorders, including sleep apnea. SDB usually induces hypoxemia and hypercapnia, which would have significant effects on cells, organs, and the whole body. We have investigated SDB for nearly 35 years. We found that SDB has significant associations with humoral factors, including coagulation systems, the body's protective factors against diseases, and metabolic and organ diseases...
2017: Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
https://www.readbyqxmd.com/read/28988703/cost-of-achieving-equivalent-outcomes-in-sicker-patients-after-liver-transplant
#11
Vikrom K Dhar, Koffi Wima, Young Kim, Richard S Hoehn, Andrew D Jung, Audrey E Ertel, Tayyab S Diwan, Flavio Paterno, Shimul A Shah
BACKGROUND: We aimed to characterize variability in cost after straightforward orthotopic liver transplant (OLT). METHODS: Using the University HealthSystem Consortium and Scientific Registry of Transplant Recipients databases, we identified patients who underwent OLT between 2011 and 2014. Patients meeting criteria for straightforward OLT, defined as length of stay < 14 days with discharge to home, were selected (n = 5763) and grouped into tertiles (low, medium, high) according to cost of perioperative stay...
October 4, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28964298/implementation-of-a-perioperative-surgical-home-protocol-for-pediatric-patients-presenting-for-adenoidectomy
#12
Vidya T Raman, Dmitry Tumin, Joshua Uffman, Arlyne K Thung, Candice Burrier, Kris R Jatana, Charles Elmaraghy, Joseph D Tobias
INTRODUCTION: The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. METHODS: Eligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#13
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28925860/pharmacologic-and-perioperative-considerations-for-antihypertensive-medications
#14
Sher-Lu Pai, Ryan M Chadha, Joan M Irizarry Alvarado, Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: As the prevalence of hypertension continues to increase, physicians routinely encounter patients preoperatively receiving one or more cardiovascular medications to manage hypertension. Thus, the physician's knowledge of perioperative antihypertensive medication management is crucial to ensure patient safety. OBJECTIVE: We discuss the decisions to continue or stop antihypertensive medications to reduce the risk of perioperative complications. METHOD: We conducted a review of the original research studies, review articles, and editorials present on PubMed within the past 60 years...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28925332/spine-deformity-surgery-in-the-elderly-risk-factors-and-30-day-outcomes-are-comparable-in-posterior-versus-combined-approaches
#15
John K Yue, David C Sing, Sourabh Sharma, Pavan S Upadhyayula, Ethan A Winkler, Jeremy D Shaw, Lionel N Metz
Objectives Risk factors portending poor outcome following elective spine deformity fusion remain in need of characterization and stratification in the elderly population. Methods Cases aged ≥60 years who underwent elective posterior or anterior-posterior ('combined') fusion were extracted from the American College of Surgeons National Surgical Quality Improvement Program years 2007-2013 and analyzed by surgical cohort (posterior vs. combined). The 30-day outcomes included operation time, hospital length of stay (HLOS), perioperative complications, and discharge destination...
September 19, 2017: Neurological Research
https://www.readbyqxmd.com/read/28922214/a-home-for-surgical-pain-management-the-perioperative-pain-service
#16
Jonathan P Wanderer, Naveen Nathan
No abstract text is available yet for this article.
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28914703/length-of-catheter-use-after-hysterectomy-as-a-risk-factor-for-urinary-tract-infection
#17
Natalie E Karp, Emily K Kobernik, Neil S Kamdar, Amanda M Fore, Daniel M Morgan
OBJECTIVES: The aims of this study were to determine the effect of length of postoperative catheterization on risk of urinary tract infection (UTI) and to identify risk factors for postoperative UTI. METHODS: This was a retrospective case-control study. Demographic and perioperative data, including duration of indwelling catheter use and postoperative occurrence of UTI within 30 days of surgery, were analyzed for hysterectomies using the Michigan Surgical Quality Collaborative database...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28913487/perioperative-surgical-home-meeting-tomorrow-s-challenges
#18
REVIEW
Teodora O Nicolescu
New healthcare models pose a variety of changes for anesthesiologists, ranging from the need to improve quality and to cost containment: as such, the concept of Perioperative Surgical Home (PSH) has been developed. Modelled after the UK's Enhanced Recovery After Surgery (ERAS), PSH takes a step further by coordinating care starting from the time a surgical decision is made for the patient to as many as 30 days postoperatively, taking a logical evidenced-based approach to judicious preoperative testing. Perioperative surgical home also relies heavily on engineering imported strategies such as the use of Lean Six Sigma methodologies, and involves active participation of all stakeholders...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28902601/impact-of-diabetes-on-perioperative-complications-in-patients-undergoing-elective-total-shoulder-arthroplasty
#19
Siddharth Mahure, Brent Mollon, Mary Quien, Raj Karia, Joseph Zuckerman, Young Kwon
INTRODUCTION: Diabetes has been associated with negative outcomes following orthopaedic surgery. While previous studies have reported on diabetes-associated complications in shoulder arthroplasty, those cohorts were heterogeneous in terms of patient population, nature of elective surgery, and arthroplasty type. Given that the number of elective total shoulder arthroplasties (TSAs) performed has grown substantially in volume and is predicted to rise even further, it is important to recognize the role that diabetes may play in developing in-hospital complications within a more homogenous sample of patients undergoing elective TSA...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28902101/early-ambulation-decreases-length-of-hospital-stay-perioperative-complications-and-improves-functional-outcomes-in-elderly-patients-undergoing-surgery-for-correction-of-adult-degenerative-scoliosis
#20
Owoicho Adogwa, Aladine A Elsamadicy, Jared Fialkoff, Joseph Cheng, Isaac O Karikari, Carlos Bagley
STUDY DESIGN: Ambispective cohort review. OBJECTIVE: To examine the effects of early mobilization on patient outcomes, complications profile, and 30-day readmission rates. SUMMARY OF BACKGROUND DATA: Prolonged immobilization after surgery can result in functional decline and an increased risk of hospital-associated complications. METHODS: We conducted an ambispective study of 125 elderly patients (>65 years) undergoing elective spinal surgery for correction of adult degenerative scoliosis...
September 15, 2017: Spine
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