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Perioperative Home

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https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#1
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323335/surgical-guidelines-for-perioperative-management-of-older-adults-what-geriatricians-need-to-know
#2
Jessica L Colburn, Sanjay Mohanty, John R Burton
A multidisciplinary panel of experts representing surgery, anesthesia, and geriatrics recently published guidelines for surgeons on the optimal perioperative management of older adults, including recommendations on postoperative recovery and posthospital transitions of care. Geriatricians have an important role in the care for older adults in the preoperative period as older adults consider surgical options and prepare for surgical procedures, during the perioperative period as inpatient consultants, and in the postoperative period as older adults transition to rehabilitation facilities or to home...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28319519/process-improvement-initiative-for-the-perioperative-management-of-patients-with-a-cardiovascular-implantable-electronic-device
#3
Margaret K Menzel Ellis, Miriam M Treggiari, Jamie M Robertson, Marc A Rozner, Peter F Graven, Michael F Aziz, Matthias J Merkel, Edward A Kahl, Norman A Cohen, Eric C Stecker, Peter M Schulman
BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28291130/making-the-pediatric-perioperative-surgical-home-come-to-life-by-leveraging-existing-health-information-technology
#4
Izabela C Leahy, Rachel Borczuk, Lynne R Ferrari
PURPOSE OF REVIEW: To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. RECENT FINDINGS: By using 360 Technology, patient data was automatically pulled from all available Electronic Health Record sources from 2005 to the present. The PPSH dashboard described in this report provides a guide for implementation of PPSH Clinical Care Pathways...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28271332/exparel-peripheral-catheter-use-in-the-ambulatory-setting-and-use-of-peripheral-catheters-postoperatively-in-the-home-setting
#5
REVIEW
Adam L Bromberg, Jeremy A Dennis, Karina Gritsenko
PURPOSE OF REVIEW: With the increasing number of ambulatory surgeries being performed, regional anesthesia has become an increasingly popular anesthetic modality, and many choices exist to provide efficient, effective quality perioperative analgesia. In this paper, we will review the various regional anesthesia options in addition to the advantages and disadvantages of each. Lastly, we will discuss liposomal bupivicaine, a long acting local anesthetic, and its future role in the anesthesiologist's armamentarium...
March 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28267070/adherence-to-a-multimodal-analgesic-clinical-pathway-a-within-group-comparison-of-staged-bilateral-knee-arthroplasty-patients
#6
Rachel C Steckelberg, Natasha Funck, T Edward Kim, Tessa L Walters, Gregory Milo Lochbaum, Stavros G Memtsoudis, Nicholas J Giori, Pier F Indelli, Lorrie J Graham, Edward R Mariano
BACKGROUND AND OBJECTIVES: Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing staged bilateral procedures. METHODS: This study was performed at a hospital with a Perioperative Surgical Home program and knee arthroplasty clinical pathway using multimodal analgesia and adductor canal catheters...
March 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28265161/effects-of-perioperative-factors-and-hip-geometry-on-hip-abductor-muscle-strength-during-the-first-6-months-after-anterolateral-total-hip-arthroplasty
#7
Takashi Ikeda, Tetsuya Jinno, Junya Aizawa, Tadashi Masuda, Kazuo Hirakawa, Kazunari Ninomiya, Kouji Suzuki, Sadao Morita
[Purpose] The importance and effect of hip joint geometry on hip abductor muscle strength are well known. In addition, other perioperative factors are also known to affect hip abductor muscle strength. This study examined the relative importance of factors affecting hip abductor muscle strength after total hip arthroplasty. [Subjects and Methods] The subjects were 97 females with osteoarthritis scheduled for primary unilateral THA. The following variables were assessed preoperatively and 2 and 6 months after surgery: isometric hip abductor strength, radiographic analysis (Crowe class, postoperative femoral offset (FO)), Frenchay Activities Index, compliance rate with home exercise, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and demographic data...
February 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28259576/female-sex-independently-predicts-mortality-after-thoracic-endovascular-aortic-repair-for-intact-descending-thoracic-aortic-aneurysms
#8
Sarah E Deery, Katie E Shean, Grace J Wang, James H Black, Gilbert R Upchurch, Kristina A Giles, Virendra I Patel, Marc L Schermerhorn
OBJECTIVE: Whereas sex differences in the pathogenesis, presentation, and outcomes of repair for abdominal aortic aneurysms are well studied, less is known about sex differences after thoracic endovascular aortic repair (TEVAR). The goal of this study was to evaluate the association between sex and morbidity and mortality after TEVAR. METHODS: A retrospective review of all TEVARs in the Society for Vascular Surgery Vascular Quality Initiative (VQI) registry from 2011 to 2015 was conducted, excluding those with dissection, trauma, and rupture...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259574/a-comparison-of-results-of-carotid-endarterectomy-in-octogenarians-and-nonagenarians-to-younger-patients-from-the-mid-america-vascular-study-group-and-the-society-for-vascular-surgery-vascular-quality-initiative
#9
Joseph R Schneider, Cheryl R Jackson, Irene B Helenowski, Michael J Verta, Julia B Wilkinson, Stanley Kim, Andrew W Hoel
OBJECTIVE: Carotid endarterectomy (CEA) reduces stroke risk in selected patients. However, CEA risk profile may be different in older patients. We compared characteristics and outcomes of octogenarians and nonagenarians with those of younger patients. METHODS: Deidentified data from CEA patients were obtained from the Society for Vascular Surgery Vascular Quality Initiative (VQI) database. Prior CEA, carotid artery stent, or combined CEA and coronary artery bypass were excluded, yielding 7390 CEAs in octogenarians and nonagenarians (≥80 years of age) and 35,303 CEAs in younger patients (<80 years of age)...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28258331/the-role-of-perioperative-surgical-home-on-health-and-longevity-in-society-importance-of-the-surgical-prehabilitation-program
#10
EDITORIAL
Masahiko Kawaguchi, Mitsuru Ida, Yusuke Naito
No abstract text is available yet for this article.
March 3, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28250727/leiomyoma-in-the-retzius-space
#11
Dobrosława Sikora-Szczęśniak
Parauterine location of leiomyomas is observed to be an extremely rare clinical condition. However, when benign or malignant primary tumours are detected in that area, they are often found in the Retzius space. There have been only six cases of leiomyomas in the Retzius space reported in the literature so far. The paper presents one such leiomyoma case located in the Retzius space. This extremely rare location of the tumour justifies its presentation. The medical records of the patient treated in the outpatient's obstetrics and gynaecology (ob-gyn) clinic, her case history, and hospital records, supplemented by information obtained from the patient's daughter, were analysed...
December 2016: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/28241134/risk-of-ischemic-stroke-and-transient-ischemic-attack-is-increased-up-to-90-days-after-non-carotid-and-non-cardiac-surgery
#12
Armin J Grau, Martin Eicke, Christoph Burmeister, Roland Hardt, Eberhard Schmitt, Sieghard Dienlin
BACKGROUND: The risk of stroke after cardiac and carotid surgery is well established. In contrast, stroke risk in association with non-cardiac and non-carotid surgery and its time course are insufficiently known. We investigated the prevalence of recent and planned surgery among patients with stroke and transient ischemic attack (TIA), time dependency of stroke risk, stroke etiology, and interruption of antithrombotic medication in association with surgery. METHODS: Data on type and date of surgery and similar interventions within the last year or planned for the next 2 weeks were anonymously collected together with demographic data, vascular risk factors, stroke severity, handicap before stroke and stroke etiology within a state-wide, mandatory, hospital-based acute stroke care quality monitoring project (Rhineland-Palatinate, Germany) for 1 year (2010)...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28216362/endovascular-aneurysm-repair-patients-who-are-lost-to-follow-up-have-worse-outcomes
#13
Caitlin W Hicks, Devin S Zarkowsky, Ian C Bostock, David H Stone, James H Black, Jens Eldrup-Jorgensen, Philip P Goodney, Mahmoud B Malas
BACKGROUND: Society for Vascular Surgery practice guidelines recommend 1- and 12-month follow-up with computed tomography imaging for the year after endovascular aneurysm repair (EVAR). We describe the incidence, risk factors, and outcomes of EVAR patients who are lost to follow-up (LTF). METHODS: All patients undergoing elective EVAR in the Vascular Quality Initiative (VQI) data set (January 2003-December 2015) were stratified according to long-term follow-up method (in-person vs phone call vs LTF)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28192627/home-visits-as-part-of-a-new-care-pathway-iaid-to-improve-quality-of-care-and-quality-of-life-in-ostomy-patients-a-cluster-randomised-stepped-wedge-trial
#14
M F Sier, R J Oostenbroek, M G W Dijkgraaf, G J Veldink, W A Bemelman, A Pronk, E J Spillenaar-Bilgen, W Kelder, C Hoff, D T Ubbink
BACKGROUND: Morbidity in patients with an 'ostomy is high. A new care pathway, including perioperative home visits by enterostomal therapists, was studied to assess whether more elaborate education and closer guidance could reduce stoma-related complications and improve quality of life, at acceptable cost. METHODS: Patients requiring an ileostomy or colostomy, for any inflammatory or malignant bowel disease, were included in a 15-centre cluster-randomised 'stepped-wedge' study...
February 13, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28177173/perioperative-considerations-in-infantile-neuroaxonal-dystrophy
#15
Jina L Sinskey, Robert S Holzman
Infantile neuroaxonal dystrophy is a rare neurological disorder that is universally fatal with life expectancy under 10 years. A 10-year-old boy with infantile neuroaxonal dystrophy and severe neuromuscular scoliosis underwent posterior spinal fusion following halo traction. He was successfully extubated to bilevel positive airway pressure on postoperative day 3 and discharged home on postoperative day 11. Infantile neuroaxonal dystrophy presents several perioperative challenges including concerns for difficult intubation and respiratory dysfunction...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28161010/return-home-after-surgery-program-a-step-toward-perioperative-medicine
#16
EDITORIAL
O Rames, K Slim
No abstract text is available yet for this article.
February 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28151765/necrotizing-soft-tissue-infection-or-sweet-syndrome-surgery-versus-no-surgery-a-case-report
#17
Tiffany M N Otero, Samuel R Barber, D Dante Yeh, Sadeq A Quraishi
The authors report a case of necrotizing Sweet syndrome in a 24-year-old transsexual male who presented with recurrent myonecrosis of the neck/upper chest. On index admission, computer tomography revealed gas and fat stranding of the sternocleidomastoid and pectoralis major muscle-findings suggestive of a necrotizing soft tissue infection. Despite debridement procedures and intravenous antibiotic therapy, myonecrosis of the affected areas persisted. Evaluation of tissue samples by dermatopathology revealed neutrophilic infiltration extending into the dermis and muscle necrosis, findings consistent with necrotizing Sweet syndrome...
February 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#18
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28118163/evolving-healthcare-delivery-paradigms-and-the-optimization-of-value-in-anesthesiology
#19
Navid Alem, Zeev Kain
PURPOSE OF REVIEW: Healthcare worldwide is evolving to yield enhanced care provided at a lowered cost. Patient-centric paradigms that hasten surgical recovery and strengthen collaboration amongst medical professionals are gaining impetus. This review will discuss the changing healthcare landscape and outline its implications on anesthesiology practice. RECENT FINDINGS: Anesthesiologists must be nimble and versatile as they adapt to healthcare redesign. An increased responsibility for patient outcomes should be embraced by extending the breadth and depth of clinical practice throughout the surgical care continuum...
April 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28089186/predictors-of-same-day-discharge-in-primary-total-joint-arthroplasty-patients-and-risk-factors-for-post-discharge-complications
#20
Alex Sher, Aakash Keswani, Dong-Han Yao, Michael Anderson, Karl Koenig, Calin S Moucha
BACKGROUND: Same-day (<24 h) discharge total joint arthroplasty (TJA) may be a safe and effective option for certain patients with end-stage osteoarthritis. Given the growing pressure to improve quality and lower TJA episode costs, surgeons must identify which TJA patients can be appropriately discharged home quickly and safely. This study identifies characteristics associated with same-day discharge post-TJA as well as assesses risk factors for complications in this select patient population...
December 22, 2016: Journal of Arthroplasty
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