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https://www.readbyqxmd.com/read/28323806/improving-pain-management-and-long-term-outcomes-following-high-energy-orthopaedic-trauma-pain-study
#1
Renan C Castillo, Srinivasa N Raja, Katherine P Frey, Heather A Vallier, Paul Tornetta, Todd Jaeblon, Brandon J Goff, Allan Gottschalk, Daniel O Scharfstein, Robert V OʼToole
Poor pain control after orthopaedic trauma is a predictor of physical disability and numerous negative long-term outcomes. Despite increased awareness of the negative consequences of poorly controlled pain, analgesic therapy among hospitalized patients after orthopaedic trauma remains inconsistent and often inadequate. The Pain study is a 3 armed, prospective, double-blind, multicenter randomized trial designed to evaluate the effect of standard pain management versus standard pain management plus perioperative nonsteroidal anti-inflammatory drugs or pregabalin in patients of ages 18-85 with extremity fractures...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28321983/chloroprocaine-for-epidural-anesthesia-in-infants-and-children
#2
REVIEW
Giorgio Veneziano, Joseph D Tobias
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28304415/vaginal-obliterative-procedures-for-pelvic-organ-prolapse-a-systematic-review
#3
REVIEW
Gunhilde M Buchsbaum, Toy Gee Lee
Importance: Pelvic organ prolapse is a common condition, the prevalence of which is likely to increase with the aging of our population. Also changing are parameters by which outcomes are assessed, shifting toward patient-centered care. Objective: To review vaginal obliterative procedures for surgical treatment of advanced pelvic organ prolapse historically and to discuss evidence on indications for colpocleisis, outcomes, and complications, as well as review pros and cons for concomitant vaginal hysterectomy and anti-incontinence procedures...
March 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28299332/relationship-between-angiotensin-converting-enzyme-apelin-and-new-onset-atrial-fibrillation-after-off-pump-coronary-artery-bypass-grafting
#4
Shu Xu, Jian Zhang, Yin-Li Xu, Hai-Bo Wu, Xiao-Dong Xue, Hui-Shan Wang
It has been shown that inflammation and oxidative stress are important factors in postoperative atrial fibrillation (POAF). Angiotensin converting enzyme (ACE) and apelin have a close relationship with inflammation and oxidative stress. The effect of ACE and apelin on POAF after off-pump coronary artery bypass grafting (OPCABG) remains a question. The concentrations of serum ACE, angiotensin II (Ang II), apelin, bradykinin (BK), malondialdehyde (MDA), and C reactive protein (CRP) were measured in the perioperative period of OPCABG...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#5
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28291129/frailty-and-anesthesia
#6
Lior Shem Tov, Idit Matot
PURPOSE OF REVIEW: This review will deliberate on contemporary concepts regarding the frailty syndrome and its association with the perioperative period. Frailty syndrome and its relevance to organ systems, scoring tools and intervention measures will be discussed in detail. RECENT FINDINGS: Frail patients have a reduced ability to respond to physical stress, similar to a decreased physiological reserve in the perioperative period. Frailty assessment is gaining popularity as a tool to guide medical interventions in the elderly population...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28283237/duodenal-ulcers-are-a-major-cause-of-gastrointestinal-bleeding-after-cardiac-surgery
#7
Frances Krawiec, Andrew Maitland, Qiuli Duan, Peter Faris, Paul J Belletrutti, William D T Kent
OBJECTIVE: To determine the incidence of gastrointestinal (GI) bleeding in patients after cardiac surgery, assess the perioperative risk factors, and determine the type of GI tract pathology associated with bleeding events. METHODS: At a tertiary referral hospital, all cardiac surgery patients having a postoperative GI bleed from April 2002 to March 2012 were identified. To determine bleeding etiology, only patients requiring endoscopy were included in the analysis...
February 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28280511/combination-treatment-of-perioperative-rehabilitation-and-psychoeducation-undergoing-thoracic-surgery
#8
Kazuhiro Hayashi, Takayuki Inoue, Motoki Nagaya, Satoru Ito, Hiroki Nakajima, Keiko Hattori, Izumi Kadono, Kohei Yokoi, Yoshihiro Nishida
Postoperative pulmonary complications are a risk associated with thoracic surgery. However, there have been few reports on cases at high risk of postoperative complications. Cancer patients often have negative automatic thoughts about illness, and these negative automatic thoughts are associated with reduced health behavior and physical activity. This case series demonstrates the successful combination treatment of perioperative rehabilitation and psychoeducation for negative automatic thoughts in two cancer patients who underwent thoracic surgery...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28272252/comparative-evaluation-of-the-effect-of-remifentanil-and-2-different-doses-of-esmolol-on-pain-during-propofol-injection-a-double-blind-randomized-clinical-consort-study
#9
RANDOMIZED CONTROLLED TRIAL
Myunghwan Lee, Taegeon Kwon, Sujin Kim, Saeyoung Kim, Kibum Park, Younghoon Jeon
BACKGROUND: Propofol is associated with pain during injection, which is stressful to patients. The present study was designed to investigate the analgesic effect of pretreatment with remifentanil and esmolol in minimizing propofol injection pain, compared with placebo. METHODS: In a randomized, double-blind, prospective trial, 120 patients, scheduled for elective dental surgery under general anesthesia, were randomized to 1 of the 4 treatment arms (n = 30 each) receiving normal saline, remifentanil 0...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28259573/functional-status-predicts-major-complications-and-death-after-endovascular-repair-of-abdominal-aortic-aneurysms
#10
Donald G Harris, Ilynn Bulatao, Connor P Oates, Richa Kalsi, Charles B Drucker, Nandakumar Menon, Tanya R Flohr, Robert S Crawford
OBJECTIVE: Endovascular aneurysm repair (EVAR) is considered a lower risk option for treating abdominal aortic aneurysms and is of particular utility in patients with poor functional status who may be poor candidates for open repair. However, the specific contribution of preoperative functional status to EVAR outcomes remains poorly defined. We hypothesized that impaired functional status, based simply on the ability of patients to perform activities of daily living, is associated with worse outcomes after EVAR...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259273/a-double-blind-placebo-randomized-controlled-trial-of-minocycline-to-reduce-pain-after-carpal-tunnel-and-trigger-finger-release
#11
Catherine M Curtin, Debbie Kenney, Paola Suarez, Vincent R Hentz, Tina Hernandez-Boussard, Sean Mackey, Ian R Carroll
PURPOSE: Minocycline is a microglial cell inhibitor and decreases pain behaviors in animal models. Minocycline might represent an intervention for reducing postoperative pain. This trial tested whether perioperative administration of minocycline reduced time to pain resolution (TPR) after standardized hand surgeries with known prolonged pain profiles: carpal tunnel release (CTR) and trigger finger release (TFR). METHODS: This double-blinded randomized controlled trial included patients undergoing CTR or TFR under local anesthesia...
March 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28258664/surgical-and-not-analgesic-technique-affects-postoperative-inflammation-following-colorectal-cancer-surgery-a-prospective-randomized-study
#12
W Siekmann, C Eintrei, A Magnuson, A Sjölander, P Matthiessen, P Myrelid, A Gupta
AIM: Epidural analgesia reduces the surgical stress response. However, its effect on pro- and anti-inflammatory cytokines in the genesis of inflammation following major abdominal surgery remains unclear. Our main objective was to elucidate whether perioperative epidural analgesia prevents the inflammatory response following colorectal cancer surgery. METHODS: 96 patients scheduled for open or laparoscopic surgery were randomized to epidural analgesia (group E) or patient controlled intravenous analgesia (group P)...
March 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28254232/comparing-the-midterm-outcome-of-single-incision-vaginal-mesh-and-transobturator-vaginal-mesh-in-treating-severe-pelvic-organ-prolapse
#13
Tsai-Hwa Yang, Ling-Ying Wu, Fei-Chi Chuang, Fu-Tsai Kung, Kuan-Hui Huang
OBJECTIVE: The aim of this study is to compare perioperative parameters and midterm clinical outcomes using two different mesh kits: transobturator vaginal mesh (TVM) (both Perigee and Apogee), versus single incision vaginal mesh (SIM) (combined Elevate anterior/apical system and Elevate posterior/apical system) in treating severe pelvic organ prolapse (POP). MATERIALS AND METHODS: This is a retrospective cohort study. During 2008 and 2013, those women with severe POP [POP quantification system (POP-Q), Stage III and Stage IV], who received either TVM or SIM operation, were enrolled for cohort comparison...
February 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28246501/how-do-surgical-stress-and-low-perioperative-serum-protein-and-albumin-impact-upon-short-term-morbidity-and-mortality-in-gastric-cancer-surgery
#14
Alexandru Munteanu, Doru Munteanu, Stefan Tigan, Adrian Bartos, Cornel Iancu
BACKGROUND: Patients undergoing surgery for gastric cancer may be expected to develop a certain range of postoperative complications. This retrospective cohort study determined if gauging the serum value of total proteins and albumins before and especially after surgery can predict an undesired short term outcome in patients with gastric resections for cancer, as we have not found studies debating the link between low postoperative total proteins or albumins and early postoperative morbidity...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/28241948/nurses-and-health-promoting-behaviors-knowledge-may-not-translate-into-self-care
#15
Alyson Ross, Margaret Bevans, Alyssa T Brooks, Susanne Gibbons, Gwenyth R Wallen
Nurses are knowledgeable regarding the importance of health-promoting activities such as healthy eating, physical activity, stress management, sleep hygiene, and maintaining healthy relationships. However, this knowledge may not translate into nurses' own self-care. Nurses may not follow recommended guidelines for physical activity and proper nutrition. Long hours, work overload, and shift work associated with nursing practice can be stressful and contribute to job dissatisfaction, burnout, and health consequences such as obesity and sleep disturbances...
March 2017: AORN Journal
https://www.readbyqxmd.com/read/28241947/cultivating-mindfulness-to-promote-self-care-and-well-being-in-perioperative-nurses
#16
Rachel E Myers
Nursing has long been regarded as a stress-filled profession; the perioperative environment in particular is considered especially challenging. Chronic stress and burnout may have detrimental effects not only on perioperative nurses but also on their coworkers, employers, and patients. Nurses often sacrifice their own needs to care for others. Nurses must first take care of themselves, however, to sustain their optimal ability to provide care for patients. The cultivation of mindfulness is one way that perioperative nurses may promote self-care and well-being...
March 2017: AORN Journal
https://www.readbyqxmd.com/read/28237537/neurocognitive-and-psychiatric-issues-post-cardiac-surgery
#17
REVIEW
Ben Indja, Michael Seco, Richard Seamark, Jason Kaplan, Paul G Bannon, Stuart M Grieve, Michael P Vallely
Neurocognitive and psychiatric complications are common following cardiac surgery and impact on patient quality of life, recovery from surgery, participation in rehabilitation and long-term mortality. Postoperative cognitive decline, depressive disorders, post-traumatic stress disorder and neurocognitive impairment related to silent brain infarcts have all been linked to the perioperative period of cardiac surgery, and potentially have serious consequences. The accurate assessment of these conditions, particularly in determining the aetiology, and impact on patients is difficult due to the poorly recognised nature of these complications as well as similarities in presentation with postoperative delirium...
February 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28235510/effect-of-stellate-ganglion-block-on-hemodynamics-and-stress-responses-during-co2-pneumoperitoneum-in-elderly-patients
#18
Yong-Quan Chen, Yu-Yizi Xie, Bin Wang, Xiao-Ju Jin
STUDY OBJECTIVE: Elderly patients undergoing elective laparoscopic cholecystectomy (LC) were given right stellate ganglion block (RSGB) to observe its effects on the hemodynamics and stress response during carbon dioxide (CO2)-pneumoperitoneum. DESIGN: A randomized, single-blinded, and placebo-controlled study. SETTING: University-affiliated teaching hospital. PARTICIPANTS: Sixty patients (aged 65-78years; weight, 45-75kg; American Society of Anesthesiologists (ASA) physical status classification, class I or II) undergoing elective LC...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28222991/perioperative-clopidogrel-is-associated-with-increased-bleeding-and-blood-transfusion-at-the-time-of-lower-extremity-bypass
#19
Douglas W Jones, Marc L Schermerhorn, Benjamin S Brooke, Mark F Conrad, Philip P Goodney, Mark C Wyers, David H Stone
OBJECTIVE: Controversy persists surrounding the perceived bleeding risk associated with perioperative clopidogrel use in patients undergoing lower extremity bypass (LEB). The purpose of this study was to examine the LEB bleeding risk and clinical sequelae associated with clopidogrel. METHODS: All LEBs in the Vascular Quality Initiative (VQI) from 2008 to 2014 were studied. The exposure was perioperative clopidogrel. Primary outcomes were blood transfusion, estimated blood loss ≥500 mL, and reoperation for bleeding...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222805/use-of-activity-tracking-in-major-visceral-surgery-the-enhanced-perioperative-mobilization-epm-trial-study-protocol-for-a-randomized-controlled-trial
#20
Steffen Wolk, Theresa Meißner, Sebastian Linke, Benjamin Müssle, Ann Wierick, Andreas Bogner, Dorothée Sturm, Nuh N Rahbari, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. "Early mobilization" is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands...
February 21, 2017: Trials
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