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https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#1
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28913499/perioperative-hyperoxia-perhaps-a-malady-in-disguise
#2
REVIEW
Yalim Dikmen, Aybike Onur
Oxygen is an element, which is used liberally during several medical procedures. The use of oxygen during perioperative care is a controversial issue. Anesthesiologists use oxygen to prevent hypoxemia during surgical procedures, but the effects of its liberal use can be harmful. Another argument for using high oxygen concentrations is to prevent surgical site infections by increasing oxygen levels at the incision site. Although inconclusive, literature concerning the use of high oxygen concentrations during anesthesia show that this approach may cause hemodynamic changes, altered microcirculation and increased oxidative stress...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912876/effect-of-intercostal-nerve-block-combined-with-general-anesthesia-on-the-stress-response-in-patients-undergoing-minimally-invasive-mitral-valve-surgery
#3
Yanping Zhan, Guo Chen, Jian Huang, Benchao Hou, Weicheng Liu, Shibiao Chen
The aim of the present study was to investigate the effect of intercostal nerve block combined with general anesthesia on the stress response and postoperative recovery in patients undergoing minimally invasive mitral valve surgery (MIMVS). A total of 30 patients scheduled for MIMVS were randomly divided into two groups (n=15 each): Group A, which received intercostal nerve block combined with general anesthesia and group B, which received general anesthesia alone. Intercostal nerve block in group A was performed with 0...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28902941/intestinal-inflammatory-and-redox-responses-to-the-perioperative-administration-of-teduglutide-in-rats
#4
Beatriz Pinto da Costa, Ana Cristina Gonçalves, Ana Margarida Abrantes, Paulo Matafome, Raquel Seiça, Ana Bela Sarmento-Ribeiro, Maria Filomena Botelho, Francisco Castro-Sousa
Purpose: To investigate the inflammatory and redox responses to teduglutide on an animal model of laparotomy and intestinal anastomosis. Methods: Wistar rats (n=62) were allocated into four groups: "Ileal Resection and Anastomosis" vs. "Laparotomy", each one split into "Postoperative Teduglutide Administration" vs. "No Treatment"; and euthanized at the third or the seventh day. Ileal and blood samples were recovered at the baseline and at the euthanasia. Flow cytometry was used to study the inflammatory response (IL-1α, MCP-1, TNF-α, IFN-γ and IL-4 levels), oxidative stress (cytosolic peroxides, mitochondrial reactive species, intracellular glutathione and mitochondrial membrane potential) and cellular viability and death (annexin V/propidium iodide double staining)...
August 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28894976/implicating-anaesthesia-and-the-perioperative-period-in-cancer-recurrence-and-metastasis
#5
Julia A Dubowitz, Erica K Sloan, Bernhard J Riedel
Cancer, currently the leading cause of death in the population aged less than 85 years, poses a significant global disease burden and is anticipated to continue to increase in incidence in both developed and developing nations. A substantial proportion of cancers are amenable to surgery, with more than 60% of patients undergoing tumour resection. Up to 80% of patients will receive anaesthesia for diagnostic, therapeutic or palliative intervention. Alarmingly, retrospective studies have implicated surgical stress in disease progression that is predominantly characterised by metastatic disease-the primary cause of cancer-associated mortality...
September 11, 2017: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/28891127/helicobacter-pylori-gastric-cancer-and-other-gastrointestinal-malignancies
#6
REVIEW
Marino Venerito, Riccardo Vasapolli, Theodore Rokkas, Jean-Charles Delchier, Peter Malfertheiner
In a retrospective study performed in California, U.S.A., ca. 3% of patients with gastric intestinal metaplasia (GIM) developed gastric cancer (GC) within a median time period of 4.6 years after diagnosis of GIM. This observation stresses the importance of targeted surveillance even in regions with a low GC prevalence. Patients with alcoholic liver disease as well as survivors of colorectal and lobular breast cancer were found to be at increased risk of secondary GC. A population-based Chinese study confirmed "serologic biopsy" as a useful screening tool for stratifying the individual risk of developing GC...
September 2017: Helicobacter
https://www.readbyqxmd.com/read/28873504/eras-anticipated-outcomes-and-realistic-goals
#7
REVIEW
Maria Manso, Jacob Schmelz, Thomas Aloia
Enhanced recovery programs emphasize implementation of perioperative measures to reduce stress and restore baseline function. Complications and length of stay are greatly improved as a result, but the field is moving toward more patient centric and longer term outcomes that better reflect functional recovery. Programs demonstrating value in these domains will undoubtedly see corollary gains in traditional metrics. Thus, greater focus on patient well-being and treatment success is key to successful implementation of enhanced recovery...
September 5, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28870052/-clinical-efficacy-of-enhanced-recovery-after-surgery-in-atrial-caval-shunting-for-type-%C3%A2-budd-chiari-syndrome
#8
G J Tian, D Y Li, H B Yu, Y D Dong, Y N Peng, P Liu, Y K Wei, H Z Xue
Objective: To investigate the clinical efficacy of enhanced recovery after surgery(ERAS) in atrial caval shunting (ACS) for type Ⅱ Budd-Chiari syndrome(BCS). Methods: The clinical data of patients underwent ACS for type Ⅱ BCS in the Henan Province People's Hospital from January 2014 to June 2016 were prospectively analyzed.Randomized and single-blind, controlled study was performed among the patients, and all of them underwent ACS and were divided into control group (patients underwent traditional perioperative management) and ERAS group (patients underwent ERAS perioperative management) based on a random number table...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28864690/interprofessional-team-assessments-of-the-patient-safety-climate-in-swedish-operating-rooms-a-cross-sectional-survey
#9
Camilla Göras, Maria Unbeck, Ulrica Nilsson, Anna Ehrenberg
BACKGROUND: A positive patient safety climate within teams has been associated with higher safety performance. The aim of this study was to describe and compare attitudes to patient safety among the various professionals in surgical teams in Swedish operating room (OR) departments. A further aim was to study nurse managers in the OR and medical directors' estimations of their staffs' attitudes to patient safety. METHODS: A cross-sectional survey with the Safety Attitudes Questionnaire (SAQ) was used to elicit estimations from surgical teams...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28838318/anesthetic-management-during-adenotonsillectomy-for-twins-with-congenital-insensitivity-to-pain-with-anhidrosis-two-case-reports
#10
Cong Wang, Xianwei Zhang, Shanna Guo, Jiaoli Sun, Ningbo Li
BACKGROUND: Congenital insensitivity to pain with anhidrosis is a rare autosomal recessive disorder characterized by hyperpyrexia, anhidrosis, pain insensitivity, self-inflicted injuries, and intellectual disability. The anesthetic management of these patients is challenging owing to the high risk of perioperative complications resulting from their autonomic dysfunction, such as hyperthermia, hypotension, and bradycardia, which result from autonomic nervous system dysfunction. CASE PRESENTATION: Two 3-year-old Han Chinese identical male twins (weighing 13...
August 25, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28829221/enhanced-recovery-after-surgery-in-laparoscopic-surgery
#11
Kay B Leissner, Jessica L Shanahan, Peter L Bekker, Houman Amirfarzan
BACKGROUND: As part of an effort to maximize value in the perioperative setting, a paradigm shift is underway in the way that patients are cared for preoperatively, on the day of surgery, and postoperatively-a setting collectively known as the perioperative care. Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based, patient-centered team approach to delivering high-quality perioperative care to surgical patients. METHODS: This review focuses on anesthesiologists, with their unique purview of perioperative setting, who are important drivers of change in the delivery of valuable perioperative care...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#12
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28814371/dental-management-considerations-in-a-pediatric-patient-with-moyamoya-disease
#13
Htet Bo, David Avenetti, Evelina Kratunova
Moyamoya disease is a rare progressive cerebral arteriopathy associated with risk of ischemic and hemorrhagic brain complications. The dental care of affected individuals should be performed in a pain- and stress-free manner to decrease the chance of occurrence of episodes of hypocapnia, hypercapnia, hypotension, hypovolemia, and hypothermia. Dental treatment may be provided in an outpatient dental setting or in a hospital setting, but both venues require interdisciplinary collaboration to ensure safe delivery of patient care...
May 15, 2017: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/28812023/use-of-a-polyethylene-bag-to-reduce-perioperative-regional-and-whole-body-heat-losses-in-low-birth-weight-neonates
#14
Pierre Tourneux, Estelle Durand, Amandine Pelletier, Laurent Ghyselen, Véronique Bach, Jean-Pierre Libert
In the delivery room, wrapping a low-birth-weight neonate (defined as ≤2.499 g) in a polyethylene bag reduces the risk of hypothermia. However, extended use of the bag (e.g., during neonatal surgery) might conceivably increase the risk of thermal stress and thus body overheating. Here, we assessed the efficacy of a polyethylene bag in infants assigned to wrap (W) or nonwrap (NW, control) groups during placement of a percutaneous vena cava catheter by applying a new mathematical model that calculates heat exchanges for covered and uncovered body segments...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28800707/radiographic-results-and-return-to-activity-after-sesamoidectomy-for-fracture
#15
Justin M Kane, James W Brodsky, Yahya Daoud
BACKGROUND: Limited data are available comparing the results of lateral sesamoidectomy and medial sesamoidectomy for the treatment of fractures recalcitrant to nonoperative treatment interventions. The hypothesis of this study was that sesamoidectomy for either lateral or medial sesamoid fractures would not change radiographic alignment of the first ray given the use of identical reconstruction of the plantar plate, intersesamoid ligament, and plantar ligament complex at the time of surgery...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28794833/preoperative-cardiac-evaluation-with-transthoracic-echocardiography-before-non-cardiac-surgery
#16
REVIEW
Chi Young Shim
Transthoracic echocardiography has become increasingly popular in clinical practice. It is used for the functional evaluation of patients with various cardiovascular diseases. Its use has been extended further in routine screening for cardiovascular health and in preoperative risk assessment before non-cardiac surgery because it is non-invasive, easy to perform, reproducible, and cost-effective. When the results of preoperative echocardiography contain abnormalities, the findings must be interpreted to determine clinical relevance...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28791678/circulating-mitochondrial-stress-70-protein-mortalin-and-cytosolic-hsp70-in-blood-risk-indicators-in-colorectal-cancer
#17
Ritta Jubran, Judit Kocsis, Nóra Garam, Éva Maláti, Tímea Gombos, Loránd Barabás, László Gráf, Zoltán Prohászka, Zvi Fishelson
Mitochondrial mortalin and cytosolic Hsp70 are essential chaperones overexpressed in cancer cells. Our goals were to reproduce our earlier findings of elevated circulating levels of mortalin and Hsp70 in colorectal cancer (CRC) patients with a larger patient cohort, to compare death risk assessment of mortalin, Hsp70, CEA and C19-9 and to assess their prognostic value in various CRC stages. Mortalin, Hsp70, CEA and CA19-9 levels were determined in sera of 235 CRC patients enrolled in the study and followed up 5 years after surgery...
August 9, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28790294/-nutrient-assessment-and-perioperative-management-in-esophageal-cancer-patients-undergoing-esophagectomy
#18
Makoto Sohda, Hiroyuki Kuwano
Esophagectomy is a most invasive operation, as compared with other operations of the gastrointestinal tract. Obstructions of the food passageway and the overgrowth of tissue postoperatively may lead to malnutrition. Therefore, significant assessment and management of nutrients is very important for esophageal cancer patients. The body mass index, albumin, the prognostic nutritional index, controlling nutritional status, and the Glasgow Prognostic Score are reported as useful assessment tools for esophageal cancer...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28766696/serial-perioperative-cell-free-dna-levels-in-donors-and-recipients-undergoing-living-donor-liver-transplantation
#19
K Prakash, S Aggarwal, S Bhardwaj, G Ramakrishna, C K Pandey
BACKGROUND: Effect of anaesthesia and surgery on cell-free DNA (cfDNA) is not known. Given that surgical stress augments inflammation and injury, we hypothesized that levels of cfDNA will fluctuate during perioperative period. Therefore, in this study serial perioperative cfDNA concentration was measured in donors and recipients undergoing living donor liver transplantation (LDLT). METHODS: Baseline, post-induction, intraoperative and post-operative plasma cfDNA levels were evaluated in 21 donors and recipients each, by Sytox green method...
August 2, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28763358/effects-of-esmolol-on-the-esophagogastric-junction-a-double-blind-randomized-crossover-study-on-14-healthy-volunteers
#20
Fredrik Ander, Anders Magnuson, Lars Berggren, Rebecca Ahlstrand, Alex de Leon
BACKGROUND: Passive regurgitation may occur throughout the perioperative period, increasing the risk for pulmonary aspiration and postoperative pulmonary complications. Hypnotics and opioids, especially remifentanil, that are used during anesthesia have been shown to decrease the pressure in the esophagogastric junction (EGJ), that otherwise acts as a barrier against passive regurgitation of gastric contents. Esmolol, usually used to counteract tachycardia and hypertension, has been shown to possess properties useful during general anesthesia...
October 2017: Anesthesia and Analgesia
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