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https://www.readbyqxmd.com/read/27906757/effect-of-an-immersive-preoperative-virtual-reality-experience-on-patient-reported-outcomes-a-randomized-controlled-trial
#1
Kimon Bekelis, Daniel Calnan, Nathan Simmons, Todd A MacKenzie, George Kakoulides
OBJECTIVE: To investigate the effect of exposure to a virtual reality (VR) environment preoperatively on patient-reported outcomes for surgical operations. BACKGROUND: There is a scarcity of well-developed quality improvement initiatives targeting patient satisfaction. METHODS: We performed a randomized controlled trial of patients undergoing cranial and spinal operations in a tertiary referral center. Patients underwent a 1:1 randomization to an immersive preoperative VR experience or standard preoperative experience stratified on type of operation...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27900413/recommendations-of-the-german-association-of-anesthesiology-and-intensive-care-medicine-dgai-on-structured-patient-handover-in-the-perioperative-setting-the-sbar-concept
#2
V von Dossow, B Zwissler
Teamwork in the operating room and in the intensive care unit necessitates clear and precise communication; however, interruptions in communication frequently occur, especially in the perioperative phase. Patients are particularly susceptible to deficits in communication, e.g. due to higher stress peaks, simultaneous admission of several patients and concomitant treatment of emergency cases. The German Society of Anesthesiology and Intensive Care Medicine (DGAI) therefore recommends the implementation of the so-called SBAR concept (S situation, B background, A assessment, R recommendation) for standardization of patient handover...
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27900224/perioperative-severe-hypotension-in-a-patient-with-multiple-endocrine-neoplasia-type-iib-and-bilateral-adrenalectomies-time-to-review-the-evidence-for-stress-dose-steroids
#3
Jens Tan, Acsa Zavala, Katherine B Hagan, Antoinette Van Meter, Uduak Ursula Williams, Wei Zhang, Pascal Owusu-Agyemang
Multiple endocrine neoplasia type IIb (MEN IIb) is an endocrine disorder which can manifest with tumors such as pheochromocytomas and neuromas. We present the case of a patient with MEN IIb, after bilateral adrenalectomies, on maintenance steroid replacement, who underwent a neuroma resection and developed severe hypotension. There is persistent controversy regarding the general administration of perioperative "stress dose" steroids for patients with adrenal insufficiency. While the most recent literature suggests that stress dose steroids are unnecessary for secondary adrenal insufficiency, the rarer form of primary adrenal insufficiency always requires supplemental steroids, specifically hydrocortisone, when undergoing surgical procedures...
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/27900218/a-prospective-randomised-controlled-study-comparing-bipolar-plasma-vaporisation-of-the-prostate-to-monopolar-transurethral-resection-of-the-prostate
#4
Ahmed M Elsakka, Hssan H Eltatawy, Khaled H Almekaty, Ahmed R Ramadan, Tarik A Gameel, Yasser Farahat
OBJECTIVES: To compare the safety and efficacy of bipolar transurethral plasma vaporisation (B-TUVP) as an alternative to the 'gold standard' monopolar transurethral resection of the prostate (M-TURP) for the treatment of benign prostatic hyperplasia (BPH) in a prospective randomised controlled study. PATIENTS AND METHODS: In all, 82 patients indicated for prostatectomy were assigned to two groups, group I (40 patients) underwent B-TUVP and group II (42 patients) underwent M-TURP...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27870734/incremental-value-of-preoperative-copeptin-for-predicting-myocardial-injury
#5
Eckhard Mauermann, Daniel Bolliger, Esther Seeberger, Christian Puelacher, Sydney Corbiere, Miodrag Filipovic, Manfred Seeberger, Christian Mueller, Giovanna Lurati Buse
BACKGROUND: Copeptin, a novel marker of endogenous stress, has shown diagnostic and prognostic value in nonsurgical patients with a suspected coronary event. We aimed to assess the incremental value of copeptin in addition to established preoperative risk indices to predict the occurrence of postoperative myocardial injury. METHODS: This secondary analysis of prospectively collected data included adults undergoing noncardiac surgery with risk factors for adverse perioperative cardiac events based on preoperative risk stratification...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27866303/anesthetic-technique-and-cancer-recurrence-in-oncologic-surgery-unraveling-the-puzzle
#6
Ryungsa Kim
Surgery/anesthetic technique-stimulated immunosuppression in the perioperative period might cause an increase in cancer-related mortality. Whether anesthetic technique can affect the outcomes of cancer patients remains inconclusive. This review discusses data from the available literature on anesthetic techniques applied in oncologic surgery, the long-term outcomes of anesthetic technique, and their relation to survival and cancer recurrence. Searches of the PubMed database up to June 30, 2016, were conducted to identify publications with the terms "anesthetic technique and cancer recurrence," "regional anesthesia and cancer recurrence," "local anesthesia and cancer recurrence," "anesthetic technique and immunosuppression," and "anesthetic technique and oncologic surgery...
November 19, 2016: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/27865641/canadian-cardiovascular-society-guidelines-on-perioperative-cardiac-risk-assessment-and-management-for-patients-who-undergo-noncardiac-surgery
#7
Emmanuelle Duceppe, Joel Parlow, Paul MacDonald, Kristin Lyons, Michael McMullen, Sadeesh Srinathan, Michelle Graham, Vikas Tandon, Kim Styles, Amal Bessissow, Daniel I Sessler, Gregory Bryson, P J Devereaux
The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery...
October 4, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27830409/perioperative-cardiovascular-evaluation-for-orthotopic-liver-transplantation
#8
REVIEW
Robert J Donovan, Calvin Choi, Asghar Ali, Douglas M Heuman, Michael Fuchs, Anthony A Bavry, Ion S Jovin
Patients with advanced liver disease have a high prevalence of cardiovascular risk factors, but many of them are asymptomatic. Cardiovascular risk stratification prior to liver transplant can be done by dobutamine stress echocardiography, stress myocardial perfusion imaging, cardiac computer tomography, and coronary angiography, but there are no clear recommendations regarding what method should be used and who should be screened. Because of this and because of inherent risk profile in this population, the variations in practice are significant...
November 9, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27828796/perioperative-anesthesia-care-and-tumor-progression
#9
Mir W Sekandarzad, André A J van Zundert, Philipp B Lirk, Chris W Doornebal, Markus W Hollmann
This narrative review discusses the most recent up-to-date findings focused on the currently available "best clinical practice" regarding perioperative anesthesia care bundle factors and their effect on tumor progression. The main objective is to critically appraise the current literature on local anesthetics, regional outcome studies, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) and their ability to decrease recurrence in patients undergoing cancer surgery. A brief discussion of additional topical perioperative factors relevant to the anesthesiologist including volatile and intravenous anesthetics, perioperative stress and anxiety, nutrition, and immune stimulation is included...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27824216/glucose-mediated-cytoprotection-in-the-gut-epithelium-under-ischemic-and-hypoxic-stress
#10
REVIEW
Chung-Yen Huang, Yu-Chen Pai, Linda Chia-Hui Yu
Single-layered intestinal epithelia play key roles in the maintenance of gut homeostasis and barrier integrity. Various types of epithelial cell death, including apoptosis, necrosis, and necroptosis, have been detected in ischemic and hypoxic stress conditions, thus resulting in bacterial translocation and gut-derived septic complications. Cytoprotective strategies, such as enteral glucose uptake, rescue intestinal epithelium from cell death after ischemic and hypoxic injury. Although glucose metabolism and energy production are generally considered to be the key factors in cytoprotection, the precise modes and sites of action have not been clarified...
November 8, 2016: Histology and Histopathology
https://www.readbyqxmd.com/read/27783239/risk-scores-as-useful-predictors-of-perioperative-complications-in-patients-with-rectal-cancer-who-received-radical-surgery
#11
Hiroshi Miyakita, Sotaro Sadahiro, Gota Saito, Kazutake Okada, Akira Tanaka, Toshiyuki Suzuki
BACKGROUND: Rectal cancer is associated with a higher rate of surgical complications. The ability to predict the risk of complications before treatment would facilitate the design of personalized treatment strategies optimally suited for each patient. METHODS: We retrospectively studied 260 patients with rectal cancer who underwent radical surgery to examine the relations between complications and 5 types of risk scores. RESULTS: Complications developed in 56 patients (21...
October 25, 2016: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27766387/learning-curves-and-perioperative-outcomes-after-endoscopic-enucleation-of-the-prostate-a-comparison-between-greenlight-532-nm-and-holmium-lasers
#12
Benoit Peyronnet, Grégoire Robert, Vincent Comat, Morgan Rouprêt, Fernando Gomez-Sancha, Jean-Nicolas Cornu, Vincent Misrai
PURPOSE: To compare the learning curves, perioperative and early functional outcomes after HoLEP and GreenLEP. METHODS: Data from the first 100 consecutive cases treated by GreenLEP and HoLEP by two surgeons were prospectively collected from dedicated databases and analysed retrospectively. En-bloc GreenLEP and two-lobar HoLEP enucleations were conducted using the GreenLight HPS™ 2090 laser and Lumenis™ holmium laser. Patients' characteristics, perioperative outcomes and functional outcomes after 1, 3 and 6 months were compared between groups...
October 20, 2016: World Journal of Urology
https://www.readbyqxmd.com/read/27761041/acute-post-operative-diabetic-ketoacidosis-atypical-harbinger-unmasking-latent-diabetes-mellitus
#13
Rudrashish Haldar, Ankur Khandelwal, Devendra Gupta, Shashi Srivastava, Prabhat K Singh
Hyperglycaemia following surgical and anaesthetic stress is a well-established entity which might have undesirable clinical consequences in known diabetics. We encountered a rare event where an undiagnosed diabetic patient developed ketoacidosis in the immediate post-operative period which was her initial presenting symptom of deranged glucoregulation. Presumably, the stress induced by surgery and anaesthesia lead to the genesis of this event. We discuss the management of this case. In addition, we highlight the importance of glycosylated haemoglobin as a subject of future research in identifying such "at risk" patients and for stratifying the risk of hyperglycaemic complications in perioperative settings...
October 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27755054/relationship-between-preoperative-evaluation-blood-pressure-and-preinduction-blood-pressure-a-cohort-study-in-patients-undergoing-general-anesthesia
#14
Wilton A van Klei, Judith A R van Waes, Wietze Pasma, Teus H Kappen, Leo van Wolfswinkel, Linda M Peelen, Cor J Kalkman
BACKGROUND: For outcomes research where changes in intraoperative blood pressure are a possible causative factor, it is important to determine an appropriate source for a reference value. We studied to what extent preinduction blood pressure values in the operating room differ from those obtained during preoperative evaluation outside the operating room. METHODS: Cohort study including 4408 patients aged 60 years or older undergoing noncardiac surgery. The outcome was the difference between the preinduction mean blood pressure (MBP) and the MBP obtained during preoperative evaluation...
October 11, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27746541/evolving-with-modern-technology-impact-of-incorporating-audiovisual-aids-in-preanesthetic-checkup-clinics-on-patient-education-and-anxiety
#15
Haramritpal Kaur, Gurpreet Singh, Amandeep Singh, Gagandeep Sharda, Shobha Aggarwal
BACKGROUND AND AIMS: Perioperative stress is an often ignored commonly occurring phenomenon. Little or no prior knowledge of anesthesia techniques can increase this significantly. Patients awaiting surgery may experience high level of anxiety. Preoperative visit is an ideal time to educate patients about anesthesia and address these fears. The present study evaluates two different approaches, i.e., standard interview versus informative audiovisual presentation with standard interview on information gain (IG) and its impact on patient anxiety during preoperative visit...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746522/anesthetic-management-of-intestinal-obstruction-a-postgraduate-educational-review
#16
S Parthasarathy, R Sripriya, N Krishnaveni
Intestinal obstruction is associated with significant morbidity and mortality. Scientific assessment of the cause, site of obstruction, appropriate correction of the fluid deficit and electrolyte imbalance with preoperative stabilization of blood gases is ideal as a preoperative workup. Placement of a preoperative epidural catheter especially in the thoracic interspace takes care of perioperative pain and stress reduction. Intraoperative management by controlled general anesthesia administering a relative high inspired fraction of oxygen with invasive monitoring in selected sick cases is mandatory...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27738739/methodology-for-a-vaginal-and-urinary-microbiome-study-in-women-with-mixed-urinary-incontinence
#17
Yuko M Komesu, Holly E Richter, Darrell L Dinwiddie, Nazema Y Siddiqui, Vivian W Sung, Emily S Lukacz, Beri Ridgeway, Lily A Arya, Halina M Zyczynski, Rebecca G Rogers, Marie Gantz
INTRODUCTION AND HYPOTHESIS: We describe the rationale and methods of a study designed to compare vaginal and urinary microbiomes in women with mixed urinary incontinence (MUI) and similarly aged, asymptomatic controls. METHODS: This paper delineates the methodology of a supplementary microbiome study nested in an ongoing randomized controlled trial comparing a standardized perioperative behavioral/pelvic floor exercise intervention plus midurethral sling versus midurethral sling alone for MUI...
October 13, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27737905/timing-surgery-in-mitral-regurgitation-defining-risk-and-optimising-intervention-using-stress-echocardiography
#18
REVIEW
Boyang Liu, Nicola C Edwards, Simon Ray, Richard P Steeds
Mitral regurgitation (MR) is the second most common form of valvular disease requiring surgery. Correct identification of surgical candidates and optimising the timing of surgery are key in management. For primary MR, this relies upon a balance between the peri-operative risks and rates of successful repair in patients undergoing early surgery when asymptomatic with the potential risk of irreversible left ventricular dysfunction if intervention is performed too late. For secondary MR, recognition that this is a highly dynamic condition where MR severity may change is key, although data on outcomes in determining whether concomitant valve intervention is performed with revascularisation has raised questions regarding timing of surgery...
December 2016: Echo Research and Practice
https://www.readbyqxmd.com/read/27724842/anesthetic-experience-of-an-adult-male-with-citrullinemia-type-ii-a-case-report
#19
Jung Ju Choi, Hong Soon Kim, Kyung Cheon Lee, Youseok Shin, Youn Yi Jo
BACKGROUND: Citrullinemia type II is an autosomal recessive urea cycle disorder and a subtype of citrin deficiency. However, the management of recurrent hyperammonemia with neurologic symptoms in patients with citrullinemia type II is quite different from the management of other types of urea cycle disorders. In pats with citrullinemia type II, regional anesthesia might be a good choice for the early detection of hyperammonemic symptoms and addressing psychic stress. CASE PRESENTATION: A 48-year-old male with adult onset citrullinemia type II was scheduled for urethral scrotal fistula repair...
October 11, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27720335/inattentional-blindness-and-failures-to-rescue-the-deteriorating-patient-in-critical-care-emergency-and-perioperative-settings-four-case-scenarios
#20
Angela Jones, Megan-Jane Johnstone
BACKGROUND: Failure to identify and respond to clinical deterioration is an important measure of patient safety, hospital performance and quality of care. Although studies have identified the role of patient, system and human factors in failure to rescue events, the role of 'inattentional blindness' as a possible contributing factor has been overlooked. OBJECTIVES: To explore the nature and possible patient safety implications of inattentional blindness in critical care, emergency and perioperative nursing contexts...
October 5, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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