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https://www.readbyqxmd.com/read/29341032/-epidemiology-diagnosis-and-treatment-of-adult-patients-with-nosocomial-pneumonia-update-2017-s3-guideline-of-the-german-society-for-anaesthesiology-and-intensive-care-medicine-the-german-society-for-infectious-diseases-the-german-society-for-hygiene-and-microbiology
#1
K Dalhoff, M Abele-Horn, S Andreas, M Deja, S Ewig, P Gastmeier, S Gatermann, H Gerlach, B Grabein, C P Heußel, G Höffken, M Kolditz, E Kramme, H Kühl, C Lange, K Mayer, I Nachtigall, M Panning, M Pletz, P-M Rath, G Rohde, S Rosseau, B Schaaf, D Schreiter, H Schütte, H Seifert, C Spies, T Welte
Nosocomial pneumonia (HAP) is a frequent complication of hospital care. Most data are available on ventilator-associated pneumonia. However, infections on general wards are increasing. A central issue are infections with multidrug resistant (MDR) pathogens which are difficult to treat in the empirical setting potentially leading to inappropriate use of antimicrobial therapy.This guideline update was compiled by an interdisciplinary group on the basis of a systematic literature review. Recommendations are made according to GRADE giving guidance for the diagnosis and treatment of HAP on the basis of quality of evidence and benefit/risk ratio...
January 2018: Pneumologie
https://www.readbyqxmd.com/read/29320788/-competence-based-training-in-the-protected-environment-from-sheltered-space-to-real-life
#2
Christina Quandt, Lars Friedrich
The idea of "learning in a protected environment" is frequently used within the framework of postgradual education in anaesthesiology. However it remains unclear and its exact meaning lies in the eye of the beholder. This paper aims to highlight the definition of the term "protected environment" and its relevance in anaesthesiology. This includes teaching and learning strategies like competence based training and simulation based training in all its variations. We conclude with an attempt to classify the wide variety of Simulators and teaching methods in use including their individual problems transferred into real life situations...
January 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29317415/examining-changes-in-the-equity-of-physician-distribution-in-japan-a-specialty-specific-longitudinal-study
#3
Koji Hara, Susumu Kunisawa, Noriko Sasaki, Yuichi Imanaka
OBJECTIVES: In this longitudinal study, we examined changes in the geographical distribution of physicians in Japan from 2000 to 2014 by clinical specialty with adjustments for healthcare demand based on population structure. METHODS: The Japanese population was adjusted for healthcare demand using health expenditure per capita stratified by age and sex. The numbers of physicians per 100 000 demand-adjusted population (DAP) in 2000 and 2014 were calculated for subprefectural regions known as secondary medical areas...
January 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29316582/-burnout-in-intensive-care
#4
Andrej Michalsen, Andreas Hillert, Andreas Schießl, Dominik Hinzmann
Both acute crises and chronically incriminating circumstances in people's lives may lead to their being afflicted by psychological and somatic ailments. "Burnout" has been coined and established as the term for chronic occupational strain. Many professions claim to be extraordinarily affected by burnout, amongst others physicians and nurses, especially those working in anaesthesiology and critical care. Usually assessed with the Maslach Burnout Inventary, the prevalence of moderate or severe burnout in these areas is estimated at about 30 % amongst nurses and about 40 % to 50 % amongst physicians...
January 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29295779/a-survey-of-international-antisepsis-procedures-for-neuraxial-catheterisation-in-labour
#5
K Fayman, A Allan, C Hudson, M Logarta
BACKGROUND: Neuraxial analgesia during labour is a mainstay of anaesthetic practice globally. Despite the potential for significant neurological and infectious complications, international antisepsis practices for neuraxial anaesthesia vary widely. AIMS: The primary aim of this study was to clarify international antisepsis practices prior to neuraxial analgesia in labour. The secondary aim was to determine an approximate international incidence of neuraxial infections and neurological complications secondary to neuraxial analgesia techniques in labour...
October 6, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#6
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29248312/stress-prevalence-and-stressors-among-anaesthesiology-and-intensive-care-unit-workers-a-multicentre-survey-study
#7
Magdalena Kwiatosz-Muc, Anna Fijałkowska-Nestorowicz, Magdalena Fijałkowska, Anna Aftyka, Michał Kowalczyk
BACKGROUND: High stress levels have been commonly reported among ICU workers. Currently, anaesthesiology is safer for the patient but more stressful for the staff working in this branch of medicine. ICU and anaesthesiology personnel are prone to stress because of the specific character of their work. OBJECTIVES: Our objectives were to assess stress prevalence among anaesthesiology and ICU workers to compare this stress prevalence in relation to professional groups, sex, job seniority, and type of hospital and describe the importance of major stressors at work...
December 13, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29239202/validation-of-the-trust-tool-in-a-greek-perioperative-setting
#8
Vasiliki-Eirini Chatzea, Dimitra Sifaki-Pistolla, Nilanjan Dey, Evangelos Melidoniotis
The aim of this study was to translate, culturally adapt and validate the TRUST questionnaire in a Greek perioperative setting. The TRUST questionnaire assesses the relationship between trust and performance. The study assessed the levels of trust and performance in the surgery and anaesthesiology department during a very stressful period for Greece (economic crisis) and offered a user friendly and robust assessment tool. The study concludes that the Greek version of the TRUST questionnaire is a reliable and valid instrument for measuring team performance among Greek perioperative teams...
June 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29233755/postoperative-fasting-after-general-anaesthesia-a-survey-of-french-anaesthesiology-practices
#9
Sylvain Le Pape, Matthieu Boisson, Thibault Loupec, FabienVigneau, Bertrand Debaene, Denis Frasca
BACKGROUND: Preoperative fasting is well-codified worldwide. In contrast, the literature on the postoperative fasting (POF) is scarce leading to potentially wide discrepancies among anaesthesiology practices. This survey assessed French POF practices. METHODS: From March 2013 to January 2014, a survey was conducted among anaesthesiologists, members of the French Society of Anaesthesiology and Critical Care. The POF durations of either fluid or solid food intake was assessed according to airway management procedures (endotracheal intubation [EI] or laryngeal mask [LMA]) and age of the patients (adult or paediatric)...
December 9, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29226340/is-there-a-place-for-dexmedetomidine-in-equine-anaesthesia-and-analgesia-a-systematic-review-2005-2017
#10
REVIEW
M Gozalo-Marcilla, F Gasthuys, S P L Luna, S Schauvliege
The objective of this review was to perform a literature compilation of all the equine publications that used dexmedetomidine as the first article on this topic was published, in 2005. We also aimed to answer the question whether the use of dexmedetomidine can currently be justified. For that, we compiled information from databases, such as PubMed, Google Scholar and Web of Science and the proceedings of the last veterinary anaesthesiology meetings. Dexmedetomidine is an attractive drug to be used in horses, mainly due to its pharmacokinetic profile and pharmacodynamics that favour its use as intravenous constant rate infusion (CRI)...
December 11, 2017: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29226232/connecting-undergraduate-and-postgraduate-medical-education-through-an-elective-epa-based-transitional-year-in-acute-care-an-early-project-report
#11
Gersten Jonker, Reinier G Hoff, Stefan Max, Cor J Kalkman, Olle Ten Cate
Objective: A well-designed final year may ease the transition from medical school to postgraduate training, if it has enough depth to enable the acquisition of early specialty expertise, while keeping enough breadth to support the graduation as all-round physician. Aim of this article is to describe the design of a multidisciplinary dedicated transitional year (DTY) around the theme of recognition and initial treatment of vitally threatened patients. Methods: Undergraduate and postgraduate training directors from the departments of Anaesthesiology, Cardiology, Emergency Medicine, Intensive Care Medicine and Respiratory Medicine at UMC Utrecht and partnering hospitals have collaboratively developed and implemented a curriculum for a final year focusing on three entrustable professional activities (EPAs) in the domain of acute care...
2017: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/29193472/intellectual-disability-is-a-risk-factor-for-delayed-emergence-from-total-intravenous-anaesthesia
#12
H Higuchi, S Maeda, M Ishii-Maruhama, Y Honda-Wakasugi, A Yabuki-Kawase, T Miyawaki
BACKGROUND: Previous studies have suggested that ID influences the depth of general anaesthesia (GA) and delays emergence from GA. In this retrospective cohort study, we investigated whether ID affects the time taken to emerge from GA. METHODS: We selected dental patients who underwent GA at the Department of Dental Anaesthesiology, Okayama University Hospital, using predefined inclusion and exclusion criteria, before dividing the selected participants into ID and non-ID (control) groups...
November 29, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29189885/invited-review-the-tale-of-ecirs-endoscopic-combined-intrarenal-surgery-in-the-galdakao-modified-supine-valdivia-position
#13
REVIEW
Cesare Marco Scoffone, Cecilia Maria Cracco
Modern-day percutaneous nephrolithotomy (PNL) has undergone considerable evolution, mainly driven by the improvement in access techniques, endoscopic instrumentation technology, lithotripsy devices and drainage management. The introduction of the supine and supine-modified positions is also part of this evolution, enabling comfortable and safe procedures from an anaesthesiological point of view, and an easy combined retrograde surgery [Endoscopic Combined IntraRenal Surgery (ECIRS)], allowing tailoring of the procedure on the patient, the dynamic anatomy of the collecting system and the urolithiasis...
November 30, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29175318/effectiveness-of-a-blended-learning-course-including-e-learning-and-flipped-classroom-in-first-year-anaesthesia-training
#14
Antoine Marchalot, Bertrand Dureuil, Benoit Veber, Jean-Luc Fellahi, Jean-Luc Hanouz, Hervé Dupont, Emmanuel Lorne, Vincent Compère
BACKGROUND: Blended learning, which combines internet-based platform and lecturing, is used in anaesthesiology and critical care teaching. However, the benefits of this method remain unclear. METHODS: We conducted a prospective, multicentre, non-randomised work between 2007 and 2014 to study the effect of blended learning on the results of first year anaesthesia and critical care residents in comparison with traditional teaching. Blended learning was implemented in Rouen University Hospital in 2011 and residents affiliated to this university corresponded as the blended learning group...
November 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29166692/-neurological-or-interdisciplinary-outpatient-pain-treatment-comparison-of-treatment-success-and-satisfaction
#15
Fabiola Escolano-Lozano, Markus Breimhorst, Gilda Soltani, Rainer Schwab, Violeta Dimova, Frank Birklein, Tanja Schlereth
The aim of this study was to compare the satisfaction and success of treatment for pain patients who were interdisciplinary (anaesthesiological, psychosomatic, neurological, orthopedic) treated or underwent neurological care alone. Methods We selected 183 patients who were treated in our neurological clinic and in our interdisciplinary pain management center (IST). Of these, 142 patients having polyneuropathy, headache or muskuloskelettal pain were included in the final analysis. 39 patients (27.5 %) were treated in the IST and 103 patients were treated exclusively by a neurologist...
November 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29161401/the-evolution-of-airway-management-new-concepts-and-conflicts-with-traditional-practice
#16
A F McNarry, A Patel
In the last 25 yr, there have been several advances in the safe management of the airway. Videolaryngoscopes and supraglottic airways, now in routine use by new trainees in anaesthesia, have had their genesis in the recent past. The 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society published in 2011 a seminal report that has influenced airway management worldwide . Understanding how the report's recommendations were constructed and how clinical guidelines compliment rather than contradict them is important in understanding the tenets of safe airway management...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#17
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29156480/-frailty-prevalence-in-the-resident-population-of-germany-70%C3%A2-%C3%A2-79-years-of-age-a-population-based-approach
#18
Judith Fuchs, Markus Busch, Christa Scheidt-Nave
In all countries life expectancy is rising, and many older persons spend a longer period in good health. Nevertheless, frailty is present in older people and can be considered as a risk factor for limitations. The "German Health Interview and Examination Survey for Adults" (DEGS1) 2008 - 2011 comprised interviews, examinations and tests. Data on 1110 community-dwelling people aged 70 to 79 years participating in DEGS1 with full records on frailty were analysed. Physical frailty was defined as exhaustion (SF-36 item), low grip strength, slowness (Timed Up-and-Go test > 15 seconds or unable to perform) and low physical activity (no sports or exertion)...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29136093/overuse-of-preoperative-laboratory-coagulation-testing-and-abo-blood-typing-a-french-national-study
#19
H Beloeil, D Ruchard, N Drewniak, S Molliex
Background: Following publication of guidelines on routine preoperative tests, the French Society of Anaesthesiology and Intensive Care (SFAR), in association with French national public health insurance, conducted a survey to evaluate adherence to guidelines and the economic consequences. Methods: Using the French Hospital Discharge Database and National Health Insurance Information system, tests performed during the 30 days before surgery were analysed for two situations: (1) standard laboratory coagulation tests and ABO blood typing in children able to walk and scheduled for tonsillectomy/adenoidectomy; and (2) ABO blood typing in adults before laparoscopic cholecystectomy, thyroidectomy, lumbar discectomy or breast surgery...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29123661/the-psychology-of-chronic-post-surgical-pain-new-frontiers-in-risk-factor-identification-prevention-and-management
#20
Aliza Z Weinrib, Muhammad A Azam, Kathryn A Birnie, Lindsay C Burns, Hance Clarke, Joel Katz
In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of chronic postsurgical pain (CPSP). We begin with a definition of CPSP and then explain what we mean by a risk/protective factor. Next, we summarize known psychological risk and protective factors for CPSP. Psychological interventions that target risk factors and may impact postsurgical pain are reviewed, including the acceptance and commitment therapy (ACT)-based approach to CPSP prevention and management we use in the Transitional Pain Service (TPS) at the Toronto General Hospital...
November 2017: British Journal of Pain
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