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Perioperative assessment

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https://www.readbyqxmd.com/read/28087282/short-term-perioperative-teriparatide-therapy-for-the-prevention-of-medication-related-osteonecrosis-of-the-jaw-a-randomized-controlled-preclinical-study-in-rats
#1
Mohammad Zandi, Arash Dehghan, Amirhossein Mohammadi-Mofrad, Payam Amini, Farshid Vahdatinia
OBJECTIVE: Dentoalveolar procedures in patients receiving bisphosphonates and other antiresorptive agents are associated with an increased risk of medication-related osteonecrosis of the jaw (MRONJ). The aim of present study was to evaluate the effects of perioperative teriparatide (TPD) therapy in prevention of MRONJ. SUBJECTS AND METHODS: Two protocols of TPD therapy were studied. For protocol A, 25 TPD-treated (AT) and 25 control (AC) rats received 5 weekly injection of 0...
December 19, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28079737/dexmedetomidine-reduces-perioperative-opioid-consumption-and-postoperative-pain-intensity-in-neurosurgery-a-meta-analysis
#2
Yi Liu, Feng Liang, Xiaochen Liu, Xinxin Shao, Nan Jiang, Xiaoliang Gan
BACKGROUND: Dexmedetomidine (DEX) has been administered to patients during neurosurgery. Some studies have found that DEX could reduce perioperative opioid consumption and postoperative pain intensity. However, no firm conclusions have been reached. The purpose of this meta-analysis was to assess the efficacy of DEX for managing pain in neurosurgical patients. MATERIALS AND METHODS: A comprehensive literature review was conducted to identify randomized controlled trials (RCTs) focusing on the effects of DEX on perioperative opioid consumption and postoperative pain intensity in patients undergoing neurosurgery...
January 10, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28079581/assessing-the-impact-of-the-anesthesia-medication-template-on-medication-errors-during-anesthesia-a-prospective-study
#3
Eliot B Grigg, Lizabeth D Martin, Faith J Ross, Axel Roesler, Sally E Rampersad, Charles Haberkern, Daniel K W Low, Kristen Carlin, Lynn D Martin
BACKGROUND: Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079430/multimodal-prehabilitation-improves-functional-capacity-before-and-after-colorectal-surgery-for-cancer-a-five-year-research-experience
#4
Enrico Maria Minnella, Guillaume Bousquet-Dion, Rashami Awasthi, Celena Scheede-Bergdahl, Francesco Carli
BACKGROUND: Multimodal prehabilitation is a preoperative conditioning intervention in form of exercise, nutritional assessment, whey protein supplementation, and anxiety-coping technique. Despite recent evidence suggesting that prehabilitation could improve functional capacity in patients undergoing colorectal surgery for cancer, all studies were characterized by a relatively small sample size. The aim of this study was to confirm what was previously found in three small population trials...
January 12, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28079259/three-point-transfusion-risk-score-in-hepatectomy
#5
M Lemke, C H L Law, J Li, E Dixon, M Tun Abraham, R Hernandez Alejandro, S Bennett, G Martel, P J Karanicolas
BACKGROUND: Perioperative red blood cell transfusions are required in up to 23 per cent of patients undergoing hepatectomy. Previous research has developed three transfusion risk scores to assess risk of perioperative red blood cell transfusion. Here, the performance of these transfusion risk scores was evaluated in a multicentre cohort of patients who underwent hepatectomy and compared with that of a simplified transfusion risk score. METHODS: A database of patients undergoing hepatectomy at four specialized centres between 2008 and 2012 was developed...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28077819/association-between-blood-transfusions-and-12-month-mortality-after-transcatheter-aortic-valve-implantation
#6
Pawel Kleczynski, Artur Dziewierz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Jaroslaw Trebacz, Robert Sobczynski, Marek Tomala, Maciej Stapor, Dariusz Dudek
Blood transfusions are considered as an important predictor of adverse outcome in patients with severe aortic (AS) undergoing transcatheter aortic valve implantation (TAVI). We sought to investigate the association between blood transfusions and mortality after TAVI. We enrolled 101 consecutive patients with severe AS undergoing TAVI. Patients who required transfusion were defined as patients in whom at least one unit of packed red blood cells (PRBCs) was transfused in the perioperative period. Twelve-month outcomes were assessed based on Valve Academic Research Consortium definitions...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28077531/sodium-bicarbonate-does-not-prevent-postoperative-acute-kidney-injury-after-off-pump-coronary-revascularization-a-double-blinded-randomized-controlled-trial
#7
S Soh, J W Song, J K Shim, J H Kim, Y L Kwak
BACKGROUND: Acute kidney injury (AKI) is a common morbidity after off-pump coronary revascularization. We investigated whether perioperative administration of sodium bicarbonate, which might reduce renal injury by alleviating oxidative stress in renal tubules, prevents postoperative AKI in off-pump coronary revascularization patients having renal risk factors. METHODS: Patients (n=162) having at least one of the following AKI risk factors were enrolled: (i) age >70 yr; (ii) diabetes mellitus; (iii) chronic renal disease; (iv) congestive heart failure or left ventricular ejection fraction <35%; and (v) reoperation or emergency...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077529/poor-agreement-in-significant-findings-between-meta-analyses-and-subsequent-large-randomized-trials-in-perioperative-medicine
#8
REVIEW
H Sivakumar, P J Peyton
BACKGROUND: The reliability of meta-analysis (MA) in predicting the findings of subsequent large randomized controlled trials (RCTs) has not been assessed in perioperative medicine and anaesthesia. METHODS: Using Medline and PubMed, large RCTs (n≥1000) published since 2000 in the anaesthesia and perioperative medicine/critical care literature were identified. All previous MAs of RCTs investigating the same intervention and population were sourced. For all reported major morbid endpoints common to each, results (significant/non-significant P<0...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28076634/immediate-versus-delayed-treatment-for-recently-symptomatic-carotid-artery-stenosis
#9
Vladimir Vasconcelos, Nicolle Cassola, Edina Mariko Koga da Silva, José Carlos Costa Baptista-Silva
BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days) compared with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28076593/brachial-insertion-of-fully-implantable-venous-catheters-for-chemotherapy-complications-and-quality-of-life-assessment-in-35-patients
#10
Igor Yoshio Imagawa Fonseca, Mariana Krutman, Kenji Nishinari, Guilherme Yazbek, Marcelo Passos Teivelis, Guilherme André Zottele Bomfim, Rafael Noronha Cavalcante, Nelson Wolosker
Objective: To prospectively evaluate the perioperative safety, early complications and satisfaction of patients who underwent the implantation of central catheters peripherally inserted via basilic vein. Methods: Thirty-five consecutive patients with active oncologic disease requiring chemotherapy were prospectively followed up after undergoing peripheral implantation of indwelling venous catheters, between November 2013 and June 2014. The procedures were performed in the operating room by the same team of three vascular surgeons...
October 2016: Einstein
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#11
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073887/perioperative-predictors-of-permanent-pacing-and-long-term-dependence-following-tricuspid-valve-surgery-a-multicentre-analysis
#12
Philip L Mar, Christopher R Angus, Rajesh Kabra, Christopher K Migliore, Rohan Goswami, Leah A John, Yixi Tu, Rakesh Gopinathannair
AIMS: Permanent pacemaker placement (PPM) is often required after valvular surgery and is especially common following tricuspid valve surgery [tricuspid valve repair or replacement (TVR)]. Literature suggests that surgical intervention for isolated tricuspid valve disease is becoming more prevalent. Predictors of PPM dependency following TVR are currently unknown and would be clinically useful from a prognostication standpoint. METHODS AND RESULTS: We conducted a multicentre, retrospective study to assess perioperative factors of TVR that predispose to PPM placement and long-term PPM dependency from 2008 to 2014...
January 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28073791/rapid-deployment-aortic-replacement-radar-registry-in-spain-a-protocol
#13
Victor Bautista-Hernandez, Natalia Cal-Purriños, Jose M Arribas-Leal, Manuel Carnero-Alcazar, Jose F Gutierrez-Diez, Jose J Cuenca-Castillo
INTRODUCTION: Rapid deployment valves (RDV) represent a newly introduced approach to aortic valve replacement which facilitates surgical implantation and minimally invasive techniques, shortens surgical times and shows excellent haemodynamic performance. However, evidence on their safety, efficacy and potential complications is mostly fitted with small-volume and retrospective studies. Moreover, no current guidelines exist. To improve our knowledge on this technology, The Rapid Deployment Aortic Replacement (RADAR) Registry will be established across Spain with the aim of assessing RDV outcomes in the real-world setting...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28073753/migraine-and-risk-of-perioperative-ischemic-stroke-and-hospital-readmission-hospital-based-registry-study
#14
Fanny P Timm, Timothy T Houle, Stephanie D Grabitz, Anne-Louise Lihn, Janne B Stokholm, Katharina Eikermann-Haerter, Ala Nozari, Tobias Kurth, Matthias Eikermann
OBJECTIVE:  To evaluate whether patients with migraine are at increased risk of perioperative ischemic stroke and whether this may lead to an increased hospital readmission rate. DESIGN:  Prospective hospital registry study. SETTING:  Massachusetts General Hospital and two satellite campuses between January 2007 and August 2014. PARTICIPANTS:  124 558 surgical patients (mean age 52.6 years; 54.5% women). MAIN OUTCOME MEASURES:  The primary outcome was perioperative ischemic stroke occurring within 30 days after surgery in patients with and without migraine and migraine aura...
January 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28073736/development-of-an-educational-game-to-set-up-surgical-instruments-on-the-mayo-stand-or-back-table-applied-research-in-production-technology
#15
Crislaine Pires Padilha Paim, Silvia Goldmeier
BACKGROUND: Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. OBJECTIVE: To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education...
January 10, 2017: JMIR Serious Games
https://www.readbyqxmd.com/read/28072935/the-addition-of-tick-boxes-related-to-tobacco-cessation-improves-smoking-related-documentation-in-the-anaesthesia-chart
#16
A Webb, A C Wilson
The Australian and New Zealand College of Anaesthetists (ANZCA) 'Guidelines on Smoking as Related to the Perioperative Period (PS12)' recommends that anaesthetists should always ask about smoking, advise quitting and refer patients to their general practitioner (GP) or a telephone quit-line for quit support. In this study we evaluated the effect of adding tick-boxes for 'quit advice given' and 'referral to GP/Quitline' to anaesthesia charts of elective surgical patients to assess whether this intervention changed documentation of compliance with the ANZCA guideline...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28070234/contemporary-review-of-minimally-invasive-pancreaticoduodenectomy
#17
Rui Dai, Ryan S Turley, Dan G Blazer
AIM: To assess the current literature describing various minimally invasive techniques for and to review short-term outcomes after minimally invasive pancreaticoduodenectomy (PD). METHODS: PD remains the only potentially curative treatment for periampullary malignancies, including, most commonly, pancreatic adenocarcinoma. Minimally invasive approaches to this complex operation have begun to be increasingly reported in the literature and are purported by some to reduce the historically high morbidity of PD associated with the open technique...
December 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28069525/utilization-of-the-nsqip-pediatric-database-in-development-and-validation-of-a-new-predictive-model-of-pediatric-postoperative-wound-complications
#18
Ilan I Maizlin, David T Redden, Elizabeth A Beierle, Mike K Chen, Robert T Russell
BACKGROUND: Surgical wound classification, introduced in 1964, stratifies the risk of surgical site infection (SSI) based on a clinical estimate of the inoculum of bacteria encountered during the procedure. Recent literature has questioned the accuracy of predicting SSI risk based on wound classification. We hypothesized that a more specific model founded on specific patient and perioperative factors would more accurately predict the risk of SSI. STUDY DESIGN: Using all observations from the 2012 to 2014 pediatric National Quality Surgical Improvement-Pediatric (NSQIP-P) Participant Use File, patients were randomized into model creation and model verification datasets...
January 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28068796/partial-nephrectomy-for-presumed-renal-cell-carcinoma-incidence-predictors-and-perioperative-outcomes-of-benign-lesions
#19
Tyler Marques Bauman, Aaron Potretzke, Alec J Wright, Brent Alexander Knight, Joel M Vetter, Robert S Figenshau
BACKGROUND: The aim of this study was to investigate the incidence of benign histology after partial nephrectomy (PN) in patients with presumed malignancy from preoperative imaging. Further, preoperative predictors of benign lesions and perioperative outcomes were also assessed. METHODS: A series of patients undergoing PN for renal masses was identified using a prospectively maintained database. Patients were excluded for known genetic conditions, if more than one renal mass was resected, or if standard preoperative imaging was not suspicious for RCC...
January 9, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28064227/pet-probe-guided-surgery-in-patients-with-breast-cancer-proposal-for-a-methodological-approach
#20
Paolo Orsaria, Agostino Chiaravalloti, Alessandro Fiorentini, Chiara Pistolese, Gianluca Vanni, Alessandra Vittoria Granai, Dimitrios Varvaras, Roberta Danieli, Orazio Schillaci, Giuseppe Petrella, Oreste Claudio Buonomo
BACKGROUND: Although it is valuable for detecting distant metastases, identifying recurrence, and evaluating responses to chemotherapy, the role of (18)F-fluorodeoxyglucose positron-emission tomography/computed tomography ((18)F-FDG PET/CT) in assessing locoregional nodal status for initial staging of breast cancer has not yet been well-defined in clinical practice. In the current report, we describe a new PET probe-based clinical approach, with evaluation of the technical performance of a handheld high-energy gamma probe for intraoperative localization of breast carcinomas, and evaluation of lymph node metastases during radio-guided oncological surgery...
January 2017: In Vivo
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