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https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#1
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28096011/a-systematic-nurse-led-approach-to-withdrawal-risk-screening-prevention-and-treatment-among-inpatients-with-an-alcohol-use-disorder-in-an-ear-nose-throat-and-jaw-surgery-department-a-formative-evaluation
#2
Deborah Linda Leuenberger, Katharina Fierz, Andreas Hinck, Daniel Bodmer, Wolfgang Hasemann
INTRODUCTION: Among patients with head and neck cancer comorbid alcohol use disorder is frequent which contributes to higher risk of developing perioperative alcohol withdrawal syndrome/delirium or delirium due to medical conditions. Although guidelines emphasize prevention and treatment of alcohol withdrawal in hospitalized patients, a validated systematic approach for management of these patients is still lacking. Our aim was to formatively evaluate our newly developed systematic approach in view of nurses' adherence to screening patients for regular alcohol consumption and managing their withdrawal symptoms using the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#3
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28091694/-evidence-based-tep-technique
#4
F Köckerling
The guidelines of all international hernia societies recommend as procedures of choice the laparoendoscopic techniques total extraperitoneal patch plasty (TEP) and transabdominal preperitoneal patch plasty (TAPP) as well as the open Lichtenstein operation for elective inguinal hernia repair. The learning curve associated with the laparoendoscopic techniques, in particular TEP, is longer than that for the open Lichtenstein technique due to the complexity of the procedures. Accordingly, for laparoendoscopic techniques it is particularly important that the operations are conducted in a standardized manner in compliance with the evidence-based recommendations given for the technical details...
January 13, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28077533/cefalotin-as-antimicrobial-prophylaxis-in-patients-with-known-intraoperative-anaphylaxis-to-cefazolin
#5
P H M Sadleir, R C Clarke, P R Platt
BACKGROUND: The most common trigger for intraoperative anaphylaxis in Western Australia for the period 2014-5 was an antibiotic used for surgical prophylaxis, cefazolin. In these patients who subsequently present for surgery, alternative cephalosporins are forbidden by current guidelines because of concerns regarding an increased risk of anaphylaxis. However, consideration of the structure-activity relationships relevant to anaphylaxis suggests that cefalotin is a safe alternative because of structural dissimilarities, although there are no pubished clinical data relevant to the perioperative setting...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074298/effect-of-intraoperative-radiotherapy-in-the-treatment-of-retroperitoneal-sarcoma
#6
Liz B Wang, David McAneny, Gerard Doherty, Teviah Sachs
BACKGROUND: Current National Comprehensive Cancer Network guidelines for the treatment of retroperitoneal sarcomas (RPS) endorse surgical resection, but the role of radiotherapy (RT) is less clear. We investigate the utilization and benefits of intraoperative RT (IORT) in the treatment of RPS. METHODS: We queried the Surveillance, Epidemiology and End Results (SEER) database (1988-2013) for the utilization of IORT and perioperative external beam RT (EBRT) in patients who underwent surgical resection of RPS...
January 10, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28074295/-neuraxial-anaesthesia-and-noacs
#7
T Standl
BACKGROUND: Cardiovascular comorbidities in surgical patients are frequent and have a substantial impact on the postoperative outcome. Neuraxial blockades are able to reduce perioperative morbidity and mortality. The increasing use of new oral anticoagulants (NOAC) requires a high level of attention, especially in patients undergoing neuraxial blockades or requiring postoperative analgesia. OBJECTIVE: The goal of this article is to present the benefit of neuraxial anaesthesia and analgesia in patients with cardiovascular risks and perioperative management of NOAC in this setting...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28073791/rapid-deployment-aortic-replacement-radar-registry-in-spain-a-protocol
#8
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/28072935/the-addition-of-tick-boxes-related-to-tobacco-cessation-improves-smoking-related-documentation-in-the-anaesthesia-chart
#9
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/28070632/-prevention-of-perioperative-hypothermia-implementation-of-the-s3-guideline
#10
E-P Horn, E Klar, J Höcker, A Bräuer, B Bein, H Wulf, A Torossian
To improve perioperative quality and patient safety, the German S3 guideline should be consistently implemented to avoid perioperative hypothermia. Perioperative normothermia is a quality indicator and should be achieved by anesthesiologists and surgeons. To detect hypothermia early during the perioperative process, measuring body temperature should be started 1-2 h preoperatively. Patients should be actively warmed for 20-30 min before starting anesthesia. Prewarming is most effective and should be included in the preoperative process...
January 9, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28062620/application-of-cardiac-troponin-in-cardiovascular-diseases-other-than-acute-coronary-syndrome
#11
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: Increased cardiac troponin concentrations in acute coronary syndrome (ACS) identify patients with ongoing cardiomyocyte necrosis who are at increased risk. However, with the use of more precise assays, cardiac troponin increases are commonly noted in other cardiovascular conditions as well. This has generated interest in the use of cardiac troponin for prognostic assessment and clinical management of these patients. In this review, we have summarized the data from studies investigating the implications of cardiac troponin concentrations in various acute and chronic conditions beyond ACS, i...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062330/minimally-invasive-cancer-surgery-indications-and-outcomes
#12
REVIEW
Virginia Sun, Yuman Fong
OBJECTIVES: To review the current evidence on the impact of minimally invasive, robotic-assisted cancer surgery (thoracic, gastrointestinal, gynecologic, genitourinary) on surgical outcomes and quality of life. DATA SOURCES: Journal articles, research reports, state of the science papers, and clinical guidelines. CONCLUSION: Minimally invasive cancer surgery is an important and integral component of the comprehensive care of cancer patients...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28062326/the-impact-of-comorbidity-on-surgical-outcomes-in-older-adults-with-cancer
#13
REVIEW
Virginia Sun, Peggy S Burhenn, Lily Lai, Arti Hurria
OBJECTIVES: To provide an overview of the impact of comorbidity on surgical outcomes and postoperative geriatric events in older adults with cancer, and review key components of quality perioperative nursing care of older adults with cancer. DATA SOURCES: Journal articles, research reports, state of the science papers, position papers, and clinical guidelines from professional organizations. CONCLUSION: The high prevalence of multiple comorbidities and the associated burden of geriatric events in older adults after cancer surgery have a substantial impact on surgical outcomes, quality of life, and health care costs...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28061830/age-nutrition-chirugie-anc-study-impact-of-a-geriatric-intervention-on-the-screening-and-management-of-undernutrition-in-elderly-patients-operated-on-for-colon-cancer-a-stepped-wedge-controlled-trial
#14
Marine Dupuis, Elisabetta Kuczewski, Laurent Villeneuve, Sylvie Bin-Dorel, Max Haine, Claire Falandry, Thomas Gilbert, Guillaume Passot, Olivier Glehen, Marc Bonnefoy
BACKGROUND: Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. METHODS/DESIGN: The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design...
January 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28058467/-treatment-of-melanoma-during-pregnancy
#15
REVIEW
L A Schneider
Melanoma diagnosed during pregnancy is a rare clinical case presentation which must be mastered. In the absence of guidelines for this clinical challenge, we performed a review of the literature and provide a practical guideline on how to manage such rare clinical cases based on our clinical experience. Expecting mothers require adequate counselling and explanation of all therapeutic options as they take responsibility for more than their own lives. However, they should be guided through the process of diagnostic and therapeutic measures in a potentially life-threatening situation...
January 5, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28056254/-interpretation-of-american-academy-of-orthopaedic-surgeons-clinical-practice-guideline-on-the-treatment-of-pediatric-diaphyseal-femur-fractures
#16
W Chen, J Li, Y Z Zhang
The original guideline on the Treatment of Pediatric Diaphyseal Femur Fractures (PDFF) was developed by the American Academy of Orthopaedic Surgeons (AAOS) in 2009, and the guideline was updated by AAOS in 2015. In this reissue, all recommendations in the original guideline identified as"inconclusive" were removed with seven recommendations reserved and without new recommendations added. The recommendations in the current guideline were listed as follows: (1) Children younger than 36 months with PDFF should be evaluated for child abuse...
January 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28049508/complete-necrosis-of-hepatocellular-carcinoma-after-preoperative-portal-vein-embolization-a-case-report
#17
H El Bacha, M Salihoun, N Kabbaj, A Benkabbou
BACKGROUND: Hepatocellular carcinoma has a poor prognosis; few patients can undergo surgical curative treatment according to Barcelona Clinic Liver Cancer guidelines. Progress in surgical techniques has led to operations for more patients outside these guidelines. Our case shows a patient with intermediate stage hepatocellular carcinoma presenting a good outcome after curative treatment. CASE PRESENTATION: We report the case of an 80-year-old Moroccan man, who was positive for hepatitis c virus, presenting an intermediate stage hepatocellular carcinoma (three lesions between 20 and 60 mm)...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28045242/evidence-for-periprocedural-antiplatelet-therapy-heparinization-and-bridging-of-coumarin-therapy-in-carotid-revascularization
#18
Art Brand, Gert J DE Borst
Thromboembolism prevention is a crucial factor determining both the natural outcome and outcome of intervention of stenotic atherosclerotic carotid artery pathology. Roughly 80% of all natural course cerebral ischemic events are caused by thromboembolism, versus 20% due to hemodynamic insufficiency. The risk of periprocedural cerebral (micro) thromboembolization during carotid revascularization is considered to be even higher, with a higher rate in carotid artery stenting (CAS) as compared to carotid endarterectomy (CEA)...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043841/non-opioid-pain-management-in-benign-minimally-invasive-hysterectomy-a-systematic-review
#19
REVIEW
Emily Blanton, Georgine Lamvu, Insiyyah Patanwala, Kenneth I Barron, Kathryn Witzeman, Frank F Tu, Sawsan As-Sanie
BACKGROUND: Less postoperative pain is typically associated with a minimally invasive hysterectomy compared to a laparotomy approach but poor pain control can still be an issues. Multiple guidelines exist for managing postoperative pain yet most are not specialty-specific and are based on procedures bearing little relevance to a minimally invasive hysterectomy. OBJECTIVE: To determine if there is enough quality evidence within the benign gynecology literature to make non-opioid pain control recommendations for women undergoing a benign minimally invasive hysterectomy...
December 30, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28043693/preoperative-biliary-stenting-versus-operation-first-in-jaundiced-patients-due-to-malignant-lesions-in-the-pancreatic-head-a-meta-analysis-of-current-literature
#20
REVIEW
Florian Scheufele, Stephan Schorn, Ihsan Ekin Demir, Mine Sargut, Elke Tieftrunk, Lenika Calavrezos, Carsten Jäger, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Obstructive jaundice is a common presenting symptom among patients with pancreatic cancer. While benefits of preoperative biliary drainage have been suggested by previous studies, recent evidence has shown no significant improvements of preoperative biliary drainage on the postoperative outcome but rather an increase of complications. There is no clear consensus on whether to treat malignant obstructive jaundice with preoperative biliary drainage prior to operative intervention or to proceed directly to resection...
December 30, 2016: Surgery
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