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https://www.readbyqxmd.com/read/28930045/antibiotic-use-among-older-adults-on-an-acute-care-general-surgery-service
#1
André S Pollmann, Jon G Bailey, Philip J B Davis, Paul M Johnson
BACKGROUND: Antibiotics play an important role in the treatment of many surgical diseases that affect older adults, and the potential for inappropriate use of these drugs is high. Our objective was to describe antibiotic use among older adults admitted to an acute care surgical service at a tertiary care teaching hospital. METHODS: Detailed data regarding diagnosis, comorbidities, surgery and antibiotic use were retrospectively collected for patients 70 years and older admitted to an acute care surgical service...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#2
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28923240/national-survey-on-perioperative-anaesthetic-management-in-the-endovascular-treatment-of-acute-ischaemic-stroke
#3
O Romero Kräuchi, L Valencia, F Iturri, A Mariscal Ortega, A López Gómez, R Valero
OBJECTIVE: To assess the anaesthetic management of treatment for endovascular acute ischaemic stroke (AIS) in Spain. MATERIALS AND METHOD: A survey was designed by the SEDAR Neuroscience Section and sent to the Spanish anaesthesiology departments with a primary stroke centre between July and November 2016. RESULTS: Of the 47 hospitals where endovascular treatment of AIS is performed, 37 anaesthesiology departments participated. Thirty responses were obtained; three of which were eliminated due to duplication (response rate of 72...
September 15, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28918776/-prophylactic-antibiotic-therapy-for-hernia-repair
#4
Siv Fonnes, Barbara Juliane Holzknecht, Magnus Arpi, Jacob Rosenberg
This article aims at outlining and recommending use of prophylactic antibiotic therapy for hernia repair according to literature and newly released guidelines. We do not recommend prophylaxis for elective repair of inguinal and ventral hernias in a low infection risk environment as Denmark except in patients with incisional hernia > 10 cm or presumed increased risk for wound infection, e.g. diabetes or immunosuppression. Antibiotic prophylaxis should always be used in emergent hernia repair. We recommend a prophylactic regimen of second-generation cephalosporin given as a single dose perioperatively...
September 11, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28913958/preoperative-nutritional-management-of-bariatric-patients-in-australia-the-current-practice-of-dietitians
#5
Ruth Bourne, Judith Tweedie, Fiona Pelly
AIM: The aim of this observational study was to investigate the reported practices of Australian dietitians managing bariatric surgery patients in the preoperative stage. METHODS: An online survey of dietitians providing nutritional care to bariatric patients was developed for the purpose of this investigation. The survey questions were guided by the Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic and Nonsurgical Support of the Bariatric Surgery Patient guidelines and current literature...
September 15, 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28911283/australian-and-new-zealand-anaesthetic-allergy-group-perioperative-anaphylaxis-investigation-guidelines
#6
R J Scolaro, H M Crilly, E J Maycock, P T McAleer, K A Nicholls, M A Rose, Rih The
These guidelines are a consensus document developed by a working party of the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) to provide an approach to the investigation of perioperative anaphylaxis. They focus primarily on the use of skin testing as it is the investigation with the greatest clinical utility for the identification of the likely causative agent and potentially safer alternatives. The practicalities and process of skin testing, its limitations, and the place of other tests are discussed...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28902776/pancreatic-cancer-arising-from-the-remnant-pancreas-is-it-a-local-recurrence-or-new-primary-lesion
#7
Daisuke Hashimoto, Akira Chikamoto, Toshiro Masuda, Shigeki Nakagawa, Katsunori Imai, Yo-Ichi Yamashita, Howard A Reber, Hideo Baba
Local recurrence of pancreatic cancer (PC) can occur in the pancreatic remnant. In addition, new primary PC can develop in the remnant. There are limited data available regarding this so-called remnant PC. The aim of this review was to describe the characteristics and therapeutic strategy regarding remnant PC. A literature search was performed using Medline published in English according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The incidence of remnant PC has been reported to be 3% to 5%...
October 2017: Pancreas
https://www.readbyqxmd.com/read/28901992/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-elderly
#8
Sibylle Kozek-Langenecker, Christian Fenger-Eriksen, Emmanuel Thienpont, Giedrius Barauskas
: The risk for postoperative venous thromboembolism (VTE) is increased in patients aged more than 70 years and in elderly patients presenting with co-morbidities, for example cardiovascular disorders, malignancy or renal insufficiency. Therefore, risk stratification, correction of modifiable risks and sustained perioperative thromboprophylaxis are essential in this patient population. Timing and dosing of pharmacoprophylaxis may be adopted from the non-aged population. Direct oral anti-coagulants are effective and well tolerated in the elderly; statins may not replace pharmacological thromboprophylaxis...
September 9, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28894976/implicating-anaesthesia-and-the-perioperative-period-in-cancer-recurrence-and-metastasis
#9
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/28888480/the-clinical-characteristics-and-microsurgical-therapy-of-pituitary-adenomas-in-elderly-patients-a-retrospective-study-of-130-cases
#10
REVIEW
Yi Zhao, Wei Lian, Bing Xing, Ming Feng, Xiaohai Liu, Renzhi Wang, Huanwen Wu
OBJECTIVE: To investigate the clinical characteristics and microsurgical therapy of pituitary adenomas in elderly patients. METHOD: This article describes a retrospective study of 130 pituitary adenomas in elderly patients over 65years of age who underwent a microsurgical operation using the transsphenoidal approach and were admitted to Peking Union Medical College Hospital (PUMCH) from January 2010 to December 2012. RESULTS: A total of 60 (46...
September 6, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28877905/perioperative-tobacco-use-treatments-putting-them-into-practice
#11
REVIEW
Margaret B Nolan, David O Warner
Treatment for tobacco use is efficacious and beneficial to health. Although guidelines recommend that all patients who use tobacco are offered treatment as a part of their clinical care, implementing treatment has proven challenging. In the case of surgical patients, this lack of treatment is particularly unfortunate, as the benefits of abstinence from tobacco are immediate in terms of reducing the risk of surgical complications, including cardiovascular, respiratory, and wound related complications. Surgery also presents an opportunity for patients to quit for good and reduce the long term health risk...
September 6, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28865633/guideline-implementation-positioning-the-patient
#12
Byron L Burlingame
Every surgical procedure requires positioning the patient; however, all surgical positions are associated with the potential for the patient to experience a positioning injury. The locations and types of potential injuries (eg, stretching, compression, pressure injury) depend on the position. Factors that may increase the patient's risk for an injury are the length of the procedure and risk factors inherent to the patient (eg, weight, age, frailty). AORN's updated "Guideline for positioning the patient" provides guidance on injury prevention practices for all surgical positions including supine, Trendelenburg, reverse Trendelenburg, lateral, lithotomy, prone, and sitting positions and modifications of these positions...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28865631/an-integrative-review-of-the-hands-free-technique-in-the-or
#13
Pamela B Linzer, Sean P Clarke
Sharps injury rates are proportionally higher in perioperative areas than in other practice settings. The hands-free technique (HFT) has been shown to decrease the hazards of sharps injuries when passing sharps during surgery. We reviewed and synthesized research studies regarding compliance with the HFT and factors facilitating its use using a key word search of online databases and a secondary search of references. We reviewed English language studies published since 2001 regarding HFT compliance rates or related factors using the Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28865630/professional-and-regulatory-infection-control-guidelines-collaboration-to-promote-patient-safety
#14
Judith L Clayton, Kimberly J Miller
Professional organizations and regulatory agencies collaborate on infection prevention and control guidelines to support preventing and controlling infection in the surgical setting. More specifically, regulatory and accrediting agencies, professional associations, and advisory committees create and promote the use of evidence-based recommendations for preventing surgical site infections. Many agencies perform accreditation surveys to ensure compliance with these standards and guidelines. Perioperative personnel can use these resources to implement and sustain essential processes for infection prevention and control and to facilitate staff member compliance with standards, regulations, and best practices...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#15
REVIEW
Yvonne Jelting, Christian Klein, Thomas Harlander, Leopold Eberhart, Norbert Roewer, Peter Kranke
BACKGROUND: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28842796/oncologic-outcomes-following-laparoscopic-colon-cancer-resection-for-t4-lesions-a-case-control-analysis-of-7-years-experience
#16
Piera Leon, Michele Giuseppe Iovino, Fabiola Giudici, Antonio Sciuto, Nicolò de Manzini, Diego Cuccurullo, Francesco Corcione
BACKGROUND: According to many Societies' guidelines, patients presenting with clinical T4 colorectal cancer should conventionally be approached by a laparotomy. Results of emerging series are questioning this attitude. METHODS: We retrospectively analysed the oncologic outcomes of 147 patients operated on between June 2008 and September 2015 for histologically proven pT4 colon cancers. All patients were treated with curative intent, either by a laparoscopic or open "en bloc" resection...
August 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28838873/the-management-of-chronic-subdural-hematoma-patients-treated-with-low-dose-acetylsalicylic-acid-an-international-survey-of-practice
#17
Jehuda Soleman, Maria Kamenova, Raphael Guzman, Luigi Mariani
BACKGROUND: The aim of this international survey was to investigate the current management of patients undergoing surgery for chronic subdural hematoma (cSDH) treated with low-dose acetylsalicylic acid (ASA). METHODS: We administered a survey via e-mail to neurosurgeons with questions relating to the surgical treatment of cSDH, emphasizing their practices on patients treated with low-dose ASA. RESULTS: We received 157 responses with a response rate of 22...
August 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28838753/we-commend-the-effort-2017-american-college-of-rheumatology-american-association-of-hip-and-knee-surgeons-guideline-for-the-perioperative-management-of-antirheumatic-medication-in-patients-with-rheumatic-diseases-undergoing-elective-total-hip-or-total-knee
#18
EDITORIAL
https://www.readbyqxmd.com/read/28835268/perioperative-antibiotic-prophylaxis-in-the-treatment-of-acute-cholecystitis-peanuts-ii-trial-study-protocol-for-a-randomized-controlled-trial
#19
Charlotte S Loozen, Hjalmar C van Santvoort, Antoinette A W van Geloven, Grard A P Nieuwenhuijzen, Philip R de Reuver, Mark H G Besselink, Bart Vlaminckx, Johannes C Kelder, Catherijne A J Knibbe, Djamila Boerma
BACKGROUND: The additional value of perioperative antibiotic prophylaxis in preventing infectious complications after emergency cholecystectomy for acute cholecystitis is a much-debated subject in the surgical community. Evidence-based guidelines are lacking, and consequently the use of antibiotic prophylaxis varies greatly among surgeons and hospitals. Recently, high-level evidence became available demonstrating that postoperative antibiotic prophylaxis in patients with acute cholecystitis does not reduce the risk of infectious complications...
August 23, 2017: Trials
https://www.readbyqxmd.com/read/28835126/ventriculoperitoneal-shunts-in-neonates-a-retrospective-study-of-outcomes-with-antibiotic-impregnated-catheters-and-a-modified-peri-operative-antibiotic-protocol
#20
Werner Jaeger, Sharon Lee, Deepa Vineet, Anthony Keil, Nitesh Agarwal, Shripada Rao
BACKGROUND: CSF infection is a significant complication of ventriculoperitoneal (VP) shunts and results in prolonged hospital stay, developmental delay and decreased quality of life. To decrease the high rates of neonatal VP shunt infections, an updated clinical guideline that included the use of antibiotic-impregnated shunts and a revised peri-operative antibiotic protocol was introduced in our neonatal unit. In this study, we evaluated the efficacy of these new guidelines in reducing the CSF shunt infection rates...
August 24, 2017: British Journal of Neurosurgery
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