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Preoperative consult

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https://www.readbyqxmd.com/read/28640783/the-implementation-of-a-preoperative-transthoracic-echocardiography-consult-service-by-anesthesiologists
#1
Sasha K Shillcutt, Daniel P Walsh, Walker R Thomas, Elizabeth Lyden, Tara R Brakke, Sheila J Ellis, Steven J Lisco, Nicholas W Markin
We describe a preoperative transthoracic echocardiography consult service led by anesthesiologists. The implementation process and the patient cohort are described. Preoperative transthoracic echocardiographic examinations were mostly performed in patients undergoing intermediate- or high-risk noncardiac surgery and in patients with a higher calculated mortality risk. All transthoracic echocardiographic examinations were interpreted by anesthesiologists.
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28634542/angioedema-perioperative-management
#2
Andrew A Maynard, Christina F Burger, Joseph J Schlesinger
OBJECTIVE: To describe the perioperative management of a patient with acquired angioedema (AAE). METHODS: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor-related intractable urticaria and mastocytosis. He was admitted for urgent laparoscopic partial gastrectomy, secondary to gastric outlet obstruction symptomatology. Previous combined attacks were characterized by a widespread rash, abdominal pain and respiratory distress resulting in hospitalization...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28631129/optimizing-the-deep-brain-stimulation-care-pathway-in-patients-with-parkinson-s-disease
#3
N J Thomas, P Mertens, T Danaila, G Polo, H Klinger, E Broussolle, S Thobois
Management of Parkinson's disease (PD) using deep brain stimulation (DBS) requires complex care in specialized, multidisciplinary centers. A well-organized, efficient patient flow is crucial to ensure that eligible patients can quickly access DBS. Delays or inefficiencies in patient care may impact a center's ability to meet demand, creating a capacity bottleneck. Analysis of the current practices within a center may help identify areas for improvement. After external audit of the DBS workflow of the Lyon Neurological Hospital and comparison with other European centers, manageable steps were suggested to restructure the care pathway...
June 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28628507/patient-reported-outcomes-following-neoadjuvant-chemotherapy-or-chemoradiotherapy-treatment-for-esophageal-cancer-a-scoping-review-protocol
#4
Camilla Trenerry, Micah D J Peters, Nadia Corsini, Raechel A Damarell, Carlene Wilson, Ingrid Flight
The objective of this scoping review is to identify, describe and compare studies investigating patient-reported outcomes (PROs) in esophageal cancer patients following neoadjuvant (preoperative) chemotherapy (CT) and surgery or neoadjuvant chemoradiotherapy (CRT) and surgery.After preliminary searching of the literature and consultation with experts in the fields of esophageal cancer surgery, behavioral science, information systems and scoping review methodology, the following research objectives were defined as follows...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28622448/ileocecal-valve-syndrome-after-surgery-in-adult-patients-myth-or-reality
#5
S Palmisano, M Silvestri, M Troian, P Germani, F Giudici, N de Manzini
AIM: The onset of symptoms after ileocecal valve (ICV) removal may be perceived as an unwanted effect of surgery and induce patients to bring unnecessary litigation against surgeons. The aim of our study is to assess the real impact on the quality of life of patients whose ICV was surgically removed, using three validated questionnaires. METHOD: In patients who had their ICV removed surgically, the Gastrointestinal Quality of life (GIQLI) questionnaire and those used by the European Organization for research and Treatment of Cancer (EORTC) were administered pre and post surgery...
June 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28621630/evaluation-of-surgical-treatment-for-neuropathic-pain-from-neuroma-in-patients-with-injured-peripheral-nerves
#6
Valérie Decrouy-Duruz, Thierry Christen, Wassim Raffoul
OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patients with long-term follow-up. METHODS The authors reviewed the charts of 231 patients (335 nerve injuries) who experienced neuropathic pain after peripheral nerve injury and underwent surgery for nerve revision at the authors' institution between 1997 and 2012...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28601562/patterns-of-benign-prostate-hyperplasia-based-on-magnetic-resonance-imaging-are-correlated-with-lower-urinary-tract-symptoms-and-continence-in-men-undergoing-a-robot-assisted-radical-prostatectomy-for-prostate-cancer
#7
Nikolaos Grivas, Rosanne van der Roest, Corinne Tillier, Daan Schouten, Erik van Muilekom, Ivo Schoots, Henk van der Poel, Stijn Heijmink
OBJECTIVE: To investigate the association between benign prostatic hyperplasia (BPH) patterns, classified by magnetic resonance imaging (MRI), with lower urinary tract symptoms (LUTS) or continence, preoperatively and after robot-assisted laparoscopic radical prostatectomy (RARP). MATERIALS AND METHODS: This retrospective study included 49 prostate cancer patients, with prostate size >47 cm(3), who underwent an endorectal MRI followed by RARP. Five BPH patterns were identified according to Wasserman and additional prostate measurements were recorded...
June 7, 2017: Urology
https://www.readbyqxmd.com/read/28592081/-comparison-of-transthoracic-or-percutaneous-balloon-pulmonary-valvuloplasty-in-the-therapy-of-pulmonary-valve-stenosis
#8
Y Q Xie, J Yan, Z D Hua, W B Ouyang, K J Pang, Y B Zhang, G J Zhang, S J Li
Objective: To compare the clinical outcome of patients with pulmonary valve stenosis underwent transthoracic and percutaneous balloon pulmonary valvuloplasty. Methods: Clinical data of 806 patients diagnosed as pulmonary valve stenosis underwent transthoracic(171 patients as group A)or percutaneous balloon pulmonary valvuloplasty (635 patients as Group B) in Fuwai Hospital from February 2006 to January 2016 were analyzed retrospectively. There were 72 males in group A (42.1%) and 344 males in group B (54.2%)...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28591483/cognition-in-epilepsy-patients-with-hypothalamic-hamartomas
#9
Kathrin Wagner, Jennifer V Wethe, Andreas Schulze-Bonhage, Michael Trippel, Harold Rekate, George P Prigatano, John F Kerrigan
Many patients with epilepsy caused by hypothalamic hamartomas (HHs) have cognitive impairments during the course of the disease or following neurosurgical treatment. The purpose of this study was to assess cognitive function in these patients, as well as factors influencing preoperative cognitive performance and cognitive outcome after neurosurgical treatment. Using the two largest and most detailed neuropsychology datasets on HH and epilepsy from two centers, we retrospectively report on cognitive functions in 48 patients with structural epilepsy due to HH (mean age ± standard deviation [SD] 20 ± 12 years, range 5-53 years, median 16 years; disease duration mean 17 ± 11 years)...
June 2017: Epilepsia
https://www.readbyqxmd.com/read/28586158/quantitative-assessment-of-fascia-preservation-improves-the-prediction-of-membranous-urethral-length-and-inner-levator-distance-on-continence-outcome-after-robot-assisted-radical-prostatectomy
#10
Nikolaos Grivas, Rosanne van der Roest, Daan Schouten, Francesca Cavicchioli, Corine Tillier, Axel Bex, Ivo Schoots, Walter Artibani, Stijn Heijmink, Henk Van Der Poel
AIMS: To determine whether preoperative prostate/pelvic anatomical structures and intraoperative fascia preservation (FP) predict continence recovery after robot-assisted radical prostatectomy (RARP). METHODS: Between January 2012 and March 2016, 439 prostate cancer (PCa) patients with normal preoperative continence were retrospectively included. FP score was defined as the extent of FP from base to apex of the prostate, quantitatively assessed by the surgeon. Anatomical prostate structures were measured on endorectal preoperative Magnetic Resonance Imaging...
June 6, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28570450/the-impact-of-physician-assistants-on-a-breast-reconstruction-practice-outcomes-and-cost-analysis
#11
Albert H Chao, Alexander Yaney, Roman J Skoracki, Patrick N Kearns
BACKGROUND: Physician assistants (PAs) are commonly employed in plastic surgery. However, limited data exist on their impact, which may guide decisions regarding how best to integrate them into practice. METHODS: A review of the practices of 2 breast reconstructive surgeons was performed. A comparison was made between a 1-year period before to a 1-year period after the addition of a PA into practice. The practice model was a one-to-one pairing of a plastic surgeon and a PA...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28567710/the-preoperative-cardiology-consultation-indications-and-risk-modification
#12
M W Groot, A Spronk, S E Hoeks, R J Stolker, F van Lier
BACKGROUND: The cardiologist is regularly consulted preoperatively by anaesthesiologists. However, insights into the efficiency and usefulness of these consultations are unclear. METHODS: This is a retrospective study of 24,174 preoperatively screened patients ≥18 years scheduled for elective non-cardiac surgery, which resulted in 273 (1%) referrals to the cardiologist for further preoperative evaluation. Medical charts were reviewed for patient characteristics, main reason for referring, requested diagnostic tests, interventions, adjustment in medical therapy, 30-day mortality and major adverse cardiac events...
May 31, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28562746/perioperative-fasting-time-among-cancer-patients-submitted-to-gastrointestinal-surgeries
#13
Nayara de Castro Pereira, Ruth Natalia Teresa Turrini, Vanessa de Brito Poveda
OBJECTIVE: To identify the length of perioperative fasting among patients submitted to gastrointestinal cancer surgeries. METHOD: Retrospective cohort study, developed by consulting the medical records of 128 patients submitted to gastrointestinal cancer surgeries. RESULTS: The mean of total length of fasting was 107.6 hours. The total length of fasting was significantly associated with the number of symptoms presented before (p=0.000) and after the surgery (p=0...
May 25, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28554911/navigating-high-risk-surgery-protocol-for-a-multisite-stepped-wedge-cluster-randomised-trial-of-a-question-prompt-list-intervention-to-empower-older-adults-to-ask-questions-that-inform-treatment-decisions
#14
Lauren J Taylor, Paul J Rathouz, Ana Berlin, Karen J Brasel, Anne C Mosenthal, Emily Finlayson, Zara Cooper, Nicole M Steffens, Nora Jacobson, Anne Buffington, Jennifer L Tucholka, Qianqian Zhao, Margaret L Schwarze
INTRODUCTION: Older patients frequently undergo operations that carry high risk for postoperative complications and death. Poor preoperative communication between patients and surgeons can lead to uninformed decisions and result in unexpected outcomes, conflict between surgeons and patients, and treatment inconsistent with patient preferences. This article describes the protocol for a multisite, cluster-randomised trial that uses a stepped wedge design to test a patient-driven question prompt list (QPL) intervention aimed to improve preoperative decision making and inform postoperative expectations...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28554808/acute-finger-tip-infection-management-and-treatment-a-103-case-series
#15
F Rabarin, J Jeudy, B Cesari, A Petit, N Bigorre, Y Saint-Cast, P-A Fouque, G Raimbeau
INTRODUCTION: Acute fingertip infections (AFTI) are common. Surgical treatment is the norm in case of effusion. There is, however, no consensus on treatment modalities, or on adjuvant antibiotic therapy (AT). We present the results of a consecutive cohort of 103 AFTIs treated in emergency consultation. MATERIALS AND METHOD: One hundred and one patients were treated by excision and extensive lavage under digital anesthesia, with systematic bacteriological sampling...
May 26, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28542018/rehabilitation-and-psychosocial-determinants-of-cochlear-implant-outcomes-in-older-adults
#16
Liyang Tang, Carol B Thompson, James H Clark, Kristin M Ceh, Jennifer D Yeagle, Howard W Francis
OBJECTIVE: The cochlear implant (CI) has been shown to be associated with better hearing, cognitive abilities, and functional independence. There is variability however in how much benefit each recipient derives from his or her CI. This study's primary objective is to determine the effects of individual and environmental characteristics on CI outcomes. DESIGN: Seventy-six adults who developed postlingual severe to profound hearing loss and received their first unilateral CI at 65 years and older were eligible for the study...
May 24, 2017: Ear and Hearing
https://www.readbyqxmd.com/read/28538561/is-rotation-a-concern-with-anatomical-breast-implants-a-statistical-analysis-of-factors-predisposing-to-rotation
#17
Paolo Montemurro, Athanasios Papas, Per Hedén
BACKGROUND: Since their introduction in 1993, anatomical implants have provided a more natural appearance in breast augmentation, and many surgeons advocate their use and promote the good aesthetic results. However, the risk of implant rotation makes some of them reluctant to use these devices. The rotation rate varies among authors. METHODS: The authors present a 6.5-year series of 531 patients who underwent primary breast augmentation with macrotextured anatomical implants in a Swedish facility performed by one consultant surgeon (P...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28532941/cataract-surgery-practices-in-the-united-states-veterans-health-administration
#18
Annika G Havnaer, Paul B Greenberg, Glenn C Cockerham, Melissa A Clark, Amy Chomsky
PURPOSE: To describe current cataract surgery practices within the United States Veterans Health Administration (VHA). SETTING: Veterans Health Administration hospitals in the U.S. DESIGN: Retrospective data analysis. METHODS: An initial e-mail containing a link to an anonymous 32-question survey of cataract surgery practices was sent to participants in May 2016. Two reminder e-mails were sent to nonresponders 1 week and 2 weeks after the initial survey was sent; the remaining nonresponders were called twice over a 2-week period...
April 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28530213/-the-model-of-perioperative-risk-assessment-in-elderly-patients-interim-analysis
#19
Izabela Grabowska, Lucyna Ścisło, Szymon Pietruszka, Elzbieta Walewska, Agata Paszko, Benita Siarkiewicz, Piotr Richter, Andrzej Budzyński, Antoni M Szczepanik
Demographic changes in contemporary society require implementation of proper perioperative care of elderly patients due to an increased risk of perioperative complications in this group. Preoperative assessment of health status identifies risks and enables preventive interventions, improving outcomes of surgical treatment. The Comprehensive Geriatric Assessment contains numerous diagnostic tests and consultations, which is expensive and difficult to use in everyday practice. The development of a simplified model of perioperative assessment of elderly patients will help identifying the group of patients who require further diagnostic workup...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28520894/validation-of-a-simple-tool-for-anxiety-trait-screening-in-children-presenting-for-surgery
#20
M Bellon, E Taillardat, A-L Hörlin, H Delivet, C Brasher, J Hilly, S Dahmani
Background.: Screening for preoperative anxiety is an important challenge during the preoperative period. The aim of our study was to validate the faces scale used to detect anxiety trait in children. Methods.: Children aged 8-18 yr were asked to quantify their anxiety trait using the readily available faces scale and to respond to the trait component of the State-Trait Anxiety Inventory (STAI) for children (C) or adults (A) before the anaesthesia consultation...
June 1, 2017: British Journal of Anaesthesia
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