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Perioperative bridging

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https://www.readbyqxmd.com/read/28817359/developing-the-storyline-for-an-advance-care-planning-video-for-surgery-patients-patient-centered-outcomes-research-engagement-from-stakeholder-summit-to-state-fair
#1
Rebecca A Aslakson, Anne L R Schuster, Thomas J Lynch, Matthew J Weiss, Lydia Gregg, Judith Miller, Sarina R Isenberg, Norah L Crossnohere, Alison M Conca-Cheng, Angelo E Volandes, Thomas J Smith, John F P Bridges
BACKGROUND: Patient-centered outcomes research (PCOR) methods and social learning theory (SLT) require intensive interaction between researchers and stakeholders. Advance care planning (ACP) is valuable before major surgery, but a systematic review found no extant perioperative ACP tools. Consequently, PCOR methods and SLT can inform the development of an ACP educational video for patients and families preparing for major surgery. OBJECTIVE: The objective is to develop and test acceptability of an ACP video storyline...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28777136/incidence-and-impact-of-on-cardiopulmonary-bypass-vasoplegia-during-heart-transplantation
#2
Lauren K Truby, Koji Takeda, Maryjane Farr, James Beck, Melana Yuzefpolskaya, Paolo C Colombo, Veli Tokpara, Donna Mancini, Yoshifumi Naka, Hiroo Takayama
Despite significant advances in the medical management of heart transplant (HT) recipients, perioperative complications, including vasoplegia, remain a significant contributor to morbidity and mortality. This is a retrospective review of patients who received HT at our institution between 2012 and 2015. Mean systemic vascular resistance (SVR) was calculated during the bypass run. Vasoplegia was defined as a mean SVR <800 dynes s/cm despite a high pressor requirement (>1,500 μg neosynephrine bolused)...
August 2, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28677422/evaluation-of-a-standardized-perioperative-management-protocol-in-the-adult-hematology-anticoagulation-management-service
#3
Diane J Lum, Patricia A Ross, Martin A Bishop, Michelle L Caetano, Michael B Streiff
BACKGROUND: In North America, 250,000 patients on vitamin K antagonists require surgical procedures each year. Temporary interruption of oral anticoagulation and perioperative bridging therapy with unfractionated heparin or low-molecular-weight heparin are recommended by the American College of Chest Physicians 2012 for select patients. OBJECTIVES: The study objectives are to evaluate adherence and nonadherence to the Johns Hopkins clinic guidelines for perioperative management of anticoagulation and identify bleeding or thromboembolic events during perioperative management of anticoagulation...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28664233/endovascular-treatment-of-wide-necked-visceral-artery-aneurysms-using-the-neurovascular-comaneci-neck-bridging-device-a-technical-report
#4
Julian Maingard, Hong Kuan Kok, Emma Phelan, Caitriona Logan, Dinesh Ranatunga, Duncan Mark Brooks, Ronil V Chandra, Michael J Lee, Hamed Asadi
INTRODUCTION: Visceral and renal artery aneurysms (VRAAs) are an uncommon clinical entity but carry a risk of rupture with associated morbidity and mortality. The rupture risk is particularly high when the aneurysms are large, of unfavourable morphology or in the setting of pregnancy and perioperative period. Endovascular approaches are now first line in the treatment of VRAA, but conventional techniques may be ineffective in excluding aneurysms with unfavourable anatomy such as those with wide necks or at arterial bifurcation points...
June 29, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28653161/the-post-sir-spheres-surgery-study-p4s-retrospective-analysis-of-safety-following-hepatic-resection-or-transplantation-in-patients-previously-treated-with-selective-internal-radiation-therapy-with-yttrium-90-resin-microspheres
#5
Fernando Pardo, Bruno Sangro, Rheun-Chuan Lee, Derek Manas, Rohan Jeyarajah, Vincent Donckier, Geert Maleux, Antonio D Pinna, Lourens Bester, David L Morris, David Iannitti, Pierce K Chow, Richard Stubbs, Paul J Gow, Gianluca Masi, Kevin T Fisher, Wan Y Lau, Konstantinos Kouladouros, Georgios Katsanos, Giorgio Ercolani, Fernando Rotellar, José I Bilbao, Michael Schoen
BACKGROUND: Reports show that selective internal radiation therapy (SIRT) may downsize inoperable liver tumors to resection or transplantation, or enable a bridge-to-transplant. A small-cohort study found that long-term survival in patients undergoing resection following SIRT appears possible but no robust studies on postsurgical safety outcomes exist. The Post-SIR-Spheres Surgery Study was an international, multicenter, retrospective study to assess safety outcomes of liver resection or transplantation following SIRT with yttrium-90 (Y-90) resin microspheres (SIR-Spheres(®); Sirtex)...
June 26, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28647195/adapting-to-a-total-endovascular-approach-for-complex-aortic-aneurysm-repair-outcomes-after-fenestrated-and-branched-endovascular-aortic-repair
#6
Jacob Budtz-Lilly, Anders Wanhainen, Jacob Eriksson, Kevin Mani
OBJECTIVE: This study reports the feasibility of adopting a total endovascular approach for the treatment of complex abdominal aortic aneurysms (AAAs) at a European aortic center and compares the short- and midterm results against those from large and multicenter studies. METHODS: All patients treated endovascular aortic repair (EVAR) for juxta/pararenal AAAs or thoracoabdominal aortic aneurysms (TAAAs), both elective and acute, as well as reoperations, from 2010 to 2015 were included...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28638315/acute-abdomen-a-rare-case-of-ruptured-hepatocellular-carcinoma
#7
Severin Gloor, Kai Oliver Jensen, Stefan Breitenstein, Christoph A Binkert, Eliane Angst, Franc Heinrich Hetzer
Spontaneous ruptures of hepatocellular carcinoma (HCC) are rare. Nevertheless they may lead to difficult decisions in the emergency situation. The acute therapies include conservative treatment, transarterial embolization and surgery. Curative treatment of HCC can be achieved by liver resection solely. The decision-making depends on prognostic patient's factors, such as hepatic viral infection status, Child-Pugh grade, liver cirrhosis and number of tumors. In this case transarterial embolization was preferable as a bridging therapy prior to further diagnostics and therapy, to lower the perioperative morbidity and mortality...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28638234/ischemic-or-toxic-injury-a-challenging-diagnosis-and-treatment-of-drug-induced-stenosis-of-the-sigmoid-colon
#8
Zong-Ming Zhang, Xiang-Chun Lin, Li Ma, An-Qin Jin, Fang-Cai Lin, Zhuo Liu, Li-Min Liu, Chong Zhang, Na Zhang, Li-Juan Huo, Xue-Liang Jiang, Feng Kang, Hong-Jun Qin, Qiu-Yang Li, Hong-Wei Yu, Hai Deng, Ming-Wen Zhu, Zi-Xu Liu, Bai-Jiang Wan, Hai-Yan Yang, Jia-Hong Liao, Xu Luo, You-Wei Li, Wen-Ping Wei, Meng-Meng Song, Yue Zhao, Xue-Ying Shi, Zhao-Hui Lu
A 48-year-old woman was admitted with 15-mo history of abdominal pain, diarrhea and hematochezia, and 5-mo history of defecation difficulty. She had been successively admitted to nine hospitals, with an initial diagnosis of inflammatory bowel disease with stenotic sigmoid colon. Findings from computed tomography virtual colonoscopy, radiography with meglumine diatrizoate, endoscopic balloon dilatation, metallic stent implantation and later overall colonoscopy, coupled with the newfound knowledge of compound Qingdai pill-taking, led to a subsequent diagnosis of ischemic or toxic bowel disease with sigmoid colon stenosis...
June 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28592584/utilising-advance-care-planning-videos-to-empower-perioperative-cancer-patients-and-families-a-study-protocol-of-a-randomised-controlled-trial
#9
Rebecca A Aslakson, Sarina R Isenberg, Norah L Crossnohere, Alison M Conca-Cheng, Ting Yang, Matthew Weiss, Angelo E Volandes, John F P Bridges, Debra L Roter
INTRODUCTION: Despite positive health outcomes associated with advance care planning (ACP), little research has investigated the impact of ACP in surgical populations. Our goal is to evaluate how an ACP intervention video impacts the patient centredness and ACP of the patient-surgeon conversation during the presurgical consent visit. We hypothesise that patients who view the intervention will engage in a more patient-centred communication with their surgeons compared with patients who view a control video...
June 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28589690/perioperative-management-of-new-oral-anticoagulants-in-patients-undergoing-elective-surgery-at-a-tertiary-hospital
#10
Henry Wamala, Ian A Scott, Xenia Caney
BACKGROUND: Increasing numbers of patients receiving new oral anticoagulants (NOACs) are undergoing elective surgery. The extent to which perioperative interruption of NOAC therapy and use of bridging heparin are concordant with best evidence is uncertain. METHODS: Retrospective study of consecutive adult patients undergoing elective surgery at a tertiary hospital between January 1(st) 2014 and June 30(th) 2015 and were receiving NOACs for at least 3 months prior to surgery...
June 7, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28574123/orthogonal-plating-of-vancouver-b1-and-c-type-periprosthetic-femur-fracture-nonunions
#11
Christopher E Birch, Michael Blankstein, Jesse D Chlebeck, Craig S Bartlett Rd
BACKGROUND: Periprosthetic femoral shaft fractures are a significant complication after total hip arthroplasty (THA). Plate osteosynthesis has been the mainstay of treatment around well-fixed stems. Nonunions are a rare and challenging complication of this fixation method. We report the outcomes of a novel orthogonal plating surgical technique for Vancouver B1 and C-type periprosthetic fractures that previously failed open reduction internal fixation (ORIF). METHODS: A retrospective review identified all patients with Vancouver B1/C THA periprosthetic femoral nonunions from 2010 to 2015...
May 27, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28569365/risk-adjusted-procedure-tailoring-leads-to-uniformly-low-complication-rates-in-ventral-and-incisional-hernia-repair-a-propensity-score-analysis-and-internal-validation-of-classification-criteria
#12
U A Dietz, A Fleischhacker, S Menzel, U Klinge, C Jurowich, K Haas, P Heuschmann, C-T Germer, A Wiegering
BACKGROUND: The usual approach in hernia surgery is to select the ideal repair method independent of the patient's characteristics. In the present study, we change the approach to ask which technique is best for the individual patient`s risk profile. For this, two criteria are important: does the patient need reconstruction of the abdominal wall? or does he or she need treatment of symptoms without being exposed to unnecessarily high perioperative risks? METHODS: In a heuristic selection procedure, 486 consecutive patients were classified according to their characteristics as low-risk or high-risk for postoperative complications...
August 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28561148/-preoperative-preparation-patient-blood-management-what-is-optimal
#13
Patrick Meybohm, Markus M Müller, Kai Zacharowski
Patient Blood Management (PBM) focusses on anemia management, the minimization of (unnecessary) iatrogenic blood loss and the exhaustion of natural tolerance to anemia with rational use of red blood cell transfusion. The focus of the current review article is now the preoperative phase with the following PBM components: management of anemia, pre-transfusion analytics and management of anticoagulants. Preoperative anemia is an independent risk factor for increased perioperative morbidity and mortality. In elective surgery, the causes of anemia should be diagnosed prior to surgery as early as possible, and if indicated, a specific treatment for treatable causes should be initiated...
May 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28556519/lessons-learned-early-termination-of-a-randomized-trial-of-calcineurin-inhibitor-and-corticosteroid-avoidance-using-belatacept
#14
K A Newell, A K Mehta, C P Larsen, P G Stock, A B Farris, S G Mehta, D Ikle, B Armstrong, Y Morrison, N Bridges, M Robien, R B Mannon
The intent of this National Institutes of Health-sponsored study was to compare a belatacept-based immunosuppressive regimen with a maintenance regimen of tacrolimus and mycophenolate. Nineteen primary, Epstein-Barr virus-immune renal transplant recipients with a negative cross-match were randomized to one of three groups. All patient groups received perioperative steroids and maintenance mycophenolate mofetil. Patients in groups 1 and 2 were induced with alemtuzumab and maintained on tacrolimus or belatacept, respectively...
May 28, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28516514/single-incision-totally-extraperitoneal-inguinal-hernia-repair-is-feasible-and-safe-in-patients-on-antithrombotic-therapy-a-single-center-experience-of-92-procedures
#15
Masaki Wakasugi, Mitsuyoshi Tei, Yozo Suzuki, Kenta Furukawa, Toru Masuzawa, Kentaro Kishi, Masahiro Tanemura, Hiroki Akamatsu
INTRODUCTION: The aim of this study was to evaluate the feasibility and safety of SILS for totally extraperitoneal inguinal hernia repair for patients on antithrombotic therapy. METHODS: A total of 365 patients who underwent SILS for totally extraperitoneal inguinal hernia repair between January 2011 and November 2015 were analyzed retrospectively. Antithrombotic drugs were stopped preoperatively, and bridging intravenous heparin therapy was given according to the operative risk of each patient...
May 17, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28515674/perioperative-management-of-patients-on-direct-oral-anticoagulants
#16
REVIEW
Virginie Dubois, Anne-Sophie Dincq, Jonathan Douxfils, Brigitte Ickx, Charles-Marc Samama, Jean-Michel Dogné, Maximilien Gourdin, Bernard Chatelain, François Mullier, Sarah Lessire
Direct oral anticoagulants (DOACs) have been licensed worldwide for several years for various indications. Each year, 10-15% of patients on oral anticoagulants will undergo an invasive procedure and expert groups have issued several guidelines on perioperative management in such situations. The perioperative guidelines have undergone numerous updates as clinical experience of emergency management has increased and perioperative studies including measurement of residual anticoagulant levels have been published...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28509773/perioperative-management-of-antithrombotic-therapies
#17
Timur Yurttas, Patrick M Wanner, Miodrag Filipovic
PURPOSE OF REVIEW: Perioperative coagulation management is becoming increasingly frequent in the daily routine of the anesthesiologist and with the plethora of new substances on the market also increasingly complex. The perioperative setting poses unique challenges requiring an individualized evaluation and management of antithrombotic therapy. This review shall summarize the newest developments in this domain. RECENT FINDINGS: New data in patients with atrial fibrillation have led to a paradigm change in the perioperative management of antithrombotics...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28502521/-extracorporeal-life-support-in-thoracic-surgery-what-are-the-indications-and-the-pertinence
#18
REVIEW
J Reeb, A Olland, S Renaud, O Collange, X Delabranche, N Santelmo, F Meziani, P-M Mertes, G Massard, P-E Falcoz
INTRODUCTION: In thoracic surgery, extracorporeal life support (ECLS) technologies are used in cases of severe and refractory respiratory failure or as intraoperative cardiorespiratory support. The objectives of this review are to describe the rationale of ECLS techniques, to review the pulmonary diseases potentially treated by ECLS, and finally to demonstrate the efficacy of ECLS, using recently published data from the literature, in order to practice evidence based medicine. STATE OF THE ART: ECLS technologies should only be undertaken in expert centers...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28501353/beta-tricalcium-phosphate-for-orthopedic-reconstructions-as-an-alternative-to-autogenous-bone-graft
#19
P Hernigou, A Dubory, J Pariat, D Potage, F Roubineau, S Jammal, C H Flouzat Lachaniette
Autogenous bone graft (autograft) remains the gold standard in the treatment of many orthopedic problems. However, graft harvest can lead to perioperative morbidity and increased cost. We tested the hypothesis that an osteoconductive matrix, beta-tricalcium phosphate (β-TCP), would be a safe and effective alternative to autograft alone. Beta-tricalcium phosphate (β-TCP) is considered as one of the most promising biomaterials for bone reconstruction. This study analyzes the outcomes of patients who received β-TCP as bone substitutes in orthopedic surgery...
May 10, 2017: Morphologie: Bulletin de L'Association des Anatomistes
https://www.readbyqxmd.com/read/28480651/the-perioperative-management-of-antithrombotic-therapies-using-enoxaparin
#20
Hun Gyu Hwang, So My Koo, Soo Taek Uh, Yang Ki Kim
Oral anticoagulant therapy is frequently and increasingly prescribed for patients at risk of arterial or venous thromboembolism (VTE). Although elective surgical or invasive procedures have necessitated temporary interruption of anticoagulants, managing these patients has been performed empirically and been poorly investigated. This study was designed to evaluate the adequacy of perioperative anticoagulation using enoxaparin. This was a retrospective, single-center study that evaluated the efficacy and safety of therapeutic-dose enoxaparin for bridging therapy in patients on long-term warfarin at Soonchunhyang University Hospital in Korea between August 2009 and July 2011...
June 2017: Journal of Korean Medical Science
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