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https://www.readbyqxmd.com/read/28319519/process-improvement-initiative-for-the-perioperative-management-of-patients-with-a-cardiovascular-implantable-electronic-device
#1
Margaret K Menzel Ellis, Miriam M Treggiari, Jamie M Robertson, Marc A Rozner, Peter F Graven, Michael F Aziz, Matthias J Merkel, Edward A Kahl, Norman A Cohen, Eric C Stecker, Peter M Schulman
BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#2
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319472/infective-endocarditis-in-children-an-update
#3
Garth Dixon, Georgi Christov
PURPOSE OF REVIEW: Infective endocarditis in children remains a clinical challenge. Here, we review the impact of the updated 2015 American Heart Association and European Society of Cardiology guidelines on management as well as the significance of the new predisposing factors, diagnostic and treatment options, and the impact of the 2007-2008 change in prophylaxis recommendations. RECENT FINDINGS: The new 2015 infective endocarditis guidelines introduced the endocarditis team, added the new imaging modalities of computer tomography and PET-computer tomography into the diagnostic criteria and endorsed the concept of safety of relatively early surgical treatment...
March 17, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28319277/the-systematic-review-and-meta-analysis-of-free-flap-safety-in-the-elderly-patients
#4
Galip Gencay Üstün, Ali Emre Aksu, Hakan Uzun, Ozan Bitik
BACKGROUND: Prolonged mean life expectancy gives rise to a more populated and older patient group. With increasing number of cases during the past decades, older patients are regarded as candidates for microsurgical interventions. Whether advanced patient age is an independent risk factor for microsurgical reconstruction is still an ongoing matter of debate. METHODS: The Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, CINAHL and EMBASE databases were screened for combination of the key words "elderly", "geriatric", "advanced age", "free flap", "microsurgery", free tissue transfer" by using time limits between 1989 and 2015...
March 20, 2017: Microsurgery
https://www.readbyqxmd.com/read/28318939/early-metabolic-improvement-after-bariatric-surgery-the-first-steps-toward-remission-of-type-2-diabetes
#5
REVIEW
Thomas Grenier-Larouche, Anne-Marie Carreau, André C Carpentier
The introduction of bariatric surgery into clinical practice in the 1980s was followed by a relatively long watch-and-wait period before the very rapid accumulation of scientific literature, over the past decade, concerning its clinical effectiveness and safety and its mechanisms of action in the treatment of obesity. These surgical procedures now emerge as the most effective therapeutic modality to induce long-term remission of type 2 diabetes. Recent research has shed light on the potential mechanisms leading to the profound improvement of glucose homeostasis following most bariatric surgery procedures...
March 17, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28318850/safety-and-efficacy-of-hyperosmolar-irrigation-solution-in-shoulder-arthroscopy
#6
Nicholas M Capito, James L Cook, Bernardo Yahuaca, Marie D Capito, Seth L Sherman, Matthew J Smith
BACKGROUND: A hyperosmolar irrigation solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar solution were compared with a standard isotonic solution when used for shoulder arthroscopy. METHODS: A prospective, double-blind, randomized controlled trial was performed to compare isotonic (273 mOsm/L) and hyperosmolar (593 mOsm/L) irrigation solutions used for arthroscopic rotator cuff repair...
March 15, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28318501/sorafenib-use-for-recurrent-hepatocellular-cancer-after-resection-or-transplantation-observations-from-a-us-regional-analysis-of-the-gideon-registry
#7
Robert C G Martin, Elizabeth Bruenderman, Allen Cohn, Bilal Piperdi, Rebecca Miksad, Jean-Francois Geschwind, Alec Goldenberg, Arun Sanyal, Ellen Zigmont, Svetlana Babajanyan, Pamela Foreman, Parvez Mantry, Brendan McGuire, Pierre Gholam
Treatment of unresectable recurrent hepatocellular carcinoma (HCC) in patients who recur after resection or orthotopic liver transplantation (OLT) remains a clinical challenge. One option is sorafenib, although little is known about its safety and tolerance in this unique patient population; therefore, we analyzed patients who underwent prior surgical resection and/or OLT and were treated with sorafenib in US cohort of GIDEON registry. In US, 645 patients were enrolled; 553 for intent to treat and 563 for safety...
November 18, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28318494/the-role-of-the-irreversible-electroporation-in-the-hepato-pancreatico-biliary-surgery
#8
Patricia Sánchez-Velázquez, Pierre-Alain Clavien
Irreversible electroporation is a novel technique growing in popularity over the last years among the ablative modalities. Its unique action mechanism produces irreversible nanopores in the membrane of the cell leading to apoptosis; therefore irreversible electroporation can be used to ablate substantial volumes of tissue without the undesirable thermal effects as the "heat sink effect". Moreover the extracellular matrix is left unperturbed, thus sparing the structural architecture of surrounding structures such as bile ducts and blood vessels...
March 16, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28317582/robotic-right-hemicolectomy-analysis-of-108-consecutive-procedures-and-multidimensional-assessment-of-the-learning-curve
#9
Amilcare Parisi, Luca Scrucca, Jacopo Desiderio, Alessandro Gemini, Salvatore Guarino, Francesco Ricci, Roberto Cirocchi, Giorgio Palazzini, Vito D'Andrea, Liliana Minelli, Stefano Trastulli
PURPOSE: Surgeons tend to view the robotic right colectomy (RRC) as an ideal beginning procedure to gain proficiency in robotic general and colorectal surgery. Nevertheless, oncological RRC, especially if performed with intracorporeal ileocolic anastomosis confectioning, cannot be considered a technically easier procedure. The aim of this study was to assess the learning curve of the RRC performed for oncological purposes and to evaluate its safety and efficacy investigating the perioperative and pathology outcomes in the different learning phases...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28317041/importance-of-critical-view-of-safety-in-laparoscopic-cholecystectomy-a-survey-of-120-serial-patients-with-no-incidence-of-complications
#10
Bulent Kaya, Mehmet Mahir Fersahoglu, Fatih Kilic, Ender Onur, Kemal Memisoglu
BACKGROUNDS/AIMS: To determine the importance of critical view of safety techniques in laparoscopic cholecystectomy. METHODS: A total of 120 patients were included in the study, between January 2015 to March 2016. Hydrodissection was performed for cases presenting with severe adhesions or cholecystitis. A critical view of safety was performed for all patients undergoing the procedure for isolation of cystic duct and cystic artery with cystic plate dissection. Demographic characteristics of the patients, as well as intraoperative and postoperative minor or major complications were recorded...
February 2017: Ann Hepatobiliary Pancreat Surg
https://www.readbyqxmd.com/read/28315797/craniotomy-versus-decompressive-craniectomy-for-acute-subdural-hematoma-systematic-review-and-meta-analysis
#11
Kevin Phan, Justin M Moore, Christoph Griessenauer, Adam A Dmytriw, Daniel B Scherman, Sharaf Sheik-Ali, Nimer Adeeb, Christopher S Ogilvy, Ajith Thomas, Jeffrey V Rosenfeld
INTRODUCTION: Acute subdural hematoma (SDH) is a major cause of morbidity following severe traumatic brain injury. Surgical evacuation of the hematoma, either via craniotomy or craniectomy, is the mainstay of treatment in patients with progressive neurological deficits or significant mass effect. However, the decision between either procedure remains controversial. METHODS: A literature search using major online databases and a manual search of reference on the topic of craniotomy and craniectomy for evacuation of subdural hematoma until September 2016 was performed...
March 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28315643/benefits-of-21-oxygen-compared-with-100-oxygen-for-delivery-of-isoflurane-to-mice-mus-musculus-and-rats-rattus-norvegicus
#12
Laura A Wilding, Joe A Hampel, Basma M Khoury, Stacey Kang, David Machado-Aranda, Krishnan Raghavendran, Jean A Nemzek
At research institutions, isoflurane delivered by precision vaporizer to a face mask is the standard for rodent surgery and for procedures with durations that exceed a few minutes. Pure oxygen is often used as the carrier gas for isoflurane anesthesia, despite documented complications from long-term 100% oxygen use in humans and known occupational safety risks. We therefore examined the effect of anesthetic delivery gas on physiologic variables in mice and rats. Rodents were anesthetized for 60 min with isoflurane delivered in either 21% or 100% oxygen by means of a nose cone...
March 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28315503/does-the-roller-pump-adjustment-in-cardiopulmonary-bypass-settings-influence-hemolysis
#13
Francisco U Vieira Junior, Nilson Antunes, Pedro P de Oliveira, Lindemberg M Silveira Filho, Karlos A S Vilarinho, Eduardo T Costa
INTRODUCTION: Roller pumps are widely used in procedures involving cardiopulmonary bypass (CPB) due to their ease of operation and maintenance, safety, and cost. Several studies in the literature have compared the use of roller pumps with centrifugal pumps, but the influence of the roller pump adjustment on hemolysis has been poorly explored. METHODS: Measurements of hemolysis rates were carried out in 86 patients. The pump was adjusted by the dynamic calibration method, which was performed by an auxiliary device, and the patients were grouped according to the pump calibration: Group 1 (n = 20) 75 mmHg; Group 2 (n = 24) 150 mmHg; Group 3 (n = 22) 300 mmHg and Group 4 (n = 21) 450 mmHg...
March 3, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28314534/total-cavopulmonary-connection-with-a-new-bioabsorbable-vascular-graft-first-clinical-experience
#14
Leo A Bockeria, Oleg Svanidze, Alex Kim, Konstantin Shatalov, Vladimir Makarenko, Martijn Cox, Thierry Carrel
OBJECTIVES: To assess safety and clinical performance of a novel bioabsorbable vascular graft in pediatric patients with univentricular cardiac malformation who received surgical correction via an extracardiac cavopulmonary conduit. METHODS: The implanted graft material is designed to attract patient's own cells and proteins, which trigger a cascade of physiological events leading to endogenous tissue restoration. As the graft resorbs progressively after implantation, components of native tissue including collagen, endothelial lining, and capillary blood vessels develop and organize into a natural tissue...
February 7, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28306734/simultaneous-liver-kidney-transplantation-and-bilateral-nephrectomy-through-a-midline-is-feasible-and-safe-in-polycystic-disease
#15
Ina Jochmans, Diethard Monbaliu, Laurens J Ceulemans, Jacques Pirenne, Jiri Fronek
In Eurotransplant, 50% of simultaneous liver kidney transplantations (SLK) are performed for polycystic disease. Classically, liver and kidney are transplanted in two steps: liver through a subcostal incision, kidney through a separate oblique incision. Liver and kidney volume can make this 'two-step' procedure challenging, especially if simultaneous native nephrectomy is indicated. A 'one-step' SLK through a xiphopubic laparotomy might be a safe alternative, facilitating mobilization of the voluminous polycystic liver and native nephrectomy whilst offering access to iliac fossae for kidney transplantation...
2017: PloS One
https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#16
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306646/prevalence-of-musculoskeletal-disorders-among-surgeons-performing-minimally-invasive-surgery-a-systematic-review
#17
Chantal C J Alleblas, Anne Marie de Man, Lukas van den Haak, Mark E Vierhout, Frank Willem Jansen, Theodoor E Nieboer
OBJECTIVE: The aim of this study was to review musculoskeletal disorder (MSD) prevalence among surgeons performing minimally invasive surgery. BACKGROUND: Advancements in laparoscopic surgery have primarily focused on enhancing patient benefits. However, compared with open surgery, laparoscopic surgery imposes greater ergonomic constraints on surgeons. Recent reports indicate a 73% to 88% prevalence of physical complaints among laparoscopic surgeons, which is greater than in the general working population, supporting the need to address the surgeons' physical health...
March 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28306630/nonoperative-management-of-appendicitis-in-children
#18
Joseph J López, Katherine J Deans, Peter C Minneci
PURPOSE OF REVIEW: The aim of this review is to summarize the recent literature investigating nonoperative management of uncomplicated and complicated appendicitis and highlight recent data establishing its safety and efficacy. RECENT FINDINGS: Recent studies and clinical trials have demonstrated the efficacy of nonoperative treatment of both uncomplicated and complicated appendicitis, defined as perforated appendicitis with or without formed abscess or phlegmon...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28306625/visualization-of-the-retina-and-vitreous-during-vitreoretinal-surgery-new-technologies
#19
Sarah P Read, Jorge A Fortun
PURPOSE OF REVIEW: Visualization remains a critical factor in successful ocular surgery.Here we review new technology that has the potential to allow for safer and more efficient retinal surgery. RECENT FINDINGS: Vitreoretinal surgery poses unique visualization challenges such as the need for specialized optical systems and the delicate and microscopic features of retinal structures. Better retinal visualization allows for new approaches to increasingly complex retinal cases...
March 16, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28306212/tracheal-extubation-practices-following-adenotonsillectomy-in-children-effects-on-operating-room-efficiency-between-two-institutions
#20
Hiromi Kako, Marco Corridore, Sarah Seo, Charles Elmaraghy, Meredith Lind, Joseph D Tobias
BACKGROUND: Adenotonsillectomy is one of the most commonly performed operative procedures in children. It is imperative to find the most efficient and cost-effective methods of practice to facilitate operating room management while maintaining patient safety. We investigated the efficiency of two different approaches of tracheal extubation in pediatric patients following adenotonsillectomy at two tertiary care pediatric hospitals with large surgical volumes. The primary aim of the study was to determine the difference in the operating room time according to the institutional practice of tracheal extubation in the postanesthesia care unit (PACU) as compared to the operating room...
March 17, 2017: Paediatric Anaesthesia
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