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https://www.readbyqxmd.com/read/28096581/role-of-preemptive-tapentadol-in-reduction-of-postoperative-analgesic-requirements-after-laparoscopic-cholecystectomy
#1
Ghanshyam Yadav, Gaurav Jain, Abhishek Samprathi, Annavi Baghel, Dinesh Kumar Singh
BACKGROUND AND AIMS: Poorly managed acute postoperative pain may result in prolonged morbidity. Various pharmacotherapies have targeted this, but research on an ideal preemptive analgesic continues, taking into account drug-related side effects. Considering the better tolerability profile of tapentadol, we assessed its role as a preemptive analgesic in the reduction of postoperative analgesic requirements, after laparoscopic cholecystectomy. MATERIAL AND METHODS: In a prospective-double-blinded fashion, sixty patients posted for above surgery, were randomized to receive tablet tapentadol 75 mg (Group A) or starch tablets (Group B) orally, an hour before induction of general anesthesia...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28086871/the-integrated-care-pathway-for-post-stroke-patients-icapps-a-shared-care-approach-between-stakeholders-in-areas-with-limited-access-to-specialist-stroke-care-services
#2
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Mohd Fairuz Ali, Noor Azah Abd Aziz, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#3
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28067594/nicotine-withdrawal-relapse-of-mental-illness-or-medication-side-effect-implementing-a-monitoring-tool-for-people-with-mental-illness-into-quitline-counseling
#4
Catherine J Segan, Amanda L Baker, Alyna Turner, Jill M Williams
BACKGROUND: Smokers with mental illness and their health care providers are often concerned that smoking cessation will worsen mental health. Smokers with mental illness tend to be more nicotine dependent and experience more severe symptoms of nicotine withdrawal, some of which are difficult to distinguish from psychiatric symptoms. In addition, smoking cessation can increase the blood levels and hence side-effects of some psychotropic medications. Improved monitoring of nicotine withdrawal and medication side-effects may help distinguish temporary withdrawal symptoms from psychiatric symptoms and facilitate targeted treatment to help smokers with mental illness manage the acute phase of nicotine withdrawal...
January 9, 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/28058211/organ-transplantation-and-drug-eluting-stents-perioperative-challenges
#5
REVIEW
Aparna Dalal
Patients listed for organ transplant frequently have severe coronary artery disease (CAD), which may be treated with drug eluting stents (DES). Everolimus and zotarolimus eluting stents are commonly used. Newer generation biolimus and novolimus eluting biodegradable stents are becoming increasingly popular. Patients undergoing transplant surgery soon after the placement of DES are at increased risk of stent thrombosis (ST) in the perioperative period. Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor such as clopidogrel, prasugrel and ticagrelor is instated post stenting to decrease the incident of ST...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28032387/action-learning-an-effective-intervention-to-improve-cancer-related-pain-management
#6
Mohammed Ali Mohammed Kasasbeh, Catherine Mccabe, Sheila Payne
PURPOSE: To evaluate the efficacy of action learning for improving cancer related pain management in the acute healthcare settings. Despite the prevalent use of action learning in private, public, clinical and non-clinical settings, no studies were found in the literature that either examined cancer pain management or used action learning as an approach to improve patient care in acute healthcare settings. METHODS: An intervention pre - posttest design was adopted using an action learning programme (ALP) as the intervention...
December 29, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#7
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28012533/a-review-of-acute-postoperative-sialadenitis-in-children
#8
Michael T Yim, Yi-Chun C Liu, Julina Ongkasuwan
OBJECTIVE: Acute postoperative sialadenitis is a previously described rare entity that has occurred following general anesthesia and has also been associated with prolonged neurosurgical procedures. We aim to better characterize this entity while performing a literature review regarding potential etiologies, diagnosis, airway management and treatment options. METHODS: A retrospective chart review was performed at a pediatric tertiary care center from 2000 to 2014...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28005124/comprehensive-care-for-joint-replacement-cjr-bundle-expense-in-perioperative-pain-management
#9
Susan D Bear
The implementaion of the Comprehensive Care for Joint Replacement (CJR) model has necessitated value-focused care for a 90-day period. Pain management in joint arthroplasty therefore represents a focused opportunity to achieve lasting change in the delivery of care. To be successful, orthopedic surgeons must integrate approaches that take into account administration route and therapy duration, and various combinations thereof, to achieve improved longer term outcomes for joint arthroplasty patients. In addition, pain management choices must be based on value and not on simple costs, as patient satisfaction scores affect CJR repayments...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28003134/benefits-of-centralized-scheduling-in-a-post-acute-residential-rehabilitation-program-for-people-with-acquired-brain-lesions-a-pilot-study
#10
Alec Vestri, Silvia Pizzighello, Sara Piccoli, Andrea Martinuzzi
OBJECTIVE: To verify if the use of a designated staff person to coordinate and schedule therapy services in a post acute residential rehabilitation program for people with acquired brain lesions results in a higher intensity treatment allowing the reaching of clinical outcome in a reduced length of stay. Cost saving and perceived satisfaction were explored. DESIGN: This nonrandomized retrospective study uses data collected relative to two different methods of scheduling: Self Planning in which each single team member makes appointments which are then displayed on a shared board, and Managed Planning in which appointments were made by a designated staff person...
December 18, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27984342/strategies-to-prevent-periprosthetic-joint-infection-after-total-knee-arthroplasty-and-lessen-the-risk-of-readmission-for-the-patient
#11
Richard Iorio, Feroz A Osmani
There is yet to be a standardized total knee arthroplasty (TKA) surgical protocol that has been studied to a sufficient degree to offer evidence-based practices regarding infection and readmission prevention. Although high-level evidence is often sought to provide guidance concerning protocol- and process-level decisions, the literature is often confusing and nondefinitive in its conclusions and recommendations regarding periprosthetic joint infection and readmission prevention. Areas of study that require further investigation include the following: the role of patient optimization and preoperative mitigation of risk; perioperative antibiotics; operating room environment; blood management; operative techniques, implants, and infection prevention measures; wound care management; and post acute care...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27981557/potentially-avoidable-readmissions-of-patients-discharged-to-post-acute-care-perspectives-of-hospital-and-skilled-nursing-facility-staff
#12
Eduard E Vasilevskis, Joseph G Ouslander, Amanda S Mixon, Susan P Bell, J Mary Lou Jacobsen, Avantika A Saraf, Daniel Markley, Kelly C Sponsler, Jill Shutes, Emily A Long, Sunil Kripalani, Sandra F Simmons, John F Schnelle
BACKGROUND: Hospital readmissions from skilled nursing facilities (SNFs) are common. Previous research has not examined how assessments of avoidable readmissions differ between hospital and SNF perspectives. OBJECTIVES: To determine the percentage of readmissions from post-acute care that are considered potentially avoidable from hospital and SNF perspectives. DESIGN: Prospective cohort study. SETTING: One academic medical center and 23 SNFs...
December 16, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27978842/fast-track-surgery-after-gynaecological-oncological-surgery-study-protocol-for-a-prospective-randomised-controlled-trial
#13
Ling Cui, Yu Shi, G N Zhang
BACKGROUND: Fast-track surgery (FTS), also known as enhanced recovery after surgery, is a multidisciplinary approach to accelerate recovery, reduce complications, minimise hospital stay without increasing readmission rates, and reduce health care costs, all without compromising patient safety. The advantages of FTS in abdominal surgery most likely extend to gynaecological surgery, but this is an assumption, as FTS in elective gynaecological surgery has not been well studied. No consensus guidelines have been developed for gynaecological oncological surgery although surgeons have attempted to introduce slightly modified FTS programmes for patients undergoing such surgery...
December 15, 2016: Trials
https://www.readbyqxmd.com/read/27976928/post-acute-care-referral-and-inpatient-rehabilitation-admission-criteria-for-persons-with-brain-injury-across-two-canadian-provinces
#14
Bonnie Swaine, Nora Cullen, Frédéric Messier, Mark Bayley, André Lavoie, Shawn Marshall, Marie-Josée Sirois, Alexis Turgeon-Fournier, Julie Lamoureux, Priscilla Lam Wai Shun
PURPOSE: Investigate health care providers' perceptions of referral and admission criteria to brain injury inpatient rehabilitation in two Canadian provinces. METHODS: Health care providers (n = 345) from brain injury programs (13 acute care and 16 rehabilitation facilities) participated in a cross-sectional web-based survey. The participants rated the likelihood of patients (traumatic brain injury and cerebral hypoxia) to be referred/admitted to rehabilitation and the influence of 19 additional factors (e...
December 15, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27933152/ensuring-availability-of-in-date-and-fit-for-purpose-emergency-guidelines-in-all-anaesthetic-areas-throughout-the-south-east-scotland-deanery
#15
Elise Hindle
Our aim was to institute a system whereby emergency anaesthetic guidelines are available in >90% of appropriate clinical areas throughout each of the acute hospital sites in three health board administrative regions, and whereby >90% of available guidelines are deemed to be in date and fit for purpose. Our objective was to achieve these targets within 6 months. Using quality improvement methodology, we inventoried available emergency anaesthetic guidelines in 132 locations throughout seven acute care hospitals...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27923754/successful-coil-embolization-of-pediatric-carotid-cavernous-fistula-due-to-ruptured-posttraumatic-giant-internal-carotid-artery-aneurysm
#16
Daisuke Wajima, Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: The goal of the treatment of direct carotid cavernous fistula (CCF) is to occlude the arteriovenous shunt and to preserve the patency of the concerned internal carotid artery. However, for the ipsilateral posttraumatic fragile cerebrum, coil embolization plus parent artery occlusion for the high-flow direct CCF is better for the prevention of hyperperfusion syndrome and intracranial hemorrhage. We experienced such a case and managed it successfully. CASE DESCRIPTION: A 6-year-old boy had severe head trauma caused by being hit by a car...
December 5, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27920753/neuroproteomics-and-systems-biology-approach-to-identify-temporal-biomarker-changes-post-experimental-traumatic-brain-injury-in-rats
#17
Firas H Kobeissy, Joy D Guingab-Cagmat, Zhiqun Zhang, Ahmed Moghieb, Olena Y Glushakova, Stefania Mondello, Angela M Boutté, John Anagli, Richard Rubenstein, Hisham Bahmad, Amy K Wagner, Ronald L Hayes, Kevin K W Wang
Traumatic brain injury (TBI) represents a critical health problem of which diagnosis, management, and treatment remain challenging. TBI is a contributing factor in approximately one-third of all injury-related deaths in the United States. The Centers for Disease Control and Prevention estimate that 1.7 million people suffer a TBI in the United States annually. Efforts continue to focus on elucidating the complex molecular mechanisms underlying TBI pathophysiology and defining sensitive and specific biomarkers that can aid in improving patient management and care...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#18
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27918156/-cesarean-section-incidence-and-vaginal-birth-success-rate-at-term-pregnancy-after-myomectomy
#19
L Mekiňová, P Janků, E Filipinská, J Kadlecová, P Ventruba
OBJECTIVE: To compare the incidence of primary and acute cesarean section (CS) and to compare success rate of vaginal delivery. To determine the frequency of maternal complications and evaluation of post-partum condition of the newborn. STUDY DESIGN: Prospective, pilot, cohort study. SETTING: Department of Gynecology and Obstetrics Masaryk University and University Hospital Brno. METHODS: Analysis of patients with physiologically ongoing singleton pregnancy and term delivery, vertex presentation...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27912248/mean-arterial-blood-pressure-management-of-acute-traumatic-spinal-cord-injured-patients-during-the-pre-hospital-and-early-admission-period
#20
Jin W Tee, Farhaan Altaf, Lise Belanger, Tamir Ailon, John Street, Scott Paquette, Michael Boyd, Charles G Fisher, Marcel F Dvorak, Brian K Kwon
The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5-7 days following acute traumatic spinal cord injury (tSCI) is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU), or operating room (OR)...
January 13, 2017: Journal of Neurotrauma
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