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https://www.readbyqxmd.com/read/28806175/point-of-care-ultrasound-facilitated-detection-of-femoral-occlusive-septic-emboli-during-mitral-valve-surgery-a-case-report
#1
Melissa L Bellomy, Susan Eagle, Mias Pretorius, Ben R Barton, Yafen Liang
Acute lower extremity ischemia from septic emboli is a surgical emergency. Timely diagnosis and management are critical to improve patient outcome. However, traditional diagnostic modalities such as intraoperative angiogram are time-consuming, require special equipment and personnel, and introduce contrast exposure for critically ill patients. There are limited reports of utilization of point-of-care ultrasound to detect peripheral septic emboli. We present a case where femoral occlusive septic emboli were identified by point-of-care ultrasound after mitral valve replacement...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28805096/perioperative-nursing-of-tracheal-silicon-stent-implantation-in-infants-report-on-four-cases
#2
Deli Li, Xiaoqing Li, Xiuli Yan, Yue Gu, Xueqin Yang, Fanzheng Meng
Since the middle of 2014, totally four tracheal silicon stent implantation were performed in our center. Of them, one case was recurrent tracheoesophageal fistula and the other three cases were tracheomalacia. Specifically, parents' psychological support, infants' nutrition support and airway care were key responses for a nurse before implantation. During the procedure of stent implantation, it was responsible for a nurse to closely monitor the infants and to support operator. After the implantation, airway care and prevention of intra-airway bacterial colonization were important to avoid complications such as hemoptysis or hemorrhage, airway obstruction, and stent displacement...
August 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28803772/perioperative-statins-do-not-prevent-acute-kidney-injury-after-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#3
Bing-Cheng Zhao, Pu Shen, Ke-Xuan Liu
OBJECTIVES: To evaluate whether perioperative statins reduce the risk of acute kidney injury (AKI) after cardiac surgery. DESIGN: Systematic review and meta-analysis of randomized trials. SETTING: Perioperative management in hospitals that perform cardiac surgery. PARTICIPANTS: Adult patients undergoing cardiac surgery. INTERVENTIONS: PubMed, EMBASE, and the Cochrane Library databases were searched for randomized trials...
April 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803771/perioperative-management-of-patients-with-end-stage-renal-disease
#4
REVIEW
Hirotsugu Kanda, Yuji Hirasaki, Takafumi Iida, Megumi Kanao-Kanda, Yuki Toyama, Takashi Chiba, Takayuki Kunisawa
End-stage renal disease (ESRD) is associated with significant alterations in cardiovascular function; homeostasis of body fluid, electrolytes, and acid-base equilibrium; bone metabolism, erythropoiesis; and blood coagulation. The prevalence of ESRD is increasing rapidly worldwide, as is the number of patients requiring surgery under general anesthesia. Patients with ESRD have significantly higher risks of perioperative morbidity and mortality due to multiple comorbidities. The perioperative management of patients with ESRD under general anesthesia therefore requires special considerations and a careful multidisciplinary approach...
April 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803455/effect-of-positive-perioperative-donor-and-recipient-respiratory-bacterial-cultures-on-early-post-transplant-outcomes-in-lung-transplant-recipients
#5
Crystal K Howell, Christopher A Paciullo, Marshall G Lyon, David Neujahr, Peter Lyu, George Cotsonis, Michael Hurtik
BACKGROUND: It is standard practice to administer prophylactic antibiotics post lung transplantation. However, no studies have evaluated the impact of culture positivity. The purpose of this study was to evaluate early post-transplant outcomes of culture-positive and culture-negative lung transplant (LT) recipients and the appropriateness of the empiric regimens used. METHODS: Adult patients who received an LT at Emory University Hospital between January 1, 2010 and August 31, 2015 were reviewed and stratified into three groups: (i) culture-positive appropriate empiric treatment, (ii) culture-positive inappropriate empiric treatment, and (iii) culture-negative...
August 13, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28803334/surgical-approaches-to-adenocarcinoma-of-the-gastroesophageal-junction-the-siewert-ii-conundrum
#6
REVIEW
Andrew M Brown, Danica N Giugliano, Adam C Berger, Michael J Pucci, Francesco Palazzo
BACKGROUND: The Siewert classification system for gastroesophageal junction adenocarcinoma has provided morphological and topographical information to help guide surgical decision-making. Evidence has shown that Siewert I and III tumors are distinct entities with differing epidemiologic and histologic characteristics and distinct patterns of disease progression, requiring different treatment. Siewert II tumors share some of the characteristics of type I and III lesions, and the surgical approach is not universally agreed upon...
August 12, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28802984/free-grafts-and-microvascular-anastomoses
#7
REVIEW
Valery F Scharf
Skin grafts and free skin flaps are useful options for closure of wounds in which primary closure or use of traditional skin flaps is not feasible. Grafts are classified by their morphology and host-donor relationship. Free skin flaps with microvascular anastomoses are developed from previously described axial pattern flaps and have the added advantage of reestablishing robust vascular supply to the flap, but require specialized equipment and a high degree of technical expertise. Despite intensive perioperative care and the risk of graft or flap failure, skin grafts and free skin flaps can serve as rewarding methods of closing difficult wounds...
August 9, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28802796/antibacterial-prophylaxis-for-gram-positive-and-gram-negative-infections-in-cranial-surgery-a-meta-analysis
#8
REVIEW
Pranav Abraham, Nayan Lamba, Michael Acosta, Joanna Gholmie, Hassan Y Dawood, Matthew Vestal, Kevin Huang, Maher Hulou, Morteza Asgarzadeh, Hasan Zaidi, Rania A Mekary, Timothy R Smith
BACKGROUND: Perioperative antibiotic prophylaxis against gram positive and gram negative infections is considered standard of care in the perioperative management of patients undergoing cranial surgery. The antibiotic regimen which best reduces the risk of surgical site infections (SSIs) remains controversial. OBJECTIVES: A systematic literature review and meta-analysis were conducted to examine the effect of various prophylactic antibiotics on infection incidence among patients undergoing cranial surgeries...
August 9, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28801975/trends-in-aging-related-services-during-nephrectomy-implications-for-surgery-in-an-aging-population
#9
Hung-Jui Tan, Mark S Litwin, Karim Chamie, Debra Saliba, Jim C Hu
OBJECTIVES: To characterize the extent to which geriatric and related healthcare services are provided to older adults undergoing surgery for kidney cancer, a potential growth area in geriatrics and oncology. DESIGN: Population-based observational study. SETTING: Surveillance, Epidemiology, and End Results cancer data linked with Medicare claims. PARTICIPANTS: Adults aged 65 and older with kidney cancer treated surgically from 2000 to 2009 (N = 19,129)...
August 11, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28801217/evaluation-of-unplanned-hospital-readmissions-after-major-urologic-inpatient-surgery-in-the-era-of-accountable-care
#10
Benjamin V Stone, Matthew R Cohn, Nicholas M Donin, Michael Schulster, James S Wysock, Danil V Makarov, Marc A Bjurlin
OBJECTIVE: To provide a multi-institutional analysis of clinical factors predicting unplanned hospital readmission after major inpatient urologic surgery. MATERIALS AND METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is a risk-adjusted data collection mechanism for analyzing clinical outcomes data including 30-day perioperative readmissions and complications. We identified 23,108 patients who underwent major inpatient urologic surgery from 2011 to 2012...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28801200/perioperative-mortality-for-patients-with-a-hip-fracture
#11
Bassey Nkanang, Martyn Parker, Emily Parker, Richard Griffiths
INTRODUCTION: Studies on mortality following hip fracture surgery have hitherto focused on the 30 day to 1 year period and beyond. This study focuses on the immediate perioperative period. It examines mortality rates, patient characteristics, operative details and post-operative complications. PATIENTS AND METHODS: A retrospective study of a hip fracture database in a large District General Hospital in the United Kingdom, from 1986 to 2015. A dataset of 9393 patients was identified, including patients undergoing surgery for curative and palliative purposes, over fifteen years of age and with no upper age limit imposed...
July 12, 2017: Injury
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#12
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28800838/noncompliance-with-surgical-antimicrobial-prophylaxis-guidelines-a-jordanian-experience-in-cesarean-deliveries
#13
Mariam Hantash Abdel Jalil, Khawla Abu Hammour, Mervat Alsous, Rand Hadadden, Wedad Awad, Faris Bakri, Kamil Fram
BACKGROUND: Surgical site infections are common, especially in developing countries. Nevertheless, up to 60% of surgical site infections can be prevented with appropriate perioperative care, which includes among other measures using suitable surgical antimicrobial prophylaxis (SAP). METHODS: After a short interview with patients and retrospective review of medical charts, compliance with 6 SAP parameters was assessed for appropriateness; those parameters are indication, choice, dose, time of administration, intraoperative redosing interval, and duration of prophylaxis in 1,173 operations...
August 8, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28800725/a-novel-thermal-compression-device-for-perioperative-warming-a-randomized-trial-for-feasibility-and-efficacy
#14
Peter Luke Santa Maria, Chloe Santa Maria, Andreas Eisenried, Nathalia Velasquez, Brian Thomas Kannard, Abhinav Ramani, David Mark Kahn, Amanda Jane Wheeler, John Gerhard Brock-Utne
BACKGROUND: Inadvertent perioperative hypothermia (IPH) leads to surgical complications and increases length of stay. IPH rates are high with the current standard of care, forced air warming (FAW). Our hypothesis is that a prototype thermal compression device that heats the popliteal fossa and soles of the feet, with lower leg compression, increases perioperative temperatures and reduces IPH compared to the current standard of care. METHODS: Thirty six female breast surgery patients, at a tertiary academic hospital, were randomized to the device or intraoperative FAW (stage I) with a further 18 patients randomized to the device with a single heating area only (stage II, popliteal fossa or sole of the feet)...
August 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28800719/total-ankle-arthroplasty-comparing-perioperative-outcomes-when-performed-at-an-orthopaedic-specialty-hospital-versus-an-academic-teaching-hospital
#15
David M Beck, Eric M Padegimas, David I Pedowitz, Steven M Raikin
BACKGROUND: The number of total ankle arthroplasties (TAAs) performed in the United States has risen significantly in recent years, as has utilization of orthopaedic specialty hospital (OSH) to treat healthy patients undergoing elective surgery. The purpose of this study was to compare postoperative outcomes following TAA at an OSH when compared with a matching population of patients undergoing TAA at an academic teaching hospital (ATH). METHODS: We identified all TAA from January 2014 to December 2014 at the OSH and January 2010 to January 2016 at the ATH...
August 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28799484/pharmacology-and-perioperative-considerations-for-diabetes-mellitus-medications
#16
Stephen Aniskevich, J Ross Renew, Ryan M Chadha, Joan M Irizarry-Alvarado
BACKGROUND: Given the prevalence of diabetes mellitus in modern society, health care providers are frequently tasked with managing glucose control in the perioperative period. When determining perioperative diabetes management, the clinician must balance the need to maintain relative euglycemia at the time of surgery with preventing hypoglycemia or hyperglycemia in a fasting surgical patient. This balance requires an understanding of the pharmacology of these medications, the type of surgery, and the patient's degree of diabetic control...
August 10, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28798876/the-criterion-validity-reliability-and-feasibility-of-an-instrument-for-assessing-the-nursing-intensity-in-perioperative-settings
#17
Satu Rauta, Sanna Salanterä, Tero Vahlberg, Kristiina Junttila
Patient classification systems generate information for staff allocation based on a patient's care needs. This study aims to test further the instrument for assessing nursing intensity (NI) in perioperative settings. Nine operating departments from five university hospitals were involved. The perioperative nurses gathered data from patients (N = 876) representing different fields of surgery. Reliability was tested by parallel classifications (n = 144). Also, the users' (n = 40) opinions were surveyed. The results support the predictive validity and interrater reliability of the instrument...
2017: Nursing Research and Practice
https://www.readbyqxmd.com/read/28797982/identification-of-preoperative-and-intraoperative-risk-factors-for-complications-in-the-elderly-undergoing-elective-craniotomy
#18
Stephen J Johans, Jonathan R Garst, Daniel J Burkett, Kurt Grahnke, Brendan Martin, Tarik F Ibrahim, Douglas E Anderson, Vikram C Prabhu
BACKGROUND: Neurosurgical patients are aging as the general population is getting older. METHODS: A retrospective review of patients ≥ 65 years of age who underwent an elective craniotomy from 2007-2015 to identify risk factors for 30-day morbidity/mortality was conducted. Key preoperative variables included age, co-morbidities, and functional status based on the Karnofsky Performance Status (KPS) score and modified Rankin Scale (mRS) score. Outcome variables included long-term care (LTC) complications, neurologic complications, systemic/infectious complications, length of stay (LOS), functional outcomes, and mortality...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28795615/international-survey-on-the-perioperative-management-of-pulmonary-endarterectomy-the-perfusion-perspective
#19
Roger D P Stanzel, Johannes Gehron, Matthias Wolff, Natalie Striegl, Peter Roth, Rolf-Hasso Boedeker, Christine Scheibelhut, Johannes Herrmann, Ingeborg Welters, Eckhard Mayer, Matthias Scheffler
INTRODUCTION: Pulmonary endarterectomy (PEA) is the most effective treatment available for chronic thromboembolic pulmonary hypertension (CTEPH). Patient selection, surgical technique and perioperative management have improved patient outcomes, which are traditionally linked to surgical and center experience. However, optimal perfusion care has not been well defined. The goal of the international survey was to better characterize the contemporary perfusion management of PEA and highlight similarities and controversies...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28795019/safe-and-ethical-living-kidney-donation-in-qatar-a-national-health-system-s-approach
#20
Muhammad Asim, Yousuf Al-Maslamani, Hassan Al-Malki
The increasing incidence of end-stage kidney disease in Qatar has led to growing demand for donor kidneys. The deceased donor kidney program has yet to achieve its full potential; hence, living kidney donation has been widely adopted as an appropriate alternative. The reliance on living kidney donors however, raises a number of social, ethical, and legal concerns surrounding informed consent, voluntarism, psychosocial evaluation, perioperative care, and long-term follow-up of living kidney donors. Many of these concerns become heightened in a multicultural, multilingual society within a Gulf country such as Qatar...
2017: Qatar Medical Journal
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