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Perioperative medicine

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https://www.readbyqxmd.com/read/28077529/poor-agreement-in-significant-findings-between-meta-analyses-and-subsequent-large-randomized-trials-in-perioperative-medicine
#1
REVIEW
H Sivakumar, P J Peyton
BACKGROUND: The reliability of meta-analysis (MA) in predicting the findings of subsequent large randomized controlled trials (RCTs) has not been assessed in perioperative medicine and anaesthesia. METHODS: Using Medline and PubMed, large RCTs (n≥1000) published since 2000 in the anaesthesia and perioperative medicine/critical care literature were identified. All previous MAs of RCTs investigating the same intervention and population were sourced. For all reported major morbid endpoints common to each, results (significant/non-significant P<0...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077526/patient-safety-and-the-risk-of-i-v-fluid-therapy-in-perioperative-medicine-importance-of-host-susceptibility-and-exposure-dose
#2
A D Shaw, M D McEvoy
No abstract text is available yet for this article.
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074823/pharmacological-update-new-drugs-in-cardiac-practice-a-critical-appraisal
#3
REVIEW
Rohan Magoon, Arindam Choudhury, Vishwas Malik, Ridhima Sharma, Poonam Malhotra Kapoor
Cardiac practice involves the application of a range of pharmacological therapies. An anesthesiologist needs to keep pace with the rampant drug developments in the field of cardiovascular medicine for appropriate management in both perioperative and intensive care set-up, to strengthen his/her role as a perioperative physician in practice. The article reviews the changing trends and the future perspectives in major classes of cardiovascular medicine.
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074295/-neuraxial-anaesthesia-and-noacs
#4
T Standl
BACKGROUND: Cardiovascular comorbidities in surgical patients are frequent and have a substantial impact on the postoperative outcome. Neuraxial blockades are able to reduce perioperative morbidity and mortality. The increasing use of new oral anticoagulants (NOAC) requires a high level of attention, especially in patients undergoing neuraxial blockades or requiring postoperative analgesia. OBJECTIVE: The goal of this article is to present the benefit of neuraxial anaesthesia and analgesia in patients with cardiovascular risks and perioperative management of NOAC in this setting...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28066904/implementing-point-of-care-ultrasonography-of-the-heart-and-lungs-in-an-anesthesia-department
#5
M T Bøtker, M L Vang, T Grøfte, H Kirkegaard, C A Frederiksen, E Sloth
BACKGROUND: Implementation of point-of-care ultrasonography (POCUS) of the heart and lungs requires image acquisition skills among providers. We aimed to determine the effect of POCUS implementation using a systematic education program on image acquisition skills and subsequent use and barriers in a department of anesthesiology. METHODS: Twenty-five anesthesiologists underwent a systematic education program in POCUS during the fall of 2012. A POCUS expert evaluated images from baseline and evaluation examinations performed on two healthy individuals as useful or not useful for clinical interpretation...
February 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28054108/-cardiac-surgery-in-the-elderly
#6
B Wiegmann, I Ismai, A Haverich
Due to the increasing demographic changes and the fact that cardiovascular diseases are still the leading cause of death, the mean chronological age of patients undergoing cardiac surgery is steadily increasing. In 2015, 14.8% of these patients were aged 80 years and older. This meta-analysis reviewed if and under what circumstances elderly patients benefit from cardiac surgical procedures without running the risk of limitations in the quality of life and high rates of morbidity and mortality. Generally, the chronological age was not a risk factor for higher perioperative and postoperative morbidity and mortality but the biological age was the critical factor, in particular the associated comorbidities of patients and the timing of the surgical procedure in the course of the disease...
January 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28050803/access-to-controlled-medicines-for-anesthesia-and-surgical-care-in-low-income-countries-a-narrative-review-of-international-drug-control-systems-and-policies
#7
Jason W Nickerson, Katherine Pettus, Kathleen E Wheeler, Christopher Hallam, David R Bewley-Taylor, Amir Attaran, Adrian W Gelb
PURPOSE: This article describes the functioning of the international drug control system, its integration into national legislation and policy, and the collective impact on access to medicines. SOURCE: We conducted a review of the three international drug control conventions, peer-reviewed articles, and grey literature known to the authors that describes national and international drug control systems and their impact on access to controlled medicines. This review was supplemented with literature derived from a structured search of MEDLINE(®) for articles relating to medical uses of ketamine in low- and middle-income countries conducted to strengthen an advocacy campaign...
January 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28034651/patient-surgeon-and-hospital-disparities-associated-with-benign-hysterectomy-approach-and-perioperative-complications
#8
Ambar Mehta, Tim Xu, Susan Hutfless, Martin A Makary, Abdulrahman K Sinno, Edward J Tanner, Rebecca L Stone, Karen Wang, Amanda N Fader
BACKGROUND: Hysterectomy is among the most common major surgical procedures performed in women. Approximately 450,000 hysterectomy procedures are performed each year in the United States for benign indications. However, little is known regarding contemporary U.S. hysterectomy trends for women with benign disease with respect to operative technique and perioperative complications, and the association between these two factors with patient, surgeon, and hospital characteristics. OBJECTIVES: To describe contemporary hysterectomy trends and explore associations between patient, surgeon, and hospital characteristics with surgical approach and perioperative complications...
December 26, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28032156/complex-truncal-masses-in-the-setting-of-cloves-syndrome-aesthetic-and-functional-implications
#9
Jason M Weissler, Valeriy Shubinets, Martin J Carney, David W Low
BACKGROUND: Congenital lipomatous overgrowth, vascular malformations, epidermal nevi, and skeletal abnormalities (CLOVES) is a complex overgrowth syndrome with dramatic aesthetic and functional implications. The truncal masses characteristic of CLOVES syndrome are described as vascular malformations or lipomatous lesions with variable vascular components. Herein, we describe our single-institution experience with surgical excision of CLOVES-related truncal masses and discuss future directions in treatment of these complex anomalies...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28028671/anesthesia-considerations-for-patients-with-an-implanted-deep-brain-stimulator-undergoing-surgery-a-review-and-update
#10
Tze Yeng Yeoh, Pirjo Manninen, Suneil K Kalia, Lashmi Venkatraghavan
PURPOSE: Deep brain stimulation (DBS) can be an effective treatment option for patients with essential tremor and Parkinson's disease. This review provides an overview on the functioning of neurostimulators and recent advances in this technology and presents an updated guide on the anesthetic management of patients with an implanted neurostimulator undergoing surgery or medical intervention. SOURCE: A search was conducted on MEDLINE®, EMBASE™, and Cochrane Database of Systematic Reviews databases to identify studies published in English from 1974 to December 2015...
December 27, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28028288/a-cost-effectiveness-analysis-of-self-debriefing-versus-instructor-debriefing-for-simulated-crises-in-perioperative-medicine-in-canada
#11
Wanrudee Isaranuwatchai, Fahad Alam, Jeffrey Hoch, Sylvain Boet
PURPOSE: High-fidelity simulation training is effective for learning crisis resource management (CRM) skills, but cost is a major barrier to implementing high-fidelity simulation training into the curriculum. The aim of this study was to examine the cost-effectiveness of self-debriefing and traditional instructor debriefing in CRM training programs and to calculate the minimum willingness-to-pay (WTP) value when one debriefing type becomes more cost-effective than the other. METHODS: This study used previous data from a randomized controlled trial involving 50 anesthesiology residents in Canada...
2017: Journal of Educational Evaluation for Health Professions
https://www.readbyqxmd.com/read/28027087/standardized-care-versus-precision-medicine-in-the-perioperative-setting-can-point-of-care-testing-help-bridge-the-gap
#12
Marc Iravani, Lisa K Lee, Maxime Cannesson
No abstract text is available yet for this article.
December 22, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27990189/effects-of-modification-of-pain-protocol-on-incidence-of-post-operative-nausea-and-vomiting
#13
Ran Schwarzkopf, Nimrod Snir, Zachary T Sharfman, Joseph B Rinehart, Michael-David Calderon, Esther Bahn, Brian Harrington, Kyle Ahn
BACKGROUND: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27980337/continuous-cooling-mask-devices-reduce-patient-discomfort-and-postoperative-pain-and-swelling-in-patients-undergoing-orofacial-surgery
#14
Analia Veitz-Keenan
Data sourcesThe resources searched included: Medline, PubMed, Embase, CINAHL, CAB Abstracts, the Cochrane Library and Google Scholar. The PRISMA guidelines for reporting systematic reviews were followed. Study selection was limited to the English language. Hand searching for additional references was performed. An intensive search was conducted for published articles describing the use of hilotherapy following oral and maxillofacial surgery.Study selectionInclusion criteria involved patients using hilotherapy after oral and maxillofacial surgery...
December 2016: Evidence-based Dentistry
https://www.readbyqxmd.com/read/27957515/ultrasound-skill-and-application-of-knowledge-assessment-using-an-innovative-osce-competition-based-simulation-approach
#15
Annette Rebel, Habib Srour, Amy DiLorenzo, Dung Nguyen, Shelly Ferrell, Sanjay Dwarakanatli, Emily Haas, Randall M Schell
BACKGROUND: Despite Point-of Care Ultrasound (PoC US) rapidly becoming an important tool in perioperative medicine structured education, PoC US is currently rarely integrated into the anesthesiology residency curriculum. The aim of this project was to assess the current ultrasound skills of anesthesiology residents at one institution and evaluate the needs for development of a formal ultrasound curriculum. METHODS: A event containing 6 different OSCE PoC US stations was developed with following stations: vascular, peripheral nerve block, lung ultrasound, transthoracic echocardiography (TTE) human model, pathologic TTE (simulator), and inferior vena cava (IVC) evaluation (simulator)...
July 2016: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/27938936/perioperative-medicine-and-the-role-of-haemodynamic-monitoring
#16
S C Ng, M Mythen
No abstract text is available yet for this article.
December 8, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27931642/hemodynamic-coherence-its-meaning-in-perioperative-and-intensive-care-medicine
#17
EDITORIAL
Can Ince, Christian Ertmer
No abstract text is available yet for this article.
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27922894/antimicrobial-prophylaxis-practice-patterns-in-breast-augmentation-a-national-survey-of-current-practice
#18
Karan Chopra, Arvind U Gowda, Colton H L McNichols, Emile N Brown, Sheri Slezak, Yvonne Rasko
BACKGROUND: Breast augmentation is one of the most commonly performed aesthetic surgery procedures worldwide. Bacterial contamination is of paramount concern due to its role in biofilm formation and capsular contracture. Plastic surgeons have adopted a variety of perioperative interventions in efforts to reduce implant contamination, however definitive evidence supporting these practices is lacking. OBJECTIVE: The goal of this study was to assess current practice patterns aimed at reducing implant-related infections in breast augmentation and comparing them to current evidence-based medicine recommendations...
December 5, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27916027/-current-status-of-lung-transplantation-in-china-problems-and-perspectives
#19
X A Wang, G N Jiang
Despite rapid progress, clinical lung transplantation in China still lags far behind. A great challenge remains in donor lung utilization and perioperative medicine. It's really abnormal that we are so backward in lung transplantation when we have come up with the advanced world levels in thoracic surgery, pulmonology and critical care medicine. Our shortcomings were analyzed by comparing lung transplantation in China and in the advanced countries. The first problem is multidisciplinary teamwork. In the United States, a lung transplant team includes physician specialized in lung transplantation, thoracic surgeons, nurses, respiratory therapists and other specialists possibly needed...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#20
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
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