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Perioperative medicine

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https://www.readbyqxmd.com/read/29133765/geriatric-anesthesia-related-morbidity-and-mortality-in-china-current-status-and-trend
#1
REVIEW
Yang Liu, Wei Xiao, Ling-Zhong Meng, Tian-Long Wang
OBJECTIVE: The population of elderly patients and the amount of geriatric anesthesia have been growing rapidly in China. Thus, understanding the morbidity and mortality associated with geriatric anesthesia in China is critical to the improvement of anesthesia quality and outcome. The aim of the review was to discuss the geriatric anesthesia-related morbidity and mortality in China, as well as to point out the future trend. DATA SOURCES: Articles in this review were all searched from Wanfang, China National Knowledge Infrastructure (CNKI), VIP, PubMed, and Web of Science databases, based on the reports originated in China from January 2011 to December 2016...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29123659/-why-me-the-problem-of-chronic-pain-after-surgery
#2
Patricia Lavand'homme
Chronic postsurgical pain (CPSP) has become a health priority and is scheduled to be included in the upcoming version of the International Classification of Diseases, 11th Revision (ICD-11). Recent studies on CPSP show unchanged prevalence despite progress made in fundamental research about underlying pathophysiological mechanisms. Nevertheless, clinical research has allowed better understanding of some CPSP aspects such as the development of neuropathic CPSP. Actually, some improvements are ongoing such as a refined definition and the assessment of CPSP in vulnerable populations, for example, paediatric patients...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29111808/the-surgical-epidemic
#3
Maeve Henry, Thomas Poyser, Sohail Bampoe
This article outlines the growing demand for surgical services globally, both in developing and developed countries. The implications of this increasing demand are explored, with particular attention focused on the enduring burden of perioperative complications. The role of critical care in ensuring the safe delivery of surgical services is also examined. Solutions to the 'surgical epidemic' are proposed including the role of perioperative medicine in reconfiguring services to provide safe surgical care.
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29111802/perioperative-medicine-an-evolutionary-process
#4
Matthew Dickinson
No abstract text is available yet for this article.
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29111801/quality-improvement-in-perioperative-medicine-driving-the-revolution
#5
Matthew Wilson, David Walker
Perioperative medicine and quality improvement are both emerging fields with the potential to contribute to safer and more reliable care for surgical patients. One key component has been the evolution of the national audit project programme. This article describes the current state of quality improvement within perioperative medicine, the evolution of the national audit project programme and the effects it has produced on the quality of patient care. The article also highlights opportunities for health-care professionals to engage with this innovative area of medicine...
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29111798/perioperative-medicine-a-new-model-of-care
#6
Lena Al-Shammari, Deborah Douglas, Geetha Gunaratnam, Chris Jones
The discipline of perioperative medicine provides a foundation for the consistent delivery of safe and good quality care to surgical patients. Its goals include the identification and optimal care of the high-risk surgical patient, fostering patient-centred decision making throughout the surgical perioperative pathway, and reducing unwarranted variation in practice. In turn, this should reduce preventable complications and improve patient satisfaction, long-term morbidity and survival. This review concludes a series of articles which have described the epidemiology of surgical disease, the growth in the objective means of risk assessment, and novel outcome measures...
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29111790/early-adopters-of-perioperative-medicine-who-are-they-and-what-motivates-them
#7
C Groves, A Whiteman, G Kumar, R Stephens, D Walker
Perioperative medicine is an emerging specialty aimed at improving outcomes in the high-risk surgical population. The authors set out to characterize the demographics and determine the motivation of 'early adopters' of this specialty by retrospectively reviewing the application forms of students enrolled on the UCL Perioperative Medicine Masters Programme. A total of 139 applications were reviewed. The median age of applicants was 35 years; 81% were UK based, with the remainder from a worldwide distribution...
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29107258/epilepsy-clinical-review-and-surgical-options
#8
Beth Karasin, Mark Karasin
Epilepsy is the fourth leading neurologic disorder in the United States and affects the quality of life of approximately 2.9 million Americans. Despite modern progress in medicine and technology, the disease may prove to be drug resistant, a condition that serves as a primary indication to consider invasive treatment modalities. Current evidence supports the efficacy of early surgical intervention for patients with drug-resistant epilepsy, although this approach continues to be underused. The positive outcomes of epilepsy surgery are a result of multidisciplinary efforts, and perioperative nurses play a vital role in the continuum of care for this patient population...
November 2017: AORN Journal
https://www.readbyqxmd.com/read/29098342/preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#9
REVIEW
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery, and may help to optimize the patient's preoperative medical condition and guide perioperative management. Whether performance of additional technical tests (e. g., blood chemistry, electrocardiography, spirometry, chest x‑ray) can contribute to reduction of the perioperative risk is often not well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists, and surgeons with respect to perioperative management of the patient's long-term medication...
November 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29090267/perioperative-patient-blood-management-programme-multidisciplinary-recommendations-from-the-patient-blood-management-initiative-group
#10
Daniela Filipescu, Răzvan Bănăţeanu, Mircea Beuran, Traean Burcoş, Dan Corneci, Dan Cristian, Mircea Diculescu, Alina Dobrotă, Gabriela Droc, Dănuţ Isacoff, Doina Goşa, Ioana Grinţescu, Anca Lupu, Liliana Mirea, Corina Posea, Oana Stanca, Mihai Ştefan, Dana Tomescu, Cristina Tudor, Daniela Ungureanu, Gabriel Mircescu
Patients with untreated anaemia or iron deficiency who undergo surgical procedures have an increased risk for mortality and morbidity. Patient Blood Management programmes address this issue worldwide and try to improve patient outcomes through a complex set of measures targeting anaemia correction, minimisation of bleeding and improvement of anaemia tolerance, in all phases of perioperative care. The Patient Blood Management Initiative Group is a multidisciplinary team of physicians from specialties including anaesthesiology, nephrology, surgery, orthopaedics, haematology, gastroenterology and transfusion medicine...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29084236/derivation-and-validation-of-a-preoperative-risk-model-for-postoperative-mortality-sampe-model-an-approach-to-care-stratification
#11
Luciana Cadore Stefani, Claudia De Souza Gutierrez, Stela Maris de Jezus Castro, Rafael Leal Zimmer, Felipe Polgati Diehl, Leonardo Elman Meyer, Wolnei Caumo
Ascertaining which patients are at highest risk of poor postoperative outcomes could improve care and enhance safety. This study aimed to construct and validate a propensity index for 30-day postoperative mortality. A retrospective cohort study was conducted at Hospital de Clínicas de Porto Alegre, Brazil, over a period of 3 years. A dataset of 13524 patients was used to develop the model and another dataset of 7254 was used to validate it. The primary outcome was 30-day in-hospital mortality. Overall mortality in the development dataset was 2...
2017: PloS One
https://www.readbyqxmd.com/read/29079408/dexamethasone-the-wonder-drug-in-perioperative-medicine
#12
EDITORIAL
Gildasio S De Oliveira, Mathew Thran
No abstract text is available yet for this article.
October 24, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29064872/no-differences-in-renal-function-between-balanced-6-hydroxyethyl-starch-130-0-4-and-5-albumin-for-volume-replacement-therapy-in-patients-undergoing-cystectomy-a-randomized-controlled-trial
#13
Tobias Kammerer, Florian Brettner, Sebastian Hilferink, Nikolai Hulde, Florian Klug, Judith Pagel, Alexander Karl, Alexander Crispin, Klaus Hofmann-Kiefer, Peter Conzen, Markus Rehm
BACKGROUND: The use of artificial colloids has declined in critical care, whereas they are still used in perioperative medicine. Little is known about the nephrotoxic potential in noncritically ill patients during routine surgery. The objective of this trial was to evaluate the influences of albumin 5% and balanced hydroxyethyl starch 6% (130/0.4) on renal function and kidney injury. METHODS: One-hundred urologic patients undergoing elective cystectomy were randomly assigned for this prospective, single-blinded, controlled study with two parallel groups to receive either albumin 5% or balanced hydroxyethyl starch 6% (130/0...
October 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29061775/perioperative-administration-of-traditional-japanese-herbal-medicine-daikenchuto-relieves-postoperative-ileus-in-patients-undergoing-surgery-for-gastrointestinal-cancer-a-systematic-review-and-meta-analysis
#14
REVIEW
Mitsuru Ishizuka, Norisuke Shibuya, Hitoshi Nagata, Kazutoshi Takagi, Yoshimi Iwasaki, Hiroyuki Hachiya, Taku Aoki, Keiichi Kubota
AIM: Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional Japanese herbal medicine, improves gastrointestinal (GI) motility in patients undergoing abdominal surgery, few studies have investigated the efficacy of perioperative DKT administration for relief of postoperative ileus (PI) in patients undergoing surgery for GI cancer. Therefore, the aim of this study was to investigate whether perioperative administration of DKT relieves PI in patients with GI cancer...
November 2017: Anticancer Research
https://www.readbyqxmd.com/read/29050061/-perioperative-anaphylaxia-on-drugs
#15
Wolfgang Pfützner, Hinnerk Wulf
The diagnostic evaluation of perioperative anaphylaxia is of great importance for the medical care of the affected persons in the context of renewed interventions in general anesthesia. The most frequent triggers include muscle relaxants, antibiotics, latex and analgesics of the type of the cyclooxygenase inhibitors, but other perioperatively administered drugs such as opioids, anesthetics, benzodiazepines, dyes, disinfectants and even corticosteroids or drug additives may also be the cause in rare cases. The most important aim is therefore the identification of the responsible drug, for which a near-time allergological diagnosis should be carried out within the first 4 weeks to 6 months after the reaction...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#16
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29040454/to-fly-as-a-pilot-after-cardiac-surgery
#17
Thomas Syburra, Ed Nicol, Stuart Mitchell, Denis Bron, Ulrich Rosendahl, John Pepper
Aircrew are responsible for safe and reliable aircraft operations. Cardiovascular disease accounts for 50% of all pilot licences declined or withdrawn for medical reasons in Western Europe and is the most common cases of sudden incapacitation in flight. Aircrew retirement age is increasing (up to age 65) in a growing number of airlines and the burden of subclinical, but potentially significant, coronary atherosclerosis is unknown in qualified pilots above age 40. Safety considerations are paramount in aviation medicine, and the most dreaded cardiovascular complications are thromboembolic events and rhythm disturbances due to their potential for sudden incapacitation...
October 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29035463/effect-of-balanced-crystalloid-gelatin-and-hydroxyethyl-starch-on-coagulation-detected-by-rotational-thromboelastometry-in-vitro
#18
Silvie Sevcikova, Tomas Vymazal, Miroslav Durila
BACKGROUND: Fluid resuscitation with crystalloid and colloid solutions is a common treatment in perioperative medicine. However, a variety of unbalanced or balanced solutions are used in clinical practice and there is still vivid debate going on regarding selection of optimal fluid with minimal negative effect on coagulation to minimize bleeding and blood transfusion requirements. The aim of the study was to investigate adverse effects of balanced crystalloids and colloids on coagulation measured by thromboelastometry in vitro...
October 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/29025135/current-perspective-on-the-use-of-opioids-in-perioperative-medicine-an-evidence-based-literature-review-national-survey-of-70-000-physicians-and-multidisciplinary-clinical-appraisal
#19
Jonathan S Jahr, Sergio D Bergese, Ketan R Sheth, Nicholas M Bernthal, Hung S Ho, Nicoleta Stoicea, Christian C Apfel
Objective: Opioids represent an important analgesic option for physicians managing acute pain in surgical patients. Opioid management is not without its drawbacks, however, and current trends suggest that opioids might be overused in the United States. An expert panel was convened to conduct a clinical appraisal regarding the use of opioids in the perioperative setting. Methods: The clinical appraisal consisted of the review, presentation, and assessment of current published evidence as it relates to the statement "Opioids are not overused in the United States, even though opioid adjunct therapy achieves greater pain control with less risk...
August 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29021511/overcoming-sleep-disordered-breathing-and-ensuring-sufficient-good-sleep-time-for-a-healthy-life-expectancy
#20
Kazuo Chin
Recent advances in basic and clinical medicine have resulted in major improvements in human health. Currently sleep has been considered an essential factor in maintaining and promoting a healthy life expectancy. Sleep disorders include more than 60 diseases. Sleep disordered breathings (SDB) have 17 disorders, including sleep apnea. SDB usually induces hypoxemia and hypercapnia, which would have significant effects on cells, organs, and the whole body. We have investigated SDB for nearly 35 years. We found that SDB has significant associations with humoral factors, including coagulation systems, the body's protective factors against diseases, and metabolic and organ diseases...
2017: Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
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