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Perioperative medicine

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https://www.readbyqxmd.com/read/28536929/inferior-pedicle-reduction-mammoplasty-with-or-without-tourniquet-a-comparative-study
#1
Canser Yilmaz Demir, Yılmaz Sultanoglu, Omer Faruk Kocak, Muhammet Eren Ersoz
OBJECTIVE: To compare the perioperative findings of inferior pedicle reduction mammoplasty (IPRM) performed with or without a tourniquet. METHODS: This study was carried out in the plastic and reconstructive surgery department at a tertiary care center on a total of 42 consecutive women scheduled for IPRM. Patients in Group I (n = 21) underwent surgery using a tourniquet, whereas patients in Group II (n = 21) were operated on without a tourniquet. Levels of hemoglobin (Hb), hematocrit (Hct), Hct/Hb ratio, and platelet counts were noted preoperatively and on postoperative 24th and 48th h...
May 23, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28534323/-era-of-enhanced-recovery-after-surgery-and-robotic-gastric-cancer-surgery
#2
Yanbing Zhou
Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#3
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#4
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28502521/-extracorporeal-life-support-in-thoracic-surgery-what-are-the-indications-and-the-pertinence
#5
REVIEW
J Reeb, A Olland, S Renaud, O Collange, X Delabranche, N Santelmo, F Meziani, P-M Mertes, G Massard, P-E Falcoz
INTRODUCTION: In thoracic surgery, extracorporeal life support (ECLS) technologies are used in cases of severe and refractory respiratory failure or as intraoperative cardiorespiratory support. The objectives of this review are to describe the rationale of ECLS techniques, to review the pulmonary diseases potentially treated by ECLS, and finally to demonstrate the efficacy of ECLS, using recently published data from the literature, in order to practice evidence based medicine. STATE OF THE ART: ECLS technologies should only be undertaken in expert centers...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28498889/uk-anaesthetists-perspectives-and-experiences-of-severe-perioperative-anaphylaxis-nap6-baseline-survey%C3%A2
#6
H I Kemp, T M Cook, M Thomas, N J N Harper
Background: There is limited information on UK anaesthetists' perspectives and experiences of perioperative anaphylaxis. This baseline survey of the Sixth National Audit Project (NAP6) aimed to identify relevant departmental preparedness and practices, and individual experiences, perceptions and drug-avoidance patterns. Methods: All anaesthetists in 356 UK NHS hospitals were invited to complete an electronic survey. Results: 11 104 anaesthetists (77% crude response rate) from 341 (96%) hospitals responded...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28495538/clinical-outcome-of-carotid-artery-stenting-according-to-provider-specialty-and-volume
#7
Ali F AbuRahma, John E Campbell, Nizar Hariri, Joseph AbuRahma, L Scott Dean, Mark C Bates, Aravinda Nanjundappa, Patrick A Stone, Ace O'vil
BACKGROUND: Several studies have demonstrated better outcomes for carotid endarterectomy (CEA) with high-volume hospitals and providers. However, only a few studies have reported on the impact of operator specialty/volume on the perioperative outcome of carotid artery stenting (CAS). This study will analyze the correlation of CAS outcomes and provider specialty and volume. METHODS: Prospectively collected data of CAS procedures done at our institution during a 10-year period were analyzed...
May 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28485821/the-role-of-telehealth-in-perioperative-medicine-for-regional-and-rural-patients-in-queensland
#8
Alec Tam, Amy Leung, Cara O'Callaghan, Narelle Fagermo
BACKGROUND: Australians living in regional, rural, and remote areas face a myriad of complexities resulting in a trend to poorer health outcomes. Telehealth is being utilised as an alternative mode of service delivery to overcome such barriers. However, there is limited published information concerning the use of telehealth in perioperative medicine. AIMS: The purpose of this study was to review the performance of the telehealth pre-operative assessment service at Mater Hospital Brisbane to determine last-minute cancellation rates secondary to medical reasons...
May 9, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28411294/hospital-medicine-and-perioperative-care-a-framework-for-high-quality-high-value-collaborative-care
#9
REVIEW
Rachel E Thompson, Kurt Pfeifer, Paul J Grant, Cornelia Taylor, Barbara Slawski, Christopher Whinney, Laurence Wellikson, Amir K Jaffer
BACKGROUND: Hospitalists have long been involved in optimizing perioperative care for medically complex patients. In 2015, the Society of Hospital Medicine organized the Perioperative Care Work Group to summarize this experience and to develop a framework for providing optimal perioperative care. METHODS: The work group, which consisted of perioperative care experts from institutions throughout the United States, reviewed current hospitalist-based perioperative care programs, compiled key issues in each perioperative phase, and developed a framework to highlight essential elements to be considered...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28405945/the-comparative-risk-of-delirium-with-different-opioids-a-systematic-review
#10
REVIEW
Lieke M Swart, Vera van der Zanden, Petra E Spies, Sophia E de Rooij, Barbara C van Munster
OBJECTIVE: There is substantial evidence that the use of opioids increases the risk of adverse outcomes such as delirium, but whether this risk differs between the various opioids remains controversial. In this systematic review, we evaluate and discuss possible differences in the risk of delirium from the use of various types of opioids in older patients. METHODS: We performed a search in MEDLINE by combining search terms on delirium and opioids. A specific search filter for use in geriatric medicine was used...
June 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28397662/-perioperative-challenges-of-parkinson-s-disease
#11
Peter Søndergaard Thyrrestrup, Lyudmyla Horodyska
Parkinson's disease (PD) is a neurogenerative disease, which causes motoric disorders, and the risk of developing PD increases with age. There is an increasing number of persons above 60 years undergoing anaesthesia, and PD is becoming a common comorbidity. PD symptoms, delayed medicine administration or medical side effects can complicate anaesthesia. The importance of correct administration of PD medication administration must be emphasized to avoid complications. Optimized perioperative care can potentially prevent complicated and prolonged admission periods...
February 20, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28392431/-urinary-catheters-prevalence-study-in-a-university-hospital
#12
J Carrouget, C Legeay, A Poirier, A-R Azzouzi, J-R Zahar, P Bigot
INTRODUCTION: Urinary tract infection is the most common healthcare-association infection, especially because of urinary catheter. We evaluated our practices concerning catheter insertion and management in our institution. MATERIALS AND METHODS: We conducted a single-centre descriptive cross-sectional study during 1 week in September 2014 in all adult departments. We noted prevalence, indications, length, management of urinary catheter (UC) and symptomatic catheter-associated urinary tract infections (SCAUTI)...
April 6, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28390881/safe-selection-of-outpatient-joint-arthroplasty-patients-with-medical-risk-stratification-the-outpatient-arthroplasty-risk-assessment-score
#13
R Michael Meneghini, Mary Ziemba-Davis, Marshall K Ishmael, Alexander L Kuzma, Peter Caccavallo
BACKGROUND: Current patient selection criteria and medical risk stratification methods for outpatient primary total joint arthroplasty (TJA) surgery are unproven. This study assessed the predictive ability of a medically based risk assessment score in selecting patients for outpatient and short stay surgery. METHODS: A retrospective review of 1120 consecutive primary TJAs in an early discharge program was performed. An Outpatient Arthroplasty Risk Assessment ("OARA") score was developed by a high-volume arthroplasty surgeon and perioperative internal medicine specialist to stratify patients as "low-moderate risk (≤59)" and "not appropriate" (≥60) for early discharge...
March 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28390846/-surgeons-anesthetists-relations-from-an-individual-responsibility-of-the-surgeon-to-a-shared-responsibility-with-the-anesthetist
#14
Philip Cohen, Karem Slim, Laure Soulier, Alexandre Theissen
Throughout the perioperative period, anesthetists and surgeons jointly provide care for patients. The advances in medicine and surgery, the practice of perioperative quality medicine and the recent application of enhanced recovery program after surgery have necessitated strengthening the place of each in its area of expertise while developing the spirit team and communication. Thus, alongside the surgeon who was once considered the head of the surgical team, the anesthetist's role has been to consolidate for the management of the surgical patient and had his spot empower themselves in the eye of the patient with the birth an own contract with the patient (due in particular to the obligation to preanesthetic consultation by the decree of December 5, 1994)...
May 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28377941/proof-of-concept-for-a-novel-curriculum-learning-a-second-language-during-anesthesiology-residency
#15
Kate Mitchell Cohen, Alvaro Andres Macias, Robert Lekowski, Mercedes Concepcion, Jose Zeballos
This article describes a novel curriculum for anesthesiology residents matriculating through Brigham and Women's Department of Anesthesiology. It is offered electively and provides physician residents with time to acquire language skills through a medically-focused immersion program abroad. It is designed for them to learn or improve a second language and then to speak it while practicing perioperative medicine. Ultimately, the elective curriculum will equip future anesthesiologists with the communication tools to deliver professional and compassionate patient care both within the United States and internationally...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28375483/esophageal-cancer-s-100-most-influential-manuscripts-a-bibliometric-analysis
#16
A G M T Powell, D L Hughes, J Brown, M Larsen, J Witherspoon, W G Lewis
Bibliometric analysis highlights key topics and publications that have shaped the understanding and management of esophageal cancer (EC). Here, the 100 most cited manuscripts in the field of EC are analyzed. The Thomson Reuters Web of Science database with the search terms 'esophageal cancer' or 'esophageal carcinoma' or 'oesophageal cancer' or 'oesophageal carcinoma' or 'gastroscopy' was used to identify all English language full manuscripts for the study. The 100 most cited papers were further analyzed by topic, journal, author, year, and institution...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28372656/what-is-the-place-of-clonidine-in-anesthesia-systematic-review-and-meta-analyses-of-randomized-controlled-trials
#17
REVIEW
Miguel Carlos Sanchez Munoz, Marc De Kock, Patrice Forget
STUDY OBJECTIVE: A place for clonidine has been suggested for many indications in perioperative medicine. The aim of this systematic review and these meta-analyses is to systematically, and quantitatively, evaluate these potential indications of clonidine. DESIGN, SETTING, PATIENTS AND INTERVENTIONS: We selected and analyzed (qualitatively and, when possible, quantitatively) the available literature published on PubMed/Medline and on the Cochrane database. Inclusion criteria included: human randomized controlled trials involving adults who received perioperative systemic (oral, intramuscular, transdermal and intravenous) clonidine for every type of surgery...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28362214/a-systematic-multidisciplinary-initiative-for-reducing-the-risk-of-complications-in-adult-scoliosis-surgery
#18
Rajiv Sethi, Quinlan D Buchlak, Vijay Yanamadala, Melissa L Anderson, Eric A Baldwin, Robert S Mecklenburg, Jean-Christophe Leveque, Alicia M Edwards, Mary Shea, Lisa Ross, Karen J Wernli
OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. METHODS The Group Health Research Institute and Virginia Mason Medical Center implemented a systematic multidisciplinary protocol, the Seattle Spine Team Protocol, in 2010...
March 31, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28341950/frontal-changes-in-the-lower-face-after-clockwise-rotation-of-the-maxillomandibular-complex-without-perisurgical-orthodontic-treatment-in-angle-class-i-and-skeletal-class-iii-women
#19
Sang Woo Lee, Jeongmok Cho, Kikap Kim, Seung Hyun Ahn
BACKGROUND: Orthognathic surgery has become more popular to slenderize a wide lower face and to improve facial esthetics in Asian patients with normal occlusion. Clockwise rotation (CR) of the maxillomandibular complex (MMC) steepens the mandibular plane. This study performed a quantitative analysis on the influence of CR on slenderness of the lower face from the frontal view. PATIENTS AND METHODS: This retrospective study included 36 female patients with Angle Class I occlusion and skeletal Class III pattern...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341949/complications-and-outcomes-after-gynecomastia-surgery-analysis-of-204-pediatric-and-1583-adult-cases-from-a-national-multi-center-database
#20
Dmitry Zavlin, Kevin T Jubbal, Jeffrey D Friedman, Anthony Echo
BACKGROUND: Gynecomastia is a common disease that is prevalent across all age groups of boys and men. Although benign in nature, it can lead to psychological and social distress, prompting affected patients to seek medical attention. Management strategies include observation and drug therapy, yet surgical procedures remain the hallmark of treatment. The goal of this study was to analyze patient demographics, outcomes, and complication rates of gynecomastia surgery in a large multi-institutional cohort...
March 24, 2017: Aesthetic Plastic Surgery
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