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Perioperative Medicine

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60 papers 25 to 100 followers
By EFRAIN PAEZ Internal Medicine since 1988. Interested in all aspects of Medicine.
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Sripal Bangalore, Jeffrey S Berger
Von Willebrand disease (VWD) is an inherited bleeding disorder that often manifests clinically with hemorrhage after invasive procedures. We investigated the association between a diagnosis of VWD and bleeding and thrombotic outcomes following major non-cardiac surgery in a large national database from the United States. Patients age ≥45 years requiring major non-cardiac surgery were identified from Healthcare Cost and Utilization Project's National Inpatient Sample data. Von Willebrand disease, perioperative major adverse cardiovascular events (MACE), thrombotic events, and hemorrhage were defined by ICD9 diagnosis codes...
May 9, 2017: Journal of Thrombosis and Thrombolysis
Radmilo J Janković, Danica Z Marković, Dušan T Sokolović, Ivana Zdravković, Massimiliano Sorbello
European Society of Cardiology (ESC)/ European Society of Anesthesiology (ESA) highlighted that anesthesiologist has a leading role in perioperative cardiovascular assessment and management in the year of 2014. During cardiovascular assessment one can rely on cooperation of multidisciplinary specialists like: other anesthesiologists, cardiologists and surgeons. For the purpose of precise systematization and decision making the Lee Score or NSQUIP database can be used besides the traditionally used ASA Score...
April 2017: Minerva Anestesiologica
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...
June 2017: Annals of Plastic Surgery
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
A Miskovic, A B Lumb
Postoperative pulmonary complications (PPCs) are common, costly, and increase patient mortality. Changes to the respiratory system occur immediately on induction of general anaesthesia: respiratory drive and muscle function are altered, lung volumes reduced, and atelectasis develops in > 75% of patients receiving a neuromuscular blocking drug. The respiratory system may take 6 weeks to return to its preoperative state after general anaesthesia for major surgery. Risk factors for PPC development are numerous, and clinicians should be aware of non-modifiable and modifiable factors in order to recognize those at risk and optimize their care...
March 1, 2017: British Journal of Anaesthesia
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Sophie Wallace
BACKGROUND: Most patients with coronary artery disease receive aspirin for primary or secondary prevention of myocardial infarction, stroke, and death. Aspirin poses a risk of bleeding in patients undergoing surgery, but it is unclear whether aspirin should be stopped before coronary artery surgery. METHODS: We used a 2-by-2 factorial trial design to randomly assign patients who were scheduled to undergo coronary artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo...
February 25, 2016: New England Journal of Medicine
C Ronald MacKenzie, Susan M Goodman
Perioperative medication management for patients with systemic autoimmune inflammatory diseases has focused on strategies to improve outcomes and mitigate risks. The emphasis has been to minimize the risk of infection associated with most antirheumatic medications, while attempting to avoid flares of disease precipitated by medication withdrawal. Management of glucocorticoids in the perioperative period has been based on an assumption that supraphysiologic increases in dose were always necessary to avoid hypotension and shock in glucocorticoid treated patients, and alternative strategies were rarely considered despite the known infectious, metabolic, and wound healing risks associated with glucocorticoid administration...
July 2016: Current Rheumatology Reports
Marc-Olivier Fischer, Yannick Le Manach
No abstract text is available yet for this article.
August 2016: Anaesthesia, Critical Care & Pain Medicine
Lene Heise Garvey
Perioperative hypersensitivity reactions are rare, often life-threatening events, and subsequent investigations to identify the culprit are important to avoid re-exposure. All exposures in the perioperative setting may potentially be the cause of a hypersensitivity reaction, but drugs administered intravenously such as neuromuscular blocking agents (NMBA), induction agents and antibiotics have traditionally been reported to be implicated most commonly. It has recently become apparent that there are geographical differences in sensitization patterns related to variation in exposures, referral patterns and performance and interpretation of investigations...
2016: Current Pharmaceutical Design
Steven L Cohn, Suparna Dutta, Barbara A Slawski, Paul J Grant, Gerald W Smetana
Recent studies have shed light on preoperative risk assessment, medical therapy to reduce postoperative cardiac complications (beta-blockers, statins, and angiotensin II receptor blockers [ARBs]), perioperative management of patients with coronary stents on antiplatelet therapy, and perioperative bridging anticoagulation.
October 2016: Cleveland Clinic Journal of Medicine
Eduardo Sucupira, Renato Matta, Patrícia Zuker, Jorge Matta, Juan Pablo Arbeláez, Carlos O Uebel
INTRODUCTION: About one in ten patients experiences iatrogenic events, and more than half of these occur in the perioperative environment. The objective of this study was to develop a complete and functional checklist for aesthetic plastic surgery and test it in patients who would undergo elective plastic surgeries. METHODS: Patient data were collected from a general hospital and the particular clinic between October 2013 and October 2015, through history, physical examination, diagnosis, laboratory tests, pre-, during, and postoperatively, and complications...
October 2016: Aesthetic Plastic Surgery
V Koenig-Oberhuber, M Filipovic
In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this review, the authors discuss the most important antiplatelet and anticoagulant drugs, the perioperative management, the handling of bleeding complications, and the interpretation of some laboratory analyses related to these agents...
September 2016: British Journal of Anaesthesia
Karna K Sundsted, Arya B Mohabbat, Dennis W Regan, Bradley R Salonen, Paul R Daniels, Karen F Mauck
Evidence in perioperative medicine is published in a wide variety of journals, given the multidisciplinary nature of its practice which spans medicine and its subspecialties, as well as surgery and anesthesiology. It can be difficult to identify new and important evidence, as perioperative practice continues to evolve in multiple areas such as medication management, anticoagulation and cardiac risk stratification, among others. New, high-quality evidence is published each year, and must be placed into the context of not only existing literature, but also practical real-world patient care...
August 2016: Hospital Practice (Minneapolis)
Anna Woodbury, Stephen Neal Soong, David Fishman, Paul S García
PURPOSE: This narrative review provides an overview of the complementary and alternative medicine (CAM) therapies that anesthesiologists and pain management practitioners commonly encounter along with recommendations for evaluation and implementation. SOURCE: A literature search of PubMed was performed using the comprehensive MeSH term, "Complementary Therapies OR Dietary Supplements", and a search was conducted of the various licensing organizations and books published on the topics of CAM and integrative medicine...
January 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Daniel J Morgan, Sanket S Dhruva, Scott M Wright, Deborah Korenstein
IMPORTANCE: Overuse of medical care, consisting primarily of overdiagnosis and overtreatment, is a common clinical problem. OBJECTIVES: To identify and highlight articles published in 2014 that are most likely to influence medical overuse, organized into the categories of overdiagnosis, overtreatment, and methods to avoid overuse, and to review these articles and interpret them for their importance to clinical medicine. EVIDENCE REVIEW: A structured review of English-language articles in PubMed published in 2014 and a review of tables of contents of relevant journals to identify potential articles that related to medical overuse in adults...
December 2015: JAMA Internal Medicine
Suparna Dutta, Steven L Cohn, Kurt J Pfeifer, Barbara A Slawski, Gerald W Smetana, Amir K Jaffer
BACKGROUND: As our surgical population becomes older and more medically complex, knowledge of the most recent perioperative literature is necessary to optimize perioperative care. We aim to summarize and critique literature published over the past year with the highest potential to impact the clinical practice of perioperative medicine. METHODS: We reviewed articles published between January 2014 and April 2015, identified via MEDLINE search. The final 10 articles selected were determined by consensus among all authors, with criteria for inclusion including scientific rigor and relevance to perioperative medicine practice...
March 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
W Timothy Brox, Karl C Roberts, Sudeep Taksali, Douglas G Wright, John J Wixted, Creighton C Tubb, Joshua C Patt, Kimberly J Templeton, Eitan Dickman, Robert A Adler, William B Macaulay, James M Jackman, Thiru Annaswamy, Alan M Adelman, Catherine G Hawthorne, Steven A Olson, Daniel Ari Mendelson, Meryl S LeBoff, Pauline A Camacho, David Jevsevar, Kevin G Shea, Kevin J Bozic, William Shaffer, Deborah Cummins, Jayson N Murray, Patrick Donnelly, Peter Shores, Anne Woznica, Yasseline Martinez, Catherine Boone, Leeaht Gross, Kaitlyn Sevarino
No abstract text is available yet for this article.
July 15, 2015: Journal of Bone and Joint Surgery. American Volume
Tessa L Walters, Edward R Mariano, J David Clark
No abstract text is available yet for this article.
September 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Lihua Zhang, Xiancui Liu, Yunxia Xue
OBJECTIVES: To find out the clinical characteristics and risk factors for deep venous thrombosis (DVT) after gynecological surgery. METHODS: Four hundred and ninety-eight patients treated surgically in the department of gynecology of our hospital from July 2012 to May 2014 were reviewed retrospectively. The data including patient age, gender, medical history, hospital stay, anesthesia type, operation time, occupation type, operative or postoperative medicine, perioperative bleeding, postoperative activity time, mortality rate and so on, were collected...
March 2015: Pakistan Journal of Medical Sciences Quarterly
Samir Shah, Shruti Kapoor, Brian Durkin
PURPOSE OF REVIEW: The management of acute pain in the opioid-tolerant patient is an area in perioperative medicine that is growing, as the use of opioids for chronic noncancer pain has been tolerated in the USA. Adding to this population is an increase in opioid abusers, addicts and those in recovery and maintenance programmes. These patients will continue to present for surgery and with acute pain that anaesthesiologists and other members of the healthcare team must become more adept at managing...
August 2015: Current Opinion in Anaesthesiology
2015-08-01 13:23:36
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