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Perioperative Medicine

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54 papers 25 to 100 followers
By EFRAIN PAEZ Internal Medicine since 1988. Interested in all aspects 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 H 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...
October 4, 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
Sweyn S Garrioch, Michael A Gillies
PURPOSE OF REVIEW: This review appraises recent evidence and provides clinical guidance on optimal perioperative fluid therapy. RECENT FINDINGS: Choice of perioperative intravenous fluid continues to be the source of much debate. Not all crystalloids are equivalent, and there is growing evidence that balanced solutions are superior to 0.9% saline in many situations. Recent evidence from the critical care population has highlighted risks associated with synthetic colloids; this and the absence of demonstrable benefit in the surgical population make it difficult to recommend their use in the perioperative period...
August 2015: Current Opinion in Critical Care
Rabih O Darouiche, Matthew J Wall, Kamal M F Itani, Mary F Otterson, Alexandra L Webb, Matthew M Carrick, Harold J Miller, Samir S Awad, Cynthia T Crosby, Michael C Mosier, Atef Alsharif, David H Berger
BACKGROUND: Since the patient's skin is a major source of pathogens that cause surgical-site infection, optimization of preoperative skin antisepsis may decrease postoperative infections. We hypothesized that preoperative skin cleansing with chlorhexidine-alcohol is more protective against infection than is povidone-iodine. METHODS: We randomly assigned adults undergoing clean-contaminated surgery in six hospitals to preoperative skin preparation with either chlorhexidine-alcohol scrub or povidone-iodine scrub and paint...
January 7, 2010: New England Journal of Medicine
Birdal Yildirim, Ulku Karagoz, Ethem Acar, Halil Beydilli, Emine Nese Yeniceri, Ozgur Tanriverdi, Omer Dogan Alatas, Şükrü Kasap
Prilocaine-induced methemoglobinemia is a rarely seen condition. In this paper, a case is presented with methemoglobinemia developed secondary to prilocaine use in a liposuction procedure, and the importance of this rarely seen condition is emphasized. A 20-year-old female patient presented with complaints of prostration, lassitude, shivering, shortness of breath, and cyanosis. It was learned that the patient underwent nearly 1000 mg prilocaine infiltration 8 hours priorly during a liposuction procedure. At admission, her blood pressure (130/80 mmHg), pulse rate (140 bpm), body temperature (36°C), and respiratory rate (40/min) were recorded...
2015: Case Reports in Emergency Medicine
Avnesh S Thakor, James Tanner, Shao J Ong, Ynyr Hughes-Roberts, Shahzad Ilyas, Claire Cousins, Teik C See, Darren Klass, Andrew P Winterbottom
Endovascular aortic aneurysm repair (EVAR) is an alternative to open surgical repair of aortic aneurysms offering lower perioperative mortality and morbidity. As experience increases, clinicians are undertaking complex repairs with hostile aortic anatomy using branched or fenestrated devices or extra components such as chimneys to ensure perfusion to visceral branch vessels whilst excluding the aneurysm. Defining the success of EVAR depends on both clinical and radiographic criteria, but ultimately depends on complete exclusion of the aneurysm from the circulation...
August 2015: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Marissa J White, Sprague W Hazard, Steven M Frank, Joan S Boyd, Elizabeth C Wick, Paul M Ness, Aaron A R Tobian
The evolution of modern anesthesia and surgical practices has been accompanied by enhanced supportive procedures in blood banking and transfusion medicine. There is increased focus on the preparation and the use of blood components including, but not limited to, preventing unnecessary type and screen/crossmatch orders, decreasing the time required to provide compatible red blood cells (RBCs), and reducing the waste of limited blood and personnel resources. The aim of this review is to help the anesthesiologist and surgical staff identify patients at highest risk for surgical bleeding...
June 2015: Anesthesia and Analgesia
Denis Correa, Robert J Farney, Frances Chung, Arun Prasad, David Lam, Jean Wong
BACKGROUND: Chronic opioid use has been associated with the development of sleep-disordered breathing (SDB) such as central sleep apnea (CSA). Patients receiving chronic opioids may suffer from unrecognized sleep apnea that contributes to opioid-overdose death. Currently, information regarding the perioperative management of patients with chronic opioid-associated CSA is limited. The objectives of this review are to define the clinical manifestations of SDB associated with chronic opioid therapy, especially CSA, and to highlight their prevalence, mechanisms, risk factors, and perioperative management...
June 2015: Anesthesia and Analgesia
2015-06-13 13:54:33
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