Need for preoperative anemia management clinics in Japan: initiatives at a university hospital in the USA

2021 ◽  
Author(s):  
Patrick Hussey ◽  
Yoshiko Onodera ◽  
Sundara Reddy ◽  
Blain Samuelson ◽  
Sudhakar Subramani ◽  
...  
Keyword(s):  
University Hospital ◽  
Preoperative Anemia ◽  
Anemia Management ◽  
The Usa

scholarly journals Assessment of memory complainers in São Paulo, Brazil: Three-year results of a memory clinic

2008 ◽  
Vol 2 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Cássio Machado de Campos Bottino ◽  
Pedro Zucollo ◽  
Maria Del Pilar Quintero Moreno ◽  
Gislaine Gil ◽  
Carla Garcia Cid ◽  
...  
Keyword(s):  
Clinical Work ◽  
Cognitive Disorder ◽  
University Hospital ◽  
Memory Clinic ◽  
Cognitive Complaints ◽  
Outpatient Group ◽  
Memory Clinics ◽  
Icd 10 ◽  
The Usa ◽  
Primary Care Doctors

Abstract Memory clinics were established in the USA and European countries as services to attend patients who complain of cognitive deficits, referred by primary care doctors, specialists and other hospitals. Objective: We aimed to describe the clinical and cognitive profile of consecutively evaluated subjects during the initial three years of service of a memory clinic from a university hospital. Methods: Subjects were submitted to a clinical work-up for dementia, which included laboratory exams, cranial computerized tomography, cognitive tests, and a comprehensive neuropsychological battery. Diagnosis was made according to ICD-10 criteria. Results: We evaluated 104 subjects (67.3% females and 32.7% males), with mean age of 59.1 years, 88.8% aged 50 years or above. Mean schooling was 9.9 years. Patients were classified into 10 different primary diagnostic categories, namely Depression (26.9%), Alzheimer's disease (17.3%), Memory complaints without objective impairment (17.3%), Mild Cognitive Disorder - MCD (14.4%), and Anxiety (12.5%) the most frequent diagnosis. Comparing patients with dementia, MCD, Depression or Anxiety and Memory complainers, by age (below and above 60 years), dementia was more commonly diagnosed in older subjects, while a higher frequency of memory complainers was found in the younger group. Conclusions: This preliminary report from an outpatient group of referred patients with cognitive complaints showed a higher frequency of psychiatric disorders in this sample. The memory clinic approach should be considered as a model of service which can evaluate subjects with cognitive complaints effectively and improve the quality of care delivered to this patient group.

Preoperative Anemia Management: What’s New in 2020?

2020 ◽  
Vol 10 (2) ◽  
pp. 166-175 ◽  
Author(s):  
Daniel A. Rubinger ◽  
Christine Cahill ◽  
Andy Ngo ◽  
Marjorie Gloff ◽  
Majed A. Refaai
Keyword(s):  
Preoperative Anemia ◽  
Anemia Management

scholarly journals Introduction and evaluation of the ACS BCon basic course in Zaragoza, Spain

2019 ◽  
Vol 4 (1) ◽  
pp. e000227
Author(s):  
Carlos Yanez ◽  
Antonio Güemes ◽  
Ana Navarro ◽  
Jacqueline Vazquez ◽  
Alberto Moreno
Keyword(s):  
Medical Students ◽  
University Hospital ◽  
Hemorrhage Control ◽  
Level Of Evidence ◽  
Significance Level ◽  
American College Of Surgeons ◽  
The Usa ◽  
Basic Course ◽  
The University ◽  
Healthcare Employees

BackgroundThe American College of Surgeons Bleeding Control Basic (BCon) course aimed at teaching hemorrhage control techniques in the USA had not yet been taught in Spain. The purpose of this study is to assess its implementation among students and healthcare employees in the Lozano Blesa University Hospital of Zaragoza, a middle-sized Spanish city.MethodsThe study was conducted in a University Hospital and at the University of Zaragoza, scheduling four free B-Con sessions from 2017 to 2018. Two groups were identified as forming the population: healthcare employees and medical students. An anonymous questionnaire was completed at the end of the course regarding content, applicability, usefulness, relevance, and satisfaction. Study variables were ranked from 0 to 10: poor (when graded from 0 to 3), fair (4 to 6) and good (7 to 10). Results were compared between the groups, expressed in percentages and χ2 tested to analyze significant differences if any.ResultsAmong the 83 individuals who completed the course, 46 were medical students and 37 healthcare employees; 61% women and 39% men; aged 21 years to 52 years. Attendees evaluated satisfaction with the highest grade (84%), followed by usefulness (73%), applicability (70%), and relevance (66%). There was no variable graded as poor. The comparison of perceptions between groups did not reveal statistical differences based on a 0.05 significance level.ConclusionWe concluded that the B-Con course was valued as good for relevance, usefulness, applicability, and satisfaction by the majority of the studied population.Level of evidenceLevel III.

scholarly journals Preoperative Anemia is Associated with Increased Intraoperative Mortality in Patients Undergoing Cardiac Surgery

2021 ◽  
Vol 36 (3) ◽  
pp. e267-e267
Author(s):  
Arwa Z. Al-Riyami ◽  
Balan Baskaran ◽  
Sathiya M. Panchatcharam ◽  
Hilal Al-Sabti
Keyword(s):  
Cardiac Surgery ◽  
Clinical Laboratory ◽  
Artery Bypass ◽  
University Hospital ◽  
Readmission Rates ◽  
Preoperative Anemia ◽  
Chi Square ◽  
Sultan Qaboos University ◽  
Post Surgery ◽  
Red Blood Cell Transfusions

Objectives: We sought to investigate the incidence of preoperative anemia in cardiac surgery and its association with outcomes. Methods: A retrospective review of clinical, laboratory, and transfusion data for all patients who underwent cardiac surgery at Sultan Qaboos University Hospital between 2008 and 2014 was performed. Patients were divided into two groups, anemic and non-anemic, with anemia defined as hemoglobin levels < 13 g/dL (males) and < 12 g/dL (females). Clinical variables were compared using chi-square and independent t-test. Factors influencing preoperative mortality were analyzed using multivariate binary logistics regression. Results: A total of 599 patients (69.9% males and 30.1% females) were included in the study; 69.3% underwent coronary artery bypass surgery. Preoperative anemia was found in 76.1% of females and 26.7% of male patients. Rates of intraoperative red blood cell transfusions were higher among anemic patients (75.9% vs. 52.3%, p < 0.001). Anemic patients had a worse risk profile with higher incidence of diabetes mellitus (53.8% vs. 38.9%, p < 0.001), congestive heart failure (51.4% vs. 28.3%, p < 0.001), arrhythmia (16.5% vs. 8.6%, p =0.004), and cerebrovascular disease (10.0% vs. 4.9%, p =0.015). In addition, they had a higher risk of overall mortality (6.4% vs. 2.6%, p =0.023). Preoperative anemia remained a risk factor for intraoperative mortality after logistic regression (odds ratio = 4.08, 95% confidence interval: 1.43–11.66; p= 0.009). Conclusions: Preoperative anemia in cardiac surgery is independently associated with increased intraoperative mortality and early readmission rates post-surgery.

scholarly journals Preoperative anemia management with intravenous iron: a systematic review

2013 ◽  
Vol 11 (10) ◽  
pp. 157-189 ◽  
Author(s):  
Bernd Froessler ◽  
Catalin Tufanaru ◽  
Allan Cyna ◽  
Alan Pearson
Keyword(s):  
Systematic Review ◽  
Intravenous Iron ◽  
Preoperative Anemia ◽  
Anemia Management

scholarly journals Conditions that increase the risk of cesarean-related blood transfusions: a single-center cohort study

2021 ◽  
Vol 29 (3) ◽  
pp. 210-216
Author(s):  
Mehmet Murat Işıkalan ◽  
Eren Berkay Özkaya ◽  
Buşra Özkaya ◽  
Nurullah Şengül ◽  
Enes Ferlibaş ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Uterine Fibroids ◽  
University Hospital ◽  
Preoperative Anemia ◽  
Multiple Gestations ◽  
Anemia During Pregnancy ◽  
Placenta Accreta Spectrum

Objective This study aimed to define the conditions that increase the possibility of receiving a blood transfusion in patients who had a cesarean section. Methods This study was conducted between January 2016 – May 2020 in a university hospital located in Konya, Turkey. Pregnant women undergoing cesarean section were included. Of 4303 eligible patients, 188 women were the transfused group and 4115 women were the non-transfused group. Logistic regression analysis was performed for potential confounding factors. Results A total of 4303 eligible patients were evaluated in this study. There were 4115 patients (95.6%) in the non-transfused group. The transfused group consisted of 188 patients (4.4%). The probability of transfusion was higher in pregnant women with placenta previa, placenta accreta spectrum, thrombocytopenia, preoperative anemia, macrosomia above 4500 g, and multiple gestations [adjusted OR values (95% CI); 10.58 (range 4.75–23.57), 7.75 (range 3.22–18.61), 7.85 (range 3.46–17.79), 5.71 (range 4.21–7.74), 4.22 (range 1.21-14.67) and 2.10 (range 1.18-3.72), respectively]. There was no increase in the possibility of transfusion in 4000–4500 gram macrosomia, uterine fibroids, preeclampsia, premature rupture of membranes, previous cesarean sections and gestational diabetes mellitus. Conclusion Placenta previa, placenta accreta spectrum, thrombocytopenia, preoperative anemia, macrosomia above 4500 g and multiple gestations increase the possibility of transfusion. Perioperative blood preparation is vital in such patients. Prevention of anemia during pregnancy is critical in reducing transfusions.

Prospective Evaluation of Chromosomal Breakages in Hemophiliac Children after Radioisotope Synovectomy with Yttrium90 and Rhenium186.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1219-1219
Author(s):  
Kaan Kavakli ◽  
Ozgur Cogulu ◽  
Semih Aydogdu ◽  
Hayal Ozkilic ◽  
Burak Durmaz ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Lymphoblastic Leukemia ◽  
Peripheral Blood Lymphocytes ◽  
University Hospital ◽  
Technical Problems ◽  
Blood Lymphocytes ◽  
Lymphocyte Cultures ◽  
Working Solution ◽  
The Usa ◽  
The Difference

Abstract Radioisotope Synovectomy (RS) is defined as the intra-articular injection of radioisotopic agents with the aim of fibrosis on hypertrophic synovium in the target joint for hemophilia. Yttrium90 (Y90) and Rhenium186 (Re186) are approved isotopes in Europe. The only radioisotope which approved in the USA for RS is Phosphorus 32 (P32). We have successfully used Y90 and Re186 for 8 years in target joints of hemophiliac patients. For the last 30 years, no malignant transformation has been reported in hemophilia with RS. However, recently, development of acute lymphoblastic leukemia in two hemophiliac children after RS has been reported in the USA. Even though P32 was the responsible radioisotopic agent, safety concerns have arisen due to exposure to all type of radioisotopic agents which may cause chromosomal breakages (CBs) and oncological transformation. The aim of this prospective and Ethics commitee-approved study was to investigate the early genotoxic effect on peripheral blood lymphocytes induced by Y90 and Re186 in children who underwent RS for chronical synovitis. All patients and parents were informed according to Helsinki Decleration. Thirty-three patients with persistent synovitis (23 hemophilia-A, 9 hemophilia-B,1 FVII deficiency) were enrolled to the study. All patients were male except one case. The mean age was 16.4 ±6.2 years (range:8–40). RS was performed as an outpatient procedure by using Y90 for knees (n=9)(5 mCi) and Re186 for elbows and ankles (n=14)(2 mCi)(CIS Bio International/Gif-sur-Yvett Cedex-France). In 6 patients, both agents were used simultaneously in one session. No radioisotope leakage away from the injection site was observed during and after procedure. Heparinised peripheral blood samples were obtained for lymphocyte cultures from all patients at three different time points (prior to RS, after 3 days and after 90 days). Diepoxybutane (DEB) test was used for the evaluation of chromosomal breakages in patients by culturing their blood along with blood from a sex-matched control with a working solution of 11 ug/ml. Five μl pure DEB was added to 5 ml of sterile dH2O. Afterwards, 10 μl of the first solution was added to 1 ml of sterile dH2O. This is the working solution at 11 ug/ml. A total of 50 metaphases from each culture were examined and scored according to the procedure. All cytogenetic analysis were performed in the Medical Genetics Laboratory of Ege University Hospital. Due to technical problems, parameters of 29 patients were evaluated. Chromosomal breakages (CB) were found in 20 patients prior to treatment. We have found CBs in 4 additional patients after 3 days of RS. However, all these CBs were disappeared 90 days after. CBs were found to be persisted in 17 patients. Mean frequency of CBs was (0.0707±0.0829/1000 cells) and was not significantly increased after 3 days (0.0828±0.0747) but significantly decreased at 90 days (0.0379±0.0456). The difference of the results of two radioisotopes were not significant. In conclusion, although RS with Y90 and Re186 does not seem to induce the genotoxic effects significantly on peripheral blood lymphocytes in hemophilic children, the significant decrease in the number of CBs between the 3rd and 90th days may be accepted as a warning for the requirement of risk/benefit ratios which should be taken into account for any individual patient. Therefore medical treatment in hemophilia for synovitis should be suggested before RS and families should be informed properly.

Perioperative Anemia Management

2019 ◽  
Vol 46 (01) ◽  
pp. 008-016
Author(s):  
Sandaruwani Abeysiri ◽  
Marisa Chau ◽  
Toby Richards
Keyword(s):  
Length Of Hospital Stay ◽  
Transfusion Practice ◽  
World Health ◽  
Current Evidence ◽  
Major Surgery ◽  
Preoperative Anemia ◽  
Anemia Management ◽  
Health Organization ◽  
Perioperative Anemia ◽  
Practice Implementation

AbstractAnemia is increasingly recognized as an interventional hematological target in patients before major surgery. Preoperative anemia increases the need for perioperative blood transfusion, and there is now a well-recognized association with increased patient complications, length of hospital stay, and worse outcomes. Patient Blood Management (PBM) is a World Health Organization endorsed, evidence-based management bundle of care in transfusion hemostasis that focuses on three main aspects: anemia management, prevention of blood loss, and appropriate transfusion practice. Implementation of PBM guidelines has been accompanied by reduced transfusion needs and improved patient outcomes. In a patient presenting with preoperative anemia or at risk of transfusion, this should initiate a program of PBM that manages the patient through the entire operative period. We review the current evidence on the three pillars of PBM and highlight those aspects with the strongest evidence in support of their impact.

scholarly journals Epidemiology, risk factors and clinical course of SARS-CoV-2 infected patients in a Swiss university hospital: an observational retrospective study

2020 ◽  
Author(s):  
Jean Regina ◽  
Matthaios Papadimitriou-Olivgeris ◽  
Raphael Burger ◽  
Paraskevas Filippidis ◽  
Jonathan Tschopp ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Clinical Course ◽  
Severe Disease ◽  
Tertiary Hospital ◽  
University Hospital ◽  
Global Pandemic ◽  
The Usa ◽  
Multivariable Regression ◽  
Qsofa Score

Background Coronavirus disease 2019 (COVID-19) is now a global pandemic with Europe and the USA at its epicenter. Little is known about risk factors for progression to severe disease in Europe. This study aims to describe the epidemiology of COVID-19 patients in a Swiss university hospital. Methods This retrospective observational study included all adult patients hospitalized with a laboratory confirmed SARS-CoV-2 infection from March 1 to March 25, 2020. We extracted data from electronic health records. The primary outcome was the need to mechanical ventilation at day 14. We used multivariate logistic regression to identify risk factors for mechanical ventilation. Follow-up was of at least 14 days. Results 200 patients were included, of whom 37 (18.5%) needed mechanical ventilation at 14 days. The median time from symptoms onset to mechanical ventilation was 9.5 days (IQR 7.00, 12.75). Multivariable regression showed increased odds of mechanical ventilation in males (3.26, 1.21-9.8; p=0.025), in patients who presented with a qSOFA score ≥2 (6.02, 2.09-18.82; p=0.001), with bilateral infiltrate (5.75, 1.91-21.06; p=0.004) or with a CRP of 40 mg/l or greater (4.73, 1.51-18.58; p=0.013). Conclusions This study gives some insight in the epidemiology and clinical course of patients admitted in a European tertiary hospital with SARS-CoV-2 infection. Male sex, high qSOFA score, CRP of 40 mg/l or greater and a bilateral radiological infiltrate could help clinicians identify patients at high risk for mechanical ventilation.

The effect of automated alerts on preoperative anemia management

Hematology ◽  
2014 ◽  
Vol 20 (3) ◽  
pp. 160-164 ◽  
Author(s):  
Andrew Dilla ◽  
Mary Kay Wisniewski ◽  
Jonathan H. Waters ◽  
Darrell J. Triulzi ◽  
Mark H. Yazer
Keyword(s):  
Preoperative Anemia ◽  
Anemia Management
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