Risk Factors for Developing Pneumonia after Elective Surgical Procedures

2016 ◽  
Vol 223 (4) ◽  
pp. e111
Author(s):  
Randi Lassiter ◽  
Colville H. Ferdinand
Keyword(s):  
Risk Factors ◽  
Surgical Procedures ◽  
Elective Surgical Procedures

scholarly journals Changes in the activity levels and financing sources of Israel’s private for-profit hospitals in the wake of reforms to the public-private divide

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Royi Barnea ◽  
Adi Niv-Yagoda ◽  
Yossi Weiss
Keyword(s):  
Health Insurance ◽  
Surgical Procedures ◽  
Health Expenditure ◽  
Medical Center ◽  
Waiting Times ◽  
Publicly Funded ◽  
Private Hospitals ◽  
The Public ◽  
For Profit ◽  
Elective Surgical Procedures

Abstract Background The Israeli National Health Insurance Law provides permanent residents with a basket of healthcare services through non-profit public health insurance plans, independently of the individual’s ability to pay. Since 2015, several reforms and programs have been initiated that were aimed at reinforcing public healthcare and redressing negative aspects of the health system, and specifically the constant rise in private health expenditure. These include the “From Reimbursement-to-Networks Arrangement”, the “Cooling-off Period” program and the program to shorten waiting times. The objectives of this study were to identify, describe, and analyze changes in private hospitals in 1) the volume of publicly and privately funded elective surgical procedures; and 2) private health expenditure on surgical procedures. Methods Data on the volume and funding of surgical procedures during 2013–2018 were obtained from Assuta Medical Center, Hertzelia Medical Center, the Israeli Ministry of Health and the Central Bureau of Statistics. The changes in the volume and financing sources of surgical activities in private hospitals, in the wake of the reforms were analyzed using aggregate descriptive statistics. Results Between 2013 and 2018 the volume of surgical activities in private for-profit hospitals increased by 7%. Between 2013 and 2017, the distribution of financing sources of surgical procedures in private hospitals remained stable, with most surgical procedures (75–77%) financed by the voluntary health insurance programs of the health plans (HP-VHI). In 2018, following the regulatory reforms, a significant change in the distribution of financing sources was observed: there was a sharp decline in the volume of HP-VHI-funded surgical procedures to 26%. Concurrently, the share of publicly-funded surgical procedures performed in private hospitals increased to 56% in 2018.,. During the study period, private spending on elective surgical procedures in private hospitals declined by 53% while public funding for them increased by 51%. Conclusions and policy implications In the wake of the reforms, there was a substantial shift from private to public financing of elective surgical activity in private hospitals. Private for-profit hospitals have become important providers of publicly-funded procedures. It is likely that the reforms affected the public-private mix in the financing of elective surgical procedures in those hospitals, but due to the absence of a control group, causality cannot be proven. It is also unclear whether waiting times were shortened. Health reforms must be accompanied by a clear and comprehensive set of indicators for measuring their success.

A Guideline for Anticipated Blood Usage during Elective Surgical Procedures

1979 ◽  
Vol 71 (6) ◽  
pp. 680-684 ◽  
Author(s):  
Leonard I. Boral ◽  
Francis J. Dannemiller ◽  
William Stanford ◽  
Sherwood S. Hill ◽  
Terry A. Cornell
Keyword(s):  
Surgical Procedures ◽  
Elective Surgical Procedures ◽  
Blood Usage

The Clinical Neuromuscular Pharmacology of 51W89 in Patients Receiving Nitrous Oxide/Opioid/Barbiturate Anesthesia 

1995 ◽  
Vol 82 (5) ◽  
pp. 1139-1145 ◽  
Author(s):  
Matthew R. Belmont ◽  
Cynthia A. Lien ◽  
Steve Quessy ◽  
Martha M. Abou-Donia ◽  
Amy Abalos ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Surgical Procedures ◽  
Blocking Agent ◽  
Neuromuscular Blocking ◽  
Neuromuscular Blocking Agent ◽  
Blocking Effect ◽  
Preclinical Studies ◽  
Physical Status ◽  
Elective Surgical Procedures ◽  
Recovery Index

Background Atracurium is a mixture of ten stereoisomers. 51W89, one of these isomers, is a potent nondepolarizing intermediate-duration neuromuscular blocking agent. Preclinical studies have shown 51W89 to be significantly more potent than atracurium but with a similar neuromuscular blocking profile. This study was undertaken to establish the neuromuscular blocking potency and pharmacodynamics of 51W89 in patients undergoing elective surgical procedures. Methods Ninety-nine ASA physical status 1 or 2 patients undergoing elective surgical procedures under nitrous oxide/opioid/barbiturate anesthesia were studied. The neuromuscular blocking effect of 51W89 was assessed after administration of bolus doses from 0.015 to 0.4 mg/kg, as well as during and after continuous infusions from 11 to 249 min in length. Results The calculated ED95 for inhibition of adductor pollicis twitch evoked at 0.15 Hz was 0.048 mg/kg. At 0.10 mg/kg, maximum block developed within 5.2 +/- 0.3 min, and recovery to 95% twitch height occurred 64.4 +/- 3.9 min after injection. At 0.4 mg/kg, onset was 1.9 +/- 0.1 min, and 95% recovery developed within 121.0 +/- 5.9 min. Comparative recovery indexes from 5% to 95% or from 25% to 75% twitch heights did not differ significantly among all dosage groups from 0.1 to 0.4 mg/kg (means ranged from 29.6 to 32.3 min and from 12.6 to 14.3 min, respectively). The average infusion rate necessary to maintain approximately 95% twitch suppression was 1.35 micrograms/kg/min. Recovery indexes from infusions were 5-95% 33.2 +/- 1.8 min and 25-75% 15.0 +/- 0.6 min, not differing significantly from recovery indexes from single bolus doses. Twenty-five patients received neostigmine (0.06 mg/kg) with atropine (0.03 mg/kg) at twitch height recovery of between 6% and 21%. Antagonism to 95% control twitch height developed within 6.8 +/- 0.3 min, and the neostigmine-accelerated 25-75% recovery index was 2.8 +/- 0.2 min. Conclusions 51W89 is a potent nondepolarizing neuromuscular blocking agent that shows noncumulative intermediate-duration neuromuscular blocking pharmacodynamics.

Allergy skin testing: Science or quackery?

PEDIATRICS ◽  
1977 ◽  
Vol 59 (4) ◽  
pp. 495-498
Author(s):  
Gail G. Shapiro ◽  
C. Warren Bierman ◽  
Clifton T. Furukawa ◽  
William E. Pierson
Keyword(s):  
Physical Examination ◽  
American Academy ◽  
Surgical Procedures ◽  
Skin Testing ◽  
Skin Tests ◽  
Elective Surgical Procedures ◽  
American Academy Of Pediatrics ◽  
Telephone Calls ◽  
Allergy Skin Testing

A commentary in Pediatrics in September 19751 condemned procedure-oriented fee schedules because they encouraged and rewarded the abuse of laboratory and elective surgical procedures. Allergy skin testing was included in this list. Letters to the American Academy of Pediatrics and telephone calls to the Chairman of the Section on Allergy of the Academy took issue with this inclusion. The commentary, however, was directed toward physicians and allergy laboratories who abuse skin testing rather than toward the procedure itself. It was directed to those who perform innumerable and casually selected skin tests as a substitute for an appropriate history, physical examination, and carefully selected tests based on that evaluation.

Middle Ear Barotraumas in Commercial Aircrew

2021 ◽  
Vol 92 (3) ◽  
pp. 182-189
Author(s):  
Oskari H. Lindfors ◽  
Kimmo S. Ketola ◽  
Tuomas K. Klockars ◽  
Tuomo K. Leino ◽  
Saku T. Sinkkonen
Keyword(s):  
Risk Factors ◽  
Middle Ear ◽  
Surgical Procedures ◽  
Poor Performance ◽  
Target Population ◽  
Survey Study ◽  
Upper Respiratory Tract ◽  
Commercial Aviation ◽  
Pressure Equalization ◽  
Tract Infections

BACKGROUND: Middle ear (ME) barotraumas are the most common condition in aviation medicine, sometimes seriously compromising flight safety. Considering this and the ever-increasing amount of commercial aviation, a detailed overview is warranted.METHODS: In this survey study, an anonymous, electronic questionnaire was distributed to commercial aircrew of the three major commercial airlines operating in Finland (N 3799), covering 93% of the target population (i.e., all commercial aircrew operating in Finland, N 4083). Primary outcomes were self-reported prevalence, clinical characteristics, and health and occupational effects of ME barotraumas in flight. Secondary outcomes were adjusted odds ratios (OR) for frequency of ME barotraumas with respect to possible risk factors.RESULTS: Response rate was 47% (N 1789/3799), with 85% (N 1516) having experienced ME barotraumas in flight. Of those affected, 60% had used medications, 5% had undergone surgical procedures, and 48% had been on sick leave due to ME barotraumas (40% during the last year). Factors associated with ME barotraumas included a high number of upper respiratory tract infections [3 URTIs/yr vs. 0 URTIs/yr: OR, 9.02; 95% confidence interval (CI) 3.9920.39] and poor subjective performance in Valsalva (occasionally vs. always successful: OR, 7.84; 95% CI 3.9715.51) and Toynbee (occasionally vs. always successful: OR, 9.06; 95% CI 2.6730.78) maneuvers.CONCLUSION: ME barotraumas were reported by 85% of commercial aircrew. They lead to an increased need for medications, otorhinolaryngology-related surgical procedures, and sickness absence from flight duty. Possible risk factors include a high number of URTIs and poor performance in pressure equalization maneuvers.Lindfors OH, Ketola KS, Klockars TK, Leino TK, Sinkkonen ST. Middle ear barotraumas in commercial aircrew. Aerosp Med Hum Perform. 2021; 92(3):182189.

Anxiety and Pain in Children undergoing Elective Surgical Procedures: A Systematic Review

2010 ◽  
Vol 8 (Supplement) ◽  
pp. 1-23
Author(s):  
Ying Jia Shermin Chieng ◽  
Hong-Gu He ◽  
Wai-Chi Sally Chan
Keyword(s):  
Systematic Review ◽  
Surgical Procedures ◽  
Elective Surgical Procedures

Patient Safety in Microvascular Plastic Surgery

2019 ◽  
Vol 35 (09) ◽  
pp. 631-639
Author(s):  
Salih Colakoglu ◽  
Seth Tebockhorst ◽  
Tae W. Chong ◽  
David W. Mathes
Keyword(s):  
Risk Factors ◽  
Patient Safety ◽  
Adverse Events ◽  
Surgical Procedures ◽  
Evidence Based ◽  
Surgical Team ◽  
Related Risk ◽  
Prophylactic Measures ◽  
Patients At Risk ◽  
Preventable Harm

Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors enables the surgical team to carry out prophylactic measures to reduce the rate of complications and adverse events.The purpose of this review is to identify the characteristics of patients, practitioners, and microvascular surgical procedures that place patients at risk for preventable harm, and to discuss evidence-based prevention practices that can potentially help to generate a culture of patient safety.

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