Short- and long-term outcomes after enucleation of pancreatic tumors: An evidence-based assessment

Pancreatology ◽  
2016 ◽  
Vol 16 (6) ◽  
pp. 1092-1098 ◽  
Author(s):  
Yanming Zhou ◽  
Min Zhao ◽  
Lupeng Wu ◽  
Feng Ye ◽  
Xiaoying Si
Keyword(s):  
Pancreatic Tumors ◽  
Evidence Based ◽  
Long Term Outcomes ◽  
Short And Long Term

Critical illness and intensive care

2017 ◽  
pp. 237-246
Author(s):  
Maria Carlo Duggan ◽  
Kwame Frimpong ◽  
E. Wesley Ely
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Older Patients ◽  
Evidence Based ◽  
Psychological Consequences ◽  
Long Term Outcomes ◽  
Icu Patients ◽  
Younger Patients ◽  
Short And Long Term

Older adults constitute the majority of intensive care unit (ICU) patients, and are increasing in both absolute and relative numbers. Critical care for elderly people should be tailored to their unique physiology, susceptibilities to complications, social circumstances, values, and goals for their care. Knowledge of the short and long-term outcomes of critical illness should guide therapy and goals of care. With a growing number of elderly ICU survivors, the functional, cognitive, and psychological consequences of critical illness and ICU exposure will become a more prominent problem to address. In this chapter, we will discuss morbidity and mortality of elderly ICU patients, provide an evidence-based bundle for the management of pain, agitation, and delirium that has been developed with the vulnerabilities of older patients in mind (though it is also being applied broadly to younger patients as well), and explore the long-term physical, cognitive, and psychological consequences that ICU survivors face.

scholarly journals Challenges in Patient Blood Management for Cardiac Surgery: A Narrative Review

2021 ◽  
Vol 10 (11) ◽  
pp. 2454
Author(s):  
Valentina Rancati ◽  
Emmanuelle Scala ◽  
Zied Ltaief ◽  
Mohamed Ziyad Gunga ◽  
Matthias Kirsch ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cell Mass ◽  
Evidence Based ◽  
Patient Blood Management ◽  
Blood Products ◽  
Blood Management ◽  
New Paradigm ◽  
Long Term Outcomes ◽  
Short And Long Term

About 15 years ago, Patient Blood Management (PBM) emerged as a new paradigm in perioperative medicine and rapidly found support of all major medical societies and government bodies. Blood products are precious, scarce and expensive and their use is frequently associated with adverse short- and long-term outcomes. Recommendations and guidelines on the topic are published in an increasing rate. The concept aims at using an evidence-based approach to rationalize transfusion practices by optimizing the patient’s red blood cell mass in the pre-, intra- and postoperative periods. However, elegant as a concept, the implementation of a PBM program on an institutional level or even in a single surgical discipline like cardiac surgery, can be easier said than done. Many barriers, such as dogmatic ideas, logistics and lack of support from the medical and administrative departments need to be overcome and each center must find solutions to their specific problems. In this paper we present a narrative overview of the challenges and updated recommendations for the implementation of a PBM program in cardiac surgery.

scholarly journals An update on vessel preparation in lower limb arterial intervention

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
William Ormiston ◽  
Shelagh Dyer-Hartnett ◽  
Rukshan Fernando ◽  
Andrew Holden
Keyword(s):  
Lower Limb ◽  
Vessel Wall ◽  
Arterial Intervention ◽  
Arterial Disease ◽  
Long Term Outcomes ◽  
Pulsatile Pressure ◽  
Short And Long Term ◽  
Late Restenosis ◽  
Vessel Preparation

Abstract Background Plain balloon angioplasty has traditionally been used to treat lower limb arterial disease but can be limited by significant residual stenosis, vessel recoil, dissection, and by late restenosis. Appropriate vessel preparation may significantly improve short and long-term outcomes. We aim to give an overview of some of the devices currently available, or under investigation, for vessel preparation in the lower limb. Main text Vessel preparation devices include those that remove plaque (atherectomy devices) and those that modify plaque. The four groups of plaque removing atherectomy devices are defined by their plaque removal method: Directional, rotational orbital and excimer laser are categories of devices investigated for plaque modification. Intravascular lithotripsy devices generate sonic pulsatile pressure waves that pass into the vessel wall cracking calcified plaques whilst sparing soft tissue. This enables dilatation of calcified lesions at low pressure by conventional balloons and enables full stent expansion. Other balloon based vessel preparation devices were designed to modify plaque and produce more controlled, lower pressure luminal expansion without major dissections and potentially with less recoil than conventional angioplasty balloons. Scoring balloons have a helical nitinol element attached to the balloon that scores plaque facilitating uniform luminal enlargement. Further specialty balloons have been developed in recent years, including the Chocolate, Phoenix and Serranator balloons. Finally, the temporary Spur self-expanding retrievable nitinol stent has a series of radially aligned spurs that are driven into the vessel wall by post-dilatation, potentially improving drug delivery. Conclusion Lesion specific vessel preparation aims to improve both short and long term outcomes through improved penetration of anti-proliferative drug, maximising luminal gain, reducing the need for stent placement and minimising intimal injury. Some forms of vessel preparation appear to improve short term outcomes; long-term outcomes remain uncertain. An overview of some of the multiple devices available for vessel preparation is presented.

Sign in / Sign up

Export Citation Format

Share Document