Preoperative assessment in coronary bypass surgery

2021 ◽  
pp. 155-160
Author(s):  
Daniel Sellers ◽  
George Djaiani
Keyword(s):  
Enhanced Recovery ◽  
Coronary Revascularization ◽  
Coronary Bypass ◽  
Preoperative Assessment ◽  
Recovery Process ◽  
Normal Function ◽  
Evidence Based ◽  
Care Givers ◽  
Revascularization Surgery

Coronary revascularization surgery has become extremely safe over the past 50 years, in terms of absolute mortality. However, in an era where quality of care and recovery are increasingly scrutinized, complications such as stroke, cognitive impairment, prolonged ventilation, renal impairment, wound infection, and even blood transfusion are increasingly important, with rapid recovery to normal function routinely expected by patients, care givers, and healthcare systems alike. These complications are ideally prevented or mitigated preoperatively, with a thorough system of preassessment, targeted evidence-based therapies to reduce morbidity, and careful risk assessment as part of a coherent perioperative approach. This chapter reviews the potential for each of these interventions to improve postoperative outcomes, in addition to an enhanced recovery process, and summarizes them in a schema ready to be introduced into practice.

scholarly journals Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update

2022 ◽  
Author(s):  
Erik Stenberg ◽  
Luiz Fernando dos Reis Falcão ◽  
Mary O’Kane ◽  
Ronald Liem ◽  
Dimitri J. Pournaras ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Assessment Development ◽  
Meta Analyses ◽  
Large Prospective Cohort

Abstract Background This is the second updated Enhanced Recovery After Surgery (ERAS®) Society guideline, presenting a consensus for optimal perioperative care in bariatric surgery and providing recommendations for each ERAS item within the ERAS® protocol. Methods A principal literature search was performed utilizing the Pubmed, EMBASE, Cochrane databases and ClinicalTrials.gov through December 2020, with particular attention paid to meta-analyses, randomized controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. After critical appraisal of these studies, the group of authors reached consensus regarding recommendations. Results The quality of evidence for many ERAS interventions remains relatively low in a bariatric setting and evidence-based practices may need to be extrapolated from other surgeries. Conclusion A comprehensive, updated evidence-based consensus was reached and is presented in this review by the ERAS® Society.

Misophonia: An Evidence-Based Case Report

2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Case History ◽  
Pure Tone ◽  
Physiological Responses ◽  
Evidence Based ◽  
Management Option ◽  
Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

Coaching Teachers to Enhance the Implementation Quality of Evidence-Based Programs

2013 ◽  
Author(s):  
Kimberly D. Becker ◽  
Dana Darney ◽  
Celene Domitrovich ◽  
Catherine Bradshaw ◽  
Nicholas S. Ialongo
Keyword(s):  
Evidence Based ◽  
Implementation Quality ◽  
Quality Of Evidence ◽  
Evidence Based Programs

Psychological influences on wound healing

2019 ◽  
Vol 98 (8) ◽  
pp. 312-314
Keyword(s):  
Wound Healing ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Wound Complications ◽  
State Of Mind ◽  
Life Threatening ◽  
Psychological Influences ◽  
Fear And Anxiety ◽  
Care Costs

Surgical wound complications remain a major cause of morbidity; although usually not life threatening, they reduce the quality of life. They are also associated with excessive health care costs. Wound healing is affected by many factors – wound characteristics, infection, comorbidities and nutritional status of the patient. In addition, though, psychological stress and depression may decrease the inflammatory response required for bacterial clearance and so delay wound healing, as well. Although the patient´s state of mind can be influenced only to a certain extent, we should nevertheless stick to ERAS (Enhanced Recovery After Surgery) guidelines and try to diminish fear and anxiety by providing enough information preoperatively, pay due attention to postoperative analgesia and seek to provide an agreeable environment.

Effect of Clopidogrel on Midterm Graft Patency following Off-Pump Coronary Revascularization Surgery

2006 ◽  
Vol 9 (6) ◽  
pp. E581-E856 ◽  
Author(s):  
Khalid Ibrahim ◽  
Ole Tjomsland ◽  
Dag Halvorsen ◽  
Rune Wiseth ◽  
Alexander Wahba ◽  
...  
Keyword(s):  
Coronary Revascularization ◽  
Graft Patency ◽  
Off Pump ◽  
Revascularization Surgery

Drug Utilization Studies – An Overview

2010 ◽  
Vol 3 (1) ◽  
pp. 803-810 ◽  
Author(s):  
Shalini S ◽  
Ravichandran V ◽  
Saraswathi R ◽  
BK Mohanty ◽  
Dhanaraj S K
Keyword(s):  
Drug Utilization ◽  
Evidence Based ◽  
Future Trends ◽  
Medical Prescription ◽  
Drug Usage ◽  
Current State ◽  
Patterns Of Use ◽  
Drug Utilization Studies ◽  
Drug Expenditures

 Aspire of the Drug Utilization Studies (DUS) is to appraise factors related to the prescribing, dispensing, administering and taking of medication, and it’s associated. Since the middle of twentieth century, interest in DUS has been escalating, first for market-only purposes, then for appraising the quality of medical prescription and comparing patterns of use of specific drugs. The scope of DUS is to evaluate the current state and future trends of drug usage, to estimate roughly disease pervasiveness, drug expenditures, aptness of prescriptions and adherence to evidence-based recommendations. The increasing magnitude of DUS as a valuable investigation resource in pharmacoepidemiology has been bridging it with other health allied areas, such as public health, rational use of drug, evidence based drug use, pharmacovigilance, pharmacoeconomics, eco-pharmacovigilance and pharmacogenetics.

Stuttering mHealth Applications: A Qualitative Rubric Assessment (Preprint)

2020 ◽  
Author(s):  
Fazwa M. Fadzilah ◽  
Noreen Izza Arshad ◽  
Izuddin Zainal-Abidin ◽  
Hui Min Low ◽  
Ahmad Kamil Mahmood ◽  
...  
Keyword(s):  
Research Evidence ◽  
Mobile Apps ◽  
Group Discussion ◽  
Standard Form ◽  
Mobile App ◽  
Evidence Based ◽  
Evaluation Instrument ◽  
Collective Effort ◽  
Speech Therapists

BACKGROUND Mobile applications (apps) that offer a variety of techniques to improve stuttering have been flourishing in the digital marketplace. In evidence-based clinical practice, speech therapists will recommend audio-enriched mobile apps to individuals with stuttering problems based on empirical research evidence. Unfortunately, many stuttering mobile apps available in the market are developed without a substantial research base. Hence, speech therapists necessitate a guideline which they could use to assess the quality of a stuttering mobile app before recommending the app to stutterers. OBJECTIVE The objective of this study is to develop a rubric for assessing the quality of the stuttering mobile app in assisting speech therapists to make informed recommendations METHODS The rubric was initially developed based on a set of criteria reviewed from the literature. Online surveys and focused group discussion were then conducted for results verification. RESULTS The outcome of this study is a rubric designed with four categories and 18-evaluative dimensions tailored to analyze the quality of stuttering mobile apps. The stuttering mobile app assessment rubric presented in the serve multiple purposes, including an evaluation instrument, providing guidelines for developing stuttering mobile apps and for creating a standard form that can be shared with professionals to facilitate a collective effort. CONCLUSIONS This rubric also offers a guidance to steer drive the future development of stuttering mobile apps that are evidence-based, and theoretically grounded

scholarly journals Using Benford’s law to assess the quality of COVID-19 register data in Brazil

2020 ◽  
Author(s):  
Lucas Silva ◽  
Dalson Figueiredo Filho
Keyword(s):  
Goodness Of Fit ◽  
Epidemiological Surveillance ◽  
Evidence Based ◽  
Mean Absolute Deviation ◽  
Chi Square ◽  
Absolute Deviation ◽  
Distortion Factor ◽  
Benford Law ◽  
Official Data

Abstract We employ Newcomb–Benford law (NBL) to evaluate the reliability of COVID-19 figures in Brazil. Using official data from February 25 to September 15, we apply a first digit test for a national aggregate dataset of total cases and cumulative deaths. We find strong evidence that Brazilian reports do not conform to the NBL theoretical expectations. These results are robust to different goodness of fit (chi-square, mean absolute deviation and distortion factor) and data sources (John Hopkins University and Our World in Data). Despite the growing appreciation for evidence-based-policymaking, which requires valid and reliable data, we show that the Brazilian epidemiological surveillance system fails to provide trustful data under the NBL assumption on the COVID-19 epidemic.

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