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846 full-text articles. Page 35 of 37.

Point-Of-Care Electronic Prompts: An Effective Means Of Increasing Compliance, Demonstrating Quality, And Improving Outcome, Nanette M. Schwann MD, Karen A. Bretz MD, Sherrine Eid MPH, Terry L. Burger RN, BSN, MBA, Deborah Fry MT, MBA, Frederick Ackler CRNA, Paul J. Evans CRNA, David Romanchuk BS, Michelle Beck BS, MBA, Anthony J. Ardire MD, MPH, Harry Lukens BS, MS, Thomas M. McLoughlin Jr, MD 2011 Lehigh Valley Health Network

Point-Of-Care Electronic Prompts: An Effective Means Of Increasing Compliance, Demonstrating Quality, And Improving Outcome, Nanette M. Schwann Md, Karen A. Bretz Md, Sherrine Eid Mph, Terry L. Burger Rn, Bsn, Mba, Deborah Fry Mt, Mba, Frederick Ackler Crna, Paul J. Evans Crna, David Romanchuk Bs, Michelle Beck Bs, Mba, Anthony J. Ardire Md, Mph, Harry Lukens Bs, Ms, Thomas M. Mcloughlin Jr, Md

Nanette M Schwann MD

No abstract provided.


Patient Safety: What Can Be Done About It?, Steven Dain 2011 Western University

Patient Safety: What Can Be Done About It?, Steven Dain

Steven L Dain

Much is said and written about patient safety. In Canada, a small group of dedicated physicians, nurses and engineers participates in the Canadian Standards Association and Standards Council of Canada Advisory Committees writing basic safety and essential performance requirements for a large range of anesthesia, respiratory care and critical care equipment. Over the past several years, in recognition of the globalization of trade and the international nature of medical device design and manufacturing, Canadian Anesthesiologists’ Society members Dr Steven Dain, Dr Karen Brown, Dr Matt Kurrek, Dr Ken LeDez, and Dr Jeremy Sloan have primarily participated in Organization for International …


Estimating Anesthesia Time Using The Medicare Claim: A Validation Study, Jeffrey H. Silber, Paul R. Rosenbaum, Orit Even-Shoshan, Lanyu Mi, Fabienne A. Kyle, Yun Teng, Dale W. Bratzler, Lee A. Fleisher 2011 University of Pennsylvania

Estimating Anesthesia Time Using The Medicare Claim: A Validation Study, Jeffrey H. Silber, Paul R. Rosenbaum, Orit Even-Shoshan, Lanyu Mi, Fabienne A. Kyle, Yun Teng, Dale W. Bratzler, Lee A. Fleisher

Health Care Management Papers

INTRODUCTION: Procedure length is a fundamental variable associated with quality of care, though seldom studied on a large scale. The authors sought to estimate procedure length through information obtained in the anesthesia claim submitted to Medicare to validate this method for future studies.

METHODS: The Obesity and Surgical Outcomes Study enlisted 47 hospitals located across New York, Texas, and Illinois to study patients undergoing hip, knee, colon, and thoracotomy procedures. A total of 15,914 charts were abstracted to determine body mass index and initial patient physiology. Included in this abstraction were induction, cut, close, and recovery room times. This chart …


Surgical Correction Of Aorto-Pulmonary Window: A Rare And Lethal Cause Of Pulmonary Hypertension, Adeel Ahmed Shamim, Mubashir Zareen Khan, Mehnaz Ahmed Atiq, Mansoor Ahmed Khan, Muhammad Muneer Amanullah 2011 Aga Khan University

Surgical Correction Of Aorto-Pulmonary Window: A Rare And Lethal Cause Of Pulmonary Hypertension, Adeel Ahmed Shamim, Mubashir Zareen Khan, Mehnaz Ahmed Atiq, Mansoor Ahmed Khan, Muhammad Muneer Amanullah

Section of Cardiothoracic Surgery

Aorto-pulmonary window is a relatively rare congenital cardiac malformation with an overall incidence of 0.1%. Pulmonary hypertension develops quickly if the lesion is left untreated hence early surgical intervention is warranted after diagnosis. The surgery for correction of APW has evolved over years, currently an open repair on cardiopulmonary bypass (CPB) with a single patch technique yields good results. Mortality is affected by association of pulmonary hypertension and other cardiac malformations. We present a case of an infant with a large type II APW with a relatively low pulmonary vascular resistance. Hospital stay was complicated because of pulmonary arterial disease …


Anesthetic Implications Of Robotic Gynecologic Surgery, J. Thomas McLarney, Gregory L. Rose 2011 University of Kentucky

Anesthetic Implications Of Robotic Gynecologic Surgery, J. Thomas Mclarney, Gregory L. Rose

Anesthesiology Faculty Publications

Surgery using robotic techniques is becoming more and more common. One of the specialties at the fore-front of robotic surgery has been gynecology, much like it was at the fore-front a generation ago in bringing laparoscopy into the operating room. New considerations have been noted and new techniques have been learned on both sides of the drape in order to ensure a successful outcome for the patient undergoing robotic gynecologic surgery. The purpose of this article is to bring, to light the concerns facing the anesthesiologist in regards to robotic procedures. We discuss the problems facing anesthesiologists, when a patient …


Bapcap2-1 Does Preoperative Aspirin Improve Outcomes In Cardiac Surgery Patients?, Jian-Zhong Sun, L. Cao, H. Liu, W. Sun, S Silvestry, J. Diehl 2011 Thomas Jefferson University

Bapcap2-1 Does Preoperative Aspirin Improve Outcomes In Cardiac Surgery Patients?, Jian-Zhong Sun, L. Cao, H. Liu, W. Sun, S Silvestry, J. Diehl

Department of Anesthesiology Faculty Papers

Best Abstracts - Runner-up Session 2 presented at Euroanaesthesia 2011 in the Netherlands.

Background and Goal of Study: The effects of preoperative aspirin on major cardiocerebral and renal outcomes and mortality remain uncertain.


Pain Control For Uterine Fibroid Embolisation : An Initial Experience In East Africa., Gilbert Mwaka, Vitalis Mung’ayi, Nigel Hacking, William. Stones 2011 Aga Khan University

Pain Control For Uterine Fibroid Embolisation : An Initial Experience In East Africa., Gilbert Mwaka, Vitalis Mung’Ayi, Nigel Hacking, William. Stones

Anaesthesiology, East Africa

Uterine fibroid embolisation (UFE) generates moderate to severe post-procedural pain. We present a case series of 24 patients who underwent UFE during our first experience in managing the sometimes excruciating pain that accompanies embolisation of the uterine arteries. We also show the evolution of our protocol for post-procedural pain management from a first to second round of procedures.


The Effect Of Midazolam On End-Tidal Concentration Of Isoflurane Necessary To Prevent Movements In Dogs, Reza Seddighi DVM, MS, PhD, Dip ACVA 2011 University of Tennessee - Knoxville

The Effect Of Midazolam On End-Tidal Concentration Of Isoflurane Necessary To Prevent Movements In Dogs, Reza Seddighi Dvm, Ms, Phd, Dip Acva

Reza Seddighi

Objective To determine the possible additive effect of midazolam, a GABAA agonist, on the end-tidal concentration of isoflurane that prevents movement (MACNM) in response to noxious stimulation. Study design Randomized crossover experimental study. Animals Six, healthy, adult intact male, mixed-breed dogs. Methods After baseline isoflurane MACNM (MACNM-B) determination, midazolam was administered as a low (LDS), medium (MDS) or high (HDS) dose series of midazolam. Each series consisted of two dose levels, low and high. The LDS was a loading dose (Ld) of 0.2 mg kg-1 and CRI (2.5 μg kg-1 minute-1) (LDL), followed by an Ld (0.4 mg kg-1) and …


The Effect Of Midazolam On End-Tidal Concentration Of Isoflurane Necessary To Prevent Movements In Dogs, Reza Seddighi DVM, MS, PhD, Dip ACVA 2011 University of Tennessee - Knoxville

The Effect Of Midazolam On End-Tidal Concentration Of Isoflurane Necessary To Prevent Movements In Dogs, Reza Seddighi Dvm, Ms, Phd, Dip Acva

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

Objective To determine the possible additive effect of midazolam, a GABAA agonist, on the end-tidal concentration of isoflurane that prevents movement (MACNM) in response to noxious stimulation. Study design Randomized crossover experimental study. Animals Six, healthy, adult intact male, mixed-breed dogs. Methods After baseline isoflurane MACNM (MACNM-B) determination, midazolam was administered as a low (LDS), medium (MDS) or high (HDS) dose series of midazolam. Each series consisted of two dose levels, low and high. The LDS was a loading dose (Ld) of 0.2 mg kg-1 and CRI (2.5 μg kg-1 minute-1) (LDL), followed by an Ld (0.4 mg kg-1) and …


Knowledge And Attitudes Of Pakistani Women Towards Anaesthesia Techniques For Caesarean Section, Imtiaz Ahmad, Gauhar Afshan 2011 Aga Khan University

Knowledge And Attitudes Of Pakistani Women Towards Anaesthesia Techniques For Caesarean Section, Imtiaz Ahmad, Gauhar Afshan

Department of Anaesthesia

OBJECTIVE: To assess knowledge and attitudes of Pakistani women towards different options of anaesthesia techniques for caesarean section and also to identify their sources of information about them.

METHODS: A total of 410 women scheduled for elective caesarean section were enrolled after informed written consent in this hospital based cross sectional survey. The women were interviewed preferably in Urdu (national) language according to structured pre coded questionnaire by one of the investigators and the sequence of questions was strictly followed. This survey included pertinent questions to assess knowledge and attitudes of our women towards choices of anaesthesia techniques. The questionnaire …


Dual Chamber Pacemaker Implants--A New Opportunity In Pakistan For Children With Congenital And Acquired Complete Heart Block, Awais Ashfaq, Mansoor Ahmed Khan, Mehnaz Atiq, Muhammad Muneer Amanullah 2011 Aga Khan University

Dual Chamber Pacemaker Implants--A New Opportunity In Pakistan For Children With Congenital And Acquired Complete Heart Block, Awais Ashfaq, Mansoor Ahmed Khan, Mehnaz Atiq, Muhammad Muneer Amanullah

Section of Cardiothoracic Surgery

Implantation of cardiac pacemakers has been practiced for at least five decades with continuous developments of the hardware. The invention of dual chamber pacemakers has initiated a debate concerning its superiority over single chamber ventricular pacemakers. Throughout the world, surgeons have been using dual chambered permanent pacemakers with successful follow ups. However, Pakistan has not yet taken the advantage of such pacemaker devices till now. We report three cases that underwent a dual chamber permanent pacemaker implantation for the first time in children less than 8 kg with successful follow ups.


Pregnant Women As Research Participants: Why Is Additional Protection Required?, Kyoko Wada 2011 The University of Western Ontario

Pregnant Women As Research Participants: Why Is Additional Protection Required?, Kyoko Wada

Research Day (Arts & Humanities, FIMS, and Education)

Today, blanket exclusion of pregnant women from research participation is not endorsed; however, a tendency still remains to exclude pregnant women from participating in research. This exclusion results in insufficient data to guide clinical practice for pregnant women, and hence adds risks to pregnant women and fetuses (Lyerly et al. 2007, 2008, 2009; Baylis 2010; Goldkind et al. 2010).


Audit Of Postoperative Nausea And Vomiting In Paediatric Day Case Surgery, Fauzia N. Minai, Faraz Shafiq, Azhar Rehman 2011 Aga Khan University

Audit Of Postoperative Nausea And Vomiting In Paediatric Day Case Surgery, Fauzia N. Minai, Faraz Shafiq, Azhar Rehman

Department of Anaesthesia

OBJECTIVE: To assess the incidence of PONV, delay in discharge or unplanned admissions in paediatric surgical cases done at the Surgical Day Care Unit at Aga Khan University between January and July 2009.

METHODS: All paediatric ASA 1-2 cases, from 6 months to 18 years of age undergoing day case surgeries at the Surgical day care unit were included in this retrospective audit. Data was collected on a designed form filled with information from preoperative, intraoperative and postoperative recovery forms. Any relevant data was also noted from nurses notes in recovery room and step down unit. Episodes of vomiting, delay …


Comparison Of Renal Effects Of Ibuprofen Versus Indomethacin During Treatment Of Patent Ductus Arteriosus In Contiguous Historical Cohorts, Alla Kushnir, Joaquim Mb Pinheiro 2011 Albany Medical College

Comparison Of Renal Effects Of Ibuprofen Versus Indomethacin During Treatment Of Patent Ductus Arteriosus In Contiguous Historical Cohorts, Alla Kushnir, Joaquim Mb Pinheiro

Alla Kushnir

No abstract provided.


Predictors Of Postoperative Respiratory Failure In Patients Receiving Anesthesia, Marty Henley 2011 Marshall University

Predictors Of Postoperative Respiratory Failure In Patients Receiving Anesthesia, Marty Henley

Theses, Dissertations and Capstones

Introduction: Postoperative Respiratory failure has been identified as a prevention quality indicator by The Agency for Health Research and Quality (AHRQ). Postoperative Respiratory Failure is associated with increased length of stay, increased costs and increased morbidity and mortality. Unfortunately, current research is limited regarding scoring methods which are predictive for postoperative respiratory failure. This retrospective case control study was conducted to determine if the various tools of evaluation of risk currently available and to determine if any are predictive of the risk of developing postoperative respiratory failure.

Methodology: The design of this research was a retrospective case control study conducted …


Course And Outcome Of Obstetric Patients Admitted To A University Hospital Intensive Care Unit, F. Githae, Vitalis Mung’ayi, William Stones 2011 Aga Khan University

Course And Outcome Of Obstetric Patients Admitted To A University Hospital Intensive Care Unit, F. Githae, Vitalis Mung’Ayi, William Stones

Anaesthesiology, East Africa

Background: Obstetric Critical Care is an important service in the reduction of maternal morbidity and mortality, but few developing country data are available.

Objectives: To review all maternity patients admitted to the ICU over a seven year period to determine the causes and outcomes of these admissions and the frequency and causes of maternal morbidity and mortality.

Design: Retrospective patient file and ICU chart review.

Subjects: ICU Charts and medical files of obstetric patients admitted to the ICU at The Aga Khan University Hospital between (November 2003 – November 2010) were reviewed.

Setting: The ICU at The Aga Khan University …


Post-Dural Puncture Posterior Reversible Encephalopathy Syndrome, Fauzia N. Minai, Syeda Fauzia Hasan, Mughis Sheerani 2011 Aga Khan University

Post-Dural Puncture Posterior Reversible Encephalopathy Syndrome, Fauzia N. Minai, Syeda Fauzia Hasan, Mughis Sheerani

Department of Anaesthesia

We report the case of a young patient with 36 weeks pregnancy, and an acute respiratory infection with severe bronchospasm, who developed an occipital headache and neck pain on the third day of inadvertent dural puncture during placement of combined epidural spinal anaesthesia for caesarian section. It was diagnosed as post-dural puncture headache until generalised tonic clonic siezures occurred the next day raising the suspicion of postpartum eclampsia or meningitis. Posterior reversible encephalopathy syndrome was diagnosed on MRI of the brain which showed features of reversible ischemia in the posterior region of the brain. With anticonvulsant therapy and antibiotics there …


Apache-Ii Score Correlation With Mortality And Length Of Stay In An Intensive Care Unit, Saad Ahmed Naved,, Shahla Siddiqui, Fazal Hameed Khan 2011 Aga Khan University

Apache-Ii Score Correlation With Mortality And Length Of Stay In An Intensive Care Unit, Saad Ahmed Naved,, Shahla Siddiqui, Fazal Hameed Khan

Department of Anaesthesia

Objective: To correlate the APACHE-II score system with mortality and length of stay in ICU. Study Design: Cohort study. Place and Duration of Study: The Intensive Care Unit (ICU) of the Aga Khan University Hospital, Karachi, from May 2005 to May 2006. Methodology: All adult patients who were admitted in the ICU were included. APACHE-II score was calculated at the second and seventh days of admission in the ICU. Patients who were discharged alive from the ICU or died after first APACHE-II Score (at 2nd day) were noted as the primary outcome measurement. Second APACHE-II score (at 7th day) was …


Spinal Cord Stimulator Induced Artifact During A Sleep Study, Robert J. Corba DO 2011 Lehigh Valley Health Network

Spinal Cord Stimulator Induced Artifact During A Sleep Study, Robert J. Corba Do

Department of Anesthesiology

No abstract provided.


Anaesthetic Challenges In Emergency Surgical Repair Of Acute Aortic Dissection Rupturing Into The Pericardium In A Pregnant Patient, Mohammad Irfan Akhtar, Khalid Samad 2011 Aga Khan University

Anaesthetic Challenges In Emergency Surgical Repair Of Acute Aortic Dissection Rupturing Into The Pericardium In A Pregnant Patient, Mohammad Irfan Akhtar, Khalid Samad

Department of Anaesthesia

Acute aortic dissection in pregnancy is a serious situation, because rapid and appropriate surgical decision making is required to save the life of both mother and baby. Aortic dissection is rare in young women but is likely during pregnancy (third trimester) secondary to the hyperdynamic and hypervolaemic circulatory state associated with pregnancy. A 35 years old 27 weeks pregnant patient weighing 90 kg presented in the emergency with severe chest pain. In the immediate post cardiopulmonary bypass period, the patient started bleeding profusely from the anastamotic sites irrespective of utilization of all the conventional methods of haemostasis including multiple units …


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