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[PMID]:29400036
[Au] Autor:Sellami M; Mnejja M; Masmoudi M; Charfeddine I; Hammami B; Ghorbel A
[Ti] Título:[Predictive factors for recurrence after surgery of nasal polyposis].
[So] Source:Rev Laryngol Otol Rhinol (Bord);136(4):149-53, 2015.
[Is] ISSN:0035-1334
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Introduction: Endoscopic sinus surgery has become the treatment of choice in the surgical management of patients with nasal polyposis. The aim of our study is to identify the role of some epidemiological, clinical and therapeutic factors in recurrence after surgery of nasal polyposis. Materials and methods: We conducted a retrospective study over a period of 11 years (between 2000 and 2010) including 184 patients operated for nasal polyposis after failure of prolonged medical treatment. We evaluated the impact of epidemiological and clinical factors (age, sex, asthma, Widal disease, allergy and stage of nasal polyposis at the time of surgery) and treatment (surgical technique, observance of postoperative topical steroids ) on postoperative recurrence. Results: Nasal poly­posis recurred in 26.6% of patients after an average period of 23 months. Widal disease, asthma and bad observance of the intranasal steroid therapy were significantly associated with postoperative recurrence in the univariate analysis. In multi­variate analysis the bad observance of the intranasal steroid therapy was the only factor significantly associated with recurren­ce. Conclusion: Postoperative steroids prescribed routi­nely in our practice can effectively prevent recurrence after endonasal surgery and this result was found in both uni­variate and multivariate analysis.
[Mh] Termos MeSH primário: Pólipos Nasais/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Asma/epidemiologia
Criança
Feminino
Seguimentos
Glucocorticoides/uso terapêutico
Seres Humanos
Masculino
Meia-Idade
Cooperação do Paciente
Cuidados Pós-Operatórios
Recidiva
Estudos Retrospectivos
Tunísia/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Glucocorticoids)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE


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[PMID]:29258973
[Au] Autor:Sanguansak T; Morley KE; Morley MG; Thinkhamrop K; Thuanman J; Agarwal I
[Ad] Endereço:Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
[Ti] Título:Two-Way Social Media Messaging in Postoperative Cataract Surgical Patients: Prospective Interventional Study.
[So] Source:J Med Internet Res;19(12):e413, 2017 Dec 19.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Social media offers a new way to provide education, reminders, and support for patients with a variety of health conditions. Most of these interventions use one-way, provider-patient communication. Incorporating social media tools to improve postoperative (postop) education and follow-up care has only been used in limited situations. OBJECTIVE: The aim of this study was to determine the feasibility and efficacy of two-way social media messaging to deliver reminders and educational information about postop care to cataract patients. METHODS: A total of 98 patients undergoing their first eye cataract surgery were divided into two groups: a no message group receiving usual pre- and postop care and a message group receiving usual care plus messages in a mobile social media format with standardized content and timing. Each patient in the message group received nine messages about hand and face hygiene, medication and postop visit adherence, and links to patient education videos about postop care. Patients could respond to messages as desired. Main outcome measures included medication adherence, postop visit adherence, clinical outcomes, and patients' subjective assessments of two-way messaging. The number, types, content, and timing of responses by patients to messages were recorded. RESULTS: Medication adherence was better in the message group at postop day 7, with high adherence in 47 patients (96%, 47/49) versus 36 patients (73%, 36/49) in the no message group (P=.004), but no statistically significant differences in medication adherence between the groups were noted at preop and postop day 30. Visit adherence was higher at postop day 30 in the message group (100%, 49/49) versus the no message group (88%, 43/49; P=.03) but was 100% (49/49) in both groups at postop day 1 and 7. Final visual outcomes were similar between groups. A total of 441 standardized messages were sent to the message group. Out of 270 responses generated, 188 (70%) were simple acknowledgments or "thank you," and 82 (30%) responses were questions that were divided into three general categories: administrative, postop care, and clinical issues. Out of the 82 question responses, 31 (11%) were about administrative issues, 28 (10%) about postop care, and 23 (9%) about clinical symptoms. All the messages about symptoms were triaged by nurses or ophthalmologists and only required reassurance or information. Patients expressed satisfaction with messaging. CONCLUSIONS: Two-way social media messaging to deliver postop information to cataract patients is feasible and improves early medication compliance. Further design improvements can streamline work flow to optimize efficiency and patient satisfaction.
[Mh] Termos MeSH primário: Catarata/terapia
Mídias Sociais/utilização
Mensagem de Texto/utilização
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Adesão à Medicação
Meia-Idade
Cuidados Pós-Operatórios
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.8330


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[PMID]:29374926
[Au] Autor:Wu YW; Liu J; Jin J; Liu LJ; Wu YF
[Ad] Endereço:Department of Critical Care Medicine, East Region of Suzhou Municipal Hospital, Suzhou Hospital Affiliated to Nanjing Medical University, Jiangsu 215001, China.
[Ti] Título:[Effects of early enteral nutrition in the treatment of patients with severe burns].
[So] Source:Zhonghua Shao Shang Za Zhi;34(1):40-46, 2018 Jan 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the effects of early enteral nutrition (EEN) in the treatment of patients with severe burns. Medical records of 52 patients with severe burns hospitalized in the three affiliations of authors from August to September in 2014 were retrospectively analyzed and divided into EEN group ( =28) and non-early enteral nutrition (NEEN) group ( =24) according to the initiation time of enteral nutrition. On the basis of routine treatment, enteral nutrition was given to patients in group EEN within post injury day (POD) 3, while enteral nutrition was given to patients in group NEEN after POD 3. The following items were compared between patients of the two groups, such as the ratio of enteral nutrition intake to total energy intake, the ratio of parenteral nutrition intake to total energy intake, the ratio of total energy intake to energy target on POD 1, 2, 3, 4, 5, 6, 7, 14, 21, and 28, the levels of prealbumin, serum creatinine, blood urea nitrogen, total bilirubin, direct bilirubin, and Acute Physiology and Chronic Health Evaluation â…¡ (APACHE â…¡) score on POD 1, 3, 7, 14, and 28, the first operation time, the number of operations, and the frequencies of abdominal distension, diarrhea, vomiting, aspiration, catheter blockage, and low blood sugar within POD 28. Data were processed with (2)test, test, Wilcoxon rank sum test, and Bonferroni correction. (1) The ratio of parenteral nutrition intake to total energy intake of patients in group EEN on POD 1 was obviously lower than that in group NEEN ( =2.078, <0.05). The ratio of enteral nutrition intake to total energy intake and the ratio of total energy intake to energy target of patients in group EEN on POD 2 and 3 were obviously higher than those in group NEEN ( =5.766, 6.404, =4.907, 6.378, <0.01). The ratio of total energy intake to energy target of patients in group EEN was obviously lower than that in group NEEN on POD 4, 5, 6, and 7 ( =4.635, 2.547, 3.751, 5.373, <0.05 or <0.01). On POD 2, 4, 5, 14, 21, and 28, the ratio of enteral nutrition intake to total energy intake of patients in group EEN was obviously higher than the ratio of parenteral nutrition intake to total energy intake within the same group ( =5.326, 2.046, 2.129, 4.118, 3.174, 3.963, <0.05 or <0.01). In group NEEN, the ratio of enteral nutrition to total energy intake of patients on POD 1, 2, and 3 was obviously lower than the ratio of parenteral nutrition intake to total energy intake within the same group ( =2.591, 2.591, 3.293, <0.05 or <0.01), while the ratio of enteral nutrition to total energy intake of patients on POD 14, 21, 28 was obviously higher than the ratio of parenteral nutrition intake to total energy intake within the same group ( =2.529, 3.173, 3.133, <0.05 or <0.01). (2) The prealbumin levels of patients in the two groups were close on POD 1, 3, 7, and 14 ( =1.983, 0.093, 0.832, 1.475, >0.05). On POD 28, the prealbumin level of patients in group EEN was obviously higher than that in group NEEN ( =3.163, <0.05). The levels of serum creatinine, blood urea nitrogen, total bilirubin, and direct bilirubin of patients in the two groups at all time points post injury were close ( =1.340, 0.547, 0.245, 0.387, 0.009, 1.170, 0.340, 1.491, 0.274, 1.953, 0.527, 0.789, 0.474, 1.156, 0.482, 0.268, 0.190, 0.116, 1.194, 0.431, >0.05). (3) The APACHE â…¡ scores of patients in group EEN were (22.5±3.1) and (15.6±3.8) points respectively on POD 1 and 3, which were close to (23.6±3.0) and (17.6±4.2) points of patients in group NEEN ( =1.352, 1.733, >0.05). The APACHE â…¡ scores of patients in group EEN on POD 7, 14, and 28 were (13.6±3.6), (13.8±4.1), and (15.5±4.1) points, respectively, which were obviously lower than (18.5±3.9), (19.5±4.2) and (20.8±3.8) points of patients in group NEEN ( =4.677, 4.843, 4.792, <0.05). (4) Within POD 28, the time of the first operation, the number of operations, and the frequencies of abdominal distension, diarrhea, vomiting, aspiration, catheter blockage and hypoglycemia were similar between patients of the two groups ( =0.684, 0.782, =0.161, 1.751, 0.525, 0.764, 0.190, 0.199, >0.05). EEN in the treatment of patients with severe burns potentially increases the energy intake at early stage and improves APACHE â…¡ score and prealbumin level on POD 28, without increasing frequencies of adverse reactions.
[Mh] Termos MeSH primário: Queimaduras/terapia
Ingestão de Energia/fisiologia
Nutrição Enteral
Nutrição Parenteral
[Mh] Termos MeSH secundário: Seres Humanos
Tempo de Internação
Cuidados Pós-Operatórios
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2018.01.008


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[PMID]:29489656
[Au] Autor:Shang Q; Geng Q; Zhang X; Xu H; Guo C
[Ad] Endereço:Department of Pathology, Linyi People's Hospital, Linyi, Shandong province.
[Ti] Título:The impact of early enteral nutrition on pediatric patients undergoing gastrointestinal anastomosis a propensity score matching analysis.
[So] Source:Medicine (Baltimore);97(9):e0045, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study was conducted to assess the clinical advantages of early enteral nutrition (EEN) in pediatric patients who underwent surgery with gastrointestinal (GI) anastomosis.EEN has been associated with clinical benefits in various aspect of surgical intervention, including GI function recovery and postoperative complications reduction. Evaluable data documenting clinical advantages with EEN for pediatric patients after surgery with GI anastomosis are limited.We retrospectively reviewed the medical records of 575 pediatric patients undergoing surgical intervention with GI anastomosis. Among them, 278 cases were managed with EEN and the remaining cases were set as late enteral nutrition (LEN) group. Propensity score (PS) matching was conducted to adjust biases in patient selection. Enteral feeding related complications were evaluated with symptoms, including serum electrolyte abnormalities, abdominal distention, abdominal cramps, and diarrhea. Clinical outcomes, including GI function recovery, postoperative complications, length of hospital stay, and postoperative follow-up, were assessed according to EEN or LEN.Following PS matching, the baseline variables of the 2 groups were more comparable. There were no differences in the incidence of enteral feeding-related complications. EEN was associated with postoperative GI function recovery, including time to first defecation (3.1 ±â€Š1.4 days for EEN vs 3.8 ±â€Š1.0 days for LEN, risk ratio [RR], 0.62; 95% confidence interval [CI] 0.43-1.08, P = .042). A lower total episodes of complication, including infectious complications and major complications were noted in patients with EEN than in patients with LEN (117 [45.9%] vs 137 [53.7%]; OR, 0.73, 95% CI 0.52-1.03, P = .046). Mean postoperative length of stay in the EEN group was 7.4 ±â€Š1.8 days versus 9.2 ±â€Š1.4 days in the LEN group (P = .007). Furthermore, the incidence of adhesive small bowel obstruction was lower for patients with laxative administration compared with control, but no significant difference was attained (P = .092)EEN was safe and associated with clinical benefits, including shorten hospital stay, and reduced overall postoperative complications on pediatric patients undergoing GI anastomosis.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Digestório
Nutrição Enteral
Cuidados Pós-Operatórios
[Mh] Termos MeSH secundário: Anastomose Cirúrgica/efeitos adversos
Pré-Escolar
Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos
Nutrição Enteral/efeitos adversos
Feminino
Seguimentos
Seres Humanos
Perfuração Intestinal/cirurgia
Intestinos/cirurgia
Tempo de Internação
Masculino
Cuidados Pós-Operatórios/efeitos adversos
Complicações Pós-Operatórias
Pontuação de Propensão
Recidiva
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010045


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[PMID]:28460456
[Au] Autor:Tong Y; Li Z; Liang Y; Yu H; Liang X; Liu H; Cai X
[Ad] Endereço:Medical College of Zhejiang University, Hangzhou, China.
[Ti] Título:Postoperative adjuvant TACE for patients of hepatocellular carcinoma in AJCC stage I: friend or foe? a propensity score analysis.
[So] Source:Oncotarget;8(16):26671-26678, 2017 Apr 18.
[Is] ISSN:1949-2553
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although the transcatheter arterial chemoembolization (TACE) was demonstrated to be an alternative treatment of hepatocellular carcinoma with favorable oncological effect, the benefit of postoperative adjuvant TACE was still controversial. The aim of this study was to evaluate the effect of postoperative TACE in hepatocellular carcinoma. RESULTS: The 1, 3, and 5-year overall and disease-free survival rates were comparable between Surgery+TACE and Surgery groups. In subgroup analysis, tumor size (≥ 5 cm) was detrimental to disease-free survival (p = 0.028) and an inferior tendency of overall survival was presented. Besides, repeated TACE for patients contributed to a poor disease-free survival (p = 0.005). While, postoperative adjuvant TACE improved the overall survival in patients with high preoperative alpha-fetoprotein or positive pathologically (p = 0.039 and p = 0.045). MATERIALS AND METHODS: The data were collected from consecutive patients between January 2010 and September 2014. After propensity score matching, baseline characteristics, overall and disease-free survival were compared between two groups. Subsequently, univariate and subgroup analysis were carried on. CONCLUSIONS: Our study indicated that single postoperative adjuvant TACE was beneficial for selected patients of stage I with tumor less than 5 cm, or high preoperative alpha-fetoprotein in serum or positive of alpha-fetoprotein pathologically.
[Mh] Termos MeSH primário: Carcinoma Hepatocelular/patologia
Carcinoma Hepatocelular/terapia
Quimioembolização Terapêutica/métodos
Neoplasias Hepáticas/patologia
Neoplasias Hepáticas/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Biomarcadores
Carcinoma Hepatocelular/mortalidade
Feminino
Seres Humanos
Neoplasias Hepáticas/mortalidade
Masculino
Meia-Idade
Estadiamento de Neoplasias
Cuidados Pós-Operatórios
Análise de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.18632/oncotarget.15793


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[PMID]:29465538
[Au] Autor:Liu F; Wang W; Wang C; Peng X
[Ad] Endereço:Department of Pharmacy.
[Ti] Título:Enhanced recovery after surgery (ERAS) programs for esophagectomy protocol for a systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);97(8):e0016, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Esophageal cancer is one of the worst malignant digestive neoplasms with poor treatment outcomes. Esophagectomy plays an important role and offers a potential curable chance to these patients. However, esophagectomy with radical lymphadenectomy is known as one of the most invasive digestive surgeries which are associated with high morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition, and psychology, which is designed for reducing complications, promoting recovery, and improving treatment outcomes. This systematic review and meta-analysis is aiming at how beneficial, and to what extent ERAS really will be. METHODS: A systematic literature search will be performed through January 2018 using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Google Scholar for relevant articles published in any language. Randomized controlled trials, prospective cohort studies, and propensity-matched comparative studies will be included. All meta-analyses will be performed using Review Manager software. The quality of the studies will be evaluated using the guidelines listed in the Cochrane Handbook. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements will be followed until the findings of the systematic review and meta-analysis are reported. RESULTS: The results of this systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION: Our study will draw an objective conclusion of the comparisons between ERAS and conventional care in aspects of perioperative outcomes and provide level I evidences for clinical decision makings.
[Mh] Termos MeSH primário: Neoplasias Esofágicas/cirurgia
Esofagectomia/reabilitação
Cuidados Pós-Operatórios/métodos
Complicações Pós-Operatórias/reabilitação
[Mh] Termos MeSH secundário: Protocolos Clínicos
Esofagectomia/efeitos adversos
Feminino
Seres Humanos
Masculino
Complicações Pós-Operatórias/etiologia
Recuperação de Função Fisiológica
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010016


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[PMID]:29452657
[Au] Autor:Beylot C; Raimbault-Gerard C
[Ad] Endereço:Professeur Emérite de l'Université de Bordeaux. Electronic address: clairebeylot@orange.fr.
[Ti] Título:[Post-inflammatory hyperpigmentation occuring after cosmetic procedures].
[Ti] Título:Les hyperpigmentations post-inflammatoires succédant à des actes esthétiques..
[So] Source:Ann Dermatol Venereol;143 Suppl 2:S33-S42, 2016 Dec.
[Is] ISSN:0151-9638
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:A post-inflammatory hyperpigmentation (PIHP) can occur after cosmetic procedures such as chemical peels and lasers. Patients must be informed about this risk. Precautionary measures before, during and after the procedure can prevent or reduce the risk of PIHP. These procedures should not be done in summer on suntanned skin and patients have to be aware of the importance of an effective photoprotection. The PIHP occurs more frequently on dark-skinned patients, in Asians as well as in women with melasma history. In these cases, risk/benefit assessment of the cosmetic procedure is required: no risky procedure in patients at risk! PIHP can also be related to technical errors such as too high concentration or too long exposure time during peel procedure as well as excessive threshold fluences during laser procedure. If many therapies for PIHP damages can be proposed, patients feel frequently that they are not as quickly effective as they would like. Patients must be reassured as many PIHP resolve spontaneously. If photoprotection is always required, it is also possible to accelerate the pigmentation's clearing using the Kligman trio or the numerous topical lightening agents targeting several steps of the hyperpigmentation process. More invasive and expensive therapies such as peels, lasers, IPL or radiofrequency might be used for refractory cases. As a pigmentary relapse might occur after these procedures, the traditional Kligman trio should be always considered.
[Mh] Termos MeSH primário: Técnicas Cosméticas/efeitos adversos
Hiperpigmentação/fisiopatologia
Inflamação/prevenção & controle
Inflamação/fisiopatologia
Complicações Pós-Operatórias/prevenção & controle
Complicações Pós-Operatórias/fisiopatologia
[Mh] Termos MeSH secundário: Hiperpigmentação/prevenção & controle
Educação de Pacientes como Assunto
Cuidados Pós-Operatórios/métodos
Fatores de Risco
Pele/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180218
[St] Status:MEDLINE


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[PMID]:29452656
[Au] Autor:Cartier H; Mazer JM
[Ad] Endereço:Groupe Laser de la Société française de dermatologie.
[Ti] Título:[Optimization of the healing process after laser procedure, except photorejuvenation].
[Ti] Título:Optimisation et gestion de la cicatrisation après acte laser, en dehors du photo-rajeunissement..
[So] Source:Ann Dermatol Venereol;143 Suppl 2:S26-S32, 2016 Dec.
[Is] ISSN:0151-9638
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:The use of Lasers in dermatology implies a crucial follow-up in order to optimize the final result and avoid any side effects. With the use of ablative laser devices, the initial phase is characterized by the development of crusts. These crusts necessitate the application of sterile ointments (regularly repeated throughout the day) as well as an antibiotic ointment two times a day. In a second step, comes a secondary inflammatory state, in the dermis, which is generally observed at the outset of all other laser treatments. The main purpose is to avoid it from being too sustained over time, but also to prevent the occurrence of post inflammatory hyperpigmentation. Obviously, a solar eviction will be strongly recommended. The risk being maximized with dark phototypes, the choice of the Laser, as well as its specific parameters will be specific and decisive.
[Mh] Termos MeSH primário: Cicatriz/prevenção & controle
Terapia a Laser/efeitos adversos
Complicações Pós-Operatórias/prevenção & controle
Dermatopatias/cirurgia
Cicatrização/fisiologia
[Mh] Termos MeSH secundário: Seres Humanos
Hiperpigmentação/prevenção & controle
Cuidados Pós-Operatórios/métodos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180218
[St] Status:MEDLINE


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[PMID]:29169593
[Au] Autor:Tosti R; Eberlin KR
[Ad] Endereço:Department of Orthopedic Surgery, The Philadelphia Hand Center, Sidney Kimmel Medical College, Thomas Jefferson University, 834 Chestnut Street Suite G114, Philadelphia, PA 19107, USA.
[Ti] Título:"Damage Control" Hand Surgery: Evaluation and Emergency Management of the Mangled Hand.
[So] Source:Hand Clin;34(1):17-26, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Mangled hand injuries are defined as those with significant damage to multiple structures, which may be limb threatening. Historically these injuries resulted in amputation or death, but modern surgical and perioperative advances allow for complex reconstruction and the possibility of a sensate and functional limb. Evaluation begins with surveying for life-threatening injuries followed by a systematic approach to identify injured structures; management begins with preserving all parts, minimizing warm ischemia time, performing débridement, and planning an operative approach to optimize the chance of a functional limb. With careful surgical planning and a well-executed reconstruction, most limbs can be salvaged.
[Mh] Termos MeSH primário: Traumatismos da Mão/cirurgia
[Mh] Termos MeSH secundário: Amputação
Antibacterianos/uso terapêutico
Medicina de Emergência
Seres Humanos
Traumatismos dos Nervos Periféricos/cirurgia
Cuidados Pós-Operatórios
Reimplante
Terapia de Salvação
Retalhos Cirúrgicos
Traumatismos dos Tendões/cirurgia
Lesões do Sistema Vascular/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


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[PMID]:29428034
[Au] Autor:Duchesne J; Majoue C; Duke M; Robledo R; Achord C; McHale L; Davis B; Nahapetyan L
[Ti] Título:Impact of Trauma-Certified Registered Nurse Anesthetists Team on Intra-Operative Resuscitation and Postoperative Outcomes of Trauma Patients.
[So] Source:Am Surg;84(1):93-98, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A Trauma Certified Registered Nurse Anesthetists Team (TCT) was created and trained to provide trauma-focused anesthesia and resuscitation. The purpose of this study was to examine patient outcomes after implementation of TCT. We conducted retrospective analyses of trauma patients managed with surgical intervention from March to December 2015. During the first five months, patients managed before the development of TCT were grouped No-TCT, patients managed after were grouped TCT. To assess outcomes, we used hospital and intensive care unit length of stay, ventilator days, and a validated 10-point intraoperative Apgar score (IOAS). IOAS is calculated using the estimated blood loss, lowest heart rate, and lowest mean arterial pressure during surgery. Higher IOAS are associated with significantly decreased complications and mortality after surgery. We used t test and nonparametric tests for analyses. Fifty two patients were included (mean age 39 years, 75% male; 46.2% managed with TCT). Patients in the No-TCT group had significantly lower use of vasopressors (0.019), lower mean IOAS (P = 0.02), and spent more days on ventilator (P = 0.005) than patients in the TCT. These results suggest that trauma centers should take into consideration implementation of TCT to improve intraoperative and overall outcomes.
[Mh] Termos MeSH primário: Cuidados Intraoperatórios/enfermagem
Enfermeiras Anestesistas
Enfermeiras e Enfermeiros
Cuidados Pós-Operatórios/enfermagem
Ressuscitação/enfermagem
Centros de Traumatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Unidades de Terapia Intensiva
Cuidados Intraoperatórios/mortalidade
Masculino
Meia-Idade
Cuidados Pós-Operatórios/mortalidade
Reprodutibilidade dos Testes
Ressuscitação/mortalidade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE



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