Articles: postoperative.
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This manuscript proposes pharmacological strategies that might decrease persistent postsurgical pain (PPSP). These recommendations are based on a review of current publications available in the literature. ⋯ A winning strategy to reduce the incidence of PPSP may well involve performing minimally invasive surgery, providing adequate perioperative analgesia based on RA, and using a multimodal approach with NMDA antagonists.
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J. Thorac. Cardiovasc. Surg. · Dec 2015
The effect of obesity on acute kidney injury after cardiac surgery.
Postoperative acute kidney injury is a frequent and serious consequence of cardiac surgery. We undertook to investigate the association of obesity and the risk of acute kidney injury development after cardiac surgery. ⋯ Obesity with body mass index 30 kg/m(2) or greater is independently associated with an increased risk of acute kidney injury after cardiac surgery. Further understanding of the molecular basis of this association is critical to the design of preventative strategies.
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Case Reports
Effectiveness of Postoperative Gamma Knife Radiosurgery to the Tumor Bed after Resection of Brain Metastases.
The role of Gamma knife radiosurgery (GKS) after the resection of brain metastases remains undefined. We evaluated the outcomes of postoperative GKS to the tumor bed after the resection of brain metastasis compared with GKS alone without resection in the same patients. ⋯ For patients with brain metastases treated with surgical resection, postoperative GKS to the resection area is an effective and safe treatment option. Particularly, concurrent postoperative GKS to the surgical cavity with GKS alone for multiple small metastatic lesions is a feasible treatment strategy for multiple brain metastases.
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Obstructive sleep apnea (OSA) prevalence has been increasing in the past years adding significant morbidity. Perioperative management is controversial and few studies have addressed this matter. The American Society of Anesthesiology (ASA) and the American Academy of Sleep Medicine (AASM) have developed clinical practice guidelines for the perioperative management of patients with OSA. Existing evidence suggest an increase in early postoperative complications in patients with OSA. Nevertheless, data about perioperative management of OSA is limited. To our knowledge, only two studies that address this matter, none in Puerto Rico. ⋯ There is a significant heterogeneity in the current clinical practice. The main barriers identified to achieve current recommendations were lack of institutional policies, awareness of current guideline, formal training in management of OSA, and access to a sleep specialist.