Articles: cations.
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Whole blood transfusion is associated with benefits including improved survival, coagulopathy, and decreased transfusion requirements. The majority of whole blood transfusion is in the form of low-titer O-positive whole blood (LTOWB). Practice at many trauma centers withholds the use of LTOWB in women of childbearing potential due to concerns of alloimmunization. The purpose of this article is to review the evidence for LTOWB transfusion in female trauma patients and generate guidelines for its application. ⋯ The use of whole blood resuscitation in trauma is associated with benefits in the resuscitation of severely injured patients. The rate at which severely injured, Rh-negative patients develop anti-D antibodies is low. Treatments for alloimmunized pregnancies have advanced, with excellent results. Fears of alloimmunization in female patients are likely overstated and may not warrant the withholding of whole blood resuscitation. The benefits of whole blood resuscitation likely outweigh the risks of alloimmunization.
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Randomized Controlled Trial
The effectiveness of telerehabilitation-based exercise combined with pain neuroscience education for patients with facet joint arthrosis: A randomized controlled study.
This study aimed to investigate the short-term effectiveness of exercise combined with PNE and exercise alone via telerehabilitation for patients with low back pain (LBP) caused by facet joint arthrosis (FJA). ⋯ This study highlights that combining exercise with PNE can lead to greater improvements compared to exercise alone or no intervention for FJA patients. The implementation of PNE in physiotherapy sessions has the potential to offer significant benefits. Furthermore, our results highlight the promising role of telerehabilitation as an effective method for delivering interventions to individuals with FJA.
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Multicenter Study
Gender Differences in Procedural Clinical Complications and Outcomes of Intracranial Aneurysms: Analysis of the Stroke Thrombectomy and Aneurysm Registry.
Some studies have shown that female patients had a poorer prognosis after endovascular treatment for ruptured intracranial aneurysm than male patients. However, data have been sparse regarding differences in the periprocedural and perioperative complication rate with ruptured and unruptured intracranial aneurysms. ⋯ This large multicenter registry of patients undergoing intracranial aneurysm treatment found that female patients were not at increased risk of perioperative complications.
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Randomized Controlled Trial
Goal-directed Perioperative Albumin Substitution Versus Standard of Care to Reduce Postoperative Complications - A Randomized Clinical Trial (SuperAdd Trial).
To investigate whether goal-directed albumin substitution during surgery and postanesthesia care to maintain a serum albumin concentration >30 g/L can reduce postoperative complications. ⋯ Maintaining serum albumin concentration of >30 g/L perioperatively cannot generally be recommended in high-risk noncardiac surgery patients.
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J. Cardiothorac. Vasc. Anesth. · Mar 2024
ReviewPractical Considerations for Obtaining Perioperative Transesophageal Echocardiography Accreditation: Collective Experiences at Early-Adopting Centers.
The Intersocietal Accreditation Commission (IAC) is a nonprofit accrediting organization committed to ensuring the quality of diagnostic imaging and related procedures. It comprises a collaboration of stakeholders spanning numerous medical professionals and specialties. In a recent initiative, IAC Echocardiography introduced a new accreditation specifically for Perioperative Transesophageal Echocardiography (PTE). ⋯ Mirroring the IAC Standards and Guidelines for PTE accreditation, this review is divided into three pivotal sections as follows: (1) organization of a perioperative echocardiography service, including stakeholder engagement to facilitate the application for accreditation; (2) performance of examinations and reporting; and (3) instituting quality improvement strategies and establishing a robust program. The pursuit of accreditation in PTE is to transcend a mere compliance exercise. It signifies a dedication to excellence, continual growth, and, above all, to the well-being of patients.