Articles: cations.
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Critical care medicine · Nov 2022
A Multiple Baseline Trial of an Electronic ICU Discharge Summary Tool for Improving Quality of Care.
Effective communication between clinicians is essential for seamless discharge of patients between care settings. Yet, discharge summaries are commonly not available and incomplete. We implemented and evaluated a structured electronic health record-embedded electronic discharge (eDischarge) summary tool for patients discharged from the ICU to a hospital ward. ⋯ Implementation of an electronic tool was associated with more timely and complete discharge summaries for patients discharged from the ICU to a hospital ward.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2022
Review[Caudal Anesthesia: Overview and Practical Recommendations].
Caudal anesthesia is one of the most commonly performed forms of regional anesthesia in childhood, which is relatively easy to learn and very effective. Indications for sacral block are all interventions below the costal arch. The puncture can be performed on premature babies and children up to 50 kg body weight. ⋯ Bupivacaine and ropivacaine can be combined with adjuvants such as clonidine, morphine or ketamine, which lead to a prolonged effect. In selected patient groups, the operation can also be performed under caudal anesthesia with sedation in order to maintain spontaneous breathing and avoid respiratory complications. This review article gives an overview of caudal anesthesia and offers practical instructions for blocks during general anesthesia and sedation.
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Frailty is influential in determining operative outcomes, including complications, in patients with cervical deformity (CD). ⋯ Although frail patients improved more often by 1Y, SF patients achieve most of their clinical improvement between 1 and 2Y. Frailty is associated with factors such as osteoporosis, poor alignment, neurological status, sarcopenia, and other medical comorbidities. Similarly, clinical outcomes can be affected by many factors (fusion status, number of pain generators within treated levels, integrity of soft tissues and bone, and deformity correction). Although accounting for such factors will ultimately determine whether frailty alone is an independent risk factor, these preliminary findings may suggest that frailty status affects the clinical outcomes and improvement after CD surgery.
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To propose a new decision algorithm combining biomarkers measured in a tumor biopsy with clinical variables, to predict recurrence after liver transplantation (LT). ⋯ HepatoPredict outperforms conventional clinical-pathologic selection criteria (Milan, UCSF), providing superior prognostic information. Accurately identifying which patients most likely benefit from LT enables an objective stratification of waiting lists and information-based allocation of optimal versus suboptimal organs.