بایگانی برچسب برای: Surgical

Surgical.Patient.Care.Improving.Safety.Quality.and.Value.[taliem.ir]

Surgical Patient Care

The ability of healthcare to save and extend life and improve the quality of life for the ill is a testament to the success of human competencies, technology and scientifc inquiry. Perhaps as a result, most healthcare systems are challenged by issues of access, quality, and cost. Although most institutions and systems provide safe and effective care for the vast majority of patients most of the time, unwanted variation in quality and safety is common . The causes for this are many and not always well understood but, in general ,they result from an increasingly complex healthcare environment, rapidly exploding medical knowledge; poor evidence for the treatments available; and an overreliance on subjective judgment . A RAND Corporation analysis highlights opportunities to improve the healthcare system in which some people receive more care than they need and others receive less, and yet others get little access to care. In this study, approximately 50% of those seeking healthcare received the recommended preventive care. For acute care, 70% received the recommended treatment and 30% of patients received contraindicated care. For chronic diseases, 60% of patients received the recommended care and 20% received contraindicated care. These studies strongly suggest that, too frequently, care delivered in developed countries does not meet professional standards or best practices. In fact, the US healthcare system gets it .“right” only 55% of the time.
Surgical.Principles.of.Minimally.Invasive.Procedures.[taliem.ir]

Surgical Principles of Minimally Invasive Procedures

Ergonomics” can be defned as the scientifc study of people at work, applying biological and engineering information to the operating room layout and personnel (including the patient) in a system approach taking into account the anatomic, physiologic, and psychological variabilities of the people who work within the given environment. The goal of ergonomics is to enhance effectiveness and effciency in the man–machine interaction while reducing surgeon discomfort, fatigue and errors, and, ultimately, increasing patient safety. In contrast to conventional “open” surgery, the surgeon performs laparoscopic operations with instruments fxed by a fulcrum point via the trocar inserted into the body wall of the cavity of interest. Loss of depth perception (in twodimensional screens), impaired peripheral vision, decoupling of the visual and motor axes and the need to unceasingly adapt to ever evolving high technology applications are among the challenges with which surgeons interact with the given environment.
Surgical.Aspects.of.Peritoneal.Dialysis.[taliem.ir]

Surgical Aspects of Peritoneal Dialysis

Approximately 14% of the US adult population (more than 20 million patients) is affected by chronic kidney disease (CKD) . For an individual, lifetime risk of CKD is high; with more than half of US adults aged 30–64 years old likely to develop CKD (Hoerger et al. 2015). CKD progresses in a substantial proportion of these patients to the point of needing some form of RRT. In 2013 alone, 120,000 patients reached End Stage Renal Disease (ESRD), of which 88% of patients started HD, 9% began PD and 2.6% received a preemptive kidney transplant . After a year-by-year rise in ESRD incidence over two decades from 1980 through 2000, it has been roughly stable from 2000 to 2013. Regardless, the prevalence of ESRD in the United States has grown in recent years. As of December 31, 2013, there were more than 660,000 prevalent cases of ESRD in the US- an increase of 3.5% since 2012 and an increase of 68% since 2000 . The vast majority of prevalent ESRD population is undergoing in-center hemodialysis (ICHD).
Bariatric.Surgical.Practice.Guide.Recommendations.2017.[taliem.ir]

Bariatric Surgical Practice Guide

Morbid obesity is becoming a serious public health problem worldwide. In Asian countries, the prevalence has increased many times over in the past few decades. Bariatric surgery has been shown to be the most effective treatment for these patients. The primary goal of bariatric surgery is to reduce the body weight or the body mass index (BMI). However, it is increasingly recognized that this surgery can also help several medical comorbidities associated with obesity such as type 2 diabetes mellitus (T2DM), dyslipidemia, obstructive sleep apnea etc. linical guidelines for bariatric surgery were frst suggested by the NIH (National Institutes of Health) in 1991 and over the past few decades, there have been many modifcations introduced by many national and international societies. BMI cutoff points and co-morbidities are commonly used to defne the indications for bariatric surgery. According to the world health organization (WHO) criteria, BMI cutoffs for obesity in Asian population are lower than the Western countries because obesity associated health risks tend to occur at a lower threshold of BMI in Asians . This aim of this chapter was to review the indications for bariatric surgery from many guidelines worldwide, especially in Asian countries. The discussed guidelines include those by the National Institutes of Health, Asian Pacifc Metabolic and Bariatric Surgery Society, Diabetes Surgery Summit, Obesity Surgery Society of Australia and New Zealand, Asian Consensus Meeting of Metabolic Surgery, Asian Diabetes Surgery Summit, The International Diabetes Federation, The International Federation for the Surgery of Obesity-Asia Pacifc, American Society for Metabolic & Bariatric Surgery and the International Federation for the Surgery of ObesityEuropean guidelines.