Vascular Disease Management’s Post

🔍 Outcomes of Task Sharing in Elective Inguinal Hernia Repair: A Randomized Clinical Trial in Sierra Leone 🔍 Can associate clinicians (ACs) perform elective surgical procedures with outcomes comparable to medical doctors (MDs)? A randomized clinical trial sheds light on this important question for low-resource settings. The study, conducted by Thomas Ashley, Hannah Ashley, Andreas Wladis, Håkon Bolkan, Alex van Duinen, JESSICA BEARD, Hertta Kalsi, Juuli Palmu, Pär Nordin, Kristina Holm, Michael Ohene-Yeboah, Jenny Löfgren, compared elective inguinal hernia repairs performed by MDs and ACs in Sierra Leone. Key findings include: ▷Safety and Effectiveness: ACs, trained for 2 years in surgery, showed similar or better outcomes than MDs in hernia recurrence rates at 1 year post-operation. ▷Low Recurrence Rates: 6.9% for MDs vs. 0.9% for ACs. ▷Implications for Task Sharing: This evidence supports optimizing surgical training programs for nonsurgeons to enhance surgical capacity in low- and middle-income countries. Read the full article for more insights and earn 1.0 CME credit! 🌟 https://lnkd.in/dgD282EU #GlobalHealth #SurgicalTraining #TaskSharing #MedicalEducation #PhysicianInsights #ClinicalResearch #CME #HerniaRepair #LowResourceSettings #DoctorsUpdate

🚑 Insightful Study on Interhospital Transfers in Emergency General Surgery 🚑 A comprehensive study conducted by Cindy Y Teng, Billie S Davis, Matthew Rosengart, Kathleen M Carley, Jeremy Kahn sheds light on the patterns and factors associated with interhospital transfers among patients with emergency general surgery (EGS) conditions. Findings: Hospitals with higher resources and EGS volumes tend to receive more incoming transfers but aren't necessarily linked to better clinical outcomes. This raises important questions about how hospitals are selected for transfers and the potential for improving patient outcomes by optimizing these networks. 🔍 Dive deeper into the study to learn more about the dynamics of hospital transfer networks and their impact on patient care. Earn 1.0 #CME credit by engaging with this research. https://lnkd.in/dQKC_qAg #HealthcareManagement #EmergencyMedicine #HospitalNetwork #MedicalResearch

A Great SYSTEM is better than Great People But, you need great people to set up the system. If you want to be truly successful, you will probably need both. Over the years, I have seen bad systems slow down, good people. For example, if you work for a hospital and you have a separate recovery area that is shared with the different department, your patients don't come first. When I worked in a  community hospital in the university system, for arterial sticks or kyphoplasties we had to have our patients use same day surgery staff to recover the patient because radiology nursing didn't have the infrastructure. What we found was because of this process it was hard to get our patients started on time and discharged without some sort of pain. Since we did so few of these as outpatients the same day surgery staff put no priority on getting our patients ready. IR and SDS are on different floors and there was no one to hold them accountable if they were late with our patients, unlike their OR patients. The only way to fix this problem is to create a system that prioritizes our patients, and makes it easy for the other party. We eventually worked out a system that had us calling for the patients sooner and we would start the IV ourselves if they had any troubles. We made it so simple for them by taking ownership of all the challenges that could prevent patients from getting to us. And for the discharge, we worked with their team to develop an order set that our physicians could put in to eliminate 90% of the calls we receive. What I learned in this process was that most people want to do a good job but if there's no consequence to their action, it is easy to let things fall through the cracks. We made a process that made it easier to do the right thing. To fix a system problem, it takes an engaged employee who is supported by management to correct the problem. I have a few more examples of how I created systems that I will share in future posts. Happy New Year. Society of Interventional Oncology Society of Interventional Radiology Society for Vascular Surgery CVIR Endovascular OEIS Society Association of Vascular and Interventional Radiographers Chas Sanders

How Are Patients Choosing Ambulatory Surgery Centers? Ambulatory surgery centers, or ASCs for short, are becoming attractive options for common outpatient procedures, with patient reviews and satisfaction scores as one of the main ways people choose where to go. https://lnkd.in/ewBf5rhR

From the Cardiovascular Ambulatory Surgery Center (ASC) Topic Center: 4 Things to Consider in 2024 as You Implement Your Cardiovascular Outmigration Strategy Marc Toth, Market President, Cardiovascular Services, Atlas Healthcare Partners, Phoenix, Arizona https://okt.to/odhZlr

#BiomedicalResearch #DigitalHealth "Revolutionizing Abdominal Surgery: Digital Health Interventions Enhance Patient Safety" #DigitalHealth is usually linked to medical practice more than surgery but this recent metanalysis in JAMA open highlights how #digitalhealth interventions can improve the #surgery outcomes. "Digital Health Interventions and Patient Safety in Abdominal Surgery: A Systematic Review and Meta-Analysis": Authors: Artem Grygorian, MD; Diego Montano, PhD; Mahdieh Shojaa, PhD; Maximilian Ferencak, MSc; Norbert Schmitz, PhD.  - Published In: JAMA Network Open, April 2024. - Volume: 7 - Issue: 4 - Article DOI:10.1001/jamanetworkopen.2024.8555  - Key Focus: Objective: The study aims to evaluate the effectiveness of digital health interventions (DHIs) in improving patient safety outcomes in abdominal surgery. Methods:  A systematic review and meta-analysis were conducted, likely involving a comprehensive search of databases and the inclusion of relevant studies that met the criteria. Results: ·       DHIs showed promise in enhancing patient monitoring post-surgery. ·       There was a noted improvement in patient outcomes and a reduction in postoperative complications. ·       Digital tools were effective in providing continuous care and support to patients during the recovery phase. Conclusion: The study concludes that DHIs can play a significant role in improving patient safety in abdominal surgery, suggesting a potential shift towards integrating digital solutions in surgical care practices. Implications for Practice: ·       The findings support the adoption of digital tools for postoperative care. - Healthcare providers may consider implementing DHIs to monitor patient recovery and reduce the risk of complications. ·       Further research and development of DHIs could lead to better patient outcomes and more efficient healthcare delivery. #DigitalHealth - #PatientSafety - #AbdominalSurgery - #HealthcareTech - #JAMANetworkOpen Ahmed-digital doc- Otokiti MD, MBA, MPH Christine Jacob 👩🏻💻 Umer Khan M. Alister Martin Jan Beger

From the Cardiovascular Ambulatory Surgery Center (ASC) Topic Center: 4 Things to Consider in 2024 as You Implement Your Cardiovascular Outmigration Strategy Marc Toth, Market President, Cardiovascular Services, Atlas Healthcare Partners, Phoenix, Arizona https://okt.to/1g3lZC

Can resistance prehabilitation training bring additional benefits in valvular cardiac surgery? protocol for a randomized controlled trial Resistance Prehabilitation in Valvular Cardiac Surgery: A Clinical Trial Protocol Introduction Cardiovascular diseases (CVD) often require major surgery for treatment. Fast-track rehabilitation programs have shown promise in reducing postoperative complications and hospital stays. This study aims to assess whether adding resistance training (RT) to cardiac exercise-based prehabilitation can decrease intensive care unit (ICU) length of stay, postoperative complications, and overall hospital length of stay (LOS). Methods The prospective, parallel, randomized clinical trial will include 96 adult patients scheduled for valvular pathology surgery. Participants will be randomly assigned to two groups: a control group receiving ventilatory and respiratory muscle strengthening, and aerobic exercise, and an experimental group receiving additional RT for peripheral muscles. Main variables assessed will include hospital and ICU stays, along with secondary variables such as exercise capacity, quality of life, and respiratory values. Quantitative variables will be analyzed using T-Test, ANOVA, or Mann-Whitney tests. Results and Conclusion This study will be the first to focus on adding strength exercise to prehabilitation for valvular cardiac surgery. The results aim to improve rehabilitation and prehabilitation protocols, emphasizing the importance of maintaining pulmonary training and including peripheral exercises to enhance physical condition and quality of life for individuals with heart disease. Clinical Trial Impact Clinical trials are essential for advancing safe and effective treatments. Our AI-driven platform, DocSym, consolidates ICD-11 standards, clinical protocols, and research, providing a comprehensive knowledge base for clinicians. Additionally, our mobile apps support scheduling, treatment monitoring, and telemedicine, streamlining operations and expanding digital services for improved patient care and outcomes. Discover how AI can enhance clinic workflows and patient outcomes at aidevmd.com. https://lnkd.in/gJPxJnDy #ClinicalTrials #AIinHealthcare #MedicalAI #HealthTech #DigitalHealth #PatientCareAI #AIResearch #MedicalInnovation #BioTech #AIforGood #HealthcareData #AIinMedicine #PharmaAI #ClinicalData #HealthAI #AIHealthSolutions #PrecisionMedicine #AIandHealth #ClinicalAnalytics #AIDiagnostics

JIM│ Association between hyperglycemia at ICU admission and postoperative acute kidney injury in patients undergoing cardiac surgery: Analysis of the MIMIC-IV database Author: Juan Ruan, Weipeng Huang, Jun Jiang, Chang Hu, Yiming Li, Zhiyong Peng, Shuhan Cai Link: https://buff.ly/3A6zPT5 #Hyperglycemia #CardiacSurgery #AKI #Mortality #MIMIC database Acute kidney injury (AKI) is one of the most common complications after cardiac surgery. Recent studies have reported an 8% mortality rate in patients undergoing cardiac surgery and a 60% or higher mortality rate in patients with postoperative complications of AKI .Therefore, early recognition and prevention of cardiac surgery-related AKI is essential to improve patient prognosis. Blood glucose is a simple and easy ICU indicator. Abnormalities of blood glucose often occur in critically ill patients. Hyperglycemia is associated with mortality in critically ill patients. Postoperative hyperglycemia is associated with poor outcomes after cardiac surgery. However, uncertainty remains regarding the relationship between postoperative hyperglycemia and the occurrence of AKI in patients after cardiac surgery. Therefore, we conducted a retrospective cohort study based on an extensive and publicly available database:Medical Information Marketplace for Intensive Care IV (MIMIC-IV). Our main objectives were to investigate the correlation between ICU admission hyperglycemia and the incidence of AKI within seven days in the ICU in patients after cardiac surgery and to explore the optimal glycemic range for patients admitted to the ICU after cardiac surgery.

Thrombosis prophylaxis in critical care patients: VTE incidence in critical care : (10-90%)depending on method of diagnosis: 1- clinical 2-ultrasound 3-Autopsy High incidence of VTE in ICU are related to : 1- Preadmission causes and 2-on admission ##preadmission : Recent high risk surgery Sepsis Trauma Stroke Advanced age Previous DVT /PE Cardiorespiratory failure ##on admission : Immobilisation Mechanical ventilation Sepsis Central venous line and other invasive procedures Renal insufficiency Evidence supporting thrombosis prophylaxis in critically ill patients are influenced by : 1- small number of studies 2-definition of critically ill : Medical Surgical Organ failure Need close monitoring Advanced clinical support Pharmacological prophylaxis has wide variety protocols: 1- timing of the first dose 2- dosing schedule 3-the need to adjust the dose 4- the need to combination of mechanical prophylaxis Heparin (LMWH) Considered the first drug in many guidelines because it doesn't influence the major bleeding in critically ill patients Another recommended drugs maybe used according to benefit/harm Another issue is antithrombotic prophylaxis according to patients education programme: How to detect early signs and symptoms of DVT after discharge.