An unidentified organism was found in the stools of 55 immunocompetent patients who presented to CIWEC Clinic Kathmandu, Nepal between June and November 1989. The microscopic features share characteristics both coccidia cyanobacteria species. From 26, 1989 17, 1989, persons were identified as having at least one stool sample. illness characterized by prolonged watery diarrhea, anorexia, fatigue, weight loss. mean ± SD duration 43 24 days (range 4–107). Thirty-four received a total 78 courses...

Children undergoing cardiac surgery with cardiopulmonary bypass are susceptible to additional inflammatory and immunogenic insults from blood transfusions. We hypothesize that washing red cells platelets transfused these patients will reduce postoperative transfusion-related immune modulation inflammation.Prospective, randomized, controlled clinical trial.University hospital pediatric intensive care unit.Children birth 17 yrs bypass.Children were randomized an unwashed or washed platelet...

Hospital readmissions are believed to be an indicator of suboptimal care and the focus efforts by Centers for Medicare Medicaid Services reduce health cost improve quality. Strategies surgical may most effective if applied prospectively patients who at increased risk readmission. Hospitals do not currently have means identify high unplanned rehospitalizations.To examine whether American College Surgeons National Surgical Quality Improvement Program (ACS NSQIP) predicted major complications...

Complications during central venous catheterization (CVC) are not rare and can be serious. The use of ultrasound (US) CVC has been recommended to improve patient safety. We performed a survey evaluate the frequency of, factors influencing, US use.We conducted an electronic all members Society Cardiovascular Anesthesiologists. Univariate multivariate logistic regressions were used assess association between hospital physician factors. All tests two-sided, P value <0.05 was considered...

To examine the impact of a restrictive vs. liberal transfusion strategy on arterial lactate and oxygen content differences in children with single-ventricle physiology post cavopulmonary connection. Children are routinely transfused postoperatively to increase systemic delivery, thresholds this population have not been studied.Prospective, randomized, controlled, clinical trial.Pediatric cardiac intensive care unit teaching hospital.Infants (n = 60) variations presenting for...

To examine the hospital variability in use of red blood cells (RBCs), fresh-frozen plasma (FFP), and platelet transfusions patients undergoing major noncardiac surgery.Blood transfusion is commonly used surgical procedures United States. Little known about perioperative rates for surgery.We University HealthSystem Consortium database (2006-2010) to allogeneic RBC, FFP, surgery. We regression-based techniques quantify practices study association between characteristics likelihood...

One of every 150 hospitalized patients experiences a lethal adverse event; nearly half these events involves surgical patients. Although variations in surgeon performance and quality have been reported the literature, less is known about influence anesthesiologists on outcomes after major surgery. Our goal this study was to determine whether there significant variation between controlling for patient case mix hospital quality.Using clinical data from New York State Cardiac Surgery Reporting...

Abstract Background: Most studies examining the prognostic value of preoperative coagulation testing are too small to examine predictive routine in patients having noncardiac surgery. Methods: Using data from American College Surgeons National Surgical Quality Improvement database, authors performed a retrospective observational study on 316,644 surgery who did not have clinical indications for testing. The used multivariable logistic regression analysis explore association between platelet...

Background: Increasing surgical access to previously underserved populations in the United States may require a major expansion of use operating rooms on weekends take advantage unused capacity. Although so-called weekend effect for surgery has been described other countries, it is unknown whether US patients undergoing moderate-to-high risk are more likely experience worse outcomes than weekdays. Objective: The aim this study was determine die or complication compared with weekday. Research...

Abstract Editor’s Perspective What We Already Know about This Topic Article Tells Us That Is New Background The 2014 American College of Cardiology Perioperative Guideline recommends risk stratifying patients scheduled to undergo noncardiac surgery using either: (1) the Revised Cardiac Index; (2) Surgeons National Surgical Quality Improvement Program Risk Calculator; or (3) Myocardial Infarction Arrest calculator. aim this study is determine how often these three risk-prediction tools agree...

<h3>Importance</h3> Perioperative strokes are a major cause of death and disability. There is limited information on which to base decisions for how long delay elective nonneurologic, noncardiac surgery in patients with history stroke. <h3>Objective</h3> To examine whether an association exists between the time elapsed since ischemic stroke risk recurrent older undergoing surgery. <h3>Design, Setting, Participants</h3> This cohort study used data from 100% Medicare Provider Analysis Review...

Infants and children undergoing open heart surgery routinely require multiple RBC transfusions. Children receiving greater numbers of transfusions have increased postoperative complications mortality. Longer storage age is also associated with morbidity mortality in critically ill children. Whether the association worse outcomes can be ameliorated by use fresh RBCs pediatric cardiac for congenital disease unknown.One hundred twenty-eight consecutively transfused repair or palliation...

To assess patient and provider perspectives on the potential value use of a bilingual portal in large safety-net health system serving predominantly Spanish-speaking patients.We captured through administration surveys to Internet access, barriers, facilitators adoption, along with preferences. We report these survey results using descriptive comparative statistics.Four hundred patients (82% response rate) 59 providers (80% participated study. Although 73% believed that would increase...

Racial minority groups account for 70% of excess deaths not related to COVID-19. Understanding the association Centers Medicare & Medicaid Services' (CMS's) moratorium delaying nonessential operations with racial disparities will help shape future pandemic responses.

Background The opioid meperidine induces spinal anesthesia and blocks nerve action potentials, suggesting it is a local anesthetic. However, whether produces effective clinical in peripheral nerves remains unclear. Classification as anesthetic requires but also blockade of voltage-dependent Na+ channels with characteristic features (tonic phasic negative shift the voltage-dependence steady-state inactivation) involving an intrapore receptor. authors tested for these molecular pharmacologic...

Racial disparities in healthcare the United States are widespread and have been well documented. However, it is unknown whether racial exist use of blood transfusion for patients undergoing major surgery. We used University HealthSystem Consortium database (2009-2011) to examine perioperative red cells (RBCs) coronary artery bypass surgery (CABG), total hip replacement (THR), colectomy. estimated multivariable logistic regressions black more likely than white receive RBC transfusion,...

Antifibrinolytic medications such as ε-aminocaproic acid (EACA) are used in pediatric heart surgery to decrease surgical bleeding and transfusion. Dosing schemes for neonates often based on adult regimens, or simply empiric, part due the lack of neonatal pharmacokinetic information. The authors sought determine pharmacokinetics EACA undergoing cardiac devise a dosing regimen this population.Ten with cardiopulmonary bypass were given according standard practice, blood was drawn at 10 time...

In creating the Merit-Based Incentive Payment System, Congress has mandated pay-for-performance (P4P) for all physicians, including anesthesiologists. There are currently no National Quality Forum-endorsed risk-adjusted outcome metrics anesthesiologists to use as basis P4P.Using clinical data from New York State Cardiac Surgery Reporting we conducted a retrospective observational study of 55,436 patients undergoing cardiac surgery between 2009 and 2012. Hierarchical logistic regression...

Importance Whether people from racial and ethnic minority groups experience disparities in access to minimally invasive mitral valve surgery (MIMVS) is not known. Objective To investigate the utilization of MIMVS. Design, Setting, Participants This cross-sectional study used data Society Thoracic Surgeons Database for patients who underwent between 2014 2019. Statistical analysis was performed January 24 August 11, 2022. Exposures Patients were categorized as non-Hispanic White, Black,...