Rev Assoc Med Bras
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Multicenter Study Comparative Study
[Impact of a program for venous thromboembolism prophylaxis in hospitalized patients in four hospitals in Salvador].
There is a discrepancy between guideline recommendations and practice of venous thromboembolism (VTE) prophylaxis in hospitals worldwide. ⋯ There is underutilization of VTE prophylaxis in Brazilian hospitals. Strategies based on passive distribution of RAT and educational lectures were not sufficient to improve the practice of prophylaxis, but improved the adequacy of VTE prophylaxis in hospitalized patients.
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This study intends to review the literature on the efficacy, safety and feasibility of lung volume reduction surgery (LVRS) in patients with advanced emphysema. Studies on LVRS from January 1995 to December 2009 were included by using Pubmed (MEDLINE) and Cochrane Library literature in English. Search words such as lung volume reduction surgery or lung reduction surgery, pneumoplasty or reduction pneumoplasty, COPD or chronic obstructive pulmonary disease and surgery, were used. ⋯ Bullous emphysema was excluded from this review. Surgical approach included median sternotomy, unilateral or bilateral thoracotomy, and videothoracoscopy with stapled or laser ablation. Results of prospective randomized trials between medical management and LVRS are essential before final assessment can be established.
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Randomized Controlled Trial
Assessment of postoperative pain and hospital discharge after inguinal and iliohypogastric nerve block for inguinal hernia repair under spinal anesthesia: a prospective study.
This study was designed to evaluate analgesia (pain intensity and analgesic consumption) and the time of discharge of patients who underwent ilioinguinal (II) and iliohypogastric (IH) nerve block associated with wound infiltration with 0.75% ropivacaine, or not, after inguinal hernia repair surgery under spinal anesthesia. ⋯ II and IH nerve block associated with surgical wound infiltration with 0.75% ropivacaine provides better postoperative analgesia and early hospital discharge in patients undergoing inguinal hernia repair under spinal anesthesia.
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Randomized Controlled Trial
Dexmedetomidine in anesthesia of children submitted to videolaparoscopic appendectomy: a double-blind, randomized and placebo-controlled study.
To evaluate the hemodynamic responses to nociceptive stimuli in children submitted to videolaparoscopic appendectomy under balanced anesthesia with isoflurane and dexmedetomidine. ⋯ Dexmedetomidine combined with inhaled isoflurane for anesthesia of children submitted to videolaparoscopic appendectomy, efficiently blocks the hemodynamic responses to nociceptive stimuli. When compared to placebo, the use of dexmedetomidine did not change the need for supplemental doses of fentanyl for maintenance of hemodynamic parameters during the intraoperative period.
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Review Comparative Study
Accreditation or accreditations? A comparative study about accreditation in France, United Kingdom and Cataluña.
This article analyzes the dynamics and changes in the accreditation process in three different places - France, UK and Cataluña (Spain) - based on documents about their health systems organizations, funding sources and regulations. The objective was to find out about the relevant aspects of the strategies of these countries' institutions that adapted accreditation to national circumstances in the healthcare policy arena. ⋯ Interests in accreditation can be driven by a number of different forces, which depend upon the model adopted. Therefore, it can only be understood in the policy arena of each country.