• Cutting-Edge Cases Navigating the Complex World of Bariatric Surgery by dr atef ahmed

    https://youtu.be/RV8bPlTQu2w
    https://www.amazon.com/dp/B0CW1GDG3W
    https://youtu.be/RV8bPlTQu2w

    Incisions & Insights (book series)
    https://www.amazon.com/dp/B0CZ7JRHYD

    Telegram group (@no1doctors)
    https://t.me/no1doctors


    #BariatricSurgery #WeightLossJourney #GastricBypass #SleeveGastrectomy #ObesityHelp #WeightLossTransformation #HealthyLiving #LapBand #GastricSleeve #MetabolicSurgery #WLSCommunity #BariatricLife #LoseWeight #BariatricEating #WLSJourney #GastricBalloon #BariatricPatient #WeightLossSupport #WLS #Bariatric #WeightLossGoals #FitnessJourney #Nutrition #HealthyChoices #BariatricCooking #WLSFood #PostOpLife #PreOpDiet #BariatricFitness #WLSNutrition #BariatricJourney #WeightLossSurgery #WLSLife #BariatricSuccess #WLSMeals #BariatricFriendly #WLSRecipes #BariatricTips #WLSCommunitySupport #BariatricWellness #WLSInspiration #BariatricTransformation #WLSMotivation #BariatricHealth #WLSStrength #BariatricAdvice #WLSVictory #BariatricSupport #WLSChallenges #BariatricProgress #WLSSuccess #BariatricSurgerySuccess #WLSBeforeAndAfter #BariatricSurgeryJourney #WLSLifeChanging #BariatricSurgerySupport #WLSPostOp #BariatricSurgeryRecovery #WLSWeightLoss #BariatricSurgeryResults #WLSHealth #BariatricSurgeryLife #WLSRecovery #BariatricSurgeryTransformation #WLSNewLife #BariatricSurgeryCommunity #WLSJourneyToHealth #BariatricSurgeryTips #WLSHealthyLiving #BariatricSurgeryAdvice #WLSLifestyle #BariatricSurgeryNutrition #WLSWeightManagement #BariatricSurgeryWeightLoss #WLSFitness #BariatricSurgeryFitness #WLSMealPlanning #BariatricSurgeryMealPlan #WLSMealPrep #BariatricSurgeryPreOp #WLSPostSurgery #BariatricSurgeryPostOp #WLSRecoveryJourney #BariatricSurgeryRecoveryTips #WLSPostOpDiet #BariatricSurgeryDiet #WLSFoodIdeas #BariatricSurgeryFood #WLSHealthyEating #BariatricSurgeryEating #WLSNutritionTips #BariatricSurgeryNutritionAdvice #WLSExercise #BariatricSurgeryExercise #WLSWorkout #BariatricSurgeryWorkout #WLSHealthyHabits #BariatricSurgeryHealthyLifestyle #WLSCommunityLove #BariatricSurgeryFamily
    Cutting-Edge Cases Navigating the Complex World of Bariatric Surgery by dr atef ahmed https://youtu.be/RV8bPlTQu2w https://www.amazon.com/dp/B0CW1GDG3W https://youtu.be/RV8bPlTQu2w Incisions & Insights (book series) https://www.amazon.com/dp/B0CZ7JRHYD Telegram group (@no1doctors) https://t.me/no1doctors #BariatricSurgery #WeightLossJourney #GastricBypass #SleeveGastrectomy #ObesityHelp #WeightLossTransformation #HealthyLiving #LapBand #GastricSleeve #MetabolicSurgery #WLSCommunity #BariatricLife #LoseWeight #BariatricEating #WLSJourney #GastricBalloon #BariatricPatient #WeightLossSupport #WLS #Bariatric #WeightLossGoals #FitnessJourney #Nutrition #HealthyChoices #BariatricCooking #WLSFood #PostOpLife #PreOpDiet #BariatricFitness #WLSNutrition #BariatricJourney #WeightLossSurgery #WLSLife #BariatricSuccess #WLSMeals #BariatricFriendly #WLSRecipes #BariatricTips #WLSCommunitySupport #BariatricWellness #WLSInspiration #BariatricTransformation #WLSMotivation #BariatricHealth #WLSStrength #BariatricAdvice #WLSVictory #BariatricSupport #WLSChallenges #BariatricProgress #WLSSuccess #BariatricSurgerySuccess #WLSBeforeAndAfter #BariatricSurgeryJourney #WLSLifeChanging #BariatricSurgerySupport #WLSPostOp #BariatricSurgeryRecovery #WLSWeightLoss #BariatricSurgeryResults #WLSHealth #BariatricSurgeryLife #WLSRecovery #BariatricSurgeryTransformation #WLSNewLife #BariatricSurgeryCommunity #WLSJourneyToHealth #BariatricSurgeryTips #WLSHealthyLiving #BariatricSurgeryAdvice #WLSLifestyle #BariatricSurgeryNutrition #WLSWeightManagement #BariatricSurgeryWeightLoss #WLSFitness #BariatricSurgeryFitness #WLSMealPlanning #BariatricSurgeryMealPlan #WLSMealPrep #BariatricSurgeryPreOp #WLSPostSurgery #BariatricSurgeryPostOp #WLSRecoveryJourney #BariatricSurgeryRecoveryTips #WLSPostOpDiet #BariatricSurgeryDiet #WLSFoodIdeas #BariatricSurgeryFood #WLSHealthyEating #BariatricSurgeryEating #WLSNutritionTips #BariatricSurgeryNutritionAdvice #WLSExercise #BariatricSurgeryExercise #WLSWorkout #BariatricSurgeryWorkout #WLSHealthyHabits #BariatricSurgeryHealthyLifestyle #WLSCommunityLove #BariatricSurgeryFamily
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  • Scalpel Chronicles:Surgical Case Scenarios (159 Short surgical cases) By Dr>Atef Ahmed

    https://www.amazon.com/dp/B0CV5G48CV

    https://x.com/DrATEFAHMED/status/1755254814357786859?s=20
    https://www.instagram.com/p/C3DTGk1MzXO/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==
    https://www.threads.net/@dr.atefahmed/post/C3DTjUfMchB

    Embark on an extraordinary journey into the heart of surgery with "Scalpel Chronicles: Surgical Case Scenarios," authored by the esteemed Dr. Atef Ahmed. This masterful book is not just a collection of surgical cases; it is a pivotal work that bridges the gap between theoretical knowledge and real-world surgical practice.

    Dr. Atef Ahmed, with his profound experience and sagacity, brings to life a series of meticulously selected cases, each unveiling the complexities and nuances of modern surgery. From routine procedures to the most challenging operations, this book covers an expansive range of topics, making it an essential read for anyone within the medical field.
    https://www.amazon.com/dp/B0CV5G48CV

    Key Features:
    - In-Depth Case Analysis : Each case is presented with comprehensive details, including patient history, diagnosis, treatment options, fostering a deeper understanding of surgical principles and decision-making.
    - Expert Insight : Dr. Ahmed's insights offer invaluable learning points, reflecting on the successes and challenges encountered in each case.
    - Multidisciplinary Approach : The book emphasizes the importance of a team approach in surgery, incorporating perspectives from various healthcare professionals.
    - Cutting-Edge Surgical Techniques : Stay abreast of the latest advancements and technologies in the field of surgery, as Dr. Ahmed expertly navigates through innovative procedures and techniques.
    - Educational Tool for All Levels : An invaluable resource for medical students, surgical residents, and seasoned surgeons. Each case is a learning opportunity, showcasing the art and science of surgery.

    https://www.amazon.com/dp/B0CV5G48CV

    "Scalpel Chronicles" is more than just a medical book; it's a testament to the art of surgery. It’s an engaging, thought-provoking read that will leave you with a profound appreciation for the complexities of this discipline. Whether you're a budding medical student, a practicing surgeon, or just someone with an interest in the world of surgery, this book offers a unique and captivating perspective.

    Get your copy of "Scalpel Chronicles: Surgical Case Scenarios" and experience the captivating world of surgery through the eyes of a master surgeon. Available now at major bookstores and online platforms. Join Dr. Atef Ahmed on this remarkable surgical odyssey!

    https://www.amazon.com/dp/B0CV5G48CV



    #SurgeryLife #ORLife #ScrubLife #SurgicalSkills #SurgeryDay #PatientCare
    #MedicalCases #ClinicalRotation #MedicalEducation #MedEd #FutureSurgeon
    #MedicalInnovation #SurgicalBreakthroughs #MinimallyInvasiveSurgery #RoboticSurgery
    #HealthcareHeroes #SurgeryTeam #ThankASurgeon #GratefulPatient #SurgicalResults
    #CardiothoracicSurgery #Neurosurgery #Plasticsurgery #Urology #OrthoSurgery
    #GeneralSurgery #Gynecology #Pediatricsurgery #LaparoscopicSurgery #EndoscopicSurgery
    #TraumaSurgery #VascularSurgery #OncologySurgery #Transplantsurgery #SurgicalAnatomy
    #SurgeryFacts #AskASurgeon #SurgeryMythBusters #SurgicalComplications #RecoveryJourney
    #BehindTheMask #ORHumor #SurgeonLife #MedTok #MedTwitter
    #ShareYourStory #InspiringPatients #GratitudeForScience #SurgeryAwareness #MakingADifference

    https://www.amazon.com/dp/B0CV5G48CV

    Surgical case report, clinical presentation, differential diagnosis, preoperative evaluation, surgical approach, intraoperative findings, postoperative care, complications, prognosis, patient outcome.
    Surgical techniques, instruments, anesthesia, sterile technique, teamwork, communication, decision-making.
    Ethical considerations, informed consent, patient safety, resource utilization, evidence-based practice.
    https://www.amazon.com/dp/B0CV5G48CV

    Specific disease processes, anatomical regions, surgical procedures (e.g., appendectomy, laparoscopic cholecystectomy, coronary artery bypass graft).
    Minimally invasive surgery, robotic surgery, advanced surgical technologies.
    Surgical education, residency training, fellowship programs, continuing medical education.
    Global surgery, access to surgical care, disparities in healthcare.

    https://www.amazon.com/dp/B0CV5G48CV

    "Surgical Case Studies Book"
    "Dr. Atef Ahmed Scalpel Chronicles"
    "Real-life Surgery Scenarios Guide"
    "Modern Surgical Techniques and Cases"
    "Comprehensive Surgical Casebook"
    "Medical Professional Surgery Cases"
    "Advanced Surgical Practices and Cases"

    https://www.amazon.com/dp/B0CV5G48CV

    Scalpel Chronicles:Surgical Case Scenarios (159 Short surgical cases) By Dr>Atef Ahmed https://www.amazon.com/dp/B0CV5G48CV https://x.com/DrATEFAHMED/status/1755254814357786859?s=20 https://www.instagram.com/p/C3DTGk1MzXO/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA== https://www.threads.net/@dr.atefahmed/post/C3DTjUfMchB Embark on an extraordinary journey into the heart of surgery with "Scalpel Chronicles: Surgical Case Scenarios," authored by the esteemed Dr. Atef Ahmed. This masterful book is not just a collection of surgical cases; it is a pivotal work that bridges the gap between theoretical knowledge and real-world surgical practice. Dr. Atef Ahmed, with his profound experience and sagacity, brings to life a series of meticulously selected cases, each unveiling the complexities and nuances of modern surgery. From routine procedures to the most challenging operations, this book covers an expansive range of topics, making it an essential read for anyone within the medical field. https://www.amazon.com/dp/B0CV5G48CV Key Features: - In-Depth Case Analysis : Each case is presented with comprehensive details, including patient history, diagnosis, treatment options, fostering a deeper understanding of surgical principles and decision-making. - Expert Insight : Dr. Ahmed's insights offer invaluable learning points, reflecting on the successes and challenges encountered in each case. - Multidisciplinary Approach : The book emphasizes the importance of a team approach in surgery, incorporating perspectives from various healthcare professionals. - Cutting-Edge Surgical Techniques : Stay abreast of the latest advancements and technologies in the field of surgery, as Dr. Ahmed expertly navigates through innovative procedures and techniques. - Educational Tool for All Levels : An invaluable resource for medical students, surgical residents, and seasoned surgeons. Each case is a learning opportunity, showcasing the art and science of surgery. https://www.amazon.com/dp/B0CV5G48CV "Scalpel Chronicles" is more than just a medical book; it's a testament to the art of surgery. It’s an engaging, thought-provoking read that will leave you with a profound appreciation for the complexities of this discipline. Whether you're a budding medical student, a practicing surgeon, or just someone with an interest in the world of surgery, this book offers a unique and captivating perspective. Get your copy of "Scalpel Chronicles: Surgical Case Scenarios" and experience the captivating world of surgery through the eyes of a master surgeon. Available now at major bookstores and online platforms. Join Dr. Atef Ahmed on this remarkable surgical odyssey! https://www.amazon.com/dp/B0CV5G48CV #SurgeryLife #ORLife #ScrubLife #SurgicalSkills #SurgeryDay #PatientCare #MedicalCases #ClinicalRotation #MedicalEducation #MedEd #FutureSurgeon #MedicalInnovation #SurgicalBreakthroughs #MinimallyInvasiveSurgery #RoboticSurgery #HealthcareHeroes #SurgeryTeam #ThankASurgeon #GratefulPatient #SurgicalResults #CardiothoracicSurgery #Neurosurgery #Plasticsurgery #Urology #OrthoSurgery #GeneralSurgery #Gynecology #Pediatricsurgery #LaparoscopicSurgery #EndoscopicSurgery #TraumaSurgery #VascularSurgery #OncologySurgery #Transplantsurgery #SurgicalAnatomy #SurgeryFacts #AskASurgeon #SurgeryMythBusters #SurgicalComplications #RecoveryJourney #BehindTheMask #ORHumor #SurgeonLife #MedTok #MedTwitter #ShareYourStory #InspiringPatients #GratitudeForScience #SurgeryAwareness #MakingADifference https://www.amazon.com/dp/B0CV5G48CV Surgical case report, clinical presentation, differential diagnosis, preoperative evaluation, surgical approach, intraoperative findings, postoperative care, complications, prognosis, patient outcome. Surgical techniques, instruments, anesthesia, sterile technique, teamwork, communication, decision-making. Ethical considerations, informed consent, patient safety, resource utilization, evidence-based practice. https://www.amazon.com/dp/B0CV5G48CV Specific disease processes, anatomical regions, surgical procedures (e.g., appendectomy, laparoscopic cholecystectomy, coronary artery bypass graft). Minimally invasive surgery, robotic surgery, advanced surgical technologies. Surgical education, residency training, fellowship programs, continuing medical education. Global surgery, access to surgical care, disparities in healthcare. https://www.amazon.com/dp/B0CV5G48CV "Surgical Case Studies Book" "Dr. Atef Ahmed Scalpel Chronicles" "Real-life Surgery Scenarios Guide" "Modern Surgical Techniques and Cases" "Comprehensive Surgical Casebook" "Medical Professional Surgery Cases" "Advanced Surgical Practices and Cases" https://www.amazon.com/dp/B0CV5G48CV
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  • 100 Questions and Answers in Anesthesiology for Medical Students


    https://www.amazon.com/dp/B0CSMRY21H
    https://x.com/DrATEFAHMED/status/1748446761734042104?s=20
    https://www.instagram.com/p/C2S7q9Tsi8s/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==




    #anesthesiaawareness
    #anesthesiaresident
    #anesthesiologist
    #painmanagement
    #perioperativemedicine
    #gasdoc
    #intubation
    #airwaymanagement
    #anesthlife
    #regionalanesthesia
    #pedsanesthesia
    #cardiacanesthesia
    #neuroanesthesia
    #obstetricanesthesia
    #opthalmicanesthesia
    #criticalcare
    #operatingroom
    #preop
    #postop
    #sedation
    #chronicpain
    #anesthhumor
    #ANES2024#safesurgery
    #patientcare
    #medstudent
    #futuredoctor
    #medschoollife
    #anatomynerd
    #boardsstudy
    #rotationlife
    #matchday
    #studentdoctor
    #medlife
    #whitecoatwednesday
    #healthcareworker
    #residencymatch
    #USMLE
    #medtwitter
    #medicalhumor
    #clinicalskills
    #dissectionlab
    #patientdoctorrelationship
    #ruralmedicine
    #globalhealth
    #womeninmedicine
    #minoritydoctors
    #doctorsofinstagram
    #medicineforall
    #healtheducation
    100 Questions and Answers in Anesthesiology for Medical Students https://www.amazon.com/dp/B0CSMRY21H https://x.com/DrATEFAHMED/status/1748446761734042104?s=20 https://www.instagram.com/p/C2S7q9Tsi8s/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA== #anesthesiaawareness #anesthesiaresident #anesthesiologist #painmanagement #perioperativemedicine #gasdoc #intubation #airwaymanagement #anesthlife #regionalanesthesia #pedsanesthesia #cardiacanesthesia #neuroanesthesia #obstetricanesthesia #opthalmicanesthesia #criticalcare #operatingroom #preop #postop #sedation #chronicpain #anesthhumor #ANES2024#safesurgery #patientcare #medstudent #futuredoctor #medschoollife #anatomynerd #boardsstudy #rotationlife #matchday #studentdoctor #medlife #whitecoatwednesday #healthcareworker #residencymatch #USMLE #medtwitter #medicalhumor #clinicalskills #dissectionlab #patientdoctorrelationship #ruralmedicine #globalhealth #womeninmedicine #minoritydoctors #doctorsofinstagram #medicineforall #healtheducation
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  • How can we reduce postoperative pain in laparoscopic surgery?
    A: Use of smaller trocars & local anesthesia at the incision site. #LaparoscopicSurgery #PainManagement
    How can we reduce postoperative pain in laparoscopic surgery? A: Use of smaller trocars & local anesthesia at the incision site. #LaparoscopicSurgery #PainManagement
    0 Comments 0 Shares 27047 Views
  • Laparoscopic Cholecystectomy and Appendectomy / Minimally Invasive Surgical Procedures /appendicitis

    https://twitter.com/DrATEFAHMED/status/1663228393943449625?s=20

    https://youtu.be/UpkctHHJf24



    #Laparoscopic #Cholecystectomy #Appendectomy Minimally Invasive #Surgical #Procedures #appendicitis #gallbaldder #choecystitis #lifes1

    In this educational video, we explore the world of laparoscopic surgery and focus on two commonly performed procedures: laparoscopic cholecystectomy (gallbladder removal) and laparoscopic appendectomy (appendix removal). Discover how these minimally invasive techniques have revolutionized the field of surgery, leading to quicker recovery times and reduced postoperative pain. Join us as we delve into the details of these operations, discussing their benefits, risks, and step-by-step procedures. Whether you're a medical professional or simply curious about modern surgical advancements, this video is an excellent resource for understanding these important procedures.
    Laparoscopic Cholecystectomy and Appendectomy / Minimally Invasive Surgical Procedures /appendicitis https://twitter.com/DrATEFAHMED/status/1663228393943449625?s=20 https://youtu.be/UpkctHHJf24 #Laparoscopic #Cholecystectomy #Appendectomy Minimally Invasive #Surgical #Procedures #appendicitis #gallbaldder #choecystitis #lifes1 In this educational video, we explore the world of laparoscopic surgery and focus on two commonly performed procedures: laparoscopic cholecystectomy (gallbladder removal) and laparoscopic appendectomy (appendix removal). Discover how these minimally invasive techniques have revolutionized the field of surgery, leading to quicker recovery times and reduced postoperative pain. Join us as we delve into the details of these operations, discussing their benefits, risks, and step-by-step procedures. Whether you're a medical professional or simply curious about modern surgical advancements, this video is an excellent resource for understanding these important procedures.
    0 Comments 0 Shares 6058 Views
  • A 65-year-old woman with well controlled type 2 diabetes mellitus presents with perforated appendicitis. She is taken to the operating room for exploration, drainage of intraabdominal abscess, and ileocecectomy. She is admitted to the surgical intensive care unit postoperatively in septic shock.
    Overnight, she is resuscitated with 9 L crystalloid. She is now on norepinephrine and vasopressin infusions to keep her mean arterial pressure above 65 mm Hg. On postoperative day 1, she is hypoxic with pulmonary edema on chest x-ray.
    Her serum potassium is 5.9 mmol/L, her serum creatinine increased from 1.5 to 5.4 mg/dL (0.4-1.3 mg/dL), her serum blood urea nitrogen is 60 mg/dL (7-20 mg/dL), her serum bicarbonate is 13 mmol/L (20-29 mmol/L), and her pH is 7.21. Her urine output is 0.3 mL/kg/hour for the last 12 hours.

    What is the next step in managing her renal failure?

    A. Continuous renal replacement therapy
    B. Intermittent hemodialysis
    C. Furosemide 80 mg intravenously
    D. Dopamine infusion
    E. Sodium bicarbonate infusion

    ANSWER: A
    Acute kidney injury in the postoperative period is associated with increased morbidity and mortality. Two classification systems were proposed in the early 2000s: the RIFLE criteria
    and the Acute Kidney Injury Network (AKIN) staging system. These systems provide concise definitions of the extent of injury and prognosis. Both systems consider increases in serum creatinine, either an absolute number or an
    increase from baseline, and urine output criteria. This patient had a marked increase in serum creatinine and has oliguria.
    According to the RIFLE criteria, she has Failure; she is in AKIN stage III.
    Additionally, she is acidemic, with a serum pH of 7.21 and bicarbonate of 13 mmol/L (20-29 mmol/L), and hyperkalemic. She also shows evidence of volume overload with hypoxemia and radiographic evidence of pulmonary
    edema.
    This patient has several indications for renal
    replacement therapy.


    Data regarding the optimal modality and timing of renal replacement therapy are conflicting. However, when patients are hemodynamically abnormal and require vasopressor support, a continuous mode of renal replacement therapy is preferred. Continuous modes require smaller volumes of
    blood to be removed at a time compared with intermittent hemodialysis and are better tolerated in hypotensive patients.
    A sodium bicarbonate infusion is used for patients with acidosis; however, starting a sodium bicarbonate infusion is generally not recommended until the serum pH is less than
    7.15. Also, there are no data confirming any reduction in morbidity and mortality for its use in renal failure.
    Aggressive diuretic therapy used in the early stages of AKI to treat volume overload and hyperkalemia is possible.
    However, once a patient advances to renal failure, renal replacement therapy is the preferred modality of management. Low-dose dopamine infusions were once
    erroneously thought to be renal protective via a mechanism of increased renal blood flow. There are currently no data to support the use of a dopamine infusion as prevention or
    treatment of AKI.
    A 65-year-old woman with well controlled type 2 diabetes mellitus presents with perforated appendicitis. She is taken to the operating room for exploration, drainage of intraabdominal abscess, and ileocecectomy. She is admitted to the surgical intensive care unit postoperatively in septic shock. Overnight, she is resuscitated with 9 L crystalloid. She is now on norepinephrine and vasopressin infusions to keep her mean arterial pressure above 65 mm Hg. On postoperative day 1, she is hypoxic with pulmonary edema on chest x-ray. Her serum potassium is 5.9 mmol/L, her serum creatinine increased from 1.5 to 5.4 mg/dL (0.4-1.3 mg/dL), her serum blood urea nitrogen is 60 mg/dL (7-20 mg/dL), her serum bicarbonate is 13 mmol/L (20-29 mmol/L), and her pH is 7.21. Her urine output is 0.3 mL/kg/hour for the last 12 hours. What is the next step in managing her renal failure? A. Continuous renal replacement therapy B. Intermittent hemodialysis C. Furosemide 80 mg intravenously D. Dopamine infusion E. Sodium bicarbonate infusion ANSWER: A Acute kidney injury in the postoperative period is associated with increased morbidity and mortality. Two classification systems were proposed in the early 2000s: the RIFLE criteria and the Acute Kidney Injury Network (AKIN) staging system. These systems provide concise definitions of the extent of injury and prognosis. Both systems consider increases in serum creatinine, either an absolute number or an increase from baseline, and urine output criteria. This patient had a marked increase in serum creatinine and has oliguria. According to the RIFLE criteria, she has Failure; she is in AKIN stage III. Additionally, she is acidemic, with a serum pH of 7.21 and bicarbonate of 13 mmol/L (20-29 mmol/L), and hyperkalemic. She also shows evidence of volume overload with hypoxemia and radiographic evidence of pulmonary edema. This patient has several indications for renal replacement therapy. Data regarding the optimal modality and timing of renal replacement therapy are conflicting. However, when patients are hemodynamically abnormal and require vasopressor support, a continuous mode of renal replacement therapy is preferred. Continuous modes require smaller volumes of blood to be removed at a time compared with intermittent hemodialysis and are better tolerated in hypotensive patients. A sodium bicarbonate infusion is used for patients with acidosis; however, starting a sodium bicarbonate infusion is generally not recommended until the serum pH is less than 7.15. Also, there are no data confirming any reduction in morbidity and mortality for its use in renal failure. Aggressive diuretic therapy used in the early stages of AKI to treat volume overload and hyperkalemia is possible. However, once a patient advances to renal failure, renal replacement therapy is the preferred modality of management. Low-dose dopamine infusions were once erroneously thought to be renal protective via a mechanism of increased renal blood flow. There are currently no data to support the use of a dopamine infusion as prevention or treatment of AKI.
    0 Comments 0 Shares 10840 Views
  • A 72-year-old woman undergoes an open sigmoid colectomy for colon cancer. Which of the following interventions reduces the incidence of postoperative ileus in this patient?

    A. Methylnaltrexone
    B. Sugar-free chewing gum
    C. Wound infiltration with liposomal bupivacaine
    D. Magnesium citrate
    E. Bisacodyl suppositories

    ANSWER: B

    Enhanced recovery after surgery (ERAS) protocols for patients undergoing colorectal surgery are derived from studies evaluating the efficacy of interventions designed to reduce the morbidity and cost of surgical procedures and
    therefore improve outcomes and value.
    One such intervention, providing sugar-free chewing gum perioperatively, is as a method of sham feeding, with the hope that the mastication motion will promote intestinal motility through the cephalic phase of vagal enteric stimulation.
    The true mechanism is not entirely understood, and a randomized controlled trial of sugared chewing gum did not show abenefit, insinuating that the hexitols in sugar-free gum may
    have a laxative effect and contribute to bowel motility. A meta-analysis summarizing the existing literature concluded that sugar-free chewing gum is an inexpensive and effective
    way to reduce postoperative ileus, and it is well-tolerated without any detrimental effect on patient outcomes

    Methylnaltrexone is currently indicated for opioid-induced constipation, but it was initially studied as an intervention to reduce postoperative ileus. Two large multicenter
    randomized controlled trials failed to show a reduction in postoperative ileus compared with placebo. Liposomal bupivacaine is gaining in popularity as a component of multimodal pain control in ERAS protocols.
    However, current data do not demonstrate superiority to conventional bupivacaine. Laxatives such as magnesium citrate and
    stimulants such as bisacodyl will induce diarrhea, but they will not increase small intestinal motility or reduce postoperative ileus
    A 72-year-old woman undergoes an open sigmoid colectomy for colon cancer. Which of the following interventions reduces the incidence of postoperative ileus in this patient? A. Methylnaltrexone B. Sugar-free chewing gum C. Wound infiltration with liposomal bupivacaine D. Magnesium citrate E. Bisacodyl suppositories ANSWER: B Enhanced recovery after surgery (ERAS) protocols for patients undergoing colorectal surgery are derived from studies evaluating the efficacy of interventions designed to reduce the morbidity and cost of surgical procedures and therefore improve outcomes and value. One such intervention, providing sugar-free chewing gum perioperatively, is as a method of sham feeding, with the hope that the mastication motion will promote intestinal motility through the cephalic phase of vagal enteric stimulation. The true mechanism is not entirely understood, and a randomized controlled trial of sugared chewing gum did not show abenefit, insinuating that the hexitols in sugar-free gum may have a laxative effect and contribute to bowel motility. A meta-analysis summarizing the existing literature concluded that sugar-free chewing gum is an inexpensive and effective way to reduce postoperative ileus, and it is well-tolerated without any detrimental effect on patient outcomes Methylnaltrexone is currently indicated for opioid-induced constipation, but it was initially studied as an intervention to reduce postoperative ileus. Two large multicenter randomized controlled trials failed to show a reduction in postoperative ileus compared with placebo. Liposomal bupivacaine is gaining in popularity as a component of multimodal pain control in ERAS protocols. However, current data do not demonstrate superiority to conventional bupivacaine. Laxatives such as magnesium citrate and stimulants such as bisacodyl will induce diarrhea, but they will not increase small intestinal motility or reduce postoperative ileus
    0 Comments 0 Shares 7040 Views
  • A surgeon at a certified bariatric center of excellence
    performs a laparoscopic sleeve gastrectomy on a 42-year-old woman with a BMI of 42 and associated hypertension. On postoperative day 1, she is doing fine and is discharged to home, which is 90 miles away. On postoperative day 2, she calls her surgeon's office with a complaint of abdominal pain
    and gets the answering service. She does not receive a call back from the covering bariatric surgeon.

    She calls the office on postoperative day 3, and a triage nurse responds telling her that the covering surgeon will call her back, but no one does.
    On postoperative day 5, the patient presents to her local emergency department in septic shock. CT scan shows evidence of a leak.

    The local emergency department does not
    have a bariatric sturgeon, and the on-call surgeon is not comfortable taking care of this patient. The patient is transferred back to the operating surgeon's hospital after discussion with the covering bariatric surgeon.
    The patient makes it to the emergency department but then dies shortly thereafter. The patient's family decides to sue. In deposition, the bariatric surgeon claims no calls were made to the covering bariatric surgeon.

    Who is mostly at fault for this
    outcome?
    A. The operative bariatric surgeon
    B. The answering service
    C. The covering bariatric surgeon
    D. The local emergency department
    E. The local general surgeon


    The Correct Answer will be at first Comment .login to see or add comments and answers
    A surgeon at a certified bariatric center of excellence performs a laparoscopic sleeve gastrectomy on a 42-year-old woman with a BMI of 42 and associated hypertension. On postoperative day 1, she is doing fine and is discharged to home, which is 90 miles away. On postoperative day 2, she calls her surgeon's office with a complaint of abdominal pain and gets the answering service. She does not receive a call back from the covering bariatric surgeon. She calls the office on postoperative day 3, and a triage nurse responds telling her that the covering surgeon will call her back, but no one does. On postoperative day 5, the patient presents to her local emergency department in septic shock. CT scan shows evidence of a leak. The local emergency department does not have a bariatric sturgeon, and the on-call surgeon is not comfortable taking care of this patient. The patient is transferred back to the operating surgeon's hospital after discussion with the covering bariatric surgeon. The patient makes it to the emergency department but then dies shortly thereafter. The patient's family decides to sue. In deposition, the bariatric surgeon claims no calls were made to the covering bariatric surgeon. Who is mostly at fault for this outcome? A. The operative bariatric surgeon B. The answering service C. The covering bariatric surgeon D. The local emergency department E. The local general surgeon The Correct Answer will be at first Comment .login to see or add comments and answers
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