Publications by authors named "Saullo Q Silveira"

Background: Enhancing security and dependability of health systems necessitates resource allocation, a well-defined infrastructure and a steadfast commitment to ensuring its safety and stability over time.

Objective: The aim of this study was to evaluate the temporal trend of patient safety culture according to the perception of professionals working in a private healthcare network in Brazil over a 7-year period (2015-2022).

Methods: The Hospital Survey on Patient Safety Culture questionnaire was distributed to 34 hospitals between 2015 and 2022 with 160 607 responders.

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Background: Recent evidence suggests that perioperative semaglutide use is associated with increased residual gastric content (RGC) and risk of bronchoaspiration under anesthesia. We compared the occurrence of increased RGC in semaglutide users and non-users undergoing esophagogastroduodenoscopy to define the time interval at which RGC becomes comparable between groups.

Methods: This was a single-center retrospective electronic chart review at a tertiary hospital.

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Article Synopsis
  • Semaglutide, a drug that slows down stomach emptying, may pose risks for patients undergoing surgery due to potential increased residual gastric content and aspiration during anesthesia, especially if taken within 10 days before the operation.
  • In a study with 220 patients, those who had taken semaglutide showed a significantly higher incidence (40%) of increased gastric content compared to only 3% in the control group.
  • The findings suggest that using semaglutide pre-operatively raises the risk of residual gastric content, although there were no reported cases of aspiration during the surgeries.
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Background: Colorectal cancer is the third most common type of cancer in Brazil, despite the availability of screening methods that reduce its risk. Colonoscopy is the only screening method that also allows therapeutic procedures. The proper screening through colonoscopy is linked to the quality of the exam, which can be evaluated according to quality criteria recommended by various institutions.

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This article provides a comprehensive review of the use of endoscopic vacuum therapy (EVT) in the management of transmural gastrointestinal (GI) defects (TGIDs) and its future perspectives, such as pre-emptive EVT and novel indications, including GI bleeding and large gastroduodenal ulcers management. This review is based on the available literature data and personal experience to demystify the mentioned limitations of EVT as technical difficulties related to the procedure, possible patients' complaints, and institutions' concerns, by sharing several tips and tricks to overcome EVT-related challenges that may discourage endoscopists from using this live-saving technique, and consequently, restricting patients to receive this therapy, which may lead to undesired outcomes. Several factors, such as placement techniques, EVT type selection, management during its use, EVT system exchanges, device removal, type of anesthesia, and how to avoid EVT-related adverse events are described in detail.

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Background: Alarms alert healthcare professionals of deviations from normal/physiologic status. However, alarm fatigue may occur when their high pitch and diversity overwhelm clinicians, possibly leading to alarms being disabled, paused, and/or ignored. We aimed to determine whether a staff educational program on customizing alarm settings of bedside monitors may decrease inconsistent alarms in the Post-Anesthesia Care Unit (PACU).

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Study Objective: Semaglutide is a long-acting glucagon-like peptide-1 receptor agonist used for management of type 2 diabetes and/or obesity. To test the hypothesis that perioperative semaglutide use is associated with delayed gastric emptying and increased residual gastric content (RGC) despite adequate preoperative fasting, we compared the RGC of patients who had and had not taken semaglutide prior to elective esophagogastroduodenoscopy. The primary outcome was the presence of increased RGC.

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Objectives: The American Society of Anesthesiologists Physical Status (ASA-PS) is a grading system routinely adopted worldwide by physicians to classify patients' overall health status. Concerns have been raised surrounding the subjectiveness of this system, potentially leading to poor inter-rater agreement/reliability. We hypothesized that physicians are overconfident when assigning ASA-PS scores and that presenting them with the ASA-PS definitions/examples would improve accuracy.

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Background: Venous thromboembolism (VTE) is a major cause of perioperative morbimortality. Despite significant efforts to advance evidence-based practice, prevention rates remain inadequate in many centres.

Objective: To evaluate the effectiveness of different strategies aimed at improving adherence to adequate VTE prophylaxis in surgical patients at high risk of VTE.

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Introduction And Objectives: Multimodal Analgesia (MMA) has shown promising results in postoperative outcomes across a broad spectrum of surgeries, including bariatric surgery. We compared the analgesic effect immediately after Laparoscopic Bariatric Surgery (LBS) of the combined effect of MMA and methadone against two techniques that were based mainly on the use of high-potency medium-acting opioids.

Methods: Two hundred seventy-one patients were retrospectively reviewed.

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Background: Orotracheal intubation (OTI) can result in aerosolisation leading to an increased risk of infection for healthcare providers, a key concern during the COVID-19 pandemic.

Objective: This study aimed to evaluate the OTI time and success rate of two aerosol-mitigating strategies under direct laryngoscopy and videolaryngoscopy performed by anaesthesiologists, intensive care physicians and emergency physicians who were voluntarily recruited for OTI in an airway simulation model.

Methodology: The outcomes were successful OTI, degree of airway visualisation and time required for OTI.

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