Managers need more time. They juggle five tasks at once. As they work on one, the other four fall to the ground. They make a list of 10 things to do and spend all day working on number 11. Yes, managers need more time, but they already have all the time there is. So they must make better use of the time they have. Many articles address this issue. Managers read them all, but none of them work. This one will.
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Background: Opioids are still being prescribed to manage acute postsurgical pain. Unnecessary opioid prescriptions can lead to addiction and death, as unused tablets are easily diverted.
Methods: To determine whether combination nonopioid analgesics are at least as good as opioid analgesics, a multisite, double-blind, randomized, stratified, noninferiority comparative effectiveness trial was conducted, which examined patient-centered outcomes after impacted mandibular third-molar extraction surgery.
Successful resolution of refractory marginal ulcer with celiac artery stenting.
Clin J Gastroenterol
January 2025
University of Connecticut, Connecticut, USA.
Marginal ulcers are a common complication following Roux-en-Y bypass surgeries with an approximate incidence of 4.6%. The pathophysiology is complex and risk factors include smoking, nonsteroidal anti-inflammatory drugs (NSAIDs) use, Helicobacter pylori infection, and a larger pouch size.
View Article and Find Full Text PDFFrom "Airway scares me" to "I would say I'm pretty comfortable": quality improvement for reducing time to obtain equipment for adult advanced airway management in a rural emergency department.
CJEM
January 2025
School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada.
Background: Management of the adult airway is one of the most stressful and time-critical procedures in emergency medicine. In the Cowichan District Hospital, a rural hospital in British Columbia, Emergency Department (ED) staff were uncomfortable with acquiring the equipment needed for adult advanced airway management and the mean length of time to acquire the equipment was 319 s. The aim of this quality improvement (QI) project was to decrease the time to obtain the equipment needed for adult advanced airway management by nurses and physicians in the Cowichan District Hospital ED to less than 90 s by May 2023.
View Article and Find Full Text PDFPrediction of pulmonary embolism by an explainable machine learning approach in the real world.
Sci Rep
January 2025
Department of Respiratory and Critical Care Medicine, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
In recent years, large amounts of researches showed that pulmonary embolism (PE) has become a common disease, and PE remains a clinical challenge because of its high mortality, high disability, high missed and high misdiagnosed rates. To address this, we employed an artificial intelligence-based machine learning algorithm (MLA) to construct a robust predictive model for PE. We retrospectively analyzed 1480 suspected PE patients hospitalized in West China Hospital of Sichuan University between May 2015 and April 2020.
View Article and Find Full Text PDFHeparin rebound in patients undergoing off-pump coronary artery bypass grafting surgery: a single-center retrospective study.
J Cardiothorac Surg
January 2025
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 167, Beilishi Road, Xicheng District, China.
Background: Heparin, an anticoagulant used in cardiac surgery, can result in heparin rebound (HR), where it returns postoperatively despite being neutralized with protamine. This study was designed to investigate the prevalence of HR in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and evaluate the impact of HR on their short-term outcomes.
Methods: HR was defined by a 10% increase in activated coagulation time (ACT) following two hours of heparin neutralization with protamine, bleeding over 200 mL/h, and abnormal laboratory coagulation examination results.
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