This study aimed to validate and refine an information model on pain management in a Brazilian hospital, considering the institutional culture, using an expert consensus approach. The first stage took place through a computerized questionnaire and Content Validity Index calculation. Pain management attributes were considered validated with 75% consensus among 19 experts. The second stage validated and refined the information model by three experts via an online meeting. Results showed that out of 11 evaluated attributes, five were validated. In the second stage, the inclusion of new attributes was suggested to address institutional culture. The final information model resulted from 23 sets of revised attributes: 12 validated, seven suggested and four not validated. The resulting Brazilian model has the potential to support the implementation of interventions and propose improvements to the institution's electronic system, which can be reused in other institutions.
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http://dx.doi.org/10.3233/SHTI240097 | DOI Listing |
J Neurosurg Anesthesiol
November 2024
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA.
This systematic review aimed to identify and describe best practice for the intraoperative anesthetic management of patients undergoing emergent/urgent decompressive craniotomy or craniectomy for any indication. The PubMed, Scopus, EMBASE, and Cochrane databases were searched for articles related to urgent/emergent craniotomy/craniectomy for intracranial hypertension or brain herniation. Only articles focusing on intraoperative anesthetic management were included; those investigating surgical or intensive care unit management were excluded.
View Article and Find Full Text PDFPLoS One
January 2025
US Department of Veterans Affairs, Palo Alto Healthcare System, National Center for Collaborative Healthcare Innovation, Palo Alto, California, United States of America.
Background: The intrauterine device (IUD) is a highly effective form of long-acting reversible contraception, widely recognized for its convenience and efficacy. Despite its benefits, many patients report moderate to severe pain during and after their IUD insertion procedure. Furthermore, reports suggest significant variability in pain control medications, including no adequate pain medication.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Pathology, Deyang Peoples' Hospital, Deyang, Sichuan Province, China.
Rationale: Ependymomas are commonly prevalent intramedullary neoplasms in adults, with hardly any cases of exophytic extramedullary ependymoma being reported. Meningiomas, on the contrary, are one of the most common intradural extramedullary (IDEM) tumors. However, the occurrence of both IDEM tumors simultaneously is extremely rare.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Anesthesiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Background: This study compares the outcomes of general anesthesia (GA) and regional anesthesia (RA) in geriatric hip fracture surgery to determine optimal anesthesia strategies for this population.
Methods: A comprehensive literature review was conducted, analyzing studies comparing GA and RA in elderly patients undergoing hip fracture surgery. Studies encompassed various designs, including randomized controlled trials, cohort studies, and meta-analyses.
Medicine (Baltimore)
January 2025
Division of Nephrology, Department of Medicine, National University Hospital, Singapore.
Rationale: We report the efficacy of combination prednisolone and intravenous (IV) rituximab as an immunosuppressive regimen for a young male presenting with extensive venous thromboembolism including a submassive pulmonary embolism secondary to life-threatening nephrotic syndrome from very high risk anti-phospholipase-A2 receptor (PLA2R) positive membranous nephropathy. Initial treatment was with mechanical thrombectomy and anticoagulation. Thereafter, oral prednisolone was initiated to induce remission, during a period of uninterrupted anticoagulation.
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