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1.
J Surg Oncol ; 124(5): 894-905, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34137038

RESUMO

BACKGROUND: Management of coagulopathy during major oncologic surgery can be multifactorial and challenging. Viscoelastic assays (VEAs) can be useful in providing vital data about the mechanism of coagulopathy in these dynamic circumstances. OBJECTIVES: A prospective nonrandomized observational study with the aim of describing the coagulation parameters of patients undergoing major oncologic surgery using the Quantra® and TEG® 5000 systems. Our secondary objectives included the correlation between Quantra and TEG parameters, and the times to result for both technologies. METHODS: This study included 74 adults undergoing oncologic surgery with an anticipated blood loss of more than 500 ml. For each subject, whole blood samples for each device were collected at multiple points perioperatively for comparison. RESULTS: Correlation coefficients between Quantra and TEG parameters were 0.8 and above, indicating a very strong correlation (p < .001). Correlation coefficients between conventional laboratory tests and Quantra ranged from 0.74 to 0.83, indicating a moderate correlation (p < .001). The mean time to obtain results and total processing time was shorter for Quantra in comparison to TEG. CONCLUSIONS: Quantra parameters strongly correlated with TEG parameters; however, Quantra parameters were available in shorter amount of time as it is specifically designed as a closed point of care device.


Assuntos
Transtornos da Coagulação Sanguínea/diagnóstico , Técnicas Hemostáticas/instrumentação , Neoplasias/cirurgia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Tromboelastografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos da Coagulação Sanguínea/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/patologia , Ensaios Clínicos Controlados não Aleatórios como Assunto , Prognóstico , Estudos Prospectivos , Adulto Jovem
2.
J Educ Perioper Med ; 21(2): E619, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31988980

RESUMO

STUDY OBJECTIVE: To assess the experiences and attitudes of practicing anesthesiologists on practice/business management training received during residency and transitioning to practice through an online survey. DESIGN: An online survey, consisting of 39 questions developed by the American Society of Anesthesiologists (ASA) Committee on Young Physicians, was emailed to 2 6551 practicing US anesthesiologists who were ASA members. MEASUREMENTS: Questions about individuals' demographic information, transition to practice (TTP) experiences, medical business training, and TTP curricula in residency were included. Results were reported as descriptive statistics. MAIN RESULTS: A total of 1199 responses were obtained (response rate 4.5%), and68% reported working in private practice over an average of 17 years. Those practicing ≤ 10 years were more likely to have a TTP curriculum in residency compared to those in practice ≥ 11 years. Common problems reported by many participants regarding TTP included: lack of effective mentorship, inadequate residency curricula/education, and an unfamiliarity with available resources. CONCLUSIONS: Although medical business practice education is now required by training programs, there is room for improvement in education. One potential solution is establishing TTP curricula in residency programs, which emphasize the business aspects of medicine and practice management, thus easing trainees from a training to practice environment.

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