The Experts below are selected from a list of 198 Experts worldwide ranked by ideXlab platform
Kumsi Sreedhar - One of the best experts on this subject based on the ideXlab platform.
-
Conversion in off pump coronary artery bypass grafting: a retrospective analysis
Indian Journal of Thoracic and Cardiovascular Surgery, 2015Co-Authors: Gananjay Gopalrao Salve, Shilpa Suresh Mavanoor, Satish Vasantrao Kakade, Kumsi SreedharAbstract:Background Intraoperative conversion of off-pump coronary artery bypass grafting (OPCAB) to on-pump coronary artery bypass grafting (ONCAB) has been associated with adverse outcomes. Inspite of several preoperative risk factors reported in the literature, conversion still remains an Unpredictable Event. This study aims to determine the incidence and predictors of conversion and attempts to evaluate strategies to prEvent the same. Methods Between June 2011 to May 2012, out of 994 patients who were planned for elective OPCAB by 8 different surgical teams at our institution, 127 patients underwent intraoperative conversion to ONCAB. We conducted a retrospective analysis of these patients under two groups—ONCAB ( n = 127) and OPCAB ( n = 867). Patients undergoing elective ONCAB and emergency OPCAB were excluded from the study. Results The incidence of intraoperative conversion was 12.77 %. Those who underwent conversion had a significantly higher rate of postoperative complications including hospital mortality (9.44 versus 2.42 %). Left ventricular dysfunction, history of myocardial infarction, and left main disease emerged as independent predictors of conversion. Conclusion Association of certain preoperative risk factors can predict the occurrence of intraoperative conversion. Planned and smooth conduct of OPCAB plays a key role to avoid higher mortality and morbidity associated with conversion. If at all unavoidable, a timely conversion can prEvent hazards of emergency conversion.
-
Conversion in off pump coronary artery bypass grafting: a retrospective analysis
Indian Journal of Thoracic and Cardiovascular Surgery, 2015Co-Authors: Gananjay Gopalrao Salve, Shilpa Suresh Mavanoor, Satish Vasantrao Kakade, Dhanyaprakash, Kumsi SreedharAbstract:Background Intraoperative conversion of off-pump coronary artery bypass grafting (OPCAB) to on-pump coronary artery bypass grafting (ONCAB) has been associated with adverse outcomes. Inspite of several preoperative risk factors reported in the literature, conversion still remains an Unpredictable Event. This study aims to determine the incidence and predictors of conversion and attempts to evaluate strategies to prEvent the same.
Richard S Hansell - One of the best experts on this subject based on the ideXlab platform.
-
Shoulder dystocia: an analysis of risks and obstetric maneuvers.
American journal of obstetrics and gynecology, 1993Co-Authors: James J Nocon, Debra K Mckenzie, L J Thomas, Richard S HansellAbstract:The purpose of this study was to determine whether there is a risk profile for predicting or prEventing shoulder dystocia and whether any of the obstetric maneuvers to disimpact a shoulder reduce the likelihood of permanent injury. A retrospective analysis of 14,297 parturients with 12,532 vaginal deliveries and 1765 cesarean sections (12.4%) from January 1986 through June 1990 was performed. A total of 204 maternal and infant charts, related to shoulder dystocia or neonatal injury, were reviewed in depth for age, parity, episiotomy, type of delivery, hemorrhage, maternal obesity, diabetes, weight gain, fetal weight, sex, and Apgar scores. In addition, the type of maneuver or combination thereof used to relieve the dystocia, type of injury to the infant, and follow-up of the injury were reviewed. The 185 coded episodes of shoulder dystocia represent 1.4% of all vaginal deliveries (12,532). There were 42 injuries recorded: 14 fractured clavicles and 28 brachial plexus injuries. An additional 19 patients, not coded for shoulder dystocia, sustained 14 fractured clavicles and five brachial plexus injuries. All but one of the brachial plexus injuries resolved by 6 months. The occurrence of shoulder dystocia increased in direct relationship to the birth weight and becomes significant in newborns over 4000 gm (p < 0.01). The occurrence of a previous large infant was also a significant risk factor (p < 0.01). Diabetes and midforceps delivery become significant factors only in the presence of a large fetus. Obesity, multiparity, postdate pregnancy, use of oxytocin, low forceps delivery, episiotomy, and type of anesthesia were unrelated to shoulder dystocia. No delivery method was without injury. This study clearly indicates that most of the traditional risk factors for shoulder dystocia have no predictive value, shoulder dystocia itself is an Unpredictable Event, and infants at risk for permanent injury are virtually impossible to predict. In addition, no delivery method in shoulder dystocia was superior to another with respect to injury. Thus no protocol should serve to substitute for clinical judgment.
-
shoulder dystocia an analysis of risks and obstetric maneuvers
American Journal of Obstetrics and Gynecology, 1993Co-Authors: James J Nocon, Debra K Mckenzie, Lisa Thomas, Richard S HansellAbstract:Objective: The purpose of this study was to determine whether there is a risk profile for predicting or prEventing shoulder dystocia and whether any of the obstetric maneuvers to disimpact a shoulder reduce the likelihood of permanent injury. Study Design: A retrospective analysis of 14.297 parturients with 12,532 vaginal deliveries and 1765 cesarean sections (12.4%) from January 1986 through June 1990 was performed. A total of 204 maternal and infant charts, related to shoulder dystocia or neonatal injury, were reviewed in depth for age, parity, episiotomy, type of delivery, hemorrhage, maternal obesity, diabetes, weight gain, fetal weight, sex, and Apgar scores. In addition, the type of maneuver or combination thereof used to relieve the dystocia, type of injury to the infant, and follow-up of the injury were reviewed. Results: The 185 coded episodes of shoulder dystocia represent 1.4% of all vaginal deliveries (12,532). There were 42 injuries recorded: 14 fractured clavicles and 28 brachial plexus injuries. An additional 19 patients, not coded for shoulder dystocia, sustained 14 fractured clavicles and five brachial plexus injuries. All but one of the brachial plexus injuries resolved by 6 months. The occurrence of shoulder dystocia increased in direct relationship to the birth weight and becomes significant in newborns over 4000 gm ( p p Conclusions: This study clearly indicates that most of the traditional risk factors for shoulder dystocia have no predictive value, shoulder dystocia itself is an Unpredictable Event, and infants at risk for permanent injury are virtually impossible to predict. In addition, no delivery method in shoulder dystocia was superior to another with respect to injury. Thus no protocol should serve to substitute for clinical judgment.
Gananjay Gopalrao Salve - One of the best experts on this subject based on the ideXlab platform.
-
Conversion in off pump coronary artery bypass grafting: a retrospective analysis
Indian Journal of Thoracic and Cardiovascular Surgery, 2015Co-Authors: Gananjay Gopalrao Salve, Shilpa Suresh Mavanoor, Satish Vasantrao Kakade, Kumsi SreedharAbstract:Background Intraoperative conversion of off-pump coronary artery bypass grafting (OPCAB) to on-pump coronary artery bypass grafting (ONCAB) has been associated with adverse outcomes. Inspite of several preoperative risk factors reported in the literature, conversion still remains an Unpredictable Event. This study aims to determine the incidence and predictors of conversion and attempts to evaluate strategies to prEvent the same. Methods Between June 2011 to May 2012, out of 994 patients who were planned for elective OPCAB by 8 different surgical teams at our institution, 127 patients underwent intraoperative conversion to ONCAB. We conducted a retrospective analysis of these patients under two groups—ONCAB ( n = 127) and OPCAB ( n = 867). Patients undergoing elective ONCAB and emergency OPCAB were excluded from the study. Results The incidence of intraoperative conversion was 12.77 %. Those who underwent conversion had a significantly higher rate of postoperative complications including hospital mortality (9.44 versus 2.42 %). Left ventricular dysfunction, history of myocardial infarction, and left main disease emerged as independent predictors of conversion. Conclusion Association of certain preoperative risk factors can predict the occurrence of intraoperative conversion. Planned and smooth conduct of OPCAB plays a key role to avoid higher mortality and morbidity associated with conversion. If at all unavoidable, a timely conversion can prEvent hazards of emergency conversion.
-
Conversion in off pump coronary artery bypass grafting: a retrospective analysis
Indian Journal of Thoracic and Cardiovascular Surgery, 2015Co-Authors: Gananjay Gopalrao Salve, Shilpa Suresh Mavanoor, Satish Vasantrao Kakade, Dhanyaprakash, Kumsi SreedharAbstract:Background Intraoperative conversion of off-pump coronary artery bypass grafting (OPCAB) to on-pump coronary artery bypass grafting (ONCAB) has been associated with adverse outcomes. Inspite of several preoperative risk factors reported in the literature, conversion still remains an Unpredictable Event. This study aims to determine the incidence and predictors of conversion and attempts to evaluate strategies to prEvent the same.
James J Nocon - One of the best experts on this subject based on the ideXlab platform.
-
Shoulder dystocia: an analysis of risks and obstetric maneuvers.
American journal of obstetrics and gynecology, 1993Co-Authors: James J Nocon, Debra K Mckenzie, L J Thomas, Richard S HansellAbstract:The purpose of this study was to determine whether there is a risk profile for predicting or prEventing shoulder dystocia and whether any of the obstetric maneuvers to disimpact a shoulder reduce the likelihood of permanent injury. A retrospective analysis of 14,297 parturients with 12,532 vaginal deliveries and 1765 cesarean sections (12.4%) from January 1986 through June 1990 was performed. A total of 204 maternal and infant charts, related to shoulder dystocia or neonatal injury, were reviewed in depth for age, parity, episiotomy, type of delivery, hemorrhage, maternal obesity, diabetes, weight gain, fetal weight, sex, and Apgar scores. In addition, the type of maneuver or combination thereof used to relieve the dystocia, type of injury to the infant, and follow-up of the injury were reviewed. The 185 coded episodes of shoulder dystocia represent 1.4% of all vaginal deliveries (12,532). There were 42 injuries recorded: 14 fractured clavicles and 28 brachial plexus injuries. An additional 19 patients, not coded for shoulder dystocia, sustained 14 fractured clavicles and five brachial plexus injuries. All but one of the brachial plexus injuries resolved by 6 months. The occurrence of shoulder dystocia increased in direct relationship to the birth weight and becomes significant in newborns over 4000 gm (p < 0.01). The occurrence of a previous large infant was also a significant risk factor (p < 0.01). Diabetes and midforceps delivery become significant factors only in the presence of a large fetus. Obesity, multiparity, postdate pregnancy, use of oxytocin, low forceps delivery, episiotomy, and type of anesthesia were unrelated to shoulder dystocia. No delivery method was without injury. This study clearly indicates that most of the traditional risk factors for shoulder dystocia have no predictive value, shoulder dystocia itself is an Unpredictable Event, and infants at risk for permanent injury are virtually impossible to predict. In addition, no delivery method in shoulder dystocia was superior to another with respect to injury. Thus no protocol should serve to substitute for clinical judgment.
-
shoulder dystocia an analysis of risks and obstetric maneuvers
American Journal of Obstetrics and Gynecology, 1993Co-Authors: James J Nocon, Debra K Mckenzie, Lisa Thomas, Richard S HansellAbstract:Objective: The purpose of this study was to determine whether there is a risk profile for predicting or prEventing shoulder dystocia and whether any of the obstetric maneuvers to disimpact a shoulder reduce the likelihood of permanent injury. Study Design: A retrospective analysis of 14.297 parturients with 12,532 vaginal deliveries and 1765 cesarean sections (12.4%) from January 1986 through June 1990 was performed. A total of 204 maternal and infant charts, related to shoulder dystocia or neonatal injury, were reviewed in depth for age, parity, episiotomy, type of delivery, hemorrhage, maternal obesity, diabetes, weight gain, fetal weight, sex, and Apgar scores. In addition, the type of maneuver or combination thereof used to relieve the dystocia, type of injury to the infant, and follow-up of the injury were reviewed. Results: The 185 coded episodes of shoulder dystocia represent 1.4% of all vaginal deliveries (12,532). There were 42 injuries recorded: 14 fractured clavicles and 28 brachial plexus injuries. An additional 19 patients, not coded for shoulder dystocia, sustained 14 fractured clavicles and five brachial plexus injuries. All but one of the brachial plexus injuries resolved by 6 months. The occurrence of shoulder dystocia increased in direct relationship to the birth weight and becomes significant in newborns over 4000 gm ( p p Conclusions: This study clearly indicates that most of the traditional risk factors for shoulder dystocia have no predictive value, shoulder dystocia itself is an Unpredictable Event, and infants at risk for permanent injury are virtually impossible to predict. In addition, no delivery method in shoulder dystocia was superior to another with respect to injury. Thus no protocol should serve to substitute for clinical judgment.
Satish Vasantrao Kakade - One of the best experts on this subject based on the ideXlab platform.
-
Conversion in off pump coronary artery bypass grafting: a retrospective analysis
Indian Journal of Thoracic and Cardiovascular Surgery, 2015Co-Authors: Gananjay Gopalrao Salve, Shilpa Suresh Mavanoor, Satish Vasantrao Kakade, Kumsi SreedharAbstract:Background Intraoperative conversion of off-pump coronary artery bypass grafting (OPCAB) to on-pump coronary artery bypass grafting (ONCAB) has been associated with adverse outcomes. Inspite of several preoperative risk factors reported in the literature, conversion still remains an Unpredictable Event. This study aims to determine the incidence and predictors of conversion and attempts to evaluate strategies to prEvent the same. Methods Between June 2011 to May 2012, out of 994 patients who were planned for elective OPCAB by 8 different surgical teams at our institution, 127 patients underwent intraoperative conversion to ONCAB. We conducted a retrospective analysis of these patients under two groups—ONCAB ( n = 127) and OPCAB ( n = 867). Patients undergoing elective ONCAB and emergency OPCAB were excluded from the study. Results The incidence of intraoperative conversion was 12.77 %. Those who underwent conversion had a significantly higher rate of postoperative complications including hospital mortality (9.44 versus 2.42 %). Left ventricular dysfunction, history of myocardial infarction, and left main disease emerged as independent predictors of conversion. Conclusion Association of certain preoperative risk factors can predict the occurrence of intraoperative conversion. Planned and smooth conduct of OPCAB plays a key role to avoid higher mortality and morbidity associated with conversion. If at all unavoidable, a timely conversion can prEvent hazards of emergency conversion.
-
Conversion in off pump coronary artery bypass grafting: a retrospective analysis
Indian Journal of Thoracic and Cardiovascular Surgery, 2015Co-Authors: Gananjay Gopalrao Salve, Shilpa Suresh Mavanoor, Satish Vasantrao Kakade, Dhanyaprakash, Kumsi SreedharAbstract:Background Intraoperative conversion of off-pump coronary artery bypass grafting (OPCAB) to on-pump coronary artery bypass grafting (ONCAB) has been associated with adverse outcomes. Inspite of several preoperative risk factors reported in the literature, conversion still remains an Unpredictable Event. This study aims to determine the incidence and predictors of conversion and attempts to evaluate strategies to prEvent the same.
