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Nguyen VP, Brauneis D, Kaku M, Sloan JM, Sarosiek S, Quillen K, Shelton AC, Sanchorawala V. Neuralgic amyotrophy following high-dose melphalan and autologous peripheral blood stem cell transplantation for AL amyloidosis. Bone Marrow Transplant 2017; 53:371-373. [PMID: 29269794 DOI: 10.1038/s41409-017-0048-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 11/16/2017] [Indexed: 11/09/2022]
Affiliation(s)
- V P Nguyen
- Section of Hematology & Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA.,Amyloidosis Center, Boston University School of Medicine, Boston, MA, USA
| | - D Brauneis
- Section of Hematology & Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA.,Amyloidosis Center, Boston University School of Medicine, Boston, MA, USA
| | - M Kaku
- Department of Neurology, Boston Medical Center, Boston, MA, USA.,Amyloidosis Center, Boston University School of Medicine, Boston, MA, USA
| | - J M Sloan
- Section of Hematology & Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA.,Amyloidosis Center, Boston University School of Medicine, Boston, MA, USA
| | - S Sarosiek
- Section of Hematology & Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA.,Amyloidosis Center, Boston University School of Medicine, Boston, MA, USA
| | - K Quillen
- Section of Hematology & Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA.,Amyloidosis Center, Boston University School of Medicine, Boston, MA, USA
| | - A C Shelton
- Section of Hematology & Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA.,Amyloidosis Center, Boston University School of Medicine, Boston, MA, USA
| | - V Sanchorawala
- Section of Hematology & Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA. .,Amyloidosis Center, Boston University School of Medicine, Boston, MA, USA.
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Freeman B, Brauneis D, Seldin DC, Quillen K, Sloan JM, Renteria AS, Shelton AC, Teschner T, Finn KT, Sanchorawala V. Hospital admissions following outpatient administration of high-dose melphalan and autologous SCT for AL amyloidosis. Bone Marrow Transplant 2014; 49:1345-6. [PMID: 24955784 DOI: 10.1038/bmt.2014.132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- B Freeman
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - D Brauneis
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - D C Seldin
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - K Quillen
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - J M Sloan
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - A S Renteria
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - A C Shelton
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - T Teschner
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - K T Finn
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
| | - V Sanchorawala
- Stem Cell Transplantation Program, Section of Hematology/Oncology, Boston Medical Center, Boston, MA, USA
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Story DA, Shelton AC, Poustie SJ, Colin-Thome NJ, McIntyre RE, McNicol PL. Effect of an anaesthesia department led critical care outreach and acute pain service on postoperative serious adverse events. Anaesthesia 2006; 61:24-8. [PMID: 16409338 DOI: 10.1111/j.1365-2044.2005.04435.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED We examined whether a combined critical care outreach and acute pain service comprising both medical and nursing staff from the Department of Anaesthesia would decrease the incidence of postoperative serious adverse events in a hospital with an established Medical Emergency Team. We called this combined service IMPACT Inpatient Management of acute Pain and Advice on Clinical Treatment. We conducted a prospective, before-and-after trial with a baseline phase (319 patients) of standard acute pain management followed by the IMPACT phase (271 patients), during which the IMPACT team systematically reviewed high-risk postoperative patients for the first three days after their return to the general wards. The incidence of serious adverse events decreased from 23 events per 100 patients to 16 events per 100 patients. The 30-day mortality decreased from 9% to 3%, p = 0.004. An acute pain service providing critical care outreach may improve postoperative outcome but the workload is considerable.
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Affiliation(s)
- D A Story
- Department of Anaesthesia, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia.
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Abstract
We proposed that critical care outreach would decrease the incidence of postoperative serious adverse events and so conducted a sequential cohort study with a surveillance-only phase (baseline) followed by an intervention phase. We studied high-risk patients in a large Australian hospital. A critical care qualified nurse reviewed patients for the first three days after return to the general wards. During the intervention phase the nurse intervened in patient care where appropriate. We examined the incidence of 11 categories of serious adverse events per 100 patients during the first three days on the general wards during the surveillance and intervention phases. The surveillance phase had 319 patients and the intervention phase 345 patients. In a subgroup analysis, there were four myocardial infarctions per 100 patients in the surveillance phase and seven per 100 patients during the intervention phase (95% confidence interval: 1-7 infarctions per 100 patients increase). For the other 10 serious adverse events there were 19 per 100 patients in the surveillance phase and 11 per 100 patients in the intervention phase (95% confidence interval: 4-11 serious adverse events per 100 patients decrease). Outreach may have led to greater detection of myocardial infarctions while reducing the incidence of other serious adverse events.
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Affiliation(s)
- D A Story
- Department of Surgery, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia.
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