Over the last 20 years, medical-surgical nursing has changed and should now be considered an international nursing speciality. Unlike other specialities, there is no opportunity to become a nurse practitioner in most Western countries. These two issues--lack of professional recognition and career development--should be addressed.

The high-risk noncardiac surgical population represents a major global healthcare challenge. Despite widespread advances in medical care, surgery remains a common and effective treatment option for a diverse range of diseases. Far from being replaced by drug therapies, the role of surgical treatment options appears to be growing. Moreover, surgery is now more frequently deemed a viable option f...

BACKGROUND Most anesthesiologists will experience at least one perioperative catastrophe over the course of their careers. Very little, however, is known about the emotional impact of these events and their effects on both immediate and long-term ability to provide care. In this study, we examined the incidence of perioperative catastrophes and the impact of these outcomes on American anesthesi...

Adrenalectomy for pheochromocytoma is reported with a mortality close to zero in recent studies. The dogma of preoperative fluid and hypotensive drug administrations is widely applied in patients scheduled for pheochromocytoma removal and is assumed to have a beneficial effect on operative outcomes. This paradigm is only based on historical studies of non-standardized practices and criteria for...

Various noninvasive tests have been proposed to stratify perioperative cardiovascular risk, including dipyridamole thallium scintigraphy (DTS), ejection fraction estimation by radionuclide ventriculography (RNV), ischemia monitoring by ambulatory electrocardiography (AECG), and dobutamine stress echocardiography (DSE). Which of these tests is most effective for predicting adverse perioperative ...

IMPORTANCE Because of the restrictions applied to the conduct of randomized clinical trials, the risks reported in their comparison of open and endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA) may not be applicable to real-world vascular surgical practice. The magnitude of this deviation is indeterminate. OBJECTIVES To compare 30-day mortality from the recent Open Vs En...

INTRODUCTION Surgical services are increasingly seen to reduce death and disability in Sub-Saharan Africa, where hospital-based mortality remains alarmingly high. This study explores two implementation approaches to improve the quality of perioperative care in a Tanzanian hospital. Effects were compared to a control group of two other hospitals in the region without intervention. METHODS All ...

Chronic postsurgical pain (CPSP) is 1 important aspect of surgical recovery. To improve perioperative care and postoperative recovery knowledge on predictors of impaired recovery is essential. The aim of this study is to assess predictors and epidemiological data of CPSP, physical functioning (SF-36PF, 0-100), and global surgical recovery (global surgical recovery index, 0-100%) 3 and 12 months...