ACS Surgery - Principles and Practice by Stanley W Ashely Ed.

By Stanley W Ashely Ed.

The single textbook bearing the imprimatur of the yankee university of Surgeons, ACS surgical procedure 7 presents a complete reference paintings throughout all levels of surgical education and perform, from resident to skilled practitioner. ACSS7 covers completely scientific wisdom and sufferer care, in addition to different talents- professionalism, interpersonal conversation, systems-based perform, and practice-based studying and development. The illustrations, diagrams, tables, and algorithms increase and make clear suggestions defined within the textual content. furthermore, per 30 days updating on-line potential the paintings is consistently renewed and present on an ongoing foundation.

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Gauss A, Rohm HJ, Schauffelen A, et al: Electrocardiographic exercise stress testing for cardiac risk assessment in patients undergoing noncardiac surgery. Anesthesiology 94:38, 2001 26. Froelicher VF, Lehmann KG, Thomas R, et al: The electrocardiographic exercise test in a population with reduced workup bias: diagnostic performance, computerized interpretation, and multivariate prediction. Ann Intern Med 128:965, 1998 27. Mangano DT: Preoperative assessment of the patient with cardiac disease.

Kaegi L: Medical outcomes trust conference presents dramatic advances in patient-based outcomes assessment and potential applications in accreditation. Jt Comm J Qual Improv 25:207, 1999 44. Parsa MH, Habif DV, Ferrer JM, et al: Intravenous hyperalimentation: indications, technique, and complications. Bull N Y Acad Med 48:920, 1972 45. Detsky AS, Baker JP, O’Rourke K, et al: Perioperative parenteral nutrition: a meta-analysis. Ann Intern Med 107:195, 1987 46. The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group: Perioperative total parenteral nutrition in surgical patients.

Drug Therapy for Preexisting Disease Two questions must be answered about a patient taking medication for preexisting disease. First, should the drug or drugs be discontinued or the dosage altered before operation [see Table 5]? , a prothrombin time and international normalized ratio [INR] for patients taking anticoagulants)? Whereas dosages of some medications, such as adrenocorticosteroids, may have to be temporarily increased, certain oral © 2004 WebMD, Inc. All rights reserved. ACS Surgery: Principles and Practice 5 OUTPATIENT SURGERY — 4 ELEMENTS OF CONTEMPORARY PRACTICE Table 5 Disposition of Current Medications before Outpatient Surgery97 Continue Antihypertensives Beta blockers Calcium channel blockers ACE inhibitors Vasodilators Bronchodilators Antiseizure medications Tricyclic antidepressants MAO inhibitors (controversial) Corticosteroids Thyroid preparations Anxiolytics ACE—angiotensin-converting enzyme Abrupt withdrawal of clonidine, which is used to treat chronic essential hypertension, is particularly dangerous because it is often associated with an increase in the plasma catecholamine level.

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