Bücher von MICHAEL FIRSTENBERG

Embolic complications of common, or sometimes uncommon, medical issues represent a significant management challenge. In addition, special populations might require unique approaches to prevention and primary disease management. Similarly, unusual embolic problems can manifest as both diagnostic and therapeutic challenges. Despite evolving guidelines to the prevention, diagnosis, and management of common diseases that can result in embolic complications, unfortunately, for many problems, such guidelines, randomized trials, or even recommendations based upon high-quality literature are lacking. Several chapters in this book are dedicated to summarizing the available data and experiences to help guide bedside care. The goal of this book is to emphasize some of the more unusual presentations and diagnostic and management aspects of embolic complications. The pathophysiologies and prevention strategies in unique patient populations are also emphasized. Clearly, a multidisciplinary team approach is critical to dealing with all aspects of these unusual and perplexing problems.

Over the past two decades, the healthcare community increasingly recognized the importance and the impact of medical errors on patient safety and clinical outcomes. Medical and surgical errors continue to contribute to unnecessary and potentially preventable morbidity and/or mortality, affecting both ambulatory and hospital settings. The spectrum of contributing variables-ranging from minor errors that subsequently escalate to poor communication to lapses in appropriate protocols and processes (just to name a few)-is extensive, and solutions are only recently being described. As such, there is a growing body of research and experiences that can help provide an organized framework-based upon the best practices and evidence-based medical principles-for hospitals and clinics to foster patient safety culture and to develop institutional patient safety champions. Based upon the tremendous interest in the first volume of our Vignettes in Patient Safety series, this second volume follows a similar vignette-based model. Each chapter outlines a realistic case scenario designed to closely approximate experiences and clinical patterns that medical and surgical practitioners can easily relate to. Vignette presentations are then followed by an evidence-based overview of pertinent patient safety literature, relevant clinical evidence, and the formulation of preventive strategies and potential solutions that may be applicable to each corresponding scenario. Throughout the Vignettes in Patient Safety cycle, emphasis is placed on the identification and remediation of team-based and organizational factors associated with patient safety events. The second volume of the Vignettes in Patient Safety begins with an overview of recent high-impact studies in the area of patient safety. Subsequent chapters discuss a broad range of topics, including retained surgical items, wrong site procedures, disruptive healthcare workers, interhospital transfers, risks of emergency department overcrowding, dangers of inadequate handoff communication, and the association between provider fatigue and medical errors. By outlining some of the current best practices, structured experiences, and evidence-based recommendations, the authors and editors hope to provide our readers with new and significant insights into making healthcare safer for patients around the world.

Endocarditis remains an elusive challenge for clinicians to master. As the population ages and their comorbidities increase, the risk of infecting cardiac structures - both native and, the ever-increasing use of, prosthetic support technology - also increases. In addition, the global epidemic of intravenous substance abuse has also resulted in a substantial increase in the number of infected patients. Fortunately, advances in the diagnostic testing, imaging, and recognition of the importance of a multidisciplinary management team have also contributed to advances in the care of these critically ill patients. Nevertheless, optimal therapies need to be individualized and considered in the ever-increasing body of scientific literature on this complex and difficult problem.

Extracorporeal membrane oxygenation (ECMO), despite a long and troubled history, is very rapidly evolving into a therapy that can be safely and effectively applied across the world in patients experiencing acute cardiac and/or pulmonary failure. As experiences grow, there is a better understanding of nuances of the importance of teamwork, therapy guidelines and protocols, patient selection, and understanding the functional aspects of pump-circuit technology as it interfaces with human biology. The challenges in managing these very sick and complex patients cannot be understated. The goal of this text is to provide a framework for the development and successful growth of a program. Authors from Centers of Excellence Worldwide have shared their experiences in the full spectrum in dealing with this evolving field.