TopMedTalk

In this piece find out how renal injury biomarkers can offer practitioners and patients hope. Presented by Professor Monty Mythen and Dr Joff Lacey featuring guests John A. Kellum, Tenured Professor, Critical Care Medicine from The University of Pittsburgh and Dr Tim Miller from Duke University Medical Centre. Join in the debate:  contact@topmedtalk.com This piece taken from a longer conversation...

Where should sleep apnea be on the perioperative surgeon's priority list? A fascinating introduction to the topic, sleep disorders affect every area of life but in the perioperative sphere it brings significantly higher risks of complications following surgery. How important is it that such conditions are picked up during pre-operative optimisation? Furthermore, why do the evaluation at all - if n...

A conversation that is now even more relevant, the changing role of the anaesthetist. Matters such as population health, lifestyle choices and a wider sense of social responsibility are discussed as Monty asks his contributors, 'is this really what you signed up for'? Presented by Monty Mythen and Joff Lacey with guests, Sol Aronson, a tenured professor at Duke University and Executive Vice Chairm...

Standby for the results of The RELIEF Trial; coming soon on TopMedTalk, Professor Monty Mythen will be presenting an exclusive programme here covering the results of the trial and discussing its impact. The REstrictive Versus LIbEral Fluid Therapy in Major Abdominal Surgery: RELIEF trial, will it answer the questions we hoped? Will this trial put to bed the questions about liberal restricted fluid...

This piece begins with the question, what does Enhanced Recovery mean to you? Here we go for a ground up approach via a 'council of nurses'. Can a 'roundtable' sometimes work better than the traditional hierarchical power structure? Desiree Chappell interviews Dr Ruchir Gupta medical lead for enhanced recovery at Stony Brook University. Taken from a longer conversation to be found here:  http://ww...

How do we bend cost curve to our advantage? How do we assert the irreducible minimum? Is it possible to spend less money and get better outcomes? Is it possible to get people to realise that not 'doing something' is sometimes the right decision? How do 'bundle payments' work in relation to overall health? Featuring Desiree Chappell, Monty Mythen, Dr Lee A. Fleisher Chair of Anesthesiology and Crit...

METS trial - exercise tolerance and surgery outcomes. The results of the METS trial were presented at the International Anaesthesia Research Society meeting in Chicago. Measurement of Exercise Tolerance before Surgery (METS) study: a protocol for an international multicentre prospective cohort study of cardiopulmonary exercise testing prior to major non-cardiac surgery ( http://bmjopen.bmj.com/con...

Opioid addiction can happen to anyone, even world leading Professors like Dr Paul Wischmeyer. Listen to Paul's story and then spread this important message to colleagues, patients and friends; there is help available, the first and most important step is to ask for it. Hosted by Desiree Chappell and Monty Mythen. Featuring Dr Paul Wischmeyer, Professor of Anaesthesiology and Surgery at Duke Anesth...

Dr Attilla Kett explains how he applies Enhanced Recovery after Surgery to obstetrics. This podcast features Desiree Chappell interviewing Dr Attila Kett, anaesthesiologist and Chairman at St Peter's University Hospital at New Jersey. Join in the debate: contact@topmedtalk.com Want to come see us live in London?  http://www.ebpom.org/

Steroids in cardiac surgery: a systematic review and meta-analysis BJA April 2018, Volume 120, Pages 657-667. See full article here:  https://www.ncbi.nlm.nih.gov/pubmed/29576107 Join in the debate: contact@topmedtalk.com Don't forget to come and meet the TopMedTalk team at one of the EBPOM events, details on the forthcoming London meeting can be found here:  https://ebpom.org/EBPOM2018

The first conference highlight from EBPOM USA 2018: How do you best work a pre-op clinic? Should they be places where you get your problems documented or where you get your problems 'fixed'? How do you convince your practice to optimise patients for life and not just 90 days? How do we encourage population health? How do we get round the fact that we're still in a 'fee for service world'? What is...

How important is it to screen patients for anaemia before surgery? Has anaemia fallen off the health care agenda? We begin with a conversation about patients who are anaemic and then turn to why this is sometimes not checked enough. Monty Mythen mentions UK University students appear to suffer from the condition more these days and Lori Heller points out that treating the condition, as part of pat...

Treating patients as people rather than 'jobs to be done' and 'boxes to be ticked' is the focus of this piece. What can Doctors do better when it comes to treating patients? Find out what happened when a perioperative care doctor became a patient. A fascinating conversation streamed live from Atlanta Georgia during the second day of TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperati...

This piece discusses how the contributors are driving better perioperative care in their clinics; the importance of getting patient records in advance; ERAS for obstetrics; challenging opioid use with the multimodal pain management; shared decision making in pain management; the importance of clear communication pathways and patient literacy. This podcast features Desiree Chappell interviewing; Dr...

Marc Koch President & CEO of Somnia Inc reviews the conference with Desiree Chappell. What should you expect at an EBPOM meeting? How useful is the practical advice given? How important is the networking side of an event like this? Hosted by Desiree Chappell. Join us on  www.topmedtalk.com  sign up for our email updates and never miss a live streamed conference again.

When it comes to breathlessness how do we better diagnose and apply treatment earlier? How do we overcome the fact that referring to a specialist can sometimes take a patient 'down the wrong route' with a condition that might not be just heart or lung related? Ronan Astin, clinical consultant in respiratory medicine at UCL Hospital, explains his more holistic approach to treatment and diagnosis. "...

Professor Monty Mythen presents Journal Club Express. Postoperative delirium in total knee and hip arthroplasty patients: a study of perioperative modifiable risk factors DOI:  10.1016/j.bja.2017.12.046 -- S. M. Weinstein et al. Br J Anaesth 2018; 120(5): 999-1008 This is an American single center retrospective study with 41,766 patients undergoing hip and knee arthroplasties over a seven year per...

This podcast concerns sleep apnea as part of pre-operative patient optimisation. How important is it to evaluate patients for sleep disorders before surgery? Are patients with sleep apnea aware of their condition and are they using some form of treatment? What are the health problems associated with sleep disorders? How do you build a financial case for including this in your practice? A piece ori...

Originally streamed live from Atlanta Georgia during TopMedTalk's coverage of "EBPOM-USA Masters Course, A Perioperative Care Practicum" this podcast includes discussion about psychological optimisation for surgery; who should have it, what does it mean and how does it work? Further conversation moves into weaning patients off opioids in advance of surgery and cutting their dependency afterwards....

The importance of exercise, weight and perioperative nutrition. Which is worse, being fat or not being fit? Malnutrition, a silent epidemic? How useful are protein shakes? Are supervised exercise sessions cost effective? Finally the team discuss the importance of starting these conversations with children, optimising nutrition and exercise for them will enhance their lives forever. Hosted by Monty...

Professor Monty Mythen's full presentation regarding 'the FEDORA trial'. This piece was originally presented during the Third Annual Quality Improvement Leadership Forum, 2018, at the Union League Club in Philidelphia. The trial looked at the effect of goal-directed haemodynamic therapy on postoperative complications in low–moderate risk surgical patients: a multicentre randomised controlled trial...

Join Desiree and Monty as they reflect on the EBPOM USA weekend so far and look ahead to what remains. Also - a reminder that you still have chance to hear the conference presentations live from the www.topmedtalk.com website. Go there now to get details, it's free and has proven to be incredibly popular around the world!

A fascinating discussion and debate regarding the central dichotomy inherent in periperative medicine. No stone is left unturned as the team get their teeth into the subject tackling the always tricky subject of profit and patient optimisation. Recorded on the first day of the conference this piece is a real stand out moment for TopMedTalk, make sure you both listen in and provide us with your tho...

Originally streamed live from the EBPOM USA conference. Desiree Chappell, Monty Mythen, Dr Tim Miller (anaestheseologist at Duke University) and Dr Angela Edwards (head of perioperative medicine at Wake Forest University School of Medicine) discuss some of the presentations and their personal highlights. Join in the conversation, email us at contact@topmedtalk.com

A fascinating conversation, streamed live from EBPOM-USA on the second day of the conference. Reflections on the conference alongside insightful discussions about how the contributors have each been attracted to perioperative medicine. Also, the perennial debate about patient care and profits, are the two factors in conflict? Featuring Desiree Chappell host of The Roundtable Blog, Dr Brian Woods a...