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https://www.readbyqxmd.com/read/29156506/lower-gastrointestinal-bleeding-in-patients-with-coronary-artery-disease-on-antithrombotics-and-subsequent-mortality-risk
#1
Parita Patel, Neha Nigam, Neil Sengupta
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is a common complication for patients with coronary artery disease (CAD) due to use of antithrombotic medications. Limited data exists describing which patients are at increased risk for mortality. AIM: To 1) determine whether patients on dual antiplatelet (DAPT) therapy or triple therapy are at higher risk of 90-day and 6-month mortality compared to patients on aspirin (ASA) alone and 2) evaluate risk factors for mortality in patients with CAD on antithrombotics hospitalized with LGIB...
November 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29155513/laparoscopic-surgery-after-neoadjuvant-therapy-in-elderly-patients-with-rectal-cancer
#2
Ruiqi Yang, Wei Qu, Zhentao He, Juan Chen, Zhongyan Wang, Yudong Huang
PURPOSE: The standard treatment for mid or low locally advanced rectal cancer is neoadjuvant therapy followed by surgical resection. Laparoscopic surgery has recently been applied for the treatment of rectal cancer. However, few studies have reported the outcomes of laparoscopic surgery for elderly patients with rectal cancer after neoadjuvant therapy. This study aimed to investigate the short- and long-term outcomes of laparoscopic surgery for elderly patients with rectal cancer after neoadjuvant therapy...
July 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29155251/the-rothman-index-as-a-predictor-of-post-discharge-adverse-events-after-elective-spine-surgery
#3
Ryan P McLynn, Nathaniel T Ondeck, Jonathan J Cui, David R Swanson, Blake N Shultz, Patawut Bovonratwet, Jonathan N Grauer
BACKGROUND CONTEXT: The Rothman Index (RI) is a comprehensive rating of overall patient condition in the hospital setting. It is used at many medical centers and calculated based on vital signs, lab values, and nursing assessments in the electronic medical record. Past research has demonstrated an association with adverse events, readmission, and mortality in other fields, but it has not been investigated in spine surgery. PURPOSE: To determine the potential utility of the RI as a predictor of adverse events after discharge following elective spine surgery...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155116/the-effect-of-steroids-on-complications-readmission-and-reoperation-after-posterior-lumbar-fusion
#4
Michael B Cloney, Roxanna M Garcia, Zachary A Smith, Nader S Dahdaleh
BACKGROUND DATA: The effects of chronic corticosteroid therapy on complications, readmission, and reoperation after posterior lumbar fusion (PLF) remains under-investigated and was examined to determine differences in outcomes. METHODS: We analyzed patients from 2006 to 2013 using the National Surgery Quality Improvement Program database (NSQIP) undergoing PLF. Patients taking steroids for a chronic condition were compared to those not taking steroids. Multivariable regression identified factors independently associated with complications, readmission, and reoperation...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29153979/individual-surgeon-practice-is-the-most-important-factor-influencing-diverting-loop-ileostomy-creation-for-patients-undergoing-sigmoid-colectomy-for-diverticulitis
#5
Cigdem Benlice, Conor P Delaney, David Liska, Jennifer Hrabe, Scott Steele, Emre Gorgun
BACKGROUND: To identify factors associated with diverting ileostomy creation (DLI) in patients undergoing sigmoid colectomy for diverticular disease in a high volume colorectal unit and to obtain information for better preoperative patient counseling. METHODS: Patients who underwent sigmoid colectomy with colorectal anastomosis with or without DLI for diverticulitis between 01/1994-12/2014 were identified. Preoperative characteristics, surgeon practice year, individual surgeon and postoperative outcomes were compared between patients with DLI or not...
November 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29151408/-protective-effect-of-5-aminosalicylic-acid-on-the-kidney-of-paraquat-poisoning-rats-by-nrf2-are-signal-pathway
#6
Yu Wang, Manhong Zhou, Yuanlan Lu, Anyong Yu, Jianguo Li
OBJECTIVE: To investigate the protective effect of 5-aminosalicylic acid (5-ASA) on renal injury poisoned by paraquat (PQ) in rats and its mechanism. METHODS: Twenty-four healthy clean male Sprague-Dawley (SD) rats were randomly divided into four groups: normal saline (NS) control group, 5-ASA control group, PQ model group and 5-ASA treatment group, with 6 rats in each group. The rat model of PQ poisoning was reproduced by intraperitoneal injection of 2% PQ solution 20 mg/kg, and the same volume of NS was given in NS control group and 5-ASA control group...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29151335/comparison-of-tidal-volume-and-deep-breath-preoxygenation-techniquesundergoing-coronary-artery-bypass-graft-surgery-effects-of-hemodynamicresponse-and-arterial-oxygenation
#7
Zafer Taş, Tülay Hoşten, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Ahmet Arıkan, Zeynep Mine Solak
Background/aim: Different techniques exist for the preoxygenation of patients that will be operated on under general anesthesia. Preoxygenation with the deep breath (DB) method may affect cardiovascular stability, which is crucial for coronary artery bypass graft (CABG) patients. In this study, we aimed to compare the effects of the 3 min TVB preoxygenation technique and 1 min 8DBs technique on hemodynamic response and arterial oxygenation in patients with normal ejection fraction that were scheduled for elective CABG surgery...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29150794/shunt-surgery-in-idiopathic-normal-pressure-hydrocephalus-is-cost-effective-a-cost-utility-analysis
#8
Mats Tullberg, Josefine Persson, Jakob Petersen, Per Hellström, Carsten Wikkelsø, Åsa Lundgren-Nilsson
BACKGROUND: The objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS: Health-related quality of life was evaluated before and 6 months after surgery using the EQ-5D-3 L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71 years; range, 65-89 years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care...
November 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29149429/population-analysis-of-predictors-of-difficult-intubation-with-direct-laryngoscopy-in-pediatric-patients-with-and-without-thyroid-disease
#9
Aalap C Shah, William C K Ng, Sean Sinnott, Joseph P Cravero
PURPOSE: There are no data on the prevalence and predictors of difficult intubation (DI) in pediatric patients with thyroid disease. This study (1) assesses the prevalence of DI in patients with thyroid disease undergoing elective operations, (2) identifies other predictors of DI in children, and (3) evaluates the effect of DI on postoperative care and length-of-stay. METHODS: A single-center retrospective cohort analysis of procedures in patients assigned with an ICD-9 code for thyroid disease between June 2012 and February 2016...
November 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29149146/dexamethasone-and-dexmedetomidine-as-an-adjuvant-to-intraarticular-bupivacaine-for-postoperative-pain-relief-in-knee-arthroscopic-surgery-a-randomized-trial
#10
Seham M Moeen, Islam K Ramadan, Hesham A Elkady
BACKGROUND: Knee arthroscopy causes minimal trauma, however, good analgesia is required for early rehabilitation and return to normal life in the patients. OBJECTIVE: We aimed to compare the analgesic effects of intraarticular dexamethasone and dexmedetomidine added to bupivacaine with those of bupivacaine alone. STUDY DESIGN: This study uses a double-blind, randomized, controlled design with allocation concealment in a 3-armed parallel group format among patients undergoing arthroscopic meniscal surgery...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148411/vitamin-d-status-in-spondyloarthritis-results-of-the-asas-comospa-international-study
#11
Sílvia Fernandes, Adrien Etcheto, Désirée van der Heijde, Robert Landewé, Filip van den Bosch, Maxime Dougados, Anna Moltó
OBJECTIVES: Spondyloarthritis (SpA) encompasses both bone production and bone loss, and the latter is particularly linked to inflammation. Vitamin D deficiency has been associated with several inflammatory conditions (i.e. cardiovascular disease, rheumatoid arthritis), but it has been poorly evaluated in SpA patients. We aimed to a) describe the prevalence of vitamin D deficiency in SpA patients worldwide; b) compare SpA patients with and without vitamin D deficiency in terms of disease phenotype, activity severity and comorbidities...
November 16, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29148408/effects-and-safety-of-99tc-mdp-in-patients-with-refractory-ankylosing-spondylitis-a-2-stage-30-week-follow-up-clinical-trial
#12
Yunyun Xu, Yi Zhong, Minjing Zhao, Liudan Tu, Meida Fan, Pingping Zhang, Qiujing Wei, Shuangyan Cao, Qiuxia Li, Zetao Liao, Zhiming Lin, Yunfeng Pan, Ou Jin, Jieruo Gu
OBJECTIVES: To evaluate the clinical efficacy and safety in patients with refractory ankylosing spondylitis (AS) initiating 99Tc-MDP therapy and explore the mechanisms. METHODS: Refractory AS patients were enrolled in the clinical trial and received 99Tc-MDP treatments for 3 or 5 courses according to ASAS improvement. Efficacy and safety evaluations were conducted during the follow-up. 37 cytokines were quantified by Luminex at baseline and week 30. p-values<0...
November 14, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29146653/identifying-bioethical-issues-in-biostatistical-consulting-findings-from-a-us-national-pilot-survey-of-biostatisticians
#13
Min Qi Wang, Alice F Yan, Ralph V Katz
OBJECTIVES: The overall purposes of this first US national pilot study were to (1) test the feasibility of online administration of the Bioethical Issues in Biostatistical Consulting (BIBC) Questionnaire to a random sample of American Statistical Association (ASA) members; (2) determine the prevalence and relative severity of a broad array of bioethical violations requests that are presented to biostatisticians by investigators seeking biostatistical consultations; and (3) establish the sample size needed for a full-size phase II study...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146432/predictors-of-hospital-length-of-stay-and-30-day-readmission-in-cervical-spondylotic-myelopathy-patients-an-analysis-of-3057-patients-using-the-acs-nsqip-database
#14
Peter G Passias, Cyrus M Jalai, Nancy Worley, Shaleen Vira, Saqib Hasan, Samantha R Horn, Frank A Segreto, Cole A Bortz, Andrew P White, Michael Gerling, Virginie LaFage, Thomas Errico
BACKGROUND: Hospital length of stay (LOS), 30-day readmission rate, and other metrics are increasingly being used to evaluate quality of surgical care. The factors most relevant to cervical spondylotic myelopathy (CSM) are not yet established. OBJECTIVE: To identify peri-operative factors associated with extended LOS and/or 30-day readmission following elective surgery for CSM. METHODS: Surgical CSM patients at institutions represented by the American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program (ACS-NSQIP) from 2010-2012 were included...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29143732/surgical-and-endovascular-treatment-of-extracranial-carotid-stenosis
#15
Hans-Henning Eckstein, Pavlos Tsantilas, Andreas Kühnl, Bernhard Haller, Thorben Breitkreuz, Alexander Zimmermann, Michael Kallmayer
BACKGROUND: Carotid endarterectomy (CEA) and carotid artery stenting (CAS) can be used to prevent stroke due to arteriosclerotic lesions of the carotid artery. In Germany, legally mandated quality assurance (QA) enables the evaluation of outcome quality after CEA and CAS performed under routine conditions. METHODS: We analyzed data on all elective CEA and CAS procedures performed over the periods 2009-2014 and 2012-2014, respectively. The endpoints of the study were the combined in-hospital stroke and death rate, stroke rate and mortality separately, local complications, and other complications...
October 27, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29143092/laparoscopic-appendectomy-minimally-invasive-surgery-training-improves-outcomes-in-basic-laparoscopic-procedures
#16
Katherine D Gray, Joshua G Burshtein, Lama Obeid, Maureen D Moore, Gregory Dakin, Alfons Pomp, Cheguevara Afaneh
BACKGROUND: To determine whether minimally invasive surgery (MIS) training improves outcomes in laparoscopic appendectomy, a procedure that is commonly performed in general surgery training. METHODS: Retrospective review was conducted of all patients undergoing laparoscopic appendectomy for suspected acute appendicitis between 2014 and 2015 at a single-center, tertiary-care academic institution. Patients operated on by MIS-trained surgeons (MIS group) were compared to those operated on by general surgeons (GS group)...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29143090/pattern-of-lower-intestinal-ostomies-in-a-low-income-country-case-of-southeast-of-niger-republic
#17
Harissou Adamou, Oumarou Habou, Ibrahim Amadou Magagi, Ousseini Adakal, Amadou Magagi, Maazou Halidou, Rachid Sani
BACKGROUND: Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country. METHODS: This was a 4-year retrospective study (January 2013 to December 2016) at Zinder National Hospital (Niger). All patients with a digestive ostomy on an ileum or colic segment were included in the study...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142549/comparison-of-pressure-vs-volume-controlled-ventilation-on-oxygenation-parameters-of-obese-patients-undergoing-laparoscopic-cholecystectomy
#18
Reza Movassagi, Majid Montazer, Ata Mahmoodpoor, Vahid Fattahi, Afshin Iranpour, Sarvin Sanaie
Background & Objective: There is no special guideline for the best ventilation mode during laparoscopic anesthesia in obese patients and there are too many studies with different controversial points. The aim of this study was to compare the effect of pressure controlled ventilation (PCV) vs. volume controlled ventilation (VCV) on respiratory and oxygenation parameters in patients undergoing laparoscopic cholecystectomy. Methods: Seventy patients with 30 <BMI<40 and ASA physical status I-II were studied in this randomized prospective trial...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29142035/the-sex-influence-on-response-to-tumor-necrosis-factor-%C3%AE-inhibitors-and-remission-in-axial-spondyloarthritis
#19
Ennio Lubrano, Fabio Massimo Perrotta, Maria Manara, Salvatore D'Angelo, Olga Addimanda, Roberta Ramonda, Leonardo Punzi, Ignazio Olivieri, Carlo Salvarani, Antonio Marchesoni
OBJECTIVE: The aim of this study was to evaluate the influence of sex on response to treatment and disease remission in patients with axial spondyloarthritis (axSpA). METHODS: In this retrospective multicenter study, patients with axSpA, according to the Assessment of Spondyloarthritis international Society (ASAS) criteria for axSpA, and treated with adalimumab, etanercept, golimumab, or infliximab, were studied. We compared clinical characteristics, patient-reported outcomes, disease activity, function, and response to treatment in male and female patients with this disease...
November 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29141838/online-perceptions-of-mothers-about-breastfeeding-and-introducing-formula-qualitative-study
#20
Anna Lena Wennberg, Sanna Jonsson, Josefine Zadik Janke, Åsa Hörnsten
BACKGROUND: Although the benefits of breastfeeding are well established for babies and their mothers, many women give formula to their infants. Whether to breastfeed or to give infant formula is a complex decision to make. Many parents use the Internet to find information and support that relate to infant feeding decisions. OBJECTIVE: The aim of this study was to analyze the perceptions of mothers, who are discussing the topic on Web forums, about introducing infant formula...
November 15, 2017: JMIR Public Health and Surveillance
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