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transfusion in surgical patients

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https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#1
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28317227/trends-in-the-surgical-treatment-of-benign-prostatic-hyperplasia-in-a-tertiary-hospital
#2
Darren Ow, Nathan Papa, Marlon Perera, Peter Liodakis, Shomik Sengupta, Stephen Clarke, Damien M Bolton, Nathan Lawrentschuk
BACKGROUND: To assess current treatment trends and perioperative outcomes of transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) in a tertiary institution. METHODS: We prospectively collected a database of all patients undergoing TURP and PVP for benign prostatic hyperplasia (BPH) at a tertiary hospital between January 2011 and December 2013. Patient characteristics such as length of stay, readmission, anticoagulation status, American Society of Anesthesiologists (ASA) score and need for blood transfusion were recorded and analysed...
March 19, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28315573/mortality-length-of-stay-and-cost-implications-of-procedural-bleeding-after-percutaneous-interventions-using-large-bore-catheters
#3
Björn Redfors, Brendan M Watson, Thomas McAndrew, Emilie Palisaitis, Dominic P Francese, Mehdi Razavi, Jordan Safirstein, Roxana Mehran, Ajay J Kirtane, Philippe Généreux
Importance: Bleeding complications after percutaneous transcatheter interventions that used large-bore catheters are frequent and associated with high mortality and morbidity. Objective: To describe the incidence of bleeding complications among patients undergoing contemporary endovascular interventions involving large-bore catheters and its association with in-hospital mortality, length of stay, and health care cost. Design, Setting, and Participants: This retrospective cohort study analyzed all 17 672 patients from the Healthcare Cost and Utilization Project's National Inpatient Sample database who were recorded as having undergone a transcatheter aortic valve replacement (n = 3223), an endovascular aneurysm repair (n = 12 633), or a percutaneous left ventricular assist device implant (n = 1816) between January 1, 2012, and December 31, 2013...
March 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28315018/influence-of-pelvic-volume-on-surgical-outcome-after-low-anterior-resection-for-rectal-cancer
#4
G Zur Hausen, J Gröne, D Kaufmann, S M Niehues, K Aschenbrenner, A Stroux, B Hamm, M E Kreis, Johannes C Lauscher
BACKGROUND: Low anterior resection (LAR) for rectal cancer is a potentially challenging operation due to limited space in the pelvis. CT pelvimetry allows to quantify pelvic space, so that its relationship with outcome after LAR may be assessed. Studies investigating this, however, yielded conflicting results. We hypothesized that a small pelvis is associated with a higher rate of incomplete mesorectal excision, anastomotic leakages, and increased rate of urinary dysfunction in patients operated for rectal cancer...
March 18, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28304219/surgical-or-transcatheter-aortic-valve-replacement-in-intermediate-risk-patients
#5
Michael J Reardon, Nicolas M Van Mieghem, Jeffrey J Popma, Neal S Kleiman, Lars Søndergaard, Mubashir Mumtaz, David H Adams, G Michael Deeb, Brijeshwar Maini, Hemal Gada, Stanley Chetcuti, Thomas Gleason, John Heiser, Rüdiger Lange, William Merhi, Jae K Oh, Peter S Olsen, Nicolo Piazza, Mathew Williams, Stephan Windecker, Steven J Yakubov, Eberhard Grube, Raj Makkar, Joon S Lee, John Conte, Eric Vang, Hang Nguyen, Yanping Chang, Andrew S Mugglin, Patrick W J C Serruys, Arie P Kappetein
Background Although transcatheter aortic-valve replacement (TAVR) is an accepted alternative to surgery in patients with severe aortic stenosis who are at high surgical risk, less is known about comparative outcomes among patients with aortic stenosis who are at intermediate surgical risk. Methods We evaluated the clinical outcomes in intermediate-risk patients with severe, symptomatic aortic stenosis in a randomized trial comparing TAVR (performed with the use of a self-expanding prosthesis) with surgical aortic-valve replacement...
March 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28304214/retroperitoneal-laparoscopic-partial-nephrectomy-for-tumors-larger-than-7%C3%A2-cm-in-renal-cell-carcinoma-initial-experience-of-single-institution
#6
Erlin Song, Xin Ma, Ruihua An, Peng Zhang, Xu Zhang, Baojun Wang, Taoping Shi, Shengkun Sun
BACKGROUND: To report our initial experience dealing with retroperitoneal laparoscopic partial nephrectomy (LPN) for tumors larger than 7 cm in renal cell carcinoma (RCC). MATERIALS AND METHODS: A total of 15 patients with malignant tumors larger than 7 cm underwent retroperitoneal LPN at our institution. Patient baseline demographics, perioperative outcomes, pathological characteristics, and estimated glomerular filtration rate (eGFR) were analyzed retrospectively in our collected database...
March 17, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28303631/surgical-outcomes-of-percutaneous-nephrolithotomy-pcnl-in-3-402-patients-and-results-of-stone-analysis-in-1-559-patients-from-a-single-centre-in-pakistan
#7
S A H Rizvi, M Hussain, S H Askari, M Lal, M N Zafar
OBJECTIVE: To report our experience of a series of PCNL from a single centre over the last 18 years in terms of patients and stone characteristics, indications, stone clearance and complications and chemical analysis of stones in a subgroup. PATIENTS AND METHODS: We retrospectively analysed the outcomes of PCNL in 3,402 adult patients who underwent the procedure between 1997 and 2014 from a prospectively maintained database. Data analysis included patients' age, sex, laboratory investigations, imaging, punctured calyx, duration of operation, volume of irrigation fluid, radiation exposure time, blood transfusion, complications and stone free status at one-month follow-up...
March 16, 2017: BJU International
https://www.readbyqxmd.com/read/28302346/postoperative-acute-kidney-injury-and-blood-product-transfusion-after-synthetic-colloid-use-during-cardiac-surgery
#8
Rajika Tobey, Hao Cheng, Mei Gao, Zhongmin Li, J Nilas Young, W Douglas Boyd, Fuhai Ji, Hong Liu
OBJECTIVES: This study assessed the effect of 2 types of hydroxyethyl starches (HES) on renal integrity and blood transfusion in cardiac surgery patients. DESIGN: Retrospective investigation. SETTING: Patients from a single tertiary medical center. PARTICIPANTS: Inclusion criteria included coronary artery bypass graft (CABG) and/or valve surgery that included cardiopulmonary bypass with aortic cross-clamping. INTERVENTIONS: Intraoperative HES and blood product administration...
December 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28302244/disseminated-intravascular-coagulation-developing-after-cranioplasty
#9
Wenming Wang, Hua Liu, Jian Yang, Yafang Shen
Disseminated intravascular coagulation (DIC) developing after cranioplasty, a skull reconstructive surgical procedure, is very rare. The presently reported patient underwent cranioplasty for cranial trauma under general anaesthesia using titanium prostheses. Her laboratory data was unremarkable. She underwent three operations, each complicated by excessive postoperative bleeding. Although the patient received massive blood transfusions, but no cryoprecipitate coagulum was given during the first two re-operations, and excessive bleeding was evident...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28298765/obturator-nerve-block-in-transurethral-resection-of-bladder-tumor-a-comparative-study-by-two-techniques
#10
Deepak Sharma, V P Singh, Nidhi Agarwal, M K Malhotra
CONTEXT: Sparing of obturator nerve is a common problem encountered during transurethral resection of bladder tumor (TURBT) under spinal anesthesia. AIMS: To evaluate and compare obturator nerve block (ONB) by two different techniques during TURBT. SETTINGS AND DESIGN: This is prospective observational study. SUBJECTS AND METHODS: Forty adult male patients from the American Society of Anesthesiologists Class I-IV planned to undergo TURBT under spinal anesthesia were divided into two groups of twenty each...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296776/totally-laparoscopic-associating-liver-tourniquet-and-portal-vein-occlusion-for-staged-hepatectomy-combined-with-simultaneous-left-hemicolectomy-for-bilateral-liver-metastases-of-the-primary-colon-cancer-a-case-report
#11
Hong-Wei Xu, Hong-Yu Li, Fei Liu, Yong-Gang Wei, Bo Li
BACKGROUND: Resection of the liver is often limited to the insufficient future liver remnant (FLR). To address this problem, the modification surgical technique "associating liver tourniquet and portal vein occlusion for staged hepatectomy" (ALTPS) was developed and led to quick hypertrophy in a short interval. In some colorectal cancer patients with multiple and bilobar metastases, the resection of the primary is often protracted immensely to the unpredictable postoperative complications for whom is to be treated with a liver-first approach...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28296737/incidence-influencing-factors-and-prognostic-impact-of-intraoperative-massive-blood-loss-in-adolescents-with-neuromuscular-scoliosis-a-strobe-compliant-retrospective-observational-analysis
#12
Rui Jia, Na Li, Bi-Yun Xu, Wei Zhang, Xiao-Ping Gu, Zheng-Liang Ma
Factors influencing massive blood loss for neuromuscular scoliosis (NMS) patients.Despite advances in surgical and anesthetic techniques, scoliosis surgery is still associated with intraoperative massive blood loss, which can result in postoperative mortality and morbidity. The aim of this study was to assess the incidence, influencing factors, and prognostic impact of intraoperative massive blood loss in adolescents with NMS.A retrospective review of adolescents who underwent posterior spinal instrumentation and fusion for NMS was performed...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28292532/-intravenous-iron-functional-recovery-and-delirium-in-patients-with-hip-fracture-federef-study-single-centre-randomised-placebo-controlled-and-double-blind-clinical-trial-2014-001923-53-eudract-number
#13
Rafael Bielza Galindo, Jesús Llorente Gutiérrez, José Luis Pérez González, Asunción Mora Casado, David Blanco Díaz, Javier Escalera Alonso, Adoración Morales Fernández, Cristina Molano Ortiz, Beredys Esmirla García López, Nazaret Del Amo Del Arco, Juan Pablo Barro Ordovas, Estefanía Arias Muñana, Marta Neira Álvarez, David Sanz Rosa, Jorge Fco Gómez Cerezo
INTRODUCTION: There are no previous studies evaluating the effect of intravenous iron therapy on functional and cognitive status of patients with hip fracture (HF). MATERIAL AND METHODS: A single-centre randomised, placebo-controlled, double-blind and parallel treatment, clinical trial has been designed to assess the efficacy of intravenous iron therapy during the peri-operative period in elderly patients suffering from a HF. Blinding will be ensured by the packaging of the drug infusion system...
March 11, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28291126/strategies-to-reduce-blood-product-utilization-in-obstetric-practice
#14
Holger Neb, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management (PBM) aims to improve patient outcome and safety by reducing the number of unnecessary RBC transfusions and vitalizing patient-specific anemia reserves. Although PBM is increasingly recognized as best clinical practice in elective surgery, implementation of PBM is restrained in the setting of obstetrics. This review summarizes recent findings to reduce blood product utilization in obstetric practice. RECENT FINDINGS: PBM-related evidence-based benefits should be urgently adopted in the field of obstetric medicine...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28288789/blood-loss-at-the-time-of-surgical-abortion-up-to-14weeks-in-anticoagulated-patients-a-case-series
#15
Bliss Kaneshiro, Mary Tschann, Jeffrey Jensen, Paula Bednarek, Ronnie Texeira, Alison Edelman
OBJECTIVE: To describe estimated blood loss (EBL) with surgical abortion≤14weeks gestation in anticoagulated patients. STUDY DESIGN: We invited 170 clinicians involved in a professional listserv to report cases when they performed a surgical abortion on a patient≤14weeks gestation taking an anticoagulant. Clinicians reported estimated blood loss (EBL) and bleeding-related complications (need for a blood transfusion, additional surgical procedures to treat bleeding)...
March 10, 2017: Contraception
https://www.readbyqxmd.com/read/28288778/videolaparoscopic-radical-nephrectomy-after-chemotherapy-in-the-treatment-of-wilms-tumor-long-term-results-of-a-pioneer-group
#16
Ricardo Jordão Duarte, Lilian Maria Cristofani, Vicente Odone Filho, Miguel Srougi, Francisco Tibor Dénes
INTRODUCTION: A high cure rate for Wilms' tumor has been achieved using a multidisciplinary approach. The natural step forward is to offer the benefits of a minimally invasive technique for surgery, which is an obligatory part of treatment. Nevertheless, some authors resist using videolaparoscopic radical nephrectomy (VRN) because of concerns about reducing the cure index. METHODS: The present study included children with unilateral Wilms' tumor treated from December 2003 to December 2015 with neoadjuvant chemotherapy followed by VRN...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28287015/cost-consequence-analysis-of-two-different-active-flowable-hemostatic-matrices-in-spine-surgery-patients
#17
D Makhija, M Rock, S Ikeme, E Kuntze, J D Epstein, G Nicholson, J S Price, V Patel
OBJECTIVES: A recently published retrospective analysis comparing two different active flowable hemostatic matrices (FLOSEAL and SURGIFLO Kit with Thrombin) showed significantly increased resource use and complications (surgery time, risk of blood product transfusion, and amount of matrix used) with SURGIFLO use compared to FLOSEAL in major spine surgery, and also significantly increased surgical time with SURGIFLO use in severe spine surgery. This analysis was developed as a follow-up to this prior analysis, to evaluate the cost-consequence of using FLOSEAL vs SURGIFLO in major and severe spine surgery...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#18
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28285425/total-bilateral-salpingectomy-versus-partial-bilateral-salpingectomy-for-permanent-sterilization-during-cesarean-delivery
#19
Shiri Shinar, Yair Blecher, Sharon Alpern, Ariel Many, Eran Ashwal, Uri Amikam, Aviad Cohen
PURPOSE: Sterilization via bilateral total salpingectomy is slowly replacing partial salpingectomy, as it is believed to decrease the incidence of ovarian cancer. Our objective was to compare short-term intra and post-operative complication rates of bilateral total salpingectomy versus partial salpingectomy performed during the course of a cesarean delivery. METHODS: A large series of tubal sterilizations during cesarean sections were studied in a single tertiary medical center between 1/2014 and 8/2016 before and after a policy change was made, switching from partial salpingectomy to total salpingectomy...
March 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28283245/effect-of-tranexamic-acid-on-intraoperative-blood-loss-and-transfusion-requirements-in-patients-undergoing-excision-of-intracranial-meningioma
#20
Bhavna Hooda, Rajendra Singh Chouhan, Girija Prasad Rath, Parmod Kumar Bithal, Ashish Suri, Ritesh Lamsal
Surgical excision of meningioma is often complicated by significant blood loss requiring blood transfusion with its attendant risks. Although tranexamic acid is used to reduce perioperative blood loss, its blood conservation effect is uncertain in neurosurgery. Sixty adults undergoing elective craniotomy for meningioma excision were randomized to receive either tranexamic acid or placebo, initiated prior to skin incision. Patients in the tranexamic acid group received intravenous bolus of 20mg/kg over 20min followed by an infusion of 1mg/kg/h till the conclusion of surgery...
March 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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