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https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#1
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29145278/safety-of-continuing-aspirin-therapy-during-spinal-surgery-a-systematic-review-and-meta-analysis
#2
Chenggui Zhang, Guodong Wang, Xiaoyang Liu, Yang Li, Jianmin Sun
BACKGROUND: Questions whether to continue or discontinue aspirin administration in the perioperative period of spinal surgery has not been systematically evaluated. OBJECTIVE: The present systematic review is carried out to assess the impact of continuing aspirin administration on the bleeding and cardiovascular events in perispinal surgery period. METHODS: Studies were retrieved through MEDLINE, EMBASE, and Springer Link Databases (search terms, aspirin, continue or discontinue, and spinal fusion), bibliographies of the articles retrieved, and the authors' reference files...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143088/the-association-of-preoperative-hematocrit-and-transfusion-with-mortality-in-patients-undergoing-elective-non-cardiac-surgery
#3
Rodney A Gabriel, Anthony I Clark, Albert P Nguyen, Ruth S Waterman, Ulrich H Schmidt
BACKGROUND: Patients with anemia frequently undergo surgery, as it is unclear at what threshold clinicians should consider delaying surgery for preoperative anemia optimization. The primary objective of this study was to determine whether there is an association of varying degrees of anemia and transfusion with 30-day mortality. METHODS: This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2013...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142955/improving-the-prediction-of-cardiac-surgery-associated-acute-kidney-injury
#4
Jordan Crosina, Jordyn Lerner, Julie Ho, Navdeep Tangri, Paul Komenda, Brett Hiebert, Nora Choi, Rakesh C Arora, Claudio Rigatto
Introduction: Acute kidney injury (AKI) is a potentially fatal complication of cardiac surgery. The inability to predict cardiac surgery-associated AKI is a major barrier to prevention and early treatment. Current clinical risk models for the prediction of cardiac surgery-associated AKI are insufficient, particularly in patients with preexisting kidney dysfunction. Methods: To identify intraoperative variables that might improve the performance of a validated clinical risk score (Cleveland Clinic Score, CCS) for the prediction of cardiac surgery-associated AKI, we conducted a prospective cohort study in 289 consecutive elective cardiac surgery patients at a tertiary care center...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29142576/frequency-and-the-risk-factors-of-hepatitis-c-virus-in-pregnant-women-a-hospital-based-descriptive-study-in-gadap-town-karachi
#5
Kausar Jilani, Bushra Zulfiqar, Qadir Bux Memon, Muhammad Faisal Fahim
Objective: To determine the frequency and the risk factors of hepatitis C virus in pregnant women at Al-Tibri Medical College & Hospital in Gadap Town Karachi. Methods: This was a descriptive cross sectional study conducted at Obstetrics & Gynecology OPD of Al-Tibri Medical College & Hospital, Isra University Karachi Campus from 10(th) June to 10(th) September 2016. A total of 400 pregnant women of 16-45 years of age, who came in outpatient department for antenatal checkup were selected for the study...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29142541/is-it-safe-to-have-multiple-repeat-cesarean-sections-a-high-volume-tertiary-care-center-experience
#6
Alper Biler, Atalay Ekin, Aykut Ozcan, Abdurrahman Hamdi Inan, Tayfun Vural, Emrah Toz
Objective: To compare the obstetric outcomes of cesarean section in women who had a history of four or more previous cesarean sections with those who had a history of two or three previous cesarean sections. Methods: Total 1318 women who underwent repeat cesarean section between January 2013 and January 2016 were retrospectively reviewed. Of these, 244 (18.5%) had previously had four or more cesarean sections (multiple repeat cesarean section group) and 1074 (81...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29141466/retrospective-cohort-analysis-of-pedal-procedures-in-the-thrombocytopenic-patient
#7
Brian M Schmidt, Crystal M Holmes
Thrombocytopenia is an important medical condition to understand prior to performing procedures in the foot and ankle. We have set forth to highlight factors a physician should take into consideration before performing procedures in the thrombocytopenic patient. A retrospective cohort analysis at a large academic institution was undertaken utilizing a cohort discovery tool to discover incidence and management strategies for patients with foot-related conditions that require in-office procedures. We demonstrate that a full history and physical are important to guide treatment along with complete blood count testing prior to intervention...
November 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#8
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29137681/influence-of-tourniquet-use-in-primary-total-knee-arthroplasty-with-drainage-a-prospective-randomised-controlled-trial
#9
Kai Zhou, Tingxian Ling, Haoyang Wang, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, Fuxing Pei
BACKGROUND: We aimed to compare the effect of tourniquet use or lack of it on recovery following uncomplicated primary total knee arthroplasty (TKA). METHODS: In a prospective randomised double-blinded study, 150 patients undergoing primary TKA were assigned to either a tourniquet or non-tourniquet group. At the early phase, 3 and 6 months after surgery, an independent observer assessed the primary outcome measure (i.e. total blood loss) and secondary outcome measures (i...
November 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29137593/central-pontine-myelinolysis-after-living-donor-liver-transplant-a-report-of-2-cases
#10
Ya-Lan Hsu, Chia-En Hsieh, Kuo-Hua Lin, Chen-Te Chou, Ping-Yi Lin, Su-Han Wang, Yao-Li Chen
Here, we present 2 patients who developed central pontine myelinolysis after living-donor liver transplant. Both patients had abnormal sodium level before living-donor liver transplant. Patient 1 presented with severe hyponatremia on admission. After administration of 3% saline, her sodium level during the first 24 hours was kept at 100 mEq/L and then increased to 116 mEq/L during the next 24 hours. The level increased 5.8 mEq/L during the 4- to 5-hour transplant procedure. Patient 2 was admitted to the hospital with an unprovoked seizure...
November 15, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29136732/-prognosis-factors-for-the-perineal-incision-complications-after-abdominoperineal-resection-for-low-rectal-cancer
#11
S Luo, J W Liang, H T Zhou, W Pei, Z X Zhou, Q Liu, X S Wang
Objective: To evaluate the prognosis factors affecting perineal incision complications after abdominoperineal resection (APR) for the low rectal cancer. Methods: This was a retrospective analysis of 151 consecutive patients with low rectal cancer undergoing APR between January and December 2013 at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The patients were comprised of 95 males and 56 females. The mean age of the patients was (57...
November 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29136561/calibrated-automated-thrombogram-values-in-infants-with-cardiac-surgery-before-and-after-cardiopulmonary-bypass
#12
Alessandra Rizza, Giovina Di Felice, Rosa Luciano, Ottavia Porzio, Ombretta Panizzon, Maurizio Muraca, Paola Cogo
INTRODUCTION: Impaired thrombin generation has been associated to increase bleeding after cardiac surgery with cardiopulmonary bypass (CPB), especially in children. The aim of this study was to evaluate standard coagulation assay, thrombin generation by calibrated automated thrombogram (CAT), thromboelastography (TEG) and procoagulant phospholipids (PPL) activity in infants undergoing cardiac surgery with CPB. MATERIALS AND METHODS: Prospective observational study performed in children aged <24months undergoing cardiac surgery with CPB...
September 21, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29136093/overuse-of-preoperative-laboratory-coagulation-testing-and-abo-blood-typing-a-french-national-study
#13
H Beloeil, D Ruchard, N Drewniak, S Molliex
Background: Following publication of guidelines on routine preoperative tests, the French Society of Anaesthesiology and Intensive Care (SFAR), in association with French national public health insurance, conducted a survey to evaluate adherence to guidelines and the economic consequences. Methods: Using the French Hospital Discharge Database and National Health Insurance Information system, tests performed during the 30 days before surgery were analysed for two situations: (1) standard laboratory coagulation tests and ABO blood typing in children able to walk and scheduled for tonsillectomy/adenoidectomy; and (2) ABO blood typing in adults before laparoscopic cholecystectomy, thyroidectomy, lumbar discectomy or breast surgery...
October 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29135529/acute-coronary-artery-thrombus-after-tranexamic-acid-during-total-shoulder-arthroplasty-in-a-patient-with-coronary-stents-a-case-report
#14
Kathryn H Bridges, Sylvia H Wilson
Tranexamic Acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29135139/-laparoscopic-transperitoneal-adrenalectomy
#15
B G Guliev, B K Komyakov, D V Semenov
AIM: To analyze the results of laparoscopic adrenalectomy (LAE) in patients with adrenal gland tumors. MATERIALS AND METHODS: From 2011 to 2016, 24 patients (15 men, 9 women), mean age 49.6 +/- 8.2 years, underwent LAE. The right, left and bilateral LAE was performed in 12, 10 and 2 patients, respectively. Indications for surgery were mainly primary and metastatic adrenal tumors. The operations were performed using a transperitoneal 4-port approach. RESULTS: Twenty six LAE were successfully performed in 24 patients...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29131276/the-expression-of-mmp-7-in-serum-and-aneurysm-tissues-of-patients-with-abdominal-aortic-aneurysm-associated-with-hypertension-and-the-clinical-efficacy-of-endovascular-exclusion
#16
W-H Zhang, C-H Qiao, X Zhang, H Luo, X-K Sun
OBJECTIVE: To investigate the expression of matrix metalloproteinase-7 (MMP-7) in abdominal aortic aneurysm (AAA) with hypertension, and the clinical efficacy of endovascular exclusion. PATIENTS AND METHODS: Seventy-two cases of AAA with hypertension were retrospectively analyzed. Patients were divided into the observation group (34 cases) and control group (38 cases). The control group was treated by AAA incision with artificial vascular replacement, while the observation group was treated by endovascular graft exclusion...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29130845/restrictive-or-liberal-red-cell-transfusion-for-cardiac-surgery
#17
C David Mazer, Richard P Whitlock, Dean A Fergusson, Judith Hall, Emilie Belley-Cote, Katherine Connolly, Boris Khanykin, Alexander J Gregory, Étienne de Médicis, Shay McGuinness, Alistair Royse, François M Carrier, Paul J Young, Juan C Villar, Hilary P Grocott, Manfred D Seeberger, Stephen Fremes, François Lellouche, Summer Syed, Kelly Byrne, Sean M Bagshaw, Nian C Hwang, Chirag Mehta, Thomas W Painter, Colin Royse, Subodh Verma, Gregory M T Hare, Ashley Cohen, Kevin E Thorpe, Peter Jüni, Nadine Shehata
Background The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. Methods In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a European System for Cardiac Operative Risk Evaluation (EuroSCORE) I of 6 or more (on a scale from 0 to 47, with higher scores indicating a higher risk of death after cardiac surgery) to a restrictive red-cell transfusion threshold (transfuse if hemoglobin level was <7...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29130008/a-rare-association-of-autoimmune-hemolytic-anemia-with-gastric-adenocarcinoma
#18
Kavita Agrawal, Flores Alfonso
An 80-year-old male presented with dyspnea on exertion for at least two months. He also complained of progressive dysphagia and weight loss of 35 pounds over the last eight months. Initial blood tests showed hemoglobin of 6.1 g/dl, reticulocytes count of 19.7%, total bilirubin of 3.2 mg/dl, lactate dehydrogenase of 600 U/L, and haptoglobin of less than 8 mg/dl, and direct Coombs test was positive for warm immunoglobulin G. The impression was autoimmune hemolytic anemia (AIHA). The evaluation of dysphagia with esophagogastroduodenoscopy revealed a single irregular 4 cm malignant appearing ulcerated mass at the incisura angularis of the stomach...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/29129343/prognostic-value-of-hyperlactatemia-and-lactate-clearance-after-mitral-valve-surgery
#19
Adam S Evans, Matthew A Levin, Hung-Mo Lin, Ken Lee, Menachem M Weiner, Anelechi Anyanwu, David H Adams, Alexander J C Mittnacht
OBJECTIVES: Blood lactate is frequently used to guide management in critically ill patients. In patients undergoing mitral valve surgery, an elevated lactate level is frequently observed; however, overall mortality is low. The authors hypothesized that hyperlactemia is not a useful predictor of poor outcomes in this patient population. The main aim of this study was to explore how blood lactate level and lactate clearance are associated with 30-day mortality and major adverse events in patients undergoing mitral valve surgery...
August 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29129340/synchronous-colorectal-cancer-and-multiple-myeloma-with-chest-wall-involvement-is-this-a-coincidence
#20
Qiu-Li Li, Jin-An Ma, Hai-Peng Li, Ren-Bing Huang, Chun-Hong Hu, Xian-Ling Liu, Ya-Wen Gao, Gang-Hua Feng, Fang Wu
Multiple primary malignant neoplasms (MPMNs) are rare malignant neoplasms that simultaneously or successively occur in the same patient as 2 or more primary malignancies. Currently, an increasing number of cases are being reported. In general, MPMNs more commonly occur as 2 solid tumors or 2 hematological malignancies. Cases of MPMN that involve a solid tumor and a hematological malignancy are rare. Here, we report a case of synchronous colorectal cancer (CRC) and multiple myeloma (MM) with chest wall involvement...
September 25, 2017: Current Problems in Cancer
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