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https://www.readbyqxmd.com/read/28100522/intraoperative-dexamethasone-does-not-increase-the-risk-of-postoperative-wound-infection-a-propensity-score-matched-post-hoc-analysis-of-the-enigma-ii-trial-endex
#1
T Corcoran, J Kasza, T G Short, E O'Loughlin, M T V Chan, K Leslie, A Forbes, M Paech, P Myles
BACKGROUND: In a post hoc analysis of the ENIGMA-II trial, we sought to determine whether intraoperative dexamethasone was associated with adverse safety outcomes. METHODS: Inverse probability weighting with estimated propensity scores was used to determine the association of dexamethasone administration with postoperative infection, quality of recovery, and adverse safety outcomes for 5499 of the 7112 non-cardiac surgery subjects enrolled in ENIGMA-II. RESULTS: Dexamethasone was administered to 2178 (40%) of the 5499 subjects included in this analysis and was not associated with wound infection [189 (8...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28088954/-experiences-of-rescuing-infective-arterial-hemorrhage-and-pseudoaneurysm-in-dcd-kidney-transplantation
#2
D D Zhao, L Q Hong, Z Y Huang, N Na, X F Hua, B Miao, H Li, Q Q Sun
Objective: To summarize experiences of rescuing arterial hemorrhage and pseudoaneurysm caused by infection in donation after cardiac death (DCD) kidney transplantation. Methods: A total of 198 consecutive DCD kidney transplantations between 1 June 2013 and 30 July 2016 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The means of rescuing infective arterial hemorrhage and pseudoaneurysm after operation and their therapeutic effects were summarized. Results: A total of 5 infective arterial hemorrhage, 2 infective pseudoaneurysm with hemorrhage, and 1 infective pseudoaneurysm developed in 198 DCD kidney transplantation recipients with total morbidity of 4...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28069013/decreased-physical-activity-is-a-predictor-for-a-complicated-recovery-post-cardiac-surgery
#3
Charlotte van Laar, Simone T TImman, Luc Noyez
BACKGROUND: Physical activity (PA) reduces the risk of cardiovascular disease and physically active survivors of a cardiac event are at lower risk of recurrent events. We hypothesized that patients with a decreased PA, undergoing cardiac surgery, are at higher risk for a postoperative complicated recovery (PCR). METHODS: Three thousand three hundred eighty two patients undergoing elective cardiac surgery between January 2007 and December 2013 were included. The group was divided into three subgroups: group A, aged ≤ 65 years (N = 1329); group B, aged > 65 years and ≤ 75 years (N = 1250); and group C aged >75 years (N = 803)...
January 7, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28066609/association-between-post-sternotomy-tracheostomy-and-deep-sternal-wound-infection-a-retrospective-analysis
#4
Yi-Chin Tsai, Kevin Phan, Andrie Stroebel, Livia Williams, Lisa Nicotra, Lesley Drake, Elizabeth Ryan, James McGree, Peter Tesar, Kiran Shekar
BACKGROUND: Tracheostomy has traditionally been used as a means of facilitated mechanical ventilation in patients requiring respiratory management following cardiac surgery. However in the clinical setting, the advantages of tracheostomy has been questioned by concerns surrounding evidence of its association with increased risk of deep sternal wound infections (DSWI). The present study sought to evaluate retrospectively our experience with post-sternotomy tracheostomy among cardiac surgery patients and association with DSWI...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28063516/massive-copper-and-selenium-losses-cause-life-threatening-deficiencies-during-prolonged-continuous-renal-replacement
#5
Nawfel Ben-Hamouda, Mélanie Charrière, Pierre Voirol, Mette M Berger
OBJECTIVE: Several trace elements are essential for immunity and wound healing, particularly after major burns. Continuous renal replacement therapy (CRRT), which is used to treat renal failure, causes significant trace elements losses. The aim of the present review is to update the current literature and draw attention to this type of complication, as copper deficiency is rarely suspected and diagnosed in clinical conditions and may occur in chronic critically ill patients. METHODS: This is an emblematic case report and review of literature...
February 2017: Nutrition
https://www.readbyqxmd.com/read/28059916/does-hospital-transfer-impact-outcomes-after-colorectal-surgery
#6
Christopher J Chow, Wolfgang B Gaertner, Christine C Jensen, Bradford Sklow, Robert D Madoff, Mary R Kwaan
BACKGROUND: With increasing public reporting of outcomes and bundled payments, hospitals and providers are scrutinized for morbidity and mortality. The impact of patient transfer before colorectal surgery has not been well characterized in a risk-adjusted fashion. OBJECTIVE: We hypothesized that hospital-to-hospital transfer would independently predict morbidity and mortality beyond traditional predictor variables. DESIGN: We constructed a retrospective cohort of 158,446 patients who underwent colorectal surgery using the 2009-2013 American College of Surgeons National Surgical Quality Improvement Program database...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28057839/niacin-promotes-cardiac-healing-after-myocardial-infarction-through-activation-of-the-myeloid-prostaglandin-d2-receptor-subtype-1
#7
Deping Kong, Juanjuan Li, Yujun Shen, Guihu Liu, Shengkai Zuo, Bo Tao, Yong Ji, Ankang Lu, Michael Lazarus, Richard M Breyer, Ying Yu
Niacin is a well-established drug used to lower cholesterol and prevent cardiovascular disease (CVD) events. However, niacin also causes cutaneous flushing side effects due to release of the proresolution mediator prostaglandin (PG) D2. Recent randomized clinical trials have demonstrated that addition of niacin with laropiprant (a PGD2 receptor subtype 1 [DP1] blocker) to statin-based therapies does not significantly decrease the risk of CVD events but increases the risk of serious adverse events. Here, we tested whether, and how, niacin beneficial effects in vivo myocardial ischemia requires the activation of the PGD2/DP1 axis...
January 5, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28054123/-clamshell-thoracotomy-after-thoracic-knife-wounds
#8
Marcus Rudolph, Niko R E Schneider, Erik Popp
Resuscitation in the event of traumatic cardiac arrest was for a long time considered to be a less than promising technique to employ; however, current data indicate that the prospects of success need not be any poorer than for resuscitation due to cardiac distress. The targeted and rapid remedying of reversible causes can re-establish the circulatory function and the European Resuscitation Council (ERC) algorithm for traumatic cardiac arrest is a helpful guide in this respect. This case report illustrates the resolute implementation of this algorithm in the prehospital environment in the case of an attempted suicide by a thoracic knife wound...
January 4, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28045369/carotid-endarterectomy-following-thrombolysis-for-acute-ischaemic-stroke
#9
Naz Ahmed, Damian Kelleher, Manmohan Madan, Sarita Sochart, George A Antoniou
BACKGROUND: Insufficient evidence exists to support the safety of carotid endarterectomy (CEA) following intravenous thrombolysis (IVT) for acute ischaemic stroke. Our study aimed to report a single-centre experience of patients treated over a five-year period. PATIENTS AND METHODS: Departmental computerised databases were interrogated to identify patients who suffered an ischaemic stroke and subsequently underwent thrombolysis followed by CEA. Mortality and stroke within 30 days of surgery were defined as the primary outcome end points...
January 3, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28034901/body-mass-index-and-mortality-among-adults-undergoing-cardiac-surgery-a-nationwide-study-with-a-systematic-review-and-meta-analysis
#10
Giovanni Mariscalco, Marcin J Woźniak, Alan G Dawson, Giuseppe F Serraino, Richard Porter, Mintu Nath, Catherine Klersy, Tracy Kumar, Gavin J Murphy
BACKGROUND: -In an apparent paradox morbidity and mortality are lower in obese patients undergoing cardiac surgery, although the nature of this association is unclear. We sought to determine whether the obesity paradox observed in cardiac surgery is attributable to reverse epidemiology, bias, or confounding. METHODS: -Data from the National Adult Cardiac Surgery registry for all cardiac surgical procedures performed between April 2002 and March 2013 were extracted...
December 28, 2016: Circulation
https://www.readbyqxmd.com/read/28031550/bug-smash-bug-splash-a-case-report-of-an-unusual-transmission-of-american-trypanosomiasis-with-a-brief-review-of-the-literature
#11
Rafael Hernán Navarrete-Sandoval, Maximiliano Servín-Rojas
BACKGROUND Chagas disease is a chronic parasitosis transmitted by the inoculation of infected triatomine feces into wounds or conjunctival sac, transfusion, congenitally, organ transplantation, and ingestion of contaminated food. The disease is classified into an acute and chronic phase; the latter is a life-long infection that can be asymptomatic or progress to cardiac or digestive complications. CASE REPORT We report a case of acute-phase Chagas disease, transmitted by the splash of gut content from an infected triatomine into the conjunctival mucosa...
December 29, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/28027730/vancomycin-paste-does-not-reduce-the-incidence-of-deep-sternal-wound-infection-after-cardiac-operations
#12
Heather L Lander, Julius I Ejiofor, Siobhan McGurk, Kaneko Tsuyoshi, Prem Shekar, Simon C Body
BACKGROUND: Deep sternal wound infection (DSWI) is a devastating complication that increases morbidity and death in cardiac surgical patients. Vancomycin is often administered intravenously for antibiotic prophylaxis in cardiac operations. Many cardiac surgeons also apply vancomycin paste topically to the sternal edges. We examined the effect of vancomycin paste on the incidence of DSWI in patients undergoing elective cardiac operations. METHODS: We retrospectively reviewed the medical records of all patients from 2003 to 2015 who underwent coronary artery bypass grafting, valve, or combined coronary artery bypass grafting and valve operations at a single institution...
December 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28027187/analysis-of-morbidity-readmission-and-reoperation-after-craniosynostosis-repair-in-children
#13
Kevin T Jubbal, Nikhil Agrawal, Larry H Hollier
The impact of specific patient comorbidities on outcomes in craniosynostosis surgical repair is not well defined. The aim of this retrospective review was to evaluate the short-term 30-day reoperation rate, unplanned readmission rate, and overall morbidity of craniosynostosis surgical repair using the 2012 through 2014 American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-Pediatric) database. Overall morbidity included pneumonia, wound occurrence, shock/sepsis, venous thromboembolism, cardiac complication, renal and urinary complications, or nerve injury...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28025309/safety-and-efficacy-of-prophylactic-negative-pressure-wound-therapy-following-open-saphenous-vein-harvest-in-cardiac-surgery-a-feasibility-study
#14
Arthur J Lee, Christina E Sheppard, William D T Kent, Holly Mewhort, Khokan C Sikdar, Paul W M Fedak
OBJECTIVES: Surgical site complications following great saphenous vein (GSV) harvest presents a significant risk of morbidity. Negative pressure wound therapy (NPWT) has shown promise in the treatment and prophylaxis of open wounds and surgical incisions but has not been studied following GSV harvest. We performed a feasibility study examining the use of NPWT following GSV harvest for coronary bypass surgery. METHODS: Sixty-four patients were recruited in this single-centre, single-blind, randomized controlled trial...
December 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28017338/complications-associated-with-femoral-cannulation-during-minimally-invasive-cardiac-surgery
#15
Joseph Lamelas, Roy F Williams, Maurice Mawad, Angelo LaPietra
BACKGROUND: Different types of cannulation techniques are available for minimally invasive cardiac surgery. At our institution, we favor a femoral platform for most minimally invasive cardiac procedures. Here, we review our results utilizing this cannulation approach. METHODS: We retrospectively reviewed all minimally invasive valve surgeries that were performed at our institution between January 2009 and January 2015. Operative times, lengths of stay, postoperative complications, and mortality were analyzed...
December 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28008902/-management-of-post-sternotomy-mediastinitis-in-cardiac-patients
#16
V A Gorbunov, R K Dzhordzhikiya, M N Mukharyamov, I I Vagizov
Post-sternotomy mediastinitis is a severe complication of cardiac surgery and accompanied by high mortality and cost of treatment. To date, there are no large clinical trials defining treatment of these patients. In this study the authors offer early postoperative wound sanitation, use of vacuum drainage in all cases and surgical repair with local tissues. Sternal destruction is cured by osteosynthesis with wire sutures and perforated metal plates. Proposed algorithm showed low incidence of reccurent wound infection, mortality and duration of treatment...
2016: Khirurgiia
https://www.readbyqxmd.com/read/27997913/the-impact-of-diabetes-mellitus-on-patients-undergoing-cervical-spondylotic-myelopathy-a-meta-analysis
#17
Yang Liu, De-Xiang Ban, Shi-Lian Kan, Tai-Wei Cao, Shi-Qing Feng
AIMS: We conducted a meta-analysis of eligible studies to compare the surgical outcomes between diabetic patients and non-diabetic patients who have undergone cervical spondylotic myelopathy (CSM). METHODS: A systematic literature search of PubMed, Embase, and Web of Science (up to February 10, 2016) was conducted. Eligible studies were case-control or cohort studies that compared the outcomes of cervical surgery between diabetic patients and non-diabetic patients...
2017: European Neurology
https://www.readbyqxmd.com/read/27996097/prevention-of-cardiac-implantable-electronic-device-infections-single-operator-technique-with-use-of-povidone-iodine-double-gloving-meticulous-aseptic-antiseptic-measures-and-antibiotic-prophylaxis
#18
Antonis S Manolis, Helen Melita
BACKGROUND: Cardiac implantable electronic device (CIED) implantation is complicated by infection still at a worrisome rate of 2-5%. Since early on during device implantation procedures, we have adopted an infection preventive technique which has hitherto resulted in effective prevention of infections. Herein we present our results of applying this technique by a single operator in a prospective series of 762 consecutive patients undergoing device implantation. METHODS: A meticulous search for and treatment of active, occult or smoldering infection was undertaken preoperatively...
December 20, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27986483/contemporary-open-repair-of-ruptured-abdominal-aortic-aneurysms
#19
Jeffrey J Siracuse, Brianna M Krafcik, Alik Farber, Jeffrey A Kalish, Andrew McChesney, Denis Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: Although endovascular repair of ruptured abdominal aortic aneurysms (rAAAs) is increasingly more prevalent and may yield better results, open repair of rAAAs is still commonly performed. Our goal was to assess the contemporary practice patterns and outcomes of open repair of rAAA. METHODS: The 2011-2014 American College of Surgeons National Surgical Quality Improvement Program targeted open AAA database was queried for all rAAAs. Patient characteristics, presentation, aneurysm details, and operative details were analyzed to identify factors that may affect outcome in this population of patients...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27977439/bilateral-sternal-infusion-of-ropivacaine-and-length-of-stay-in-icu-after-cardiac-surgery-with-increased-respiratory-risk-a-randomised-controlled-trial
#20
Vedat Eljezi, Etienne Imhoff, Daniel Bourdeaux, Bruno Pereira, Mehdi Farhat, Pierre Schoeffler, Kasra Azarnoush, Christian Dualé
BACKGROUND: The continuous bilateral infusion of a local anaesthetic solution around the sternotomy wound (bilateral sternal) is an innovative technique for reducing pain after sternotomy. OBJECTIVE: To assess the effects of the technique on the need for intensive care in cardiac patients at increased risk of respiratory complications. DESIGN: Randomised, observer-blind controlled trial. SETTING: Single centre, French University Hospital...
February 2017: European Journal of Anaesthesiology
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