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https://www.readbyqxmd.com/read/29141552/para-prosthetic-leaks-following-mitral-valve-replacement-case-analysis-on-a-20-year-period
#1
Melvin Dziubek, Charalampos Pierrakos, Louis Chebli, Helene Demanet, Ahmed Sanoussi, Pierre Wauthy
BACKGROUND: Mitral para-prosthetic leaks are rare but major complications of mitral heart valve replacements. When they must be re-operated, they are burdened with high mortality rates. We propose to review our surgical experience in terms of approach and type of operation carried out. METHODS: Demographic, preoperative, intraoperative and postoperative characteristics of 34 patients who benefited from a surgical treatment of mitral paravalvular leak at the Brugmann University Hospital between 1996 and 2016 have been gathered retrospectively...
November 9, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29132697/treatment-of-postsurgical-chylothorax
#2
Janani S Reisenauer, Carlos A Puig, Chris J Reisenauer, Mark S Allen, Emily Bendel, Stephen D Cassivi, Francis C Nichols, Rob K Shen, Dennis A Wigle, Shanda H Blackmon
BACKGROUND: Postoperative chylothorax can be managed by any or all of observation, parenteral nutrition, surgical duct ligation, pleurodesis, or thoracic duct embolization. The objective of this study was to determine the efficacy of standard therapies, such as surgical duct ligation and observation, compared with newer treatment methods (thoracic duct embolization). METHODS: A prospectively maintained database at a single institution was used to identify and review patients with postoperative chylothorax from 2008 to 2015...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29123584/analysis-of-postoperative-morbidity-and-mortality-following-surgery-for-gastric-cancer-surgeon-volume-as-the-most-significant-prognostic-factor
#3
Maciej Ciesielski, Wiesław J Kruszewski, Jakub Walczak, Mariusz Szajewski, Jarosław Szefel, Jacek Wydra, Tomasz Buczek, Maksymilian Czerepko
Introduction: Surgical resection is the only potentially curative modality for gastric cancer and it is associated with substantial morbidity and mortality. Aim: To determine risk factors for postoperative morbidity and mortality following major surgery for gastric cancer. Material and methods: Between 1.08.2006 and 30.11.2014 in the Department of Oncological Surgery of Gdynia Oncology Centre 162 patients underwent gastric resection for adenocarcinoma...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29122076/a-systematic-review-of-secondary-cerebrospinal-fluid-leaks
#4
Neeraja Konuthula, Mohemmed N Khan, Anthony Del Signore, Satish Govindaraj, Raj Shrivastava, Alfred M Iloreta
BACKGROUND: Secondary cerebrospinal leaks (CSF) are leaks that recur after an initial endoscopic repair of CSF leaks. Identification of characteristics that could predict secondary leaks may allow surgeons to plan repairs with the knowledge that these defects are more likely to fail. OBJECTIVE: To identify characteristics that could predict secondary CSF leaks. METHODS: A search of all studies that reported outcomes after endoscopic repair of CSF leaks was conducted by using medical literature data bases...
November 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29121081/intraoperative-ventilatory-leak-predicts-prolonged-air-leak-after-lung-resection-a-retrospective-observational-study
#5
Won Ho Kim, Hyung-Chul Lee, Ho-Geol Ryu, Hyun-Kyu Yoon, Chul-Woo Jung
Prolonged air leak (PAL), defined as air leak more than 5 days after lung resection, has been associated with various adverse outcomes. However, studies on intraoperative risk factors for PAL are not sufficient. We investigated whether the intraoperative ventilatory leak (VL) can predict PAL. A retrospective study of 1060 patients with chest tubes after lung resection was conducted. Tidal volume data were retrieved from the electronic anesthesia records. Ventilatory leak (%) was calculated as [(inspiratory tidal volume-expiratory tidal volume)/ inspiratory tidal volume × 100] and was measured after restart of two-lung ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/29112566/what-is-the-risk-of-anastomotic-leak-after-repeat-intestinal-resection-in-patients-with-crohn-s-disease
#6
W Forrest Johnston, Caitlin Stafford, Todd D Francone, Thomas E Read, Peter W Marcello, Patricia L Roberts, Rocco Ricciardi
BACKGROUND: Approximately half of Crohn's patients require intestinal resection, and many need repeat resections. OBJECTIVE: The purpose of this study was to evaluate the increased risk of clinical anastomotic leak in patients with a history of previous intestinal resection undergoing repeat resection with anastomosis for Crohn's disease. DESIGN: This was a retrospective analysis of prospectively collected departmental data with 100% capture...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29110271/induced-bias-due-to-crossover-within-randomized-controlled-trials-in-surgical-oncology-a-meta-regression-analysis-of-minimally-invasive-versus-open-surgery-for-the-treatment-of-gastrointestinal-cancer
#7
REVIEW
George Garas, Sheraz R Markar, George Malietzis, Hutan Ashrafian, George B Hanna, Emmanouil Zacharakis, Long R Jiao, Athanassios Argiris, Ara Darzi, Thanos Athanasiou
BACKGROUND: Randomized controlled trials (RCTs) inform clinical practice and have provided the evidence base for introducing minimally invasive surgery (MIS) in surgical oncology. Crossover (unplanned intraoperative conversion of MIS to open surgery) may affect clinical outcomes and the effect size generated from RCTs with homogenization of randomized groups. OBJECTIVES: Our aims were to identify modifiable factors associated with crossover and assess the impact of crossover on clinical endpoints...
November 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29107626/mri-measurements-of-blood-brain-barrier-function-in-dementia-a-review-of-recent-studies
#8
REVIEW
Rajikha Raja, Gary A Rosenberg, Arvind Caprihan
Blood-brain barrier (BBB) separates the systemic circulation and the brain, regulating transport of most molecules to protect the brain microenvironment. Multiple structural and functional components preserve the integrity of the BBB. Several imaging modalities are available to study disruption of the BBB. However, the subtle changes in BBB leakage that occurs in vascular cognitive impairment and Alzheimer's disease have been less well studied. Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is the most widely adopted non-invasive imaging technique for evaluating BBB breakdown...
October 28, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29099022/efficacy-of-pancreatic-endotherapy-in-pancreatic-ascites-and-pleural-effusion
#9
Sudhir Gupta, Nitin Gaikwad, Amol Samarth, Niraj Sawalakhe, Tushar Sankalecha
Pancreatic ascites and effusion is a challenging complication to manage, hence our aim was to evaluate the efficacy of pancreatic endotherapy in pancreatic ascites and pleural effusion. Endotherapy included endoscopic retrograde cholangiopancreatography (ERCP) with a pancreatogram and pancreatic stent placement across the leak in patients with pancreatic ascites/effusion. A total of 53 patients were included after successful cannulation. The male:female ratio was 7.8:1. The pancreatogram revealed a leak from the pancreatic duct in 20/53 (37...
March 27, 2017: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29098278/cranioplasty-using-a-mixture-of-biologic-and-nonbiologic-agents
#10
Demetri Arnaoutakis, Arash Bahrami, Jason E Cohn, Jesse E Smith
Importance: A surgeon faces challenges with cranioplasty techniques to achieve a successful result with relatively few complications. Objective: To describe a unique technique for incorporating both biologic autologous bone and nonbiologic allograft materials for defect coverage in cranioplasty with favorable outcomes and low occurrence of complications. Design, Setting, and Participants: A retrospective medical records review of all 26 patients who underwent primary cranioplasty procedure with a modified technique between January 2011 and December 2015 at a high-volume head and neck oncologic reconstructive practice was conducted; data analysis was also performed during that period...
November 2, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29097442/a-p190brhogap-mutation-and-prolonged-rhob-activation-in-fatal-systemic-capillary-leak-syndrome
#11
Richard W Pierce, Jonathan Merola, John Paul Lavik, Martin S Kluger, Anita Huttner, Mustafa K Khokha, Jordan S Pober
We describe a fatal case of pediatric systemic capillary leak (Clarkson's disease) associated with a point mutation in p190BRhoGAP. Dermal microvascular endothelial cells (ECs) isolated from this patient form monolayers with similar levels and distribution of junctional proteins and transendothelial electrical resistance compared with normal human dermal microvascular ECs. However, patient-derived ECs demonstrate a greater increase in permeability and impaired recovery of barrier function in response to tumor necrosis factor (TNF) compared with normal donor EC cultures...
November 2, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29091335/outcome-of-restorative-proctocolectomy-with-ileo-anal-pouch-for-ulcerative-colitis-effect-of-changes-in-clinical-practice
#12
Adeline Germain, Anthony de Buck van Overstraeten, Albert Wolthuis, Marc Ferrante, Séverine Vermeire, Gert Van Assche, Andre D'Hoore
BACKGROUND: Surgery for ileal pouch-anal anastomosis (IPAA) has evolved over time, especially since the introduction of laparoscopy. OBJECTIVE: The aim of this retrospective study was to report the impact of surgical evolution on outcome over a period of 25 years. DESIGN AND PATIENTS: All patients with IPAA surgery for ulcerative colitis from 1990 to 2015 at the University Hospitals of Leuven were included. Patients were divided into 3 period arms (Period A:1990 - 1999; Period B: 2000 - 2009; Period C: 2010 - 2015)...
November 1, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29083507/complications-and-donor-site-morbidity-of-3-layer-reconstruction-with-iliotibial-tract-of-the-anterior-skull-base-retrospective-analysis-of-186-patients
#13
Davide Mattavelli, Alberto Schreiber, Andrea Bolzoni Villaret, Remo Accorona, Mario Turri-Zanoni, Alessia Lambertoni, Marco Ferrari, Paolo Castelnuovo, Piero Nicolai
BACKGROUND: Anterior skull base reconstruction after resection of sinonasal cancers may be challenging when pedicled flaps are unavailable. The purpose of the present study was to analyze the complication rate and donor site morbidity of 3-layer reconstruction with the iliotibial tract (ITT). METHODS: We retrospectively reviewed all anterior skull base reconstructions with ITT performed from 2007 to 2015. Donor site morbidity was investigated by a dedicated questionnaire...
October 30, 2017: Head & Neck
https://www.readbyqxmd.com/read/29076220/factors-affecting-colostrum-quality-in-australian-pasture-based-dairy-herds
#14
G M Chuck, P D Mansell, M A Stevenson, M M Izzo
OBJECTIVE: The aim of this study was to identify factors affecting colostrum quality in dairy cattle. METHODS: Colostrum samples were collected from lactating dairy cows (n = 990) from nine commercial dairy herds in south-west Victoria. Colostrum quality was measured using an optical Brix refractometer. Cow-level factors thought to influence colostrum quality included season of calving, dam breed and age, volume of first-milking colostrum produced and whether the dam leaked colostrum prior to calving...
November 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/29075913/role-of-echocardiography-in-transcatheter-valvular-heart-disease-interventions
#15
REVIEW
Omar K Khalique, Rebecca T Hahn
PURPOSE OF REVIEW: Transcatheter valvular interventions have increased in importance and utility for surgical valve repair and replacement. Cardiac imaging is the most crucial aspect of procedural planning and guidance. Echocardiography is a widely used, portable, and dynamic imaging modality used for many of these interventions. This review will summarize the role echocardiography in structural heart valvular interventions. RECENT FINDINGS: Intraprocedural echocardiographic guidance has been a mainstay of structural heart interventions...
October 27, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/29075744/multidisciplinary-clinic-management-of-head-and-neck-cancer
#16
Melanie Townsend, Dorina Kallogjeri, Nicholas Scott-Wittenborn, Katherine Gerull, Stacy Jansen, Brian Nussenbaum
Importance: Contemporary management of head and neck cancer involves professionals from multiple specializations. Streamlined care that reduces delays yet allows for comprehensive evaluation is needed. Objective: To evaluate a single-day, single-appointment, multidisciplinary head and neck clinic model for reduction in treatment delay and comprehensiveness of care. Design, Setting, and Participants: A retrospective cohort analysis was conducted from June 1, 2015, to July 31, 2016, of outpatients at a single, academic medical center...
October 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29062741/clinical-outcomes-and-prognostic-factors-of-transcatheter-aortic-valve-implantation-in-bicuspid-aortic-valve-patients
#17
Sung-Han Yoon, Rahul Sharma, Tarun Chakravarty, Hiroyuki Kawamori, Yoshio Maeno, Masaki Miyasaka, Takahiro Nomura, Tomoki Ochiai, Sharjeel Israr, Tanya Rami, Mamoo Nakamura, Wen Chen, Raj R Makkar
BACKGROUND: The purpose of this study was to evaluate the outcomes of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS). METHODS: From April 2012 and December 2016, 108 patients with bicuspid AS underwent TAVR using the Sapien XT (34 patients) and Sapien 3 (74 patients) valves. Procedural and clinical outcomes were assessed according to VARC-2 criteria and compared between the two devices. RESULTS: In the overall cohort, the majority of patients were male (71...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29056477/biliary-complications-among-live-donors-following-live-donor-liver-transplantation
#18
Johns Shaji Mathew, K Manikandan, K Y Santosh Kumar, S T Binoj, Dinesh Balakrishnan, Unnikrishnan Gopalakrishnan, Ramachandran Narayana Menon, Puneet Dhar, O V Sudheer, S Aneesh, Surendran Sudhindran
INTRODUCTION: In live donor liver transplantation (LDLT), bile duct division is a critical step in donor hepatectomy. Biliary complications hence are a feared sequelae even among donors. Long term data on biliary complications in donors from India are sparse. METHODS: Prospective evaluation of 452 live donors over 10 years was performed to ascertain the incidence & risk factors of clinically significant biliary complications. RESULTS: Of the 452 donor hepatectomies (M: F = 114:338, median age = 38), 66...
October 19, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29049665/reoperation-for-mitral-paravalvular-leak-a-single-centre-experience-with-200-patients
#19
Sameh M Said, Hartzell V Schaff, Kevin L Greason, Alberto Pochettino, Richard C Daly, Joseph A Dearani
OBJECTIVES: Paravalvular leak (PVL) is a major cause of morbidity and mortality after mitral valve replacement. Risk factors and data on long-term surgical outcomes are lacking. METHODS: Between January 1995 and December 2012, 206 [118 males (57%)] patients underwent reoperation due to mitral PVL. Mean age was 64 ± 11 years. Haemolytic anaemia was present in 85 (41%) patients, while 137 (67%) patients were in New York Heart Association Class III or IV. Baseline creatinine was above 1...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049477/association-of-the-addition-of-oral-antibiotics-to-mechanical-bowel-preparation-for-left-colon-and-rectal-cancer-resections-with-reduction-of-surgical-site-infections
#20
Elaine Vo, Nader N Massarweh, Christy Y Chai, Hop S Tran Cao, Nader Zamani, Sherry Abraham, Kafayat Adigun, Samir S Awad
Importance: Surgical site infections (SSIs) after colorectal surgery remain a significant complication, particularly for patients with cancer, because they can delay the administration of adjuvant therapy. A combination of oral antibiotics and mechanical bowel preparation (MBP) is a potential, yet controversial, SSI prevention strategy. Objective: To determine the association of the addition of oral antibiotics to MBP with preventing SSIs in left colon and rectal cancer resections and its association with the timely administration of adjuvant therapy...
October 18, 2017: JAMA Surgery
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