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https://www.readbyqxmd.com/read/29793011/thoracic-endovascular-aortic-repair-tevar-versus-best-medical-treatment-bmt-for-high-risk-type-b-intramural-hematoma-imh-a-systematic-review-of-clinical-studies
#1
REVIEW
Lin Li, Yuanyong Jiao, Junjie Zou, Xiwei Zhang, Hongyu Yang, Hao Ma
BACKGROUND: To date , thoracic endovascular aortic repair (TEVAR) for type B aortic dissection is favorable, but TEVAR for type B IMH remains uncertain. There are numerous clinical (eg, refractory pain) and radiologic (eg, IMH thickness) factors that are reported to be associated with IMH progression, challenging the treatment for high-risk type B IMH with high risk factors in clinical practice. OBJECTIVE: To perform a systematic review of clinical studies to investigate outcomes of TEVAR+BMT and BMT in the treatment of high-risk type B IMH ...
May 21, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29792999/does-solid-fusion-eliminate-rod-fracture-after-pedicle-subtraction-osteotomy-in-ankylosing-spondylitis-related-thoracolumbar-kyphosis
#2
Shi-Zhou Zhao, Bang-Ping Qian, Mu Qiao, Jun Jiang, Yong Qiu
BACKGROUND CONTEXT: Rod fracture (RF) has a negative impact on the surgical outcome of ankylosing spondylitis (AS) patients following lumbar pedicle subtraction osteotomy (PSO). However, there is a paucity of published studies analyzing the risk factors for RF in PSO-treated AS patients with thoracolumbar kyphosis. PURPOSE: To investigate the risk factors for RF after PSO for thoracolumbar kyphosis secondary to AS. STUDY DESIGN/SETTING: Retrospective single-center study...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792998/bmi-and-gender-increase-risk-for-sacral-fractures-after-multilevel-instrumented-spinal-fusion-compared-to-bone-mineral-density-and-pelvic-parameters
#3
Stephan N Salzmann, Courtney Ortiz Miller, John A Carrino, Jingyan Yang, Jennifer Shue, Andrew A Sama, Frank P Cammisa, Federico P Girardi, Alexander P Hughes
BACKGROUND CONTEXT: Sacral fractures are a rare but potentially devastating complication. Long-fusion constructs including the sacrum that do not extend to the pelvis may result in sacral fractures. Besides established risk factors including gender, age and number of levels fused, body mass index (BMI), pelvic parameters and bone mineral density (BMD) have also been proposed as potential risk factors for postoperative sacral fractures. The literature supporting this, however, is limited...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792994/lumbar-spinal-stenosis-comparison-of-surgical-practice-variation-and-clinical-outcome-in-three-national-spine-registries
#4
Greger Lønne, Peter Fritzell, Olle Hägg, Dennis Nordvall, Paul Gerdhem, Tobias Lagerbäck, Mikkel Andersen, Søren Eiskjaer, Martin Gehrchen, Wilco Jacobs, Miranda L van Hooff, Tore K Solberg
BACKGROUND: Decompression surgery for lumbar spinal stenosis (LSS) is the most common spinal procedure in the elderly. To avoid persisting low back pain, adding arthrodesis has been recommended, especially if there is a coexisting degenerative spondylolisthesis. However, this strategy remains controversial, resulting in practice-based variation. PURPOSE: To evaluate in a pragmatic study if surgical selection criteria and variation in use of arthrodesis in three Scandinavian countries can be linked to variation in treatment effectiveness...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792992/frailty-status-as-a-predictor-of-three-month-cognitive-and-functional-recovery-following-spinal-surgery-a-prospective-pilot-study
#5
Robert J Rothrock, Jeremy M Steinberger, Henry Badgery, Andrew C Hecht, Samuel K Cho, John M Caridi, Stacie Deiner
Background Context As increasing numbers of elderly Americans undergo spinal surgery, it is important to identify which patients are at highest risk for poor cognitive and functional recovery. Frailty is a geriatric syndrome which has been closely linked to poor outcomes, and short form screening may be a helpful tool for preoperative identification of at risk patients. Purpose To conduct a pilot study on the usefulness of a short-form screening tool to identify elderly patients at increased risk for prolonged cognitive and functional recovery following elective spine surgery...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792925/change-in-patient-reported-outcomes-in-patients-with-and-without-mechanical-symptoms-undergoing-arthroscopic-meniscal-surgery-a-prospective-cohort-study
#6
Kenneth Pihl, Aleksandra Turkiewicz, Martin Englund, L Stefan Lohmander, Uffe Jørgensen, Nis Nissen, Jeppe Schjerning, Jonas B Thorlund
OBJECTIVE: Patients with degenerative or traumatic meniscal tears are at high risk of developing knee osteoarthritis. We investigated if younger (≤40 years) and older (>40 years) patients with preoperative mechanical symptoms improved more in patient-reported outcomes after meniscal surgery than those without mechanical symptoms. DESIGN: Patients from Knee Arthroscopy Cohort Southern Denmark (KACS) undergoing arthroscopic surgery for a meniscal tear completed online questionnaires before surgery, and at 12 and 52 weeks follow-up...
May 21, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29792883/plasma-n-glycan-signatures-associate-with-features-of-inflammatory-bowel-diseases
#7
Florent Clerc, Mislav Novokmet, Viktoria Dotz, Karli R Reiding, Noortje de Haan, Guinevere S M Kammeijer, Hans Dalebout, Marco R Bladergroen, Frano Vukovic, Erdmann Rapp, Stephan R Targan, Gildardo Barron, Natalia Manetti, Anna Latiano, Dermot P B McGovern, Vito Annese, Gordan Lauc, Manfred Wuhrer
BACKGROUND & AIMS: Biomarkers are needed for early detection of Crohn's disease (CD) and ulcerative colitis (UC) or to predict patient outcomes. Glycosylation is a common and complex post-translational modification of proteins that affects their structure and activity. We compared plasma N-glycosylation profiles between patients with CD or UC and healthy individuals (controls). METHODS: We analyzed the total plasma N-glycomes of 2635 patients with inflammatory bowel diseases and 996 controls by mass spectrometry with a linkage-specific sialic acid derivatization technique...
May 21, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29792853/preoperative-obstructive-sleep-apnea-screening-in-gynecologic-oncology-patients
#8
Ross F Harrison, Erin E Medlin, Chase B Petersen, Stephen L Rose, Ellen M Hartenbach, David M Kushner, Ryan J Spencer, Laurel W Rice, Ahmed N Al-Niaimi
BACKGROUND: Women with a gynecologic cancer tend to be older, obese, and postmenopausal, characteristics that are associated with an increased risk for obstructive sleep apnea. However, there is limited investigation regarding the condition's prevalence in this population or its impact on postoperative outcomes. In other surgical populations, patients with obstructive sleep apnea have been observed to be at increased risk for adverse postoperative events. OBJECTIVES: To estimate the prevalence of obstructive sleep apnea among gynecologic oncology patients undergoing elective surgery and to investigate for a relationship between obstructive sleep apnea and postoperative outcomes...
May 21, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29792536/outcomes-in-paediatric-external-dacryocystorhinostomy-a-single-centre-experience
#9
Tarjani Vivek Dave, Edak Ezeanosike, Milind N Naik, Mohammad Javed Ali
PURPOSE: To report the outcomes of external dacryocystorhinostomy (Ext DCR) in paediatric patients. METHODS: A single-centre, retrospective, interventional, non-comparative case series was performed on all paediatric patients who underwent Ext DCR between July 2010 and July 2014. Surgery was performed as per standard Ext DCR protocols with only anterior flap suturing. Data collected include demographics, clinical presentations, primary diagnosis, associated systemic anomalies, past interventions, indications for the surgery, use of adjuvants, intraoperative and post-operative complications, aetiology of DCR failure, anatomical and functional successes...
May 24, 2018: Orbit
https://www.readbyqxmd.com/read/29792393/outcomes-of-transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-geriatric-patients-with-chronic-kidney-disease
#10
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a less invasive treatment modality for patients with severe aortic valve stenosis (AS) who are at a higher risk if they have surgery. Preoperative chronic kidney disease (CKD) influences outcomes of cardiac surgery and is associated with a higher mortality and more complicated hospital course. The aims of our study were to evaluate the comparative outcomes of TAVI versus surgical aortic valve replacement (SAVR) in geriatric patients with preoperative CKD...
May 24, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29792345/dysembryoplastic-neuroepithelial-tumours-clinical-radiological-pathological-features-and-outcome
#11
Cihan Isler, Ozdem Erturk Cetin, Doga Ugurlar, Cigdem Ozkara, Nil Comunoglu, Osman Kizilkilic, Buge Oz, Yasemin Kayadibi, Taner Tanriverdi, Mustafa Uzan
OBJECT: To analyse the clinical, imaging and histopathological data of patients who were diagnosed to have Dysembrioplastic Neuroepithelial Tumour (DNET) and underwent surgery between 1995-2015. MATERIALS AND METHODS: Age at seizure onset, age at surgery, gender, disease duration, seizure outcome of 44 patients were analysed together with Magnetic Resonance Imaging (MRI) of 21 patients. MRI types were classified as type 1 (cystic/polycystic-like, well-delineated, strongly hypointense T1), type 2 (nodularlike,heterogeneous), type 3 (dysplastic-like, iso/hyposignal T1, poor delineation, gray-white matter blurring)...
May 24, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29792278/a-novel-endoscopic-grading-system-for-prediction-of-disease-related-outcomes-in-patients-with-diverticulosis
#12
Meara Dean, Joseph Valentino, Kaitlin Ritter, James Church
BACKGROUND: We describe a simple endoscopic grading system of diverticular disease for the assessment of disease severity and prediction of outcomes. METHODS: A retrospective analysis of prospectively maintained colonoscopy database was conducted. A single endoscopist prospectively graded disease severity according to the number and size of diverticula, the degree of muscular hypertrophy and rigidity of the sigmoid colon. RESULTS: 762 patients were included in the analysis...
May 12, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29792232/effect-of-postoperative-goal-directed-therapy-in-cancer-patients-undergoing-high-risk-surgery-a-randomized-clinical-trial-and-meta-analysis
#13
Aline Rejane Muller Gerent, Juliano Pinheiro Almeida, Evgeny Fominskiy, Giovanni Landoni, Gisele Queiroz de Oliveira, Stephanie Itala Rizk, Julia Tizue Fukushima, Claudia Marques Simoes, Ulysses Ribeiro, Clarice Lee Park, Rosana Ely Nakamura, Rafael Alves Franco, Patricia Inês Cândido, Cintia Rosa Tavares, Ligia Camara, Graziela Dos Santos Rocha Ferreira, Elisangela Pinto Marinho de Almeida, Roberto Kalil Filho, Filomena Regina Barbosa Gomes Galas, Ludhmila Abrahão Hajjar
BACKGROUND: Perioperative goal-directed hemodynamic therapy (GDHT) has been advocated in high-risk patients undergoing noncardiac surgery to reduce postoperative morbidity and mortality. We hypothesized that using cardiac index (CI)-guided GDHT in the postoperative period for patients undergoing high-risk surgery for cancer treatment would reduce 30-day mortality and postoperative complications. METHODS: A randomized, parallel-group, superiority trial was performed in a tertiary oncology hospital...
May 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29792183/estimated-intraoperative-blood-loss-correlates-with-postoperative-cardiopulmonary-complications-and-length-of-stay-in-patients-undergoing-video-assisted-thoracoscopic-lung-cancer-lobectomy-a-retrospective-cohort-study
#14
Shuangjiang Li, Kun Zhou, Yutian Lai, Cheng Shen, Yanming Wu, Guowei Che
BACKGROUND: The purpose of our study was to estimate the influence of estimated intraoperative blood loss (EIBL) on postoperative cardiopulmonary complications (PCCs) in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for non-small-cell lung cancer (NSCLC). METHODS: We conducted a single-center retrospective analysis on the clinical data of consecutive patients in our institution between April 2015 and February 2016. Demographic differences between PCC group and non-PCC group were initially assessed...
May 23, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29792086/risk-of-further-surgery-on-the-same-or-opposite-side-and-mortality-after-primary-total-hip-arthroplasty-a-multi-state-analysis-of-133-654-patients-from-the-swedish-hip-arthroplasty-register
#15
Peter H J Cnudde, Szilard Nemes, Erik Bülow, A John Timperley, Sarah L Whitehouse, Johan Kärrholm, Ola Rolfson
Background and purpose - The hip-related timeline of patients following a total hip arthroplasty (THA) can vary. Ideally patients will live their life without need for further surgery; however, some will undergo replacement on the contralateral hip and/or reoperations. We analyzed the probability of mortality and further hip-related surgery on the same or contralateral hip. Patients and methods - We performed a multi-state survival analysis on a prospectively followed cohort of 133,654 Swedish patients undergoing an elective THA between 1999 and 2012...
May 23, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29792018/predictive-factors-of-a-poor-outcome-following-revascularization-for-critical-limb-ischemia-implications-for-practice
#16
Mireia Martínez, Claudia Sosa, Alina Velescu, Carme Llort, Roberto Elosua, Albert Clarà
BACKGROUND/OBJECTIVE: Advancements in open and endovascular techniques have brought a widespread indication of revascularization in the majority of patients with critical limb ischemia (CLI). However, some cases still have a dismal short-term outcome. Identifying preoperative variables that characterize these patients could be important to prevent futile decisions. The aim of this study was to define predictive risk factors of mortality and/or major amputation after revascularization for CLI...
May 23, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29791966/outcomes-of-bethesda-categories-iii-and-iv-thyroid-nodules-over-5-years-and-performance-of-the-afirma-gene-expression-classifier-a-single-institution-study
#17
Kelsi E Deaver, Bryan R Haugen, Nikita Pozdeyev, Carrie B Marshall
OBJECTIVE: The second edition Bethesda System for Reporting Thyroid Cytology estimates 6-18% malignancy rate of category III (B3) and 10-40% for category IV (B4) nodules; however, reported malignancy rates have considerable variability among institutions. Use of molecular classifiers (including Afirma Gene Expression Classifier, GEC) can be utilized in management of thyroid nodules. Our objective was to analyze malignancy rates of B3 and B4 nodules and determine clinical outcomes of GEC Benign nodules...
May 23, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29791928/the-impact-of-medical-comorbidities-on-primary-total-knee-arthroplasty-reimbursements
#18
Karim G Sabeh, Samuel Rosas, Leonard T Buller, Andrew A Freiberg, Cynthia L Emory, Martin W Roche
Medical comorbidities have been shown to cause an increase in peri-and postoperative complications following total knee arthroplasty (TKA). However, the increase in cost associated with these complications has yet to be determined. Factors that influence cost have been of great interest particularly after the initiation of bundled payment initiatives. In this study, we present and quantify the influence of common medical comorbidities on the cost of care in patients undergoing primary TKA. A retrospective level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary TKA between 2007 and 2015...
May 23, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29791927/treatment-outcome-of-reconstruction-for-isolated-posterior-cruciate-injury-subjective-and-objective-evaluations
#19
Satoshi Ochiai, Tetsuo Hagino, Shinya Senga, Takashi Yamashita, Hirotaka Haro
There is no consensus regarding the treatment method and outcome of posterior cruciate ligament (PCL) injury. We hypothesized that although the outcome of PCL reconstruction was favorable in terms of knee stability, the outcome was unsatisfactory in terms of patient-based assessments. The purpose of this study is to evaluate the treatment outcomes of knees that underwent reconstruction for PCL injury by subjective and objective assessments, and to analyze the correlation between various assessments. Twenty-three patients who underwent PCL reconstruction were studied...
May 23, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29791900/re-operative-pancreaticoduodenectomy-challenges-and-outcomes
#20
Manish S Bhandare, Nikhil Mehta, Vikram Chaudhari, Naveena An Kumar, Esha Pai, Mahesh Goel, Shailesh V Shrikhande
BACKGROUND: Tata Memorial Centre (TMC) is a high-volume centre for pancreatic tumour resections. We found a continually increasing referral of pancreatic tumours for re-evaluation for surgery, after an initial unsuccessful attempt at resection. AIM: To evaluate reasons of initial in-operability, the feasibility of re-operative pancreatico-duodenectomy (R-PD) and short- and long-term outcomes after R-PD. METHODS: Data was collected from a prospective database of GI and hepato-pancreato-biliary service, TMC, Mumbai from January 2008 to December 2016...
May 23, 2018: Digestive Surgery
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