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Tests before elective surgery

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https://www.readbyqxmd.com/read/29132699/is-endocan-a-diagnostic-marker-for-pneumonia-after-cardiac-surgery-the-endolung-study
#1
Andréa Perrotti, Camille Chenevier-Gobeaux, Fiona Ecarnot, Karine Bardonnet, Benoit Barrucand, Guillaume Flicoteaux, Philippe Lassalle, Sidney Chocron
BACKGROUND: Postoperative pneumonia is frequent after cardiac surgery and is associated with increased morbidity and mortality. We tested the hypothesis that endocan is an early biomarker for the detection of pneumonia after cardiac surgery. METHODS: Between January and May 2016, 155 patients scheduled to undergo elective cardiac surgery with cardiopulmonary bypass were prospectively included in the study. Serum level of endocan was measured at five timepoints (preoperative, and at 6, 24, 48, and 72 hours after the end of surgery)...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29098342/preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#2
REVIEW
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery, and may help to optimize the patient's preoperative medical condition and guide perioperative management. Whether performance of additional technical tests (e. g., blood chemistry, electrocardiography, spirometry, chest x‑ray) can contribute to reduction of the perioperative risk is often not well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists, and surgeons with respect to perioperative management of the patient's long-term medication...
November 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29095318/percutaneous-transhepatic-gallbladder-drainage-followed-by-elective-laparoscopic-cholecystectomy-for-patients-with-moderate-to-severe-acute-cholecystitis
#3
Ryukyung Lee, Heontak Ha, Young Seok Han, Hyung Jun Kwon, Hunkyu Ryeom, Jae Min Chun
Percutaneous transhepatic gallbladder drainage followed by laparoscopic cholecystectomy (PTGBD+LC) is one treatment option for patients with moderate to severe acute cholecystitis (AC). However, the impact of PTGBD on operative difficulties in performing LC is controversial. We designed this retrospective study to clarify the surgical outcomes after PTGBD+LC for the management of patients with moderate to severe AC.The medical records of 85 patients who underwent LC for moderate to severe AC from January 2013 to September 2016 were evaluated...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29078891/prolonged-length-of-stay-in-delayed-cholecystectomy-is-not-due-to-intraoperative-or-postoperative-contributors
#4
Misha Bhandari, Chad Wilson, Kenneth Rifkind, Charles DiMaggio, Patricia Ayoung-Chee
BACKGROUND: Previous studies have reported that same-day laparoscopic cholecystectomy for acute cholecystitis is superior to delayed elective cholecystectomy. Although this practice is ideal, it requires significant hospital resources, particularly for an underprivileged inner-city population at a large, municipal hospital. We sought to evaluate the implementation of same-day laparoscopic cholecystectomy in a large, municipal hospital and assess the possible benefits of decreasing preoperative length of stay (LOS), particularly its effect on operative time and length of stay in patients with acute cholecystitis...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29057343/the-prevalence-of-undiagnosed-pre-surgical-cognitive-impairment-and-its-post-surgical-clinical-impact-in-elderly-patients-undergoing-surgery-for-adult-spinal-deformity
#5
Owoicho Adogwa, Aladine A Elsamadicy, Emily Lydon, Victoria D Vuong, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
BACKGROUND: Pre-existing cognitive impairment (CI) is emerging as a predictor of poor post-operative outcomes in elderly patients. Little is known about impaired preoperative cognition and outcomes after elective spine surgery in this patient population. The purpose of this study was to assess the prevalence of neuro CI in elderly patients undergoing deformity surgery and its impact on postoperative outcomes. METHODS: Elderly subjects undergoing elective spinal surgery for correction of adult degenerative scoliosis were enrolled in this study...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29051043/lysyl-oxidase-and-adipose-tissue-dysfunction
#6
Emilie Pastel, Emily Price, Kajsa Sjöholm, Laura J McCulloch, Nikolaj Rittig, Neil Liversedge, Bridget Knight, Niels Moller, Per-Arne Svensson, Katarina Kos
BACKGROUND/OBJECTIVES: Lysyl oxidase (LOX) is an enzyme crucial for collagen fibre crosslinking and thus for fibrosis development. Fibrosis is characterised by a surplus of collagen fibre accumulation and is amongst others also a feature of obesity-associated dysfunctional adipose tissue (AT) which has been linked with type 2 diabetes. We hypothesised that in type 2 diabetes and obesity LOX expression and activity will be increased as a consequence of worsening AT dysfunction. This study aimed to provide a comprehensive characterisation of LOX in human AT...
October 16, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29039829/-factors-for-the-development-of-persistent-postoperative-cognitive-dysfunction-in-patients-undergoing-coronary-artery-bypass-surgery-under-extracorporeal-circulation
#7
O A Trubnikova, I V Tarasova, O V Maleva, E S Kagan, O L Barbarash, L S Barbarash
AIM: To analyze the factors contributing to the increased risk of persistent postoperative cognitive dysfunction (POCD) in patients undergoing coronary artery bypass surgery (CABS) under extracorporeal circulation (EC). SUBJECTS AND METHODS: 257 male patients aged 45 to 69 years with coronary heart disease (CHD) undergoing elective CABS under EC were examined. In addition to conventional clinical examination, all the patients underwent neuropsychological testing 3-5 days before, 7-14 days and 1 year after CABS...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28984098/role-of-flexible-fiberoptic-laryngoscopy-in-predicting-difficult-intubation
#8
Ying Guo, Yufang Feng, Hui Liang, Rubo Zhang, Xiaolan Cai, Xinliang Pan
BACKGROUND: The ability to precisely predict which intubations will be difficult during administration of anesthesia is an importantpart of preoperative preparation. This study's goal is to accurately identify patients who will be difficult to intubate using the number of tracheal rings observed preoperatively by fiberoptic laryngoscopy. METHODS: We enrolled 994 adult patients in our study who required general anesthesia and orotracheal intubation for their elective surgeries...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28974065/predicting-postoperative-morbidity-in-adult-elective-surgical-patients-using-the-surgical-outcome-risk-tool-sort
#9
D J N Wong, C M Oliver, S R Moonesinghe
Background: The Surgical Outcome Risk Tool (SORT) is a risk stratification instrument used to predict perioperative mortality. We wanted to evaluate and refine SORT for better prediction of the risk of postoperative morbidity. Methods: We analysed prospectively collected data from a single-centre cohort of adult patients undergoing major elective surgery. The data set was split randomly into derivation and validation samples. We used logistic regression to construct a model in the derivation sample to predict postoperative morbidity as defined using the validated Postoperative Morbidity Survey (POMS) assessed at 1 week after surgery...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28958653/the-surgical-skills-and-technology-elective-program-sstep-a%C3%A2-comprehensive-simulation-based-surgical-skills-initiative-for-preclerkship-medical-students
#10
Riaz J Karmali, Jennifer M Siu, Daniel Z You, Stefania Spano, Andrea L Winthrop, John F Rudan, Richard K Reznick, Anthony T Sanfilippo, Paul Belliveau
BACKGROUND: The Surgical Skills and Technology Elective Program (SSTEP) is a voluntary preclerkship surgical bootcamp that uses simulation learning to build procedural knowledge and technical skills before clerkship. METHODS: Eighteen second year students (n = 18) participated in simulation workshops over the course of 7 days to learn clerkship-level procedural skills. A manual was supplied with the program outline. Assessment of the participants involved: 1) a written exam 2) a single videotaped Objective Structured Assessment of Technical Skill (OSATS) station 3) an exit survey to document changes in career choices...
September 20, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28922337/role-of-the-internet-as-an-information-resource-before-anaesthesia-consultation-a-french-prospective-multicentre-survey
#11
Bastian Nucci, Pierre-Geraud Claret, Gilles Leclerc, Arnaud Chaumeron, Philippe Grillo, Clément Buleon, Vincent Leprince, Mathieu Raux, Vincent Minville, Emmanuel Futier, Jean-Yves Lefrant, Philippe Cuvillon
BACKGROUND: Use of the internet as an information search tool has increased dramatically. Our study assessed preoperative use of the internet by patients to search for information regarding anaesthesia, surgery, pain or outcomes. OBJECTIVE(S): The aim of this study was to test whether patients used the internet prior to surgery and what kinds of information they looked for (anaesthetic technique, pain, adverse events, outcomes and surgery). Correlation between patient age and information sought about surgery from the internet was also explored...
December 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28920038/comparing-the-effect-of-preoperative-administration-of-melatonin-and-passiflora-incarnata-on-postoperative-cognitive-disorders-in-adult-patients-undergoing-elective-surgery
#12
Faranak Rokhtabnak, Mohammad Reza Ghodraty, Alireza Kholdebarin, Ali Khatibi, Seyedeh Somayeh Seyed Alizadeh, Zahra Sadat Koleini, Mohammad Mahdi Zamani, Alireza Pournajafian
BACKGROUND: Anxiety is a preoperative complication, which most patients encounter. The use of a premedication to reduce preoperative anxiety with minimal cognitive impairment is crucial. OBJECTIVES: This study was conducted to compare the sedative effect of preoperative melatonin and Passiflora incarnata in patients undergoing elective surgery regarding their potential for postoperative cognitive disorders. METHODS: In this clinical trial, 52 patients American society of anesthesiologists grade (ASA) I and II of both genders were selected to receive either Passiflora incarnata (1000 mg nature made) (n = 26) or melatonin (6 mg) (n = 26) as premedication one hour before surgery...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28884102/effects-of-preoperative-walking-ability-and-patient-s-surgical-education-on-quality-of-life-and-functional-outcomes-after-total-knee-arthroplasty
#13
Sunil K Dash, Nishit Palo, Geetanjali Arora, Sidharth S Chandel, Mithilesh Kumar
OBJECTIVE: Prospectively analyze the effect of preoperative walking status and the patient's surgical education on functional outcomes and the three dimensions of quality of life (QoL) (pain, physical function, and mental health) after elective total knee arthroplasty (TKA). METHODS: A comparative analysis on the QoL and functional outcomes in patients who underwent total knee arthroplasty between January 2014 and June 2015. To compare effects of the patient's walking status and knowledge of the surgical procedure on QoL and functional outcomes following TKA by means of SF-36 questionnaire, CES D10, VAS, KSS, KSFS, WOMAC, as well as Friedmann and Wyman scores, 10MWT, and 30-second timed chair test, assessed before the operation and one, three, and six months after the operation...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28858535/implementation-of-surgeon-initiated-gene-expression-profile-testing-onco-type-dx-among-patients-with-early-stage-breast-cancer-to-reduce-delays-in-chemotherapy-initiation
#14
Katya Losk, Rachel A Freedman, Nancy U Lin, Mehra Golshan, Stephen M Pochebit, Susan C Lester, Kelsey Natsuhara, Kristen Camuso, Tari R King, Craig A Bunnell
PURPOSE: Delays to adjuvant chemotherapy initiation in breast cancer may adversely affect clinical outcomes and patient satisfaction. We previously identified an association between genomic testing (Onco type DX) and delayed chemotherapy initiation. We sought to reduce the interval between surgery and adjuvant chemotherapy initiation by developing standardized criteria and workflows for Onco type DX testing. METHODS: Criteria for surgeon-initiated reflex Onco type DX testing, workflows for communication between surgeons and medical oncologists, and a streamlined process for receiving and processing Onco type DX requests in pathology were established by multidisciplinary consensus...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28854542/association-between-delirium-and-cognitive-change-after-cardiac-surgery
#15
A C Sauër, D S Veldhuijzen, T H Ottens, A J C Slooter, C J Kalkman, D van Dijk
Background: Previous studies provide inconsistent data on whether postoperative delirium (POD) is a risk factor for postoperative cognitive decline (POCD). We thus investigated the relationship between POD and cognitive change after cardiac surgery and assessed the relationship between preoperative cognitive domain scores and POD. Methods: Postoperative delirium was assessed with the Confusion Assessment Method (CAM) adapted for the intensive care unit and the conventional CAM accompanied by chart review...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28851399/a-mixed-methods-feasibility-and-external-pilot-study-to-inform-a-large-pragmatic-randomised-controlled-trial-of-the-effects-of-surgical-wound-dressing-strategies-on-surgical-site-infections-bluebelle-phase-b-study-protocol-for-a-randomised-controlled-trial
#16
Barnaby C Reeves, Lazaros Andronis, Jane M Blazeby, Natalie S Blencowe, Melanie Calvert, Joanna Coast, Tim Draycott, Jenny L Donovan, Rachael Gooberman-Hill, Robert J Longman, Laura Magill, Jonathan M Mathers, Thomas D Pinkney, Chris A Rogers, Leila Rooshenas, Andrew Torrance, Nicky J Welton, Mark Woodward, Kate Ashton, Katarzyna D Bera, Gemma L Clayton, Lucy A Culliford, Jo C Dumville, Daisy Elliott, Lucy Ellis, Hannah Gould-Brown, Rhiannon C Macefield, Christel McMullan, Caroline Pope, Dimitrios Siassakos, Sean Strong, Helen Talbot
BACKGROUND: Surgical site infections (SSIs) are common, occurring in up to 25% of > 4 million operations performed in England each year. Previous trials of the effect of wound dressings on the risk of developing a SSI are of poor quality and underpowered. METHODS/DESIGN: This study is a feasibility and pilot trial to examine the feasibility of a full trial that will compare simple dressings, no dressing and tissue-glue as a dressing. It is examining the overall acceptability of trial participation, identifying opportunities for refinement, testing the feasibility of and validating new outcome tools to assess SSI, wound management issues and patients' wound symptom experiences...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28834795/microvascular-reactivity-monitored-with-near-infrared-spectroscopy-is-impaired-after-induction-of-anaesthesia-in-cardiac-surgery-patients-an-observational-study
#17
Lien Vandenbulcke, Koen G Lapage, Katrien V Vanderstraeten, Filip M De Somer, Stefan G De Hert, Annelies T Moerman
BACKGROUND: Induction of anaesthesia causes significant macrohaemodynamic changes, but little is known about its effects on the microcirculation. However, alterations in microvascular perfusion are known to be associated with impaired tissue oxygenation and organ dysfunction. Microvascular reactivity can be assessed with vascular occlusion testing, which evaluates the response of tissue oxygen saturation to transient ischaemia and reperfusion. OBJECTIVE: The aim of the current study was to evaluate the effects of an opioid-based anaesthesia induction on microvascular reactivity...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28818674/effects-of-electroacupuncture-administered-24hours-prior-to-surgery-on-postoperative-nausea-and-vomiting-and-pain-in-patients-undergoing-gynecologic-laparoscopic-surgery-a-feasibility-study
#18
Sha Li, Man Zheng, Wenzhong Wu, Jie Guo, Fangbin Ji, Zhen Zheng
OBJECTIVE: Our study aimed to investigate the feasibility and effectiveness of preoperative electroacupuncture (EA), delivered 24hours before surgery, on postoperative nausea and vomiting (PONV) and postoperative pain in patients undergoing gynecologic laparoscopic surgery. METHODS: In this randomized controlled trial, 40 patients scheduled for elective gynecologic laparoscopic surgery were randomly assigned to the usual care (UC) group and the EA group (n = 20 each)...
June 30, 2017: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/28797752/efficacy-of-continuous-positive-airway-pressure-and-incentive-spirometry-on-respiratory-functions-during-the-postoperative-period-following-supratentorial-craniotomy-a-prospective-randomized-controlled-study
#19
Hulya Kahraman Sah, Eren Fatma Akcil, Yusuf Tunali, Hayriye Vehid, Ozlem Korkmaz Dilmen
STUDY OBJECTIVE: Volume controlled ventilation with low PEEP is used in neuro-anesthesia to provide constant PaCO2 levels and prevent raised intracranial pressure. Therefore, neurosurgery patients prone to atelectasis formation, however, we could not find any study that evaluates prevention of postoperative pulmonary complications in neurosurgery. DESIGN: A prospective, randomized controlled study. SETTING: Intensive care unit in a university hospital in Istanbul...
August 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28783209/impact-of-pre-operative-cardiology-consultation-prior-to-intermediate-risk-surgical-procedures
#20
Volkan Dogan, Murat Biteker, Eda Özlek, Bülent Özlek, Özcan Başaran, Birdal Yıldırım, Kadir Kayataş, Oğuzhan Çelik, Marwa Mouline Doğan
BACKGROUND: Patients undergoing noncardiac, nonvascular surgery (NCNVS) are at risk of perioperative cardiovascular events. However, benefits of cardiology consultation (CC) in patients with known or suspected cardiac disease undergoing intermediate-risk NCNVS is unknown. METHODS: The study group included 700 consecutive patients referred for CC before intermediate-risk NCNVS in a tertiary-care teaching hospital. The control group included 1200 age-matched and sex-matched consecutive patients proceeded to the intermediate-risk surgery without preoperative CC during the same period...
August 7, 2017: European Journal of Clinical Investigation
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