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Wound Hazard Cox

Yohsuke Honda, Keisuke Hirano, Masahiro Yamawaki, Shinsuke Mori, Shigemitsu Shirai, Kenji Makino, Takahiro Tokuda, Takuro Takama, Masakazu Tsutumi, Yasunari Sakamoto, Hideyuki Takimura, Norihiro Kobayashi, Motoharu Araki, Yoshiaki Ito
We assessed wound healing in patients on hemodialysis (HD) with critical limb ischemia (CLI). This study enrolled 267 patients (including 120 patients on HD and 147 patients not on HD) who underwent endovascular therapy (EVT) for CLI. The primary endpoint was wound-healing rate at two years. Secondary endpoints were time to wound healing, wound recurrence rate, and limb salvage at two years. The percentage of male and young patients was higher in the HD patients (p < 0.01). A lower patency of the pedal arch after EVT was observed frequently in HD patients (p < 0...
October 6, 2016: Vascular
Kristýna Špillerová, Fausto Biancari, Nicla Settembre, Anders Albäck, Maarit Venermo
BACKGROUND: The definition of angiosome-targeted revascularization is confusing, especially when a tissue lesion affects several angiosomes. Two different definitions of direct revascularization exist in the literature. The study aim was: 1) to compare the two definitions of direct revascularization in patients with foot lesions involving more than one angiosome, and 2) to evaluate which definition better predicts clinical outcome. MATERIALS AND METHODS: This study cohort comprises 658 patients with Rutherford 5-6 foot lesions who underwent infrapopliteal endovascular or surgical revascularization between January 2010 and July 2013...
September 29, 2016: Annals of Vascular Surgery
Sara L Zettervall, Peter A Soden, Klaas H J Ultee, Crystal Seldon, Jinhee Oh, Kevin McGann, Marc L Schermerhorn, Raul J Guzman
OBJECTIVE: Elevated serum phosphate levels have been associated with increased risks of cardiovascular events and death in several patient populations. The effects of serum phosphate on outcomes in patients with critical limb ischemia (CLI) have not been evaluated. In this study, we assessed the effect of abnormal phosphate levels on mortality and major limb events after surgical intervention for CLI. METHODS: A retrospective review was undertaken to identify all patients at a single institution who underwent a first-time open or endovascular intervention for CLI between 2005 and 2014...
September 22, 2016: Journal of Vascular Surgery
Janine M Duke, Sean M Randall, Mark W Fear, James H Boyd, Suzanne Rea, Fiona M Wood
BACKGROUND AND OBJECTIVE: The systemic responses triggered by burns and resuscitative measures may cause pulmonary damage and edema in the acute phase. These effects may occur in the absence of inhalation injury. Currently, there is a paucity of data on the recovery of the respiratory system postburn. This study aimed to examine 10-year hospital service use for respiratory morbidity in children with cutaneous burns and no smoke inhalation injury. METHODS: A population-based longitudinal study with 10-year follow-up using linked hospital and death from Western Australia for children <5 years when hospitalized for a first burn injury (n = 5290) between 1980 and 2012 and a frequency matched noninjury comparison cohort, randomly selected from Western Australia's birth registrations (n = 27 061)...
September 23, 2016: Pediatrics
Bernd Brüggenjürgen, Frank Andersohn, Jörg Burkowitz, Nadja Ezzat, Maren Gaudig, Stefan N Willich
BACKGROUND: The individual and societal burden of Alzheimer's disease (AD) is substantial. Identifying relevant factors deteriorating AD and inducing need for nursing care would be of high relevance for healthcare planning. OBJECTIVE: The main objective of this study was the identification of predictors of first assignment of a level of long-term care in AD, used as an approximation for disease progression. METHODS: In a retrospective cohort study using data from a large German statutory health and long-term care insurance (SHI) company, co-morbidities and drug exposure were evaluated with respect to their predictive value for disease progression (first day the amount of daily nursing care exceeded 1...
October 18, 2016: Journal of Alzheimer's Disease: JAD
Amit Bardia, Akshay Sood, Feroze Mahmood, Vwaire Orhurhu, Ariel Mueller, Mario Montealegre-Gallegos, Marc R Shnider, Klaas H J Ultee, Marc L Schermerhorn, Robina Matyal
Importance: Epidural analgesia (EA) is used as an adjunct procedure for postoperative pain control during elective abdominal aortic aneurysm (AAA) surgery. In addition to analgesia, modulatory effects of EA on spinal sympathetic outflow result in improved organ perfusion with reduced complications. Reductions in postoperative complications lead to shorter convalescence and possibly improved 30-day survival. However, the effect of EA on long-term survival when used as an adjunct to general anesthesia (GA) during elective AAA surgery is unknown...
September 7, 2016: JAMA Surgery
Menachem M Meller, Nader Toossi, Mark H Gonzalez, Min-Sun Son, Edmund C Lau, Norman Johanson
BACKGROUND: Patients with morbid obesity, defined as a BMI greater than 40 kg/m(2), and super obesity, defined as a BMI greater than 50 kg/m(2), increasingly present for total hip replacement. There is disagreement in the literature whether these individuals have greater surgical risks and costs for the episode of care, and the magnitude of those risks and costs. There also is no established threshold for obesity as defined by BMI in identifying increased complications, risks, and costs of care...
November 2016: Clinical Orthopaedics and related Research
Kenneth Tran, Brant W Ullery, Marcus R Kret, Jason T Lee
BACKGROUND: The aim of this study was to evaluate the performance and predictors of stent failure of paclitaxel drug-eluting stents for the treatment of femoropopliteal disease. METHODS: A retrospective review of clinical and angiographic data was performed for patients treated for femoropopliteal disease with the Zilver PTX (Cook Medical, Bloomington, IN) stent by a single operator between 2012 and 2015 at a tertiary referral center. Clinical grading was determined by both Rutherford classification and the Society for Vascular Surgery's Wound, Ischemia, and Foot Infection (WIFi) scoring system, and lesions were classified anatomically by the TransAtlantic Intersociety Consensus (TASC) II criteria...
August 20, 2016: Annals of Vascular Surgery
Jonathan P Meizoso, Juliet J Ray, Charles A Karcutskie, Casey J Allen, Tanya L Zakrison, Gerd D Pust, Tulay Koru-Sengul, Enrique Ginzburg, Louis R Pizano, Carl I Schulman, Alan S Livingstone, Kenneth G Proctor, Nicholas Namias
INTRODUCTION: Timely hemorrhage control is paramount in trauma; however, a critical time interval from emergency department arrival to operation for hypotensive gunshot wound (GSW) victims is not established. We hypothesize that delaying surgery for more than 10 minutes from arrival increases all-cause mortality in hypotensive patients with GSW. METHODS: Data of adults (n = 309) with hypotension and GSW to the torso requiring immediate operation from January 2004 to September 2013 were retrospectively reviewed...
October 2016: Journal of Trauma and Acute Care Surgery
Grant W Reed, Negar Salehi, Pejman R Giglou, Rami Kafa, Umair Malik, Michael Maier, Mehdi H Shishehbor
PURPOSE: There are few studies that quantify the impact of time to wound healing on outcomes after endovascular revascularization of critical limb ischemia (CLI). MATERIAL AND METHODS: In this retrospective study, 179 patients with CLI and tissue loss were assessed for adverse events after endovascular therapy. Associations between time to wound healing and outcomes were determined via Cox proportional hazards analysis. The long-term probability of events was assessed with Kaplan-Meier analysis...
June 25, 2016: Annals of Vascular Surgery
Grant W Reed, Pejman Raeisi-Giglou, Rami Kafa, Umair Malik, Negar Salehi, Mehdi H Shishehbor
BACKGROUND: The significance of hospital readmission after endovascular therapy for critical limb ischemia (CLI) is not well established. We sought to investigate the incidence, timing, and causes of readmissions after endovascular therapy for CLI and whether readmission is associated with major adverse limb events (MALE) or mortality. METHODS AND RESULTS: This was a retrospective study of 252 patients treated with endovascular therapy for CLI. During median follow-up of 381 days (interquartile range [IQR], 115-718), 140 (56%) were readmitted, with median time to readmission of 83 days (IQR, 33-190)...
May 2016: Journal of the American Heart Association
Attila Podolyak, Daniel I Sessler, Christian Reiterer, Edith Fleischmann, Ozan Akça, Edward J Mascha, Robert Greif, Andrea Kurz
BACKGROUND: A follow-up analysis from a large trial of oxygen and surgical-site infections reported increased long-term mortality among patients receiving supplemental oxygen, especially those having cancer surgery. Although concerning, there is no obvious mechanism linking oxygen to long-term mortality. We thus tested the hypothesis that supplemental oxygen does not increase long-term mortality in patients undergoing colorectal surgery. Secondarily, we evaluated whether the effect of supplemental oxygen on mortality depended on cancer status...
June 2016: Anesthesia and Analgesia
Han Wu, Xue-Liang Shi, Hai-Jian Zhang, Qing-Jie Song, Xiao-Bing Yang, Wei-Dong Hu, Guang-Lin Mei, Xi Chen, Qin-Sheng Mao, Zhong Chen
PURPOSE: Excessive ST3Gal-I levels predict a poor outcome for patients with several types of tumors. This study aims to investigate the role of ST3Gal-I in determining the invasive and metastatic potential of human hepatocellular carcinoma (HCC) and clinical prognosis for patients with HCC. METHODS: We compared the expression of ST3Gal-I in various HCC cell lines and in 20 pairs of tumor and peritumor tissue samples using Western blot analysis. Changes in the degree of invasiveness and migration were determined before and after small interfering RNA-induced knockdown of ST3Gal-I using a Transwell matrigel invasion assay and scratch wound assay...
2016: OncoTargets and Therapy
Hiroshi Suzuki, Atsuo Maeda, Hideyuki Maezawa, Tomoichiro Togo, Hitoshi Nemoto, Yoshiaki Kasai, Yoshinori Ito, Tokio Nakada, Hirohiko Sueki, Aya Mizukami, Mamiko Takayasu, Kenji Iwaku, Susumu Takeuchi, Hiroyuki Tanaka, Yoshitaka Iso
The aim of the present study was to clarify the characteristics of Japanese critical limb ischemia (CLI) patients and analyze the rates of real-world mortality and amputation-free survival (AFS) in all patients with Fontaine stage IV CLI who were treated with/without revascularization therapy by an intra-hospital multidisciplinary care team. All consecutive patients who presented with CLI at Showa University Fujigaoka Hospital between April 2008 and March 2014 were prospectively registered. The intra-hospital committee consisted of cardiologists, plastic surgeons, dermatologists, diabetologists, nephrologists, cardiovascular surgeons, and vascular technologists...
April 22, 2016: Heart and Vessels
Andrea L Russo, Judith A Adams, Elizabeth A Weyman, Paul M Busse, Saveli I Goldberg, Mark Varvares, Daniel D Deschler, Derrick T Lin, Thomas F Delaney, Annie W Chan
PURPOSE: Squamous cell carcinoma (SCC) is the most common sinonasal cancer and is associated with one of the poor outcomes. Proton therapy allows excellent target coverage with maximal sparing of adjacent normal tissues. We evaluated the long-term outcomes in patients with sinonasal SCC treated with proton therapy. METHODS AND MATERIALS: Between 1991 and 2008, 54 patients with Stage III and IV SCC of the nasal cavity and paranasal sinus received proton beam therapy at our institution to a median dose of 72...
May 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Menachem M Meller, Nader Toossi, Norman A Johanson, Mark H Gonzalez, Min-Sun Son, Edmund C Lau
BACKGROUND: This study investigated the risk and cost of postoperative complications associated with morbid and super obesity after total knee arthroplasty (TKA). METHODS: A retrospective cohort study was conducted of patients who underwent TKA using Medicare hospital claims data. The International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code V85.4x was used to identify morbidly obese patients (body mass index [BMI] ≥40 kg/m(2)) and superobese patients (BMI ≥50 kg/m(2)) in 2011-2013...
October 2016: Journal of Arthroplasty
M Awad, L S C Czer, M A De Robertis, J Mirocha, A Ruzza, M Rafiei, H Reich, A Trento, J Moriguchi, J Kobashigawa, F Esmailian, F Arabia, D Ramzy
PURPOSE: The impact of prior implantation of a ventricular assist device (VAD) on short- and long-term postoperative outcomes of adult heart transplantation (HTx) was investigated. METHODS: Of the 359 adults with prior cardiac surgery who underwent HTx from December 1988 to June 2012 at our institution, 90 had prior VAD and 269 had other (non-VAD) prior cardiac surgery. RESULTS: The VAD group had a lower 60-day survival when compared with the Non-VAD group (91...
January 2016: Transplantation Proceedings
Kristian K Jensen, Peter-Martin Krarup, Thomas Scheike, Lars N Jorgensen, Tommie Mynster
BACKGROUND: Laparoscopic surgery for colonic cancer decreases the incidence of postoperative complications and length of hospital stay as compared with open surgery, while the oncologic outcome remains equivalent. It is unknown whether the surgical approach impacts on the long-term rate of incisional hernia. Furthermore, risk factors for incisional hernia formation are not fully elucidated. The aim of this study was to evaluate the long-term effect of elective open versus laparoscopic surgery for colonic cancer on development of incisional hernia...
October 2016: Surgical Endoscopy
S M Beecher, D P O'Leary, R McLaughlin, K J Sweeney, M J Kerin
BACKGROUND: The rate of immediate breast reconstruction is rising. Postoperative infections are more frequent in patients who undergo reconstruction. The inflammatory response to a postoperative infection can increase the risk of tumour recurrence in other forms of cancer through the release of proinflammatory mediators. The aim of this study was to assess the relationship between complications and breast cancer recurrence in patients undergoing immediate reconstruction. METHODS: This was a review of a prospectively maintained database of all patients who had immediate breast reconstruction between 2004 and 2009 at Galway University Hospital, a tertiary breast cancer referral centre serving the west of Ireland...
March 2016: British Journal of Surgery
Shin Okamoto, Osamu Iida, Mitsuyoshi Takahara, Yasutaka Yamauchi, Keisuke Hirano, Yoshimitsu Soga, Kenji Suzuki, Masaaki Uematsu
PURPOSE: To investigate the thus far poorly defined impact of perioperative complications (POCs) on clinical outcomes after endovascular therapy (EVT) of diabetic patients with critical limb ischemia (CLI) due to isolated infrapopliteal lesions. METHODS: A multicenter registry of CLI patients was interrogated to identify 780 consecutive diabetic patients (mean age 71 ± 10 years; 553 men) who successfully underwent balloon angioplasty for isolated infrapopliteal lesions...
April 2016: Journal of Endovascular Therapy
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