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https://www.readbyqxmd.com/read/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#1
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28738031/perioperative-care-implementation-evidence-based-practice-for-patients-with-pancreaticoduodenectomy-using-the-enhanced-recovery-after-surgery-guidelines-%C3%A2
#2
Cesar Aviles, Marilyn Hockenberry, Dionisios Vrochides, David Iannitti, Allyson Cochran, Kendra Tezber, Misty Eller, Janet Desamero
BACKGROUND: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.
. OBJECTIVES: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28737636/reducing-length-of-stay-direct-cost-and-readmissions-in-total-joint-arthroplasty-patients-with-an-outcomes-manager-led-interprofessional-team
#3
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737635/reducing-length-of-stay-direct-cost-and-readmissions-in-total-joint-arthroplasty-patients-with-an-outcomes-manager-led-interprofessional-team
#4
Melissa Arana, Licia Harper, Huanying Qin, Jay Mabrey
The purpose of this quality improvement project was to determine whether an outcomes manager-led interprofessional team could reduce length of stay and direct cost without increasing 30-day readmission rates in the total joint arthroplasty patient population. The goal was to promote interprofessional relationships combined with collaborative practice to promote coordinated care with improved outcomes. Results from this project showed that length of stay (total hip arthroplasty [THA] reduced by 0.4 days and total knee arthroplasty [TKA] reduced by 0...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737132/differences-in-characteristics-and-outcomes-between-community-and-hospital-acquired-acute-kidney-injury-a-systematic-review-and-meta-analysis%C3%A2
#5
Ryota Inokuchi, Yoshitaka Hara, Hideo Yasuda, Noritomo Itami, Yoshio Terada, Kent Doi
INTRODUCTION: No comprehensive review has examined the difference between community-acquired (CA) and hospital-acquired (HA) acute kidney injury (AKI) in terms of patient characteristics, in-hospital mortality, and hospital stay length. MATERIALS AND METHODS: We conducted a systematic review and meta-analysis of observational studies, using MEDLINE, EMBASE, Web of Science, Google Scholar, and the Cochrane Library from their inceptions to April 10, 2016. Observational studies that (1) were published in peer-reviewed journals; (2) compared CA-AKI with HA-AKI, irrespective of the AKI definition during the same period; and (3) investigated in-hospital mortality and length of hospital stay were studied...
July 24, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28737097/elevated-levels-of-procalcitonin-and-interleukin-6-are-linked-with-postoperative-complications-in-cardiac-surgery
#6
A Brocca, G M Virzì, M de Cal, D Giavarina, M Carta, C Ronco
BACKGROUND: Cardiac surgery-associated acute kidney injury is a frequent and serious postoperative complication of cardiac surgery and is associated with an increased risk of morbidity, mortality, and length stay. In this study, we hypothesized that persistent elevation in inflammation in the first 48 h might be a powerful predictor of clinical outcome. Our aim was to elucidate the usefulness of interleukin-6 and procalcitonin postoperative levels in predicting mortality and renal complications in cardiac surgery patients...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28737073/bleeding-pelvic-fracture-patients-evolution-of-resuscitation-protocols
#7
T Söderlund, T Ketonen, L Handolin
BACKGROUND AND AIMS: Massive transfusion protocol seems to improve outcome in massively bleeding trauma patients, but not pelvic fracture patients. The aim of this study was to evaluate the effect of massive transfusion protocol on the mortality and fluid resuscitation of shocked pelvic fracture patients. MATERIAL AND METHODS: This is a trauma register study from a single hospital. From the trauma registry patients with pelvic fracture, injury severity score >15, admission base excess below -5, age >15 years, blunt trauma, and primary admission from the scene were identified...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28737025/-influence-of-initial-protocolized-treatment-with-steroids-in-length-of-stay-and-costs-of-community-acquired-pneumonia
#8
J Gómez Gómez, J L Gómez Torres, A Hernández Torres, J A García Córdoba, M Canteras Jordana
OBJECTIVE: The aim of the study was to analyze the impact of steroid treatment in patients with community acquired pneumonia (CAP), both in length of stay and economical cost of admission at a clinical university hospital. METHODS: Prospective study of admitted patients with the diagnosis of CAP, both in Internal Medicine and Infectious diseases department. The study was conducted from January to march 2015; patients receiving steroids from diagnosis to end of antibiotic treatment were classified as group I; otherwise, they were considered in group II...
July 24, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28736646/sarcopenia-related-to-neoadjuvant-chemotherapy-and-perioperative-outcomes-in-resected-gastric-cancer-a-multi-institutional-analysis
#9
Katelin A Mirkin, Franklyn E Luke, Alexandra Gangi, Jose M Pimiento, Daniel Jeong, Christopher S Hollenbeak, Joyce Wong
BACKGROUND: This study's objective was to evaluate the change in sarcopenia score following neoadjuvant chemotherapy (NAC) and to correlate both sarcopenia and change in score with perioperative outcomes in patients with advanced resected gastric cancer. METHODS: Multi-institutional analysis of patients with gastric cancer who underwent NAC and resection from 2000-2015 was performed. Demographic and perioperative data were included. Sarcopenia score was defined as CT measurement of total psoas muscle at L3, stratified by height (m)...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28736640/systematic-review-and-a-meta-analysis-of-hospital-and-surgeon-volume-outcome-relationships-in-colorectal-cancer-surgery
#10
Ya Ruth Huo, Kevin Phan, David L Morris, Winston Liauw
BACKGROUND: Numerous hospitals worldwide are considering setting minimum volume standards for colorectal surgery. This study aims to examine the association between hospital and surgeon volume on outcomes for colorectal surgery. METHODS: Two investigators independently reviewed six databases from inception to May 2016 for articles that reported outcomes according to hospital and/or surgeon volume. Eligible studies included those in which assessed the association hospital or surgeon volume with outcomes for the surgical treatment of colon and/or rectal cancer...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28736319/robotic-ureteroplasty-with-buccal-mucosa-graft-for-the-management-of-complex-ureteral-strictures
#11
Ziho Lee, Benjamin T Waldorf, Eric Y Cho, Jeffrey C Liu, Michael J Metro, Daniel D Eun
PURPOSE: Surgical management of proximal and mid ureteral strictures not amenable to primary excision and anastomosis is challenging. Although buccal mucosa graft is commonly utilized during substitution urethroplasty, its use in substitution ureteroplasty is limited. We describe our technique for robotic ureteroplasty with buccal mucosa graft for the management of complex ureteral strictures and report our outcomes. MATERIALS AND METHODS: We retrospectively reviewed 12 patients who underwent robotic ureteroplasty with buccal mucosa graft between September 2014 and June 2016...
July 20, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28736006/advantages-of-epidural-analgesia-on-pulmonary-functions-in-liver-transplant-donors
#12
H K Atalan, B Gucyetmez, R Donmez, A Kargi, K Y Polat
OBJECTIVE: Epidural analgesia (EA) has positive effects on anesthetic requirement, blood loss, postoperative analgesia, and pulmonary function tests (PFTs). The purpose of the present study was to investigate the effect of EA on postoperative PFTs in liver transplant donors (LTDs). METHODS: In the present study, 66 LTDs were classified as total intravenous anesthesia (TIVA) and TIVA+EA groups. Patient's age, sex, body mass index, induction and maintenance dose of propofol (IDP and MDP), operation duration, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, visual analog scale (VAS), atelectasis scores, and lengths of intensive care unit (ICU) and hospital stays were recorded...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736003/kidney-graft-salvage-strategies-for-vascular-complications-during-kidney-transplantation-a-single-center-experience
#13
P Horvath, I Capobianco, J Rolinger, A Königsrainer, S Nadalin, I Königsrainer
BACKGROUND: Kidney-related unknown vascular injuries are rare and usually diagnosed only after reperfusion. Hemorrhage that makes in situ reconstruction impossible can lead to graft loss. In an era of organ shortage and an increasing number of patients on the waiting list for transplantation, a kidney graft salvage procedure consisting of graft nephrectomy, reperfusion, reconstruction, and reimplantation should be undertaken whenever possible as a contribution to extending the organs available for transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736002/high-flow-nasal-cannula-versus-noninvasive-ventilation-for-treatment-of-acute-hypoxemic-respiratory-failure-in-renal-transplant-recipients
#14
G Tu, H He, K Yin, M Ju, Y Zheng, D Zhu, Z Luo
OBJECTIVE: This study aimed to evaluate the outcomes of high-flow nasal cannula (HFNC) oxygen therapy compared with noninvasive ventilation (NIV) for the treatment of acute hypoxemic respiratory failure in renal transplant recipients. METHODS: Data were retrospectively collected from a tertiary intensive care unit (ICU) from July 1, 2011, to September 31, 2015. All renal recipients who had acute respiratory failure at that period of time were classified into the HFNC or NIV group depending on the initial form of respiratory support...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735994/kidney-transplantation-using-gonadal-vein-for-venous-anastomosis-in-patients-with-iliac-vein-thrombosis-or-stenosis-a-series-of-cases
#15
J B G de Cerqueira, C M C de Oliveira, B G B Silva, L C O Santos, A G Fernandes, P F C B C Fernandes, E L Maia
BACKGROUND: Kidney transplantation is the treatment of choice for patients with end-stage renal disease. The standard surgery uses the recipient's iliac vessels for vascular anastomosis. Thrombosis and/or stenosis of the iliac vein, which are possible complications of multiple vascular access points for dialysis, can be detected intraoperatively, constituting a surgical challenge. An infrequently reported option is the use of the gonadal vein. OBJECTIVES: This study aims to evaluate the outcomes of venous anastomosis in the gonadal vein in patients with iliac vein thrombosis and/or stenosis submitted to kidney transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735894/geographical-variation-and-trends-in-outcomes-of-laparoscopic-spleen-preserving-distal-pancreatectomy-with-or-withour-splenic-vessel-preservation-a-meta-analysis
#16
REVIEW
Hua Yongfei, Ammar A Javed, Richard Burkhart, Niek A Peters, Alina Hasanain, Matthew J Weiss, Christopher L Wolfgang, Jin He
BACKGROUND: Distal pancreatectomy (DP) is performed to treat tumors of the pancreatic body and tail. Traditionally, splenectomy is performed with a DP, however, laparoscopic spleen-preserving DP (SPDP) using Warshaw's (splenic vessels ligation) or Kimura's (splenic vessels preservation) techniques have been reported. The clinical benefits of using either technique remain unclear. In this study, we conducted a meta-analysis to compare the clinical outcomes of patients undergoing Warshaw's and Kimura SPDP...
July 20, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28735841/the-perioperative-effects-of-chronic-preoperative-opioid-use-on-shoulder-arthroplasty-outcomes
#17
Jonathan W Cheah, David C Sing, Dell McLaughlin, Brian T Feeley, C Benjamin Ma, Alan L Zhang
HYPOTHESIS AND BACKGROUND: Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. METHODS: A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed. Patients were stratified by preoperative opioid use (nonusers, short-acting opioid users, and long-acting opioid users), and their postoperative clinical outcomes were assessed...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735804/effect-of-type-2-diabetes-on-in-hospital-postoperative-complications-and-mortality-after-primary-total-hip-and-knee-arthroplasty
#18
Maria A Martínez-Huedo, Rodrigo Jiménez-García, Isabel Jiménez-Trujillo, Valentín Hernández-Barrera, Benito Del Rio Lopez, Ana López-de-Andrés
BACKGROUND: We aimed to compare in-hospital postoperative complications (IHPC) and in-hospital mortality between patients with and without type 2 diabetes mellitus (T2DM) undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: We analyzed data from the Spanish National Hospital Discharge Database, 2010-2014. We selected patients who had undergone THA (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 81...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735733/incidence-predictors-and-outcomes-associated-with-pneumothorax-during-cardiac-electronic-device-implantation-a-16-year-review-in-over-3-7-million-patients
#19
Gbolahan O Ogunbayo, Richard Charnigo, Yousef Darrat, Gustavo Morales, John Kotter, Odunayo Olorunfemi, Ayman Elbadawi, Vincent L Sorrell, Susan S Smyth, Claude S Elayi
BACKGROUND: Pneumothorax (PTX) is a potential complication of vascular access during cardiac implantable electronic device (CIED) procedure and is under scrutiny as considered a healthcare-acquired condition. OBJECTIVE: Determine the trends in PTX incidence in the United Stated over a 16-year period and whether PTX is associated with increased mortality after adjustment for other factors. METHODS: Using weighted sampling in the largest inpatient health database in the US (National Inpatient Sample), we evaluated data from patients with a primary procedure of CIED implant from 1998 to 2013 who had at least one new vascular access (new or upgrade of prior CIED)...
July 20, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28735551/quality-of-pharmacist-managed-anticoagulation-therapy-in-long-term-ambulatory-settings-a-systematic-review
#20
Beenish S Manzoor, Wei-Han Cheng, James C Lee, Ellen M Uppuluri, Edith A Nutescu
OBJECTIVE: To perform a systematic review to evaluate the quality of warfarin anticoagulation control in outpatient pharmacist-managed anticoagulation services (PMAS) compared with routine medical care (RMC). DATA SOURCES: MEDLINE, SCOPUS, EMBASE, IPA, CINAHL, and Cochrane CENTRAL, from inception to May 2017. Search terms employed: ("pharmacist-managed" OR "pharmacist-provided" OR "pharmacist-led" OR "pharmacist-directed") AND ("anticoagulation services" OR "anticoagulation clinic" OR "anticoagulation management" OR "anticoagulant care") AND ("quality of care" OR "outcomes" OR "bleeding" OR "thromboembolism" OR "mortality" OR "hospitalization" OR "length of stay" OR "emergency department visit" OR "cost" OR "patient satisfaction")...
July 1, 2017: Annals of Pharmacotherapy
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