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https://www.readbyqxmd.com/read/29156022/anaortic-off-pump-versus-clampless-off-pump-using-the-pas-port-device-versus-conventional-coronary-artery-bypass-grafting-mid-term-results-from-a-matched-propensity-score-analysis-of-5422-unselected-patients
#1
Nobuyuki Furukawa, Oliver Kuss, Konstantin Preindl, André Renner, Anas Aboud, Kavous Hakim-Meibodi, Michael Benzinger, Thomas Pühler, Stephan Ensminger, Buntaro Fujita, Tobias Becker, Jan F Gummert, Jochen Börgermann
OBJECTIVES: Meta-analyses from observational and randomized studies have demonstrated benefits of off-pump surgery for hard and surrogate endpoints. In some of them, increased re-revascularization was noted in the off-pump groups, which could impact their long-term survival. Therefore, we analyzed the course of all patients undergoing isolated coronary surgery regarding the major cardiac and cerebrovascular event (MACCE) criteria. METHODS: A prospective register was taken from a high-volume off-pump center recording all anaortic off-pump (ANA), clampless off-pump (PAS-Port) and conventional (CONV) coronary artery bypass operations between July 2009 and June 2015...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29156019/the-aspartate-transaminase-alanine-transaminase-deritis-ratio-predicts-mid-term-mortality-and-renal-and-respiratory-dysfunction-after-left-ventricular-assist-device-implantation
#2
Kevin Pilarczyk, Henning Carstens, Jens Heckmann, Ali Canbay, Achim Koch, Nikolaus Pizanis, Heinz Jakob, Markus Kamler
OBJECTIVES: Preoperative liver dysfunction is a well-known risk factor for adverse events after major surgery. However, there is only little data regarding the precise role of the Model of End-Stage Liver Disease (MELD) score and the De Ritis ratio (DRR, alanine transaminase/aspartate aminotransferase) as a predictor for outcome after left ventricular assist device (LVAD) implantation. METHODS: A retrospective analysis of all patients undergoing LVAD implantation at our institution between January 2012 and August 2014 was performed...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155339/body-mass-index-predicts-risk-of-complications-in-lumbar-spine-surgery-based-on-surgical-invasiveness
#3
Olivia J Bono, Gregory W Poorman, Norah Foster, Cyrus M Jalai, Samantha R Horn, Jonathan Oren, Alexandra Soroceanu, Subaraman Ramachandran, Taylor E Purvis, Deeptee Jain, Shaleen Vira, Bassel G Diebo, Breton Line, Daniel M Sciubba, Themistocles S Protopsaltis, Aaron J Buckland, Thomas J Errico, Virginie Lafage, Shay Bess, Peter G Passias
BACKGROUND CONTEXT: Obesity as a comorbidity in spine pathology may increase the risk of complications following surgical treatment. The BMI threshold at which obesity becomes clinically relevant, and the exact nature of that effect, remains poorly understood. PURPOSE: Identify the body mass index (BMI) that independently predicts risk of postoperative complications following lumbar spine surgery. STUDY DESIGN/SETTING: Retrospective review of the National Surgery Quality Improvement Program (NSQIP) years 2011-2013...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155251/the-rothman-index-as-a-predictor-of-post-discharge-adverse-events-after-elective-spine-surgery
#4
Ryan P McLynn, Nathaniel T Ondeck, Jonathan J Cui, David R Swanson, Blake N Shultz, Patawut Bovonratwet, Jonathan N Grauer
BACKGROUND CONTEXT: The Rothman Index (RI) is a comprehensive rating of overall patient condition in the hospital setting. It is used at many medical centers and calculated based on vital signs, lab values, and nursing assessments in the electronic medical record. Past research has demonstrated an association with adverse events, readmission, and mortality in other fields, but it has not been investigated in spine surgery. PURPOSE: To determine the potential utility of the RI as a predictor of adverse events after discharge following elective spine surgery...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155116/the-effect-of-steroids-on-complications-readmission-and-reoperation-after-posterior-lumbar-fusion
#5
Michael B Cloney, Roxanna M Garcia, Zachary A Smith, Nader S Dahdaleh
BACKGROUND DATA: The effects of chronic corticosteroid therapy on complications, readmission, and reoperation after posterior lumbar fusion (PLF) remains under-investigated and was examined to determine differences in outcomes. METHODS: We analyzed patients from 2006 to 2013 using the National Surgery Quality Improvement Program database (NSQIP) undergoing PLF. Patients taking steroids for a chronic condition were compared to those not taking steroids. Multivariable regression identified factors independently associated with complications, readmission, and reoperation...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29152709/perioperative-gastrointestinal-problems-in-the-icu
#6
Annika Reintam Blaser, Joel Starkopf, Pieter-Jan Moonen, Manu L N G Malbrain, Heleen M Oudemans-van Straaten
Gastrointestinal (GI) problems after surgery are common and are not limited to patients undergoing abdominal surgery. GI function is complicated to monitor and is not included in organ dysfunction scores widely used in the ICUs. In most cases, it recovers after surgery, if systemic and local inflammation and perfusion improve, gut oedema resolves, and analgosedation is reduced. However, perioperative GI problems may have severe consequences and increase the risk of death if not recognized and managed in a timely manner...
November 20, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29151960/r-e-n-a-l-nephrometry-score-a-preoperative-risk-factor-predicting-the-fuhrman-grade-of-clear-cell-renal-carcinoma
#7
Shao-Hao Chen, Yu-Peng Wu, Xiao-Dong Li, Tian Lin, Qing-Yong Guo, Ye-Hui Chen, Jin-Bei Huang, Yong Wei, Xue-Yi Xue, Qing-Shui Zheng, Ning Xu
Objective: The purpose of this study was to evaluate the efficacy and feasibility of the R.E.N.A.L. Nephrometry Score to postoperatively predict high-grade clear-cell renal carcinoma (ccRCC). Methods: The study included 288 patients diagnosed with ccRCC who had complete CT/CTA data and R.E.N.A.L. Nephrometry Scores and underwent renal surgery at our center between January 2012 and December 2015. The relationship between the pathological grade of renal masses and R.E.N.A.L. Nephrometry Score was evaluated. Results: Univariate analysis indicated that diagnostic modality, cystic necrosis, enlargement of the regional lymph node, distant metastasis, clinical T stage, TNM stage, surgical modality, tumor size, nearness of the tumor to the collecting system or sinus, total Nephrometry Score and individual anatomic descriptor components were significantly associated with postoperative tumor grade (P < 0...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/29151782/salvage-low-dose-rate-brachytherapy-for-recurrent-prostate-cancer-after-external-beam-radiotherapy-results-from-a-single-institution-with-focus-on-toxicity-and-functional-outcomes
#8
F Barbera, L Triggiani, M Buglione, P Ghirardelli, P Vitali, B Caraffini, P Borghetti, D Greco, L Bardoscia, N Pasinetti, L Costa, M Maddalo, B Ghedi, B La Face, S M Magrini
Background/aim: Low dose rate brachytherapy has been used as salvage therapy for locally recurrent prostate cancer (PC) after primary external beam radiation therapy (EBRT), along with surgery and cryotherapy. All these techniques, in particular, when applied to the whole gland, involve a relatively high risk of toxicity and may worsen the patient's quality of life. Our aim is to evaluate the results of whole-gland salvage brachytherapy (SBT) after primary EBRT in terms of toxicity, functional outcomes, and efficacy...
2017: Clinical Medicine Insights. Oncology
https://www.readbyqxmd.com/read/29151228/previously-implanted-intra-peritoneal-mesh-increases-morbidity-during-re-laparoscopy-a-retrospective-case-matched-cohort-study
#9
A Sharma, P Chowbey, N S Kantharia, M Baijal, V Soni, R Khullar
PURPOSE: Laparoscopic ventral hernia repair (LVHR) with intra-peritoneal mesh placement is standard surgical treatment of abdominal wall hernias. During laparoscopic re-intervention, we examined adhesions that develop after previous intra-peritoneal mesh placement and ascertained morbidity and risk of adverse events. METHODS: This is a retrospective, case-matched comparison of three patient groups-previous intra-peritoneal mesh (Group A), previous abdominal surgery (Group B) and no previous abdominal surgery (Group C)...
November 18, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#10
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29149144/the-efficacy-of-preoperative-gabapentin-in-spinal-surgery-a-meta-analysis-of-randomized-controlled-trials
#11
Chao Han, Ming-Jie Kuang, Jian-Xiong Ma, Xin-Long Ma
BACKGROUND: Pain management after spinal surgery has been studied for years. Gabapentin is a third-generation antiepileptic drug that selectively affects the nociceptive process and has been used for pain relief after surgery. However, the relationship between gabapentin and postoperative pain in spinal surgery is still controversial. OBJECTIVE: To assess the efficacy of the pre-emptive use of gabapentin in spinal surgery. STUDY DESIGN: A meta-analysis of randomized controlled studies...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148256/toward-standardization-of-care-the-feeding-readiness-assessment-after-congenital-cardiac-surgery
#12
Daniel E Ehrmann, Matthew Mulvahill, Shaunda Harendt, Jessica Church, Amy Stimmler, Piyagarnt Vichayavilas, Sanja Batz, Jennifer Rodgers, Michael DiMaria, James Jaggers, Cindy Barrett, Jon Kaufman
BACKGROUND: Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care. METHODS: Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1-year period at a single center...
November 17, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29148080/genetic-risk-factors-for-perception-of-symptoms-in-gerd-an-observational-cohort-study
#13
A Patel, S Hasak, B D Nix, G S Sayuk, R D Newberry, C P Gyawali
BACKGROUND: Genetic polymorphisms in G-protein beta-3 subunit (GNβ3) and beta-2 adrenergic receptor (ADRB2) are associated with pain and gut hypersensitivity, which can overlap with gastroesophageal reflux disease (GERD). AIM: To evaluate relationships between single nucleotide polymorphisms (SNPs) within GNβ3 and ADRB2 systems, and reflux symptom burden, GERD phenotypes from ambulatory reflux monitoring, and quality of life. METHODS: Symptomatic adults undergoing ambulatory reflux testing were recruited and phenotyped based on acid burden and symptom reflux association; major oesophageal motor disorders and prior foregut surgery were exclusions...
November 17, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29147878/knowledge-gaps-in-the-management-of-postoperative-crohn-s-disease-a-us-national-survey
#14
Vu Q Nguyen, Jessica L Mays, Marissa Lang, Yingxing Wu, Themistocles Dassopoulos, Miguel Regueiro, Alan Moss, Deborah D Proctor, Dario Sorrentino
BACKGROUND: Postoperative recurrence (POR) of Crohn's disease (CD) is common. Guidelines on POR management have recently been issued, but clinical practice may vary. AIMS: To examine the current clinical practice of POR management in the USA METHODS: A web-based survey was sent to all members of the American Gastroenterological Association and the American College of Gastroenterology. The survey consisted of multiple-choice questions with clinical scenarios to assess how participants manage POR...
November 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29147763/frailty-in-end-stage-hip-or-knee-osteoarthritis-validation-of-the-groningen-frailty-indicator-gfi-questionnaire
#15
Jennifer M T A Meessen, Claudia S Leichtenberg, Claire Tilbury, Bart L Kaptein, Lennard A Koster, P Eline Slagboom, Suzan H M Verdegaal, Ron Onstenk, Henrike M J van der Linden-van der Zwaag, Herman Kaptijn, Stephan B W Vehmeijer, Willem-Jan C Marijnissen, Pieter-Jan Damen, Rob G H H Nelissen, Thea P M Vliet Vlieland
Frailty is highly prevalent in the elderly, increasing the risk of poor health outcomes. The Groningen Frailty Indicator (GFI) is a 15-item validated questionnaire for the elderly. Its value in patients with end-stage hip or knee osteoarthritis (OA) has not yet been determined. This study assesses the validity of the GFI in this patient group. End-stage hip or knee OA patients completed the GFI (range 0-15, ≥ 4 = frail) before arthroplasty surgery. Convergent validity was determined by Spearman-rank correlation between the SF-12 physical (PCS) and mental (MCS) component scores and the physical and mental GFI-domains, respectively...
November 17, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29147743/low-implant-migration-of-the-sigma-%C3%A2-medial-unicompartmental-knee-arthroplasty
#16
Daan Koppens, Maiken Stilling, Stig Munk, Jesper Dalsgaard, Søren Rytter, Ole Gade Sørensen, Torben Bæk Hansen
PURPOSE: The purpose of this study was to evaluate implant migration of the fixed-bearing Sigma(®) medial unicompartmental knee arthroplasty (UKA). UKA is a regularly used treatment for patients with medial osteoarthritis (OA) of the knee. UKA has a higher revision rate than total knee arthroplasty. Implant migration can be used as a predictor of implant loosening. METHODS: A prospective radiostereometric cohort study was performed. Forty-five patients with medial OA of the knee were included and received a cemented Sigma(®) UKA...
November 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29146626/clinical-outcomes-in-1731-patients-undergoing-mitral-valve-surgery-for-rheumatic-valve-disease
#17
Wan Kee Kim, Ho Jin Kim, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
OBJECTIVE: Unlike degenerative mitral valve (MV) disease, the advantages of valve repair procedure over replacement have been debated in rheumatic MV disease. This study aims to evaluate the impact of procedural types on long-term outcomes through analyses on a large data set from an endemic area of rheumatic disease. METHODS: We evaluated 1731 consecutive patients (52.3±12.5 years; 1190 women) undergoing MV surgery for rheumatic MV disease between 1997 and 2015...
November 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29146268/surgical-apgar-score-predicts-30-day-morbidity-in-elderly-patients-who-undergo-non-laparoscopic-gynecologic-surgery-a-retrospective-analysis
#18
Kazumi Kurata, Yoko Chino, Akiko Shinagawa, Tetsuji Kurokawa, Yoshio Yoshida
INTRODUCTION: The aim of this study was to determine whether a preoperative health status index and intraoperative data could predict perioperative morbidity and mortality in women over the age of 65 years undergoing surgery for gynecologic disorders. METHODS: The medical records of 68 female patients who were ≥65 years of age and who underwent surgery under general anesthesia in our institute from January 2014 to December 2015 were retrospectively reviewed. Preoperative data were extracted from a database and included comorbidities, American Society of Anesthesiologists physiological status classification, the Charlson Comorbidity Index, the Subjective Global Assessment 2011 revision, the subjects' risk of falling, body mass index, and age...
November 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29146036/long-term-outcomes-after-infected-mini-open-rotator-cuff-repair-results-of-a-10-year-review
#19
REVIEW
Rafik Asaid, Kevin Eng, Graeme Brown, Richard Page
BACKGROUND: Infection after rotator cuff repair (RCR) is uncommon. There are few reports in the literature regarding the management and long-term results of patients in whom deep infection of the shoulder develops after RCR. The objective of this study was to assess the long-term clinical and radiologic outcomes of these patients. METHODS: We retrospectively reviewed a consecutive series of 764 patients after mini-open RCR in which 9 patients had postoperative infection...
November 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29145993/an-absorbable-hydrogel-spray-reduces-postoperative-mediastinal-adhesions-after-congenital-heart-surgery
#20
Nahidh Hasaniya, Anees Razzouk, Jennifer Newcombe, Dana Hassneiah, Jessica Heimes, Joshua Gysbers, Timothy Martens, Leonard Bailey
BACKGROUND: Adhesions encountered during reoperative cardiac surgery can prolong operative time and increase operative risk. The purpose of this clinical study was to investigate the antiadhesion property of a synthetic bioabsorbable polymer spray after cardiac reoperations in infants. METHODS: A prospective randomized double-blinded study was designed. Forty infants requiring staged cardiac operations were randomly allocated to a study group (n = 20) or a control group (n = 20)...
November 14, 2017: Annals of Thoracic Surgery
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