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https://www.readbyqxmd.com/read/28821166/perioperative-acute-myocardial-infarction-associated-with-non-cardiac-surgery
#1
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, Jeffrey S Berger, Sripal Bangalore
Aims: Acute myocardial infarction (AMI) is a significant cardiovascular complication following non-cardiac surgery. We sought to evaluate national trends in perioperative AMI, its management, and outcomes. Methods and results: Patients who underwent non-cardiac surgery from 2005 to 2013 were identified using the United States National Inpatient Sample. Perioperative AMI was evaluated over time. Propensity score matching was used to compile a cohort of AMI patients managed invasively (defined as cardiac catheterization or coronary revascularization) vs...
August 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28807383/prediction-of-major-cardiac-events-after-vascular-surgery
#2
Danielle M Gualandro, Christian Puelacher, Giovanna LuratiBuse, Gisela B Llobet, Pai C Yu, Francisco A Cardozo, Noemi Glarner, Andres Zimmerli, Jaqueline Espinola, Sydney Corbière, Daniela Calderaro, Andre C Marques, Ivan B Casella, Nelson de Luccia, Mucio T Oliveira, Andreas Lampart, Daniel Bolliger, Luzius Steiner, Manfred Seeberger, Christoph Kindler, Stefan Osswald, Lorenz Gürke, Bruno Caramelli, Christian Mueller
OBJECTIVE: Predicting cardiac events is essential to provide patients with the best medical care and to assess the risk-benefit ratio of surgical procedures. The aim of our study was to evaluate the performance of the Revised Cardiac Risk Index (Lee) and the Vascular Study Group of New England Cardiac Risk Index (VSG) scores for the prediction of major cardiac events in unselected patients undergoing arterial surgery and to determine whether the inclusion of additional risk factors improved their accuracy...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28772186/an-evaluation-of-involving-family-caregivers-in-the-self-care-of-heart-failure-patients-on-hospital-readmission-randomised-controlled-trial-the-family-study
#3
Hiba Deek, Sungwon Chang, Phillip J Newton, Samar Noureddine, Sally C Inglis, Ghina Al Arab, Samer Kabbani, Wael Chalak, Nadim Timani, Peter S Macdonald, Patricia M Davidson
BACKGROUND: The prevalence of heart failure is increasing in Lebanon but to date there is no systematic evaluation of a disease management intervention. OBJECTIVE: The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission. DESIGN: A multi-site, block randomised controlled trial. SETTINGS: The study was conducted over a 13-month period in three tertiary medical centres in Beirut and Mount Lebanon, Lebanon...
July 25, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28768786/posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis-using-a-convex-pedicle-screw-technique-a-novel-concept-of-deformity-correction
#4
A I Tsirikos, G Mataliotakis, N Bounakis
AIMS: We present the results of correcting a double or triple curve adolescent idiopathic scoliosis using a convex segmental pedicle screw technique. PATIENTS AND METHODS: We reviewed 191 patients with a mean age at surgery of 15 years (11 to 23.3). Pedicle screws were placed at the convexity of each curve. Concave screws were inserted at one or two cephalad levels and two caudal levels. The mean operating time was 183 minutes (132 to 276) and the mean blood loss 0...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28766692/truncal-varicose-vein-diameter-and-patient-reported-outcome-measures
#5
T R A Lane, L Varatharajan, F Fiorentino, A C Shepherd, L Zimmo, M S Gohel, I J Franklin, A H Davies
BACKGROUND: Varicose veins and chronic venous disease are common, and some funding bodies ration treatment based on a minimum diameter of the incompetent truncal vein. This study assessed the effect of maximum vein diameter on clinical status and patient symptoms. METHODS: A prospective observational cohort study of patients presenting with symptomatic varicose veins to a tertiary referral public hospital vascular clinic between January 2011 and July 2012. Patients underwent standardized assessment with venous duplex ultrasonography, and completed questionnaires assessing quality of life (QoL) and symptoms (Aberdeen Varicose Vein Questionnaire, EuroQol Five Domain QoL assessment and EuroQol visual analogue scale)...
August 2, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28756046/a-preoperative-risk-score-for-transfusion-in-infrarenal-endovascular-aneurysm-repair-to-avoid-type-and-cross
#6
Thomas F X O'Donnell, Katie E Shean, Sarah E Deery, Thomas C F Bodewes, Mark C Wyers, Kerry L O'Brien, Robina Matyal, Marc L Schermerhorn
OBJECTIVE: Preoperative type and cross are often routinely ordered before elective endovascular aneurysm repair (EVAR), but the cost of this practice is high, and transfusion is rare. We therefore aimed to stratify patients by their risk of transfusion to identify a cohort in whom a type and screen would be sufficient. METHODS: We queried the targeted vascular module of the National Surgical Quality Improvement Program (NSQIP) for all elective EVARs from 2011 to 2015...
July 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28750481/aqueous-shunts-for-glaucoma
#7
REVIEW
Victoria L Tseng, Anne L Coleman, Melinda Y Chang, Joseph Caprioli
BACKGROUND: Aqueous shunts are employed to control intraocular pressure (IOP) for people with primary or secondary glaucomas who fail or are not candidates for standard surgery. OBJECTIVES: To assess the effectiveness and safety of aqueous shunts for reducing IOP in glaucoma compared with standard surgery, another type of aqueous shunt, or modification to the aqueous shunt procedure. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 8), MEDLINE Ovid (1946 to August 2016), Embase...
July 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28739464/prophylactic-groin-wound-vacuum-assisted-therapy-in-vascular-surgery-patients-at-enhanced-risk-for-postoperative-wound-infection
#8
Luke O Pesonen, Brian G Halloran, Abdulhameed Aziz
OBJECTIVE: Vascular groin wounds have higher than expected surgical site infection (SSI) rates and some patients are at enhanced risk. The Wiseman et al. paper suggests an objective scoring system that identifies patients at enhanced risk of postdischarge SSI. We hypothesize that prophylactic groin wound vacuum-assisted closure (VAC) therapy in enhanced risk patients will decrease SSI and readmission and the Wiseman model provides potential evidence that enhanced risk patients can be objectively identified...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28728556/influence-of-staphylococcus-aureus-on-outcomes-after-valvular-surgery-for-infective-endocarditis
#9
Sang Myung Han, Robert A Sorabella, Sowmya Vasan, Mark Grbic, Daniel Lambert, Rahul Prasad, Catherine Wang, Paul Kurlansky, Michael A Borger, Rachel Gordon, Isaac George
BACKGROUND: As Staphylococcus aureus (SA) remains one of the leading cause of infective endocarditis (IE), this study evaluates whether S. aureus is associated with more severe infections or worsened outcomes compared to non-S. aureus (NSA) organisms. METHODS: All patients undergoing valve surgery for bacterial IE between 1995 and 2013 at our institution were included in this study (n = 323). Clinical data were retrospectively collected from the chart review. Patients were stratified according to the causative organism; SA (n = 85) and NSA (n = 238)...
July 20, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28692690/risk-of-surgical-site-infection-acute-kidney-injury-and-clostridium-difficile-infection-following-antibiotic-prophylaxis-with-vancomycin-plus-a-beta-lactam-versus-either-drug-alone-a-national-propensity-score-adjusted-retrospective-cohort-study
#10
MULTICENTER STUDY
Westyn Branch-Elliman, John E Ripollone, William J O'Brien, Kamal M F Itani, Marin L Schweizer, Eli Perencevich, Judith Strymish, Kalpana Gupta
BACKGROUND: The optimal regimen for perioperative antimicrobial prophylaxis is controversial. Use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. Thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (SSIs). Potential harms associated with combination regimens, including acute kidney injury (AKI) and Clostridium difficile infection (CDI), were also considered...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28689947/a-novel-iliac-morphology-score-predicts-procedural-mortality-and-major-vascular-complications-in-transfemoral-aortic-valve-replacement
#11
Juliet Blakeslee-Carter, David Dexter, Paul Mahoney, Sadie Ahanchi, Samuel Steerman, Sebastian Larion, Brandon Cain, Jean Panneton
OBJECTIVES: Vascular complications remain a significant technical challenge for transfemoral TAVR (Transcatheter Aortic Valve Replacement). The goal of this study was to develop a pre-operative tool for prediction of major vascular complications of TAVR. METHODS: A retrospective review was performed of all patients who underwent transfemoral TAVR at a tertiary medical center from 2011-2015. Iliofemoral arterial measurements were obtained with CTA 3D reconstructions images and an Iliac Morphology Score (IMS) was created from these measurements...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28657940/the-fifth-vital-sign-postoperative-pain-predicts-30-day-readmissions-and-subsequent-emergency-department-visits
#12
Tina Hernandez-Boussard, Laura A Graham, Karishma Desai, Tyler S Wahl, Elise Aucoin, Joshua S Richman, Melanie S Morris, Kamal M Itani, Gordon L Telford, Mary T Hawn
OBJECTIVE: We hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. BACKGROUND: Surgical readmissions have few known modifiable predictors. Pain experienced by patients may reflect surgical complications and/or inadequate or difficult symptom management. METHODS: National Veterans Affairs Surgical Quality Improvement data on inpatient general, vascular, and orthopedic surgery from 2008 to 2014 were merged with laboratory, vital sign, health care utilization, and postoperative complications data...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28638446/overexpression-of-transcobalamin-1-is-an-independent-negative-prognosticator-in-rectal-cancers-receiving-concurrent-chemoradiotherapy
#13
Yi-Ying Lee, Yu-Ching Wei, Yu-Feng Tian, Ding-Ping Sun, Ming-Jen Sheu, Ching-Chieh Yang, Li-Ching Lin, Chen-Yi Lin, Chung-Hsi Hsing, Wan-Shan Li, Chien-Feng Li, Pei-Ling Hsieh, Ching-Yih Lin
Objective: Neoadjuvant concurrent chemoradiotherapy (CCRT) is an increasingly common therapeutic strategy for locally advanced rectal cancer, but stratification of risk and final outcomes remain a major challenge. Transcobalamin 1 (TCN1), a vitamin B12 (cobalamin)-binding protein, regulates cobalamin homeostasis. High expression of TCN1 have been reported in neoplasms such as breast cancer and hepatocellular carcinoma. However, little is known about the relevance of TCN1 to rectal cancer receiving CCRT. This study examined the predictive and prognostic impact of TCN1 expression in patients with rectal cancer following neoadjuvant CCRT...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28622175/predictors-prognosis-and-management-of-new-clinically-important-atrial-fibrillation-after-noncardiac-surgery-a-prospective-cohort-study
#14
MULTICENTER STUDY
Pablo Alonso-Coello, Deborah Cook, Shou Chun Xu, Alben Sigamani, Otavio Berwanger, Soori Sivakumaran, Homer Yang, Denis Xavier, Luz Ximena Martinez, Pedro Ibarra, Purnima Rao-Melacini, Janice Pogue, Kelly Zarnke, Pilar Paniagua, Jack Ostrander, Salim Yusuf, P J Devereaux
BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28608956/systematic-review-of-mortality-risk-prediction-models-in-the-era-of-endovascular-abdominal-aortic-aneurysm-surgery
#15
REVIEW
N Lijftogt, T W F Luijnenburg, A C Vahl, E D Wilschut, V J Leijdekkers, M F Fiocco, M W J M Wouters, J F Hamming
BACKGROUND: The introduction of endovascular aneurysm repair (EVAR) has reduced perioperative mortality after abdominal aortic aneurysm (AAA) surgery. The objective of this systematic review was to assess existing mortality risk prediction models, and identify which are most useful for patients undergoing AAA repair by either EVAR or open surgical repair. METHODS: A systematic search of the literature was conducted for perioperative mortality risk prediction models for patients with AAA published since 2006...
July 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28588090/associations-between-cardiac-troponin-mechanism-of-myocardial-injury-and-long-term-mortality-after-noncardiac-vascular-surgery
#16
Grant W Reed, Samuel Horr, Laura Young, Joshua Clevenger, Umair Malik, Stephen G Ellis, A Michael Lincoff, Steven E Nissen, Venu Menon
BACKGROUND: The time-sensitive hazard of perioperative cardiac troponin T (cTnT) elevation and whether long-term mortality differs by mechanism of myocardial injury are poorly understood. METHODS AND RESULTS: In this observational study of 12 882 patients who underwent noncardiac vascular surgery, patients were assessed for cTnT sampling within 96 hours postoperatively. Mortality out to 5-years was stratified by cTnT level and mechanism of myocardial injury. During a median follow-up of 26...
June 6, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28570233/sex-related-differences-in-outcomes-after-percutaneous-balloon-aortic-valvuloplasty
#17
Marzena Daniec, Artur Dziewierz, Danuta Sorysz, Paweł Kleczyński, Tomasz Rakowski, Łukasz Rzeszutko, Jarosław Trębacz, Marek Tomala, Bartłomiej Nawrotek, Krzysztof Żmudka, Dariusz Dudek
OBJECTIVES: We aimed to evaluate sex-related differences in short-term and long-term outcomes of patients undergoing balloon aortic valvuloplasty (BAV) for severe aortic stenosis (AS). METHODS: A total of 112 patients with severe AS underwent 114 BAV procedures as palliative procedure, bridge to definitive treatment, or before urgent non-cardiac surgery. Patients were followed for 24 months. RESULTS: Of the 112 patients, 70 (62.5%) were women...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28562573/predictors-of-secondary-amputation-in-patients-with-grade-iiic-lower-limb-injuries-a-retrospective-analysis-of-35-patients
#18
Wenhao Song, DongSheng Zhou, Jinlei Dong
The aim of this study was to identify risk factors for failure of limb salvage surgery in grade IIIC lower extremity injuries.A single-institution, retrospective review was performed of all patients with grade IIIC lower limb injuries presenting from January 2009 to April 2014. We gathered the data on each patient who underwent limb salvage and analyzed the final outcome for these patients (limb salvage vs secondary amputation).Grade IIIC lower limb injuries were identified in 41 patients. Primary amputation was performed in 6 patients (15%) as the initial procedure...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28537037/abdominal-paragangliomas-a-quantitative-prognostic-score-as-predictive-factor-of-the-feasibility-of-the-laparoscopic-approach
#19
Giovanni Alemanno, Carlo Bergamini, Riccardo Somigli, Paolo Prosperi, Alessandro Bruscino, Andrea Valeri
The gold standard treatment for abdominal paraganglioma is the complete surgical excision. The surgical approach may be either open or laparoscopic. The aim of this study is to identify clinical-pathological predictive factors for the failure of the laparoscopic approach in the treatment of abdominal paragangliomas, with the aim of reducing the rate of conversion to the open technique. A retrospective review was conducted on the medical records of patients who underwent laparoscopic surgery for suspected abdominal paraganglioma...
May 23, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28501136/delayed-splenic-vascular-injury-after-nonoperative-management-of-blunt-splenic-trauma
#20
Alessandro Furlan, Mitchell E Tublin, Mitchell A Rees, Dederia H Nicholas, Jason L Sperry, Louis H Alarcon
BACKGROUND: Delayed splenic vascular injury (DSVI) is traditionally considered a rare, often clinically occult, harbinger of splenic rupture in patients with splenic trauma that are managed conservatively. The purpose of our study was to assess the incidence of DSVI and associated features in patients admitted with blunt splenic trauma and managed nonoperatively. MATERIALS AND METHODS: A retrospective analysis was conducted over a 4-y time. Patients admitted with blunt splenic trauma, managed no-operatively and with a follow-up contrast-enhanced computed tomography (CT) scan study during admission were included...
May 1, 2017: Journal of Surgical Research
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