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Post operative risk score

Kumar Rajnish, Sathasivam Sureshkumar, Manwar S Ali, Chellappa Vijayakumar, Sundaramurthi Sudharsanan, Chinnakali Palanivel
Introduction Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Routinely used electrocautery produces more smoke, which masks the operating field, thereby prolongs the surgery and posing an increased risk of gallbladder (GB) perforation. The titanium clips used for clipping the cystic artery and cystic duct have a risk of slippage, which may lead to bleeding, and an increased risk for bile leakage. In addition, it may act as a nidus for stone formation. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips...
January 18, 2018: Curēus
A Galland, S Airaudi, J Mancini, R Gravier, D Camus
BACKGROUND: Reports of early glenoid wear after humeral resurfacing hemiarthroplasty have prompted the use, in combination with this procedure, of newly developed glenoid implants. This combination can increase global humeral offset. The objectives of this study were to assess changes in overall lateral offset and their potential short-term clinical consequences after combined humeral resurfacing and glenoid replacement. HYPOTHESIS: Combined humeral resurfacing and glenoid replacement induces a large increase in overall lateral offset, resulting in short-term clinical consequences...
March 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ziyang Sun, Hao Xiong, Cunyi Fan
BACKGROUND: Diabetes and prediabetes are worldwide public health problems and are considered predisposing factors for adverse functional outcomes after various orthopedic operations. The purpose of this retrospective study was to determine the impact of glucose metabolism status on functional outcomes and complications after open arthrolysis for post-traumatic elbow stiffness. METHODS: The study included 152 patients with post-traumatic elbow stiffness undergoing arthrolysis, including 120 in the normoglycemic group, 21 in the impaired glucose regulation group, and 11 in the diabetes mellitus group...
March 16, 2018: Journal of Shoulder and Elbow Surgery
Islam Abdelrahman, Ingrid Steinvall, Bassem Mossaad, Folke Sjoberg, Moustafa Elmasry
BACKGROUND: Gynaecomastia is a benign enlargement of the male breast, of which the psychological burden on the patient can be considerable, with the increased risk of disorders such as depression, anxiety, and social phobia. Minimal scarring can be achieved by liposuction alone, though it is known to have a limited effect on the dense glandular and fibroconnective tissues. We know of few studies published on "liposuction alone", so we designed this study to evaluate the outcome of combining liposuction with glandular liposculpturing through two axillary incisions as a single treatment for the management of grades I and II gynaecomastia...
March 16, 2018: Aesthetic Plastic Surgery
Ting-Shi Su, Ren Luo, Ping Liang, Tao Cheng, Ying Zhou, Yong Huang
PURPOSE: To build and validate multivariate normal tissue complication probability (NTCP) models for radiation-induced hepatic toxicity (RIHT) after stereotactic body radiation therapy (SBRT). METHODS: Eighty-five patients with hepatocellular carcinoma (HCC) in a phase II clinical trial were enroled. A progression of at least 1 or 2 points in the Child-Pugh (CP) score post-SBRT was classified as RIHT (≥1 or ≥2). NTCP models for RIHT (≥1 or ≥2) were developed using logistic regression...
March 13, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
David Asuzu, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Small bowel obstruction is common and often requires surgical management. Simple preoperative models are lacking to predict post-operative complications after surgical management of adhesive small bowel obstruction. METHODS: We retrospectively analyzed data from 15,036 patients who underwent open lysis of adhesions for small bowel obstruction from 2005 to 2013 using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database...
March 6, 2018: American Journal of Surgery
Rachel A Hoopsick, D Lynn Homish, Paul T Bartone, Gregory G Homish
Background: Much research has focused on stress related to deployments; however, a substantial proportion of soldiers never deploy. In a study of 1.3 million veterans, suicide risk was higher among veterans who had never deployed. Thus, not being deployed may have an impact on soldiers' well-being; however, no measures exist to assess emotions regarding non-deployment. We aimed to develop and test an original measure of non-deployment emotions. Methods: We examined the Non-Deployment Emotions (NDE) questionnaire, a novel four-item measure of guilt, unit value, unit camaraderie, and unit connectedness in a sample of never-deployed male and female US Army Reserve/National Guard (USAR/NG) soldiers (N = 174)...
March 14, 2018: Military Medicine
Pelumi Adedayo, Kimberly Resnick, Sareena Singh
OBJECTIVE: Our objective was to examine the association of the modified frailty index (mFI) and non-home discharge in patients undergoing surgery for endometrial cancer (EMCA). METHODS: Patients who underwent surgery for EMCA from 2011 to 2012 were identified from the American College of Surgeons - Nastional Surigical Quality Improvement Project (ACS-NSQIP) database. Current Procedural Terminology (CPT) codes were used to identify surgical characteristics. We excluded patients who were already living in a non-home facility...
March 9, 2018: Journal of Geriatric Oncology
Weiwei Lin, Hongtao Xu, Guman Duan, Jinjin Xie, Yisheng Chen, Baohua Jiao, Haitao Lan
Purpose Tethered cord syndrome (TCS) is the clinical manifestation of an abnormal stretch on the spinal cord, caused by several pathological conditions. Tethered cord release is the gold standard treatment for TCS. However, direct untethering carries potential risks of spinal cord injury, post-operative retethering, and CSF-related complications. Spine-shortening osteotomy (SSO) has recently been performed as an alternative technique to avoid these risks. We aimed to systematically review the literature on indications and outcome of SSO in TCS patients...
March 12, 2018: Neurological Research
Vincent Johan Nijenhuis, Joyce Peper, Veronique M M Vorselaars, Martin J Swaans, Thom De Kroon, Jan A S Van der Heyden, Benno J W M Rensing, Robin Heijmen, Willem-Jan W Bos, Jurrien M Ten Berg
Transcatheter aortic valve implantation (TAVI) is associated with acute kidney injury (AKI), but can also improve the kidney function (IKF). We assessed the effects of kidney function changes in relation to baseline kidney function on 2-year clinical outcomes after TAVI. In total, 639 consecutive patients with aortic stenosis who underwent TAVI were stratified into 3 groups according to the ratio of serum creatinine post- to pre-TAVI: IKF (≤0.80; n = 95 [15%]), stable kidney function (0.80 to 1.5; n = 477 [75%]), and AKI (≥1...
February 12, 2018: American Journal of Cardiology
Mauro Dobran, Alessandra Marini, Davide Nasi, Valentina Liverotti, Roberta Benigni, Maurizio Iacoangeli, Massimo Scerrati
OBJECTIVE: Study of mortality rate and clinical outcomes in octogenarians patients operated for intracranial meningiomas. PATIENTS AND METHODS: Clinical, radiological and surgical data of 25 elderly patients aging over 80 years old operated at our Department from 2013 to 2016 for intracranial meningiomas have been recorded and analyzed. One-month mortality and clinical outcome at six-months after surgery were evaluated. Logistic regression was used for detecting the risk factors influencing mortality and neurological functions...
April 2018: Clinical Neurology and Neurosurgery
Barış Akça, Nevzat Erdil, Mehmet Cengiz Colak, Olcay Murat Disli, Bektas Battaloglu, Cemil Colak
BACKGROUND:  We aimed to investigate the risk factors of post-coronary artery bypass grafting (CABG) atrial fibrillation (AF) in male and female patients without any history of AF, to identify the sex-specific risk factors, and to examine the effect of sex-specific risk factors on the overall population. METHODS:  This retrospective study was conducted using the hospital database with 4,758 patients who underwent CABG surgery. Among them, 2,836 patients with complete data participated in this study...
March 6, 2018: Thoracic and Cardiovascular Surgeon
Zoltán Fekete, Szilvia Körösi, Gábor Németh
INTRODUCTION: The prevalence of pelvic organ prolapse (POP) with aging is escalating alarmingly, and now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh (TVM) has been employed with increasing popularity in the treatment of POP until the end of the last decade. After the U.S. Drug and Food Administration (FDA) warnings in the years 2008 and 2011, the number of vaginal mesh operations has decreased dramatically. AIM: The aim of the study was to evaluate and compare the anti-POP effectivity, the anti-stress incontinence (anti-SUI) efficacy, and the late (36 months) post-operative complications of the anterior vaginoplasty and the TVM operations...
March 2018: Orvosi Hetilap
B B Partido, B M Wright
INTRODUCTION: Dental professionals are at high risk of musculoskeletal disorders (MSDs) due to static working positions for extended periods of time. Musculoskeletal pain has been identified as early as during their entry-level dental education. The purpose of this study was to determine whether feedback involving photography and self-assessment would improve ergonomic scores and the accuracy of ergonomic self-assessments amongst dental students. MATERIALS AND METHODS: The study involved a randomised control design of 135 dental students...
March 2, 2018: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
Joshua D Palmer, Charles J Schneider, Neil Hockstein, Alexandra L Hanlon, Jordan Silberg, Jon Strasser, Elizabeth A Mauer, Michael Dzeda, Robert Witt, Adam Raben
OBJECTIVES: The objective of this study was to investigate the safety, tolerability and preliminary efficacy of radiotherapy plus cetuximab in high risk CSCC patients. MATERIALS AND METHODS: Patients with high-risk CSCC diagnosed between 2006 and 2013 were analyzed. Patients were divided into two groups: radiotherapy alone versus radiotherapy plus cetuximab. Among 68 patients meeting study criteria, we identified 29 treated with cetuximab plus RT and 39 with RT alone...
March 2018: Oral Oncology
Cave Sinai, Tatja Hirvikoski, Maria Wiklander, Anna-Lena Nordström, Peter Nordström, Åsa Nilsonne, Alexander Wilczek, Marie Åsberg, Jussi Jokinen
BACKGROUND: This study aims to determine the validity of the Karolinska Interpersonal Violence Scale (KIVS), as a screening tool for PTSD, among women with borderline personality disorder (BPD) and severe suicidal behavior. METHOD: 106 women with BPD and at least two suicide attempts were assessed with the KIVS for exposure to interpersonal violence as a child and as an adult. The screening ability of the KIVS for the diagnosis of PTSD was analyzed using receiver operating characteristic curve analysis...
February 3, 2018: Psychiatry Research
Johan J A Van Cleemput, Tom O M Verbelen, Lucas N L Van Aelst, Filip R L Rega
We compared survival in our heart recipients with survival rates reported by the International Society of Heart and Lung Transplantation (ISHLT) Registry. As recipient and donor characteristics are changing over time, we studied four different eras. In order to differentiate between short- and long-term survival, we analyzed both overall survival and survival at one year. Obviously, this exercise is only relevant when baseline donor and recipient characteristics are comparable, as these differences may affect the outcome in opposite directions...
January 2018: Annals of Cardiothoracic Surgery
Yueh-Hsia Chen, Wei-An Liang, Chung-Yin Hsu, Siang-Lan Guo, Shwu-Huei Lien, Hsiao-Jung Tseng, Yuan-Hung Chao
Background: Advanced treatment of oral cancer increases survival rates; however, it also increases the risk of developing shoulder dysfunction, dysphagia, oral dysfunction, donor site morbidity and psychological issues. This single-arm preliminary pilot study aims to explore the effects of a six-month early intervention program following reconstructive surgery in oral cancer survivors. Methods: A total of 65 participants were analyzed following reconstructive surgery...
2018: PeerJ
Raisa S Pompe, Marco Bandini, Felix Preisser, Michele Marchioni, Emanuele Zaffuto, Zhe Tian, Georg Salomon, Thorsten Schlomm, Hartwig Huland, Markus Graefen, Derya Tilki, Shahrokh F Shariat, Pierre I Karakiewicz
BACKGROUND: Early biochemical recurrence (eBCR) after radical prostatectomy (RP) heralds poor oncological outcomes and may be prevented with adjuvant radiation (aRT). METHODS: We developed a contemporary eBCR nomogram in 13 797 RP patients from Hamburg (2005-2016) and externally validated it in 5952 RP patients from Vienna. Receiver operating characteristics-derived area under the curve (AUC), Heagerty's C-index, and decision curve analysis (DCA) were used to quantify model accuracy and to compare the current tool with the Walz nomogram, the online Memorial Sloan Kettering Cancer Center (MSKCC) nomogram and the post-surgical Cancer of the Prostate Risk Assesment (CAPRA-S)...
February 27, 2018: Prostate Cancer and Prostatic Diseases
Lucy C Walker, Nick D Clement, Michelle Bardgett, David Weir, Jim Holland, Craig Gerrand, David J Deehan
PURPOSE: The primary aim of this study was to define a classification in the WOMAC score after total knee arthroplasty (TKA) according to patient satisfaction. The secondary aims were to describe patient demographics for each level of satisfaction. METHODS: A retrospective cohort consisting of 2589 patients undergoing a primary TKA were identified from an established arthroplasty database. Patient demographics, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and short form (SF) 12 scores were collected pre-operatively and 1 year post-operatively...
February 26, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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