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https://www.readbyqxmd.com/read/28228937/predictors-of-total-morbidity-burden-on-days-3-5-and-8-after-cardiac-surgery
#1
Julie Sanders, Jackie Cooper, Michael G Mythen, Hugh E Montgomery
BACKGROUND: Post-operative morbidity affects up to 36% of cardiac surgical patients. However, few countries reliably record morbidity outcome data, despite patients wanting to be informed of all the risks associated with surgery. The Cardiac Post-Operative Morbidity Score (C-POMS) is a new tool for describing and scoring (0-13) total morbidity burden after cardiac surgery, derived by noting the presence/absence of 13 morbidity domains on days 3, 5, 8 and 15. Identifying modifiable C-POMS risk factors may suggest targets for intervention to reduce morbidity and healthcare costs...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28223051/functional-status-and-quality-of-life-in-survivors-of-extracorporeal-membrane-oxygenation-after-the-norwood-operation
#2
Joshua M Friedland-Little, Karen Uzark, Sunkyung Yu, Ray Lowery, Ranjit Aiyagari, Jennifer C Hirsch-Romano
BACKGROUND: Infants who require extracorporeal membrane oxygenation (ECMO) support after a Norwood operation are at increased risk for early and late death compared with patients who do not require ECMO post-Norwood. Little is known about the effect that ECMO post-Norwood has on functional status and quality of life among long-term survivors. METHODS: We prospectively evaluated functional status and health-related quality of life in 12 surviving patients (cases) and 19 corresponding patients (controls) from a previous retrospective case-control assessment of long-term survival in patients requiring ECMO post-Norwood...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28220653/systematic-review-of-the-oncological-and-functional-outcomes-of-pelvic-organ-preserving-cystectomy-compared-with-standard-radical-cystectomy-in-women-who-undergo-curative-surgery-and-orthotopic-neobladder-substitution-for-bladder-cancer
#3
REVIEW
Erik Veskimäe, Yann Neuzillet, Mathieu Rouanne, Steven MacLennan, Thomas B L Lam, Yuhong Yuan, Eva Compérat, Nigel C Cowan, Georgios Gakis, Antoine G van der Heijden, Maria J Ribal, J Alfred Witjes, Thierry Lebrét
CONTEXT: Pelvic-organ preserving radical cystectomy (POPRC) for female patients may improve postoperative sexual and urinary functions without compromising the oncological outcome compared with standard radical cystectomy (RC). OBJECTIVE: To determine the effect of POPRC on sexual, oncological and urinary outcomes compared with RC in women who undergo standard curative surgery and orthotopic neobladder substitution for bladder cancer (BCa). EVIDENCE ACQUISITION: Medline, Embase, Cochrane controlled trials databases and clinicaltrial...
February 20, 2017: BJU International
https://www.readbyqxmd.com/read/28217251/biliary-complications-following-liver-transplantation-single-center-experience-over-three-decades-and-recent-risk-factors
#4
Alexander Kaltenborn, André Gutcke, Jill Gwiasda, Jürgen Klempnauer, Harald Schrem
AIM: To identify independent risk factors for biliary complications in a center with three decades of experience in liver transplantation. METHODS: A total of 1607 consecutive liver transplantations were analyzed in a retrospective study. Detailed subset analysis was performed in 417 patients, which have been transplanted since the introduction of Model of End-Stage Liver Disease (MELD)-based liver allocation. Risk factors for the onset of anastomotic biliary complications were identified with multivariable binary logistic regression analyses...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28215612/postoperative-infections-after-excision-of-neurogenic-heterotopic-ossifications-at-the-hip-risk-factors-and-causative-organisms
#5
L Gatin, F Genêt, A Dinh, P Denormandie
BACKGROUND: Neurogenic heterotopic ossification (NHO) is usually treated by surgical excision. Post-operativeinfection (POI) is a possible complication, whose epidemiology, causative organisms, and risk factors are poorly known.We therefore conducted a case-control study to 1) identify the risk factors for POI after surgical excision of NHO at the hip, 2) determine the frequency of POI, 3) and identify the causative organisms. HYPOTHESIS: Risk factors for POI after NHO excision at the hip can be identified...
February 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28209402/chemokine-receptor-patterns-and-right-heart-failure-in-mechanical-circulatory-support
#6
Aditi Nayak, Colin Neill, Robert L Kormos, Luigi Lagazzi, Indrani Halder, Charles McTiernan, Jennifer Larsen, Ana Inashvili, Jeffrey Teuteberg, Timothy N Bachman, Karen Hanley-Yanez, Dennis M McNamara, Marc A Simon
BACKGROUND: Right ventricular failure (RVF) complicates 9% to 44% of left ventricular assist device (LVAD) implants post-operatively. Current prediction scores perform only modestly in validation studies, and do not include immune markers. Chemokines are inflammatory signaling molecules with a fundamental role in cardiac physiology and stress adaptation. In this study we investigated chemokine receptor regulation in LVAD recipients who develop RVF. METHODS: Expression of chemokine receptor (CCR) genes 3 to 8 were examined in the peripheral blood of 111 LVAD patients, collected 24 hours before implant...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28199411/cortical-porosity-not-superior-to-conventional-densitometry-in-identifying-hemodialysis-patients-with-fragility-fracture
#7
Bernhard Bielesz, Janina M Patsch, Lukas Fischer, Marija Bojic, Wolfgang Winnicki, Michael Weber, Daniel Cejka
Hemodialysis (HD) patients face increased fracture risk, which is further associated with elevated risk of hospitalization and mortality. High-resolution peripheral computed tomography (HR-pQCT) has advanced our understanding of bone disease in chronic kidney disease by characterizing distinct changes in both the cortical and trabecular compartments. Increased cortical porosity (Ct.Po) has been shown to be associated with fracture in patients with osteopenia or in postmenopausal diabetic women. We tested whether the degree of Ct...
2017: PloS One
https://www.readbyqxmd.com/read/28197692/feasibility-of-establishing-an-australian-acl-registry-a-pilot-study-by-the-australian-orthopaedic-association-national-joint-replacement-registry-aoanjrr
#8
Christina Lekkas, Richard Clarnette, Stephen E Graves, Sophia Rainbird, David Parker, Michelle Lorimer, Roger Paterson, Justin Roe, Hayden Morris, Julian A Feller, Peter Annear, Ben Forster, David Hayes
PURPOSE: Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry...
February 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28181577/age-dependent-changes-in-the-articular-cartilage-and-subchondral-bone-of-c57bl-6-mice-after-surgical-destabilization-of-medial-meniscus
#9
Henry Huang, Jordan D Skelly, David C Ayers, Jie Song
Age is the primary risk factor for osteoarthritis (OA), yet surgical OA mouse models such as destabilization of the medial meniscus (DMM) used for evaluating disease-modifying OA targets are frequently performed on young adult mice only. This study investigates how age affects cartilage and subchondral bone changes in mouse joints following DMM. DMM was performed on male C57BL/6 mice at 4 months (4 M), 12 months (12 M) and 19+ months (19 M+) and on females at 12 M and 18 M+. Two months after surgery, operated and unoperated contralateral knees were harvested and evaluated using cartilage histology scores and μCT quantification of subchondral bone plate thickness and osteophyte formation...
February 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28173819/cardiovascular-magnetic-resonance-evaluation-of-symptomatic-severe-aortic-stenosis-association-of-circumferential-myocardial-strain-and-mortality
#10
Tarique Al Musa, Akhlaque Uddin, Peter P Swoboda, Timothy A Fairbairn, Laura E Dobson, Anvesha Singh, Pankaj Garg, Christopher D Steadman, Bara Erhayiem, Ananth Kidambi, David P Ripley, Adam K McDiarmid, Philip Haaf, Daniel J Blackman, Sven Plein, Gerald P McCann, John P Greenwood
BACKGROUND: It is unknown whether circumferential strain is associated with prognosis after treatment of aortic stenosis (AS). We aimed to characterise strain in severe AS, using myocardial tagging cardiovascular magnetic resonance (CMR), prior to and following Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR), and determine whether abnormalities in strain were associated with outcome. METHODS: CMR was performed pre- and 6 m post-intervention in 98 patients (52 TAVI, 46 SAVR; 77 ± 8 years) with severe AS...
February 8, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28168421/screening-for-distress-using-the-distress-thermometer-and-the-university-of-washington-quality-of-life-in-post-treatment-head-and-neck-cancer-survivors
#11
Naseem Ghazali, Brenda Roe, Derek Lowe, Sank Tandon, Terry Jones, James Brown, Richard Shaw, Janet Risk, Simon N Rogers
The primary aim was to determine the efficacy of the Distress Thermometer (DT) in screening for anxiety and mood problems against the University of Washington Quality of Life, version 4 (UWQOL). Secondary aims were to evaluate the association between demographic, clinical and health-related QOL variables with significant distress. Two hundred and sixty one disease-free HNC ambulatory patients attending routine follow-up clinics were prospectively recruited. Both DT and UWQOL were completed pre-consultation...
February 6, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28161583/cumulative-exposure-to-work-related-traumatic-events-and-current-post-traumatic-stress-disorder-in-new-york-city-s-first-responders
#12
Lupo Geronazzo-Alman, Ruth Eisenberg, Sa Shen, Cristiane S Duarte, George J Musa, Judith Wicks, Bin Fan, Thao Doan, Guia Guffanti, Michaeline Bresnahan, Christina W Hoven
BACKGROUND AND OBJECTIVES: Cumulative exposure to work-related traumatic events (CE) is a foreseeable risk for psychiatric disorders in first responders (FRs). Our objective was to examine the impact of work-related CE that could serve as predictor of posttraumatic stress disorder (PTSD) and/or depression in FRs. DESIGN: Cross-sectional examination of previous CE and past-month PTSD outcomes and depression in 209 FRs. METHODS: Logistic (probable PTSD; probable depression) and Poisson regressions (PTSD score) of the outcomes on work-related CE indexes, adjusting for demographic variables...
December 21, 2016: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28161482/evaluation-of-a-standardized-risk-based-venous-thromboembolism-prophylaxis-protocol-in-the-setting-of-thyroid-and-parathyroid-surgery
#13
Ryan Macht, Ivy Gardner, Stephanie Talutis, Pamela Rosenkranz, Gerard Doherty, David McAneny
BACKGROUND: An elevated odds ratio for venous thromboembolism (VTE) prompted the development of a Caprini risk assessment and risk-based prophylaxis protocol for all General Surgery patients. This system includes pre- and post-operative prophylactic heparin as well as extended courses of low molecular weight heparin for high-risk patients. This study evaluates the safety of this chemoprophylaxis program in thyroid and parathyroid surgery. STUDY DESIGN: A retrospective review was conducted of all General Surgery patients undergoing thyroid or parathyroid operations after the implementation of the Caprini prophylaxis protocol...
February 1, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28161216/the-impact-of-perioperative-red-blood-cell-transfusions-in-patients-undergoing-liver-resection-a-systematic-review
#14
REVIEW
Sean Bennett, Laura K Baker, Guillaume Martel, Risa Shorr, Timothy M Pawlik, Alan Tinmouth, Daniel I McIsaac, Paul C Hébert, Paul J Karanicolas, Lauralyn McIntyre, Alexis F Turgeon, Jeffrey Barkun, Dean Fergusson
BACKGROUND: Liver resection is associated with a high proportion of red blood cell transfusions. There is a proposed association between perioperative transfusions and increased risk of complications and tumor recurrence. This study reviews the evidence of this association in the literature. METHODS: The Medline, EMBASE, and Cochrane databases were searched for clinical trials or observational studies of patients undergoing liver resection that compared patients who did and did not receive a perioperative red blood cell transfusion...
February 1, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28161008/genito-urinary-sequelae-after-carcinological-rectal-resection-what-to-tell-patients-in-2017
#15
A Abdelli, X Tillou, A Alves, B Menahem
Although we have seen revolutionary changes with multi-disciplinary management of patients with rectal cancer, the evaluation of genito-urinary sequelae remains of great concern. Precise pre-operative evaluation with validated scores allows detection of urinary disorders in 16 to 23% of patients, and sexual disorders in nearly 35% of men and 50% of women. Regardless of the surgical approach, it is fundamental to respect the autonomic innervation during total mesorectal excision in order to prevent these sequelae...
February 1, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28158159/full-endoscopic-assisted-lumbar-decompressive-surgery-performed-in-an-outpatient-ambulatory-facility-report-of-5-years-of-complications-and-risk-factors
#16
Solomon Kamson, Andrea M Trescot, Paul D Sampson, Yiyi Zhang
BACKGROUND: Minimally invasive surgery (MIS) technique is becoming the standard tissue sparing approach for decompression of lumbar central and lateral recess stenosis, intervertebral disc herniation, or any situation that would have required extensive open decompression laminectomy. Full-endoscopic or arthroscopic assisted surgery is arguably the "ultra-MIS" approach to lumbar spinal pathology. Age and body mass index (BMI) are significant risk factors to be considered in full-endoscopic assisted ultra-MIS...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28155822/treatment-of-displaced-intra-articular-calcaneal-fractures-by-intramedullary-nail-preliminary-report
#17
Mirosław Falis, Krystian Pyszel
BACKGROUND: Open reduction and plate stabilisation is a recognised method of treatment of intra-articular calcaneal fractures. The surgical approach to the calcaneal bone used in these procedures is associated with a high risk of complications. The aim of this paper is to present the author's experience with a new surgical method and analyse early outcomes of the treatment of calcaneal fractures by Calcanail intramedullary nailing. MATERIAL AND METHODS: The study encompassed 17 patients (5 women and 12 men) with 18 calcaneal fractures (5 in the right foot and 13 in the left foot)...
March 23, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28152685/optimizing-discharge-teaching-process-to-increase-the-efficiency-and-effectiveness-of-the-follow-up-call
#18
Gina Aranzamendez, Beverly A Hayes, Kavita Pathak, Duke Rohe, Valerie Haywood
: 226 Background: Patients undergoing complex oncologic operations are at high risk for perioperative complications associated with adverse effects on quality of life, costs and overall outcomes. Complications within 30 days of discharge are most commonly identified during first 48-72 hours post-discharge. Telephone follow-up can provide a safety net and is part of a larger discharge teaching process. Initial review of the current follow up processes underscored many variations. An interdisciplinary team was tasked to optimize discharge processes across the continuum of care which leads to a more efficient follow-up call encounter...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148663/pre-operative-functional-mobility-as-an-independent-determinant-of-inpatient-functional-recovery-after-total-knee-arthroplasty-during-three-periods-that-coincided-with-changes-in-clinical-pathways
#19
G van der Sluis, R A Goldbohm, J E Elings, M W Nijhuis-van der Sanden, R P Akkermans, R Bimmel, T J Hoogeboom, N L van Meeteren
AIMS: To investigate whether pre-operative functional mobility is a determinant of delayed inpatient recovery of activities (IRoA) after total knee arthroplasty (TKA) in three periods that coincided with changes in the clinical pathway. PATIENTS AND METHODS: All patients (n = 682, 73% women, mean age 70 years, standard deviation 9) scheduled for TKA between 2009 and 2015 were pre-operatively screened for functional mobility by the Timed-up-and-Go test (TUG) and De Morton mobility index (DEMMI)...
2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28146230/a-framework-to-improve-surgeon-communication-in-high-stakes-surgical-decisions-best-case-worst-case
#20
Lauren J Taylor, Michael J Nabozny, Nicole M Steffens, Jennifer L Tucholka, Karen J Brasel, Sara K Johnson, Amy Zelenski, Paul J Rathouz, Qianqian Zhao, Kristine L Kwekkeboom, Toby C Campbell, Margaret L Schwarze
Importance: Although many older adults prefer to avoid burdensome interventions with limited ability to preserve their functional status, aggressive treatments, including surgery, are common near the end of life. Shared decision making is critical to achieve value-concordant treatment decisions and minimize unwanted care. However, communication in the acute inpatient setting is challenging. Objective: To evaluate the proof of concept of an intervention to teach surgeons to use the Best Case/Worst Case framework as a strategy to change surgeon communication and promote shared decision making during high-stakes surgical decisions...
February 1, 2017: JAMA Surgery
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