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https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#1
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a-randomized-controlled-trial
#2
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment in premenopausal women, who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: To evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138920/concurrent-arthroscopic-osteochondral-lesion-treatment-and-lateral-ankle-ligament-repair-has-no-substantial-effect-on-the-outcome-of-chronic-lateral-ankle-instability
#3
Dong Jiang, Yin-Fang Ao, Chen Jiao, Xing Xie, Lin-Xin Chen, Qin-Wei Guo, Yue-Lin Hu
PURPOSE: The purpose of the study was to evaluate the effect of concurrent arthroscopic osteochondral lesion (OCL) treatment and lateral ankle ligament repair on the outcome of chronic lateral ankle instability. It was hypothesized that the arthroscopic OCL treatment might have some negative effect on the outcome of chronic lateral ankle instability (CLAI) by compromising the rehabilitation program. METHODS: Ankle arthroscopy and anatomic lateral ankle ligament repair with suture anchors were performed for 70 patients with CLAI between 2010 and 2012...
November 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29138544/early-postoperative-delirium-after-hemiarthroplasty-in-elderly-patients-aged-over-70-years-with-displaced-femoral-neck-fracture
#4
Yi-Hwa Choi, Dae-Hwan Kim, Tae-Young Kim, Tae-Wan Lim, Seok-Woo Kim, Je-Hyun Yoo
Purpose: Postoperative delirium is a risk factor for worse outcome after hip fracture surgery in elderly patients. Postoperative delirium is associated with anesthesia, postoperative pain, and patient factors. We investigated the incidence, predictors, and prognostic implications of post-operative delirium after hemiarthroplasty (HA) in elderly patients with femoral neck fracture. Patients and methods: A total of 356 consecutive patients aged >70 years who underwent HA for femoral neck fracture were enrolled...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29135883/an-analysis-of-the-incidence-and-outcomes-of-major-vs-minor-neurological-decline-after-complex-adult-spinal-deformity-surgery-a-sub-analysis-of-scoli-risk-1-study
#5
So Kato, Michael G Fehlings, Stephen J Lewis, Lawrence G Lenke, Christopher I Shaffrey, Kenneth M C Cheung, Leah Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Sigurd H Berven
STUDY DESIGN: A sub-analysis from a prospective, multicenter, international cohort study in 15 sites (Scoli-RISK-1). OBJECTIVE: To report detailed information regarding the severity of neurological decline related to complex adult spine deformity (ASD) surgery and to examine outcomes based on severity. SUMMARY OF BACKGROUND DATA: The basis of post-operative neurological decline after ASD surgeries can occur due to nerve root(s) or spinal cord dysfunction...
November 10, 2017: Spine
https://www.readbyqxmd.com/read/29134253/the-role-of-the-neutrophil-lymphocyte-ratio-nlr-and-the-crp-albumin-ratio-car-in-predicting-mortality-following-emergency-laparotomy-in-the-over-80-age-group
#6
G Simpson, R Saunders, J Wilson, C Magee
INTRODUCTION: Emergency laparotomy in the elderly is an increasingly common procedure which carries high morbidity and mortality. Risk prediction tools, although imperfect, can help guide management decisions. Novel markers of surgical outcomes may contribute to these scoring systems. The neutrophil:lymphocyte ratio (NLR) and CRP:albumin ratio (CAR) have been associated with outcomes in malignancy and sepsis. We assessed the use of ratio NLR and CAR as prognostic indicators in patients over the age of 80 undergoing emergency laparotomy...
November 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29133246/potentially-inappropriate-liver-transplantation-in-the-era-of-the-sickest-first-policy-a-search-for-the-upper-limits
#7
REVIEW
Michael Linecker, Tanja Krones, Thomas Berg, Claus U Niemann, Randolph H Steadman, Philipp Dutkowski, Pierre-Alain Clavien, Ronald W Busuttil, Robert D Truog, Henrik Petrowsky
Liver transplantation has emerged to a highly efficient treatment for a variaty of acute and chronic liver diseases. Organ shortage, however, is becoming an increasing problem worldwide, limiting the applicability of liver transplantation. In addition, potential recipients are becoming sicker, thereby increasing the risk of loosing the graft during transplantation or in the initial post-operative period after liver transplantation (3 months). This trend is challenging the MELD allocation model where sickest candidates are prioritized and no delisting criteria are given...
November 10, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29127918/management-of-type-iib-and-iiib-olecranon-fractures-case-series
#8
Mohammed Ali, Catherine Hatzantonis, Dimitrios Aspros, Nirad Joshi, D I Clark, Amol Tambe
OBJECTIVES: to report and evaluate the functional outcome of plate fixation in comminuted olecranon fractures (Mayo types IIB and IIIB). METHOD: 23 consecutive patients with comminuted fractures of the olecranon presenting to our unit Between Feb 2011 and Jan 2015, at a mean follow-up of thirty-six months. Main outcome measurements include radiographic healing, post-operative range of motion, complications, outcome score and patient satisfaction. RESULTS: Our study included thirteen females and ten males with a mean age of 55(18-97)...
November 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29127195/microcatheter-contrast-injection-in-stent-retriever-neurothrombectomy-is-safe-and-useful-insights-from-swift-prime
#9
Radoslav Raychev, Reza Jahan, Jeffrey L Saver, Raul G Nogueira, Mayank Goyal, Vitor M Pereira, Elad Levy, Dileep R Yavagal, Christophe Cognard, David Liebeskind
Microcatheter contrast injection (MCI) prior to stent retriever deployment for the treatment of acute ischemic stroke may be useful for evaluation of distal anatomy and flow patterns beyond the occlusion. However, prior data from intra-arterialthrombolysis suggested that MCI increases the risk of intracranial hemorrhage (ICH). The safety and utility of MCI has not been investigated in the setting of thrombectomy. METHODS: We analyzed the Solitaire With the Intention For Thrombectomy as Primary Endovascular Treatment (SWIFT PRIME) trial to correlate pre-intervention MCI flow with collateral flow, and to investigate its impact on ICH and clinical outcome after thrombectomy with the Solitaire device...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29126549/predicting-new-onset-post-coronary-artery-bypass-graft-atrial-fibrillation-with-existing-risk-scores
#10
Benjamin D Pollock, Giovanni Filardo, Briget da Graca, Teresa K Phan, Gorav Ailawadi, Vinod Thourani, Ralph J Damiano, James R Edgerton
BACKGROUND: New-onset atrial fibrillation (AF) after coronary artery bypass graft (CABG) operation is associated with poorer survival. Blanket prophylaxis efforts have not appreciably decreased incidence, making targeted prevention for high-risk patients desirable. We compared predictive abilities of existing scores developed/used to predict adverse CABG outcomes (Society of Thoracic Surgeons' [STS] risk of mortality) or AF not associated with cardiac operation (the Cohorts for Heart and Aging Research in Genomic Epidemiology [CHARGE]-AF score, the CHA2DS2-VASc score), and a risk model for predicting postoperative AF following cardiac operations (POAF score), with age (the most consistently identified post-CABG AF risk factor)...
November 7, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29124889/the-neurosafe-approach-to-nerve-sparing-in-robotic-assisted-radical-prostatectomy-in-a-british-setting-a-prospective-observational-comparative-study
#11
George Mirmilstein, Bhavan Rai, Olayinka Gbolahan, Vinaya Srirangam, Ashish Narula, Samita Agarwal, Tim Lane, Nikhil Vasdev, Jim Adshead
OBJECTIVES: To evaluate the NeuroSAFE technique in a British setting in men undergoing RALP. PATIENTS AND METHODS: We retrospectively analysed our prospectively maintained database of patients who underwent RALP between Nov 2008 and Feb 2017. We examined preoperative pathological and functional parameters, intra-operative nerve sparing, post-operative histology as well as functional and oncological follow-up. We compared those who had a NeuroSAFE approach and those who had nerve sparing without NeuroSAFE...
November 10, 2017: BJU International
https://www.readbyqxmd.com/read/29121983/early-psychological-screening-of-intensive-care-unit-survivors-a-prospective-cohort-study
#12
Anna Milton, Emily Brück, Anna Schandl, Matteo Bottai, Peter Sackey
BACKGROUND: A majority of patients survive their episode of critical illness but up to 30% of patients suffer from psychological problems such as post-traumatic stress, anxiety and depression in the year after intensive care unit (ICU) stay. A method to identify discharged patients at risk for adverse psychological outcome would be helpful in the triage for ICU follow-up and could enable early intervention. The aim of this study was to evaluate whether early screening with validated questionnaires after ICU discharge can identify patients at risk for symptoms of post-traumatic stress, anxiety and depression 3 months after ICU stay...
November 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29120365/macrophage-migration-inhibitory-factor-predicts-outcome-in-complex-aortic-surgery
#13
Alexander Gombert, Christian Stoppe, Ann Christina Foldenauer, Tobias Schuerholz, Lukas Martin, Johannes Kalder, Gereon Schälte, Gernot Marx, Michael Jacobs, Jochen Grommes
The perioperative inflammatory response is associated with outcome after complex aortic repair. Macrophage migration inhibitory factor (MIF) shows protective effects in ischemia-reperfusion (IR), but also adverse pro-inflammatory effects in acute inflammation, potentially leading to adverse outcome, which should be investigated in this trial. This prospective study enrolled 52 patients, of whom 29 (55.7%) underwent open repair (OR) and 23 (44.3%) underwent endovascular repair (ER) between 2014 and 2015. MIF serum levels were measured until 72 h post-operatively...
November 9, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29117844/early-results-of-the-arpe-arthroplasty-versus-trapeziectomy-for-the-treatment-of-thumb-carpometacarpal-joint-osteoarthritis
#14
Johnathan D Craik, Simon Glasgow, James Andren, Mark Sims, Reza Mansouri, Ritesh Sharma, Najab Ellahee
BACKGROUND: Thumb carpometacarpal joint arthroplasty for osteoarthritis may hold advantages over trapeziectomy by preserving range of motion, whilst providing stability and preventing thumb shortening. METHODS: We compare functional and satisfaction outcomes scores, radiological shortening and complication rates between patients treated with trapeziectomy and those receiving the ARPE thumb CMCJ arthroplasty. RESULTS: Seventy-five trapeziectomies and one hundred and ten ARPE arthroplasties were performed over the study period...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29110652/open-subpectoral-biceps-tenodesis-in-patients-over-65-does-not-result-in-an-increased-rate-of-complications
#15
Andreas Voss, Simone Cerciello, Jessica DiVenere, Olga Solovyova, Felix Dyrna, John Apostolakos, David Lam, Mark P Cote, Knut Beitzel, Augustus D Mazzocca
BACKGROUND: Long head biceps tendon pathology is a common cause of anterior shoulder pain and is often associated with other shoulder conditions, such as rotator cuff tears and osteoarthritis. It is well accepted that older patients are at increased risk for major and minor peri- and postoperative complications. The purpose of this study is to investigate patients over 65 years old who underwent subpectoral biceps tenodesis and compare the complication rates of this group to those of patients younger than 65 years old...
November 6, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29107104/novel-recurrence-risk-stratification-of-resected-pancreatic-neuroendocrine-tumor
#16
Heli Gao, Liang Liu, Wenquan Wang, Huaxiang Xu, Kaizhou Jin, Chuntao Wu, Zihao Qi, Shirong Zhang, Chen Liu, Jinzhi Xu, Quanxing Ni, Xianjun Yu
Radical surgical resection represents the only hope of cure for pancreatic neuroendocrine tumor (PanNET). Adjuvant therapy is rarely used because there is no evidence to distinguish patients with high recurrence risk. Here we investigated the recurrence feature of resected PanNET and established a novel risk stratification to predict its recurrence. We analyzed 505 PanNET patients who underwent R0 resection at our institute from January 2004 through May 2015. The median follow-up was 71months (range: 12months-143months), 129 patients (25...
October 26, 2017: Cancer Letters
https://www.readbyqxmd.com/read/29097040/-retrospective-comparison-of-the-reproducibility-and-the-performances-of-r-e-n-a-l-score-12-segments-score-and-uprcc-score-for-the-partial-nephrectomy
#17
L Gury-Coupier, F Audenet, C Delavaud, M-O Timsit, A Mejean
INTRODUCTION: Compare three morphometrics scores of the kidney on the reproductibility and the predictability of complications per- and post-partial nephrectomy. MATERIALS AND METHODS: This comparative study analyzed a monocentric retrospective cohort of 47 patients affected by a unique renal tumor and operated by partial nephrectomy by lumbotomy excluding the genetic diseases from January till December, 2014. The preoperative scanners were reviewed in double-blind by a radiologist and an internal surgeon who classified each tumor according to the three classifications: R...
October 30, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/29089967/a-risk-prediction-score-model-for-predicting-occurrence-of-post-pci-vasovagal-reflex-syndrome-a-single-center-study-in-chinese-population
#18
Hai-Yan Li, Yu-Tao Guo, Cui Tian, Chao-Qun Song, Yang Mu, Yang Li, Yun-Dai Chen
BACKGROUND: The vasovagal reflex syndrome (VVRS) is common in the patients undergoing percutaneous coronary intervention (PCI). However, prediction and prevention of the risk for the VVRS have not been completely fulfilled. This study was conducted to develop a Risk Prediction Score Model to identify the determinants of VVRS in a large Chinese population cohort receiving PCI. METHODS: From the hospital electronic medical database, we identified 3550 patients who received PCI (78...
August 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29089823/ct-enterography-for-surveillance-of-anastomotic-recurrence-within-12-months-of-bowel-resection-in-patients-with-crohn-s-disease-an-observational-study-using-an-8-year-registry
#19
In Young Choi, Sang Hyoung Park, Seong Ho Park, Chang Sik Yu, Yong Sik Yoon, Jong Lyul Lee, Byong Duk Ye, Ah Young Kim, Suk-Kyun Yang
OBJECTIVE: To investigate the diagnostic yield and accuracy of CT enterography (CTE) for early (< 12 postoperative months) surveillance of anastomotic recurrence after bowel resection for Crohn's disease (CD). MATERIALS AND METHODS: We analyzed 88 adults (60 males and 28 females; mean age, 31.4 ± 9.6 years) who underwent bowel surgery for CD that created ileocolic anastomosis without enteric stoma, and underwent CTE for surveillance of CD recurrence/aggravation within 12 post-operative months...
November 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/29089206/pre-burn-malnutrition-increases-operative-mortality-in-burn-patients-who-undergo-early-excision-and-grafting-in-a-sub-saharan-african-burn-unit
#20
Joana Grudziak, Carolyn Snock, Tiyamike Zalinga, Wone Banda, Jared Gallaher, Laura Purcell, Bruce Cairns, Anthony Charles
INTRODUCTION: In the developed world, pre-existing malnutrition in the burn population influences operative outcomes. However, studies on pre-existing malnutrition and operative outcomes of burn patients in the developing world are lacking. We therefore sought to characterize the burn injury outcomes following operative intervention based on nutritional status. METHODS: This is a retrospective review of operative patients admitted to our burn unit from July 2011 to May 2016...
October 28, 2017: Burns: Journal of the International Society for Burn Injuries
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