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https://www.readbyqxmd.com/read/29773957/perioperative-predictors-of-delirium-and-incidence-factors-in-adult-patients-post-cardiac-surgery
#1
Stavros Theologou, Konstantinos Giakoumidakis, Christos Charitos
Background: Delirium is a quite common complication in adult patients post-cardiac surgery. The purpose of our study was to identify perioperative characteristics and also focus on incidence factors that could predict delirium in the cardiac surgery intensive care unit (CICU) postoperatively. Methods: We conducted a prospective study of 179 consecutive patients, who underwent open-heart surgical operation and were admitted to the CICU of a general tertiary hospital in Athens, Greece...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29767327/follow-up-after-curative-treatment-of-localised-renal-cell-carcinoma
#2
REVIEW
Saeed Dabestani, Lorenzo Marconi, Teele Kuusk, Axel Bex
PURPOSE: Patients with localised renal cell carcinoma (RCC) receiving curative surgery, either radical or partial nephrectomy, have been shown in contemporary studies to develop recurrence within 5 years in 20-30% of case. Therefore, post-operative follow-up (FU) imaging plays a crucial role in detecting recurrent or metastatic disease. A number of prognostic scores have been developed to predict risk of recurrence. This review summarises the current knowledge on established FU protocols and their limitations...
May 16, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29761259/-sense-of-coherence-scale-according-to-antonovsky-as-a-possible-predictor-for-return-to-work-for-cardiac-surgery-intensive-care-patients
#3
C Benstoem, R Wübker, M Lüngen, T Breuer, G Marx, R Autschbach, A Goetzenich, H Schnoering
BACKGROUND: For cardiac surgery patients who were employed prior to surgery, the return to their professional life is of special importance. In addition to medical reasons, such as pre-existing conditions, the success of the operation or postoperative course and patient-intrinsic reasons, which can be assessed with the Sense of Coherence (SOC) scale by Antonovsky, may also play a role in the question of a possible return into working life. METHODS: In this study 278 patients (invasive coronary artery bypass graft surgery and/or surgery on heart valves, age < 60 years, employed) were questioned postoperatively via post with the SOC questionnaire...
May 14, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29759061/role-of-ultrasound-guided-transversus-abdominis-plane-block-as-a-component-of-multimodal-analgesic-regimen-for-lower-segment-caesarean-section-a-randomized-double-blind-clinical-study
#4
Ashok Jadon, Priyanka Jain, Swastika Chakraborty, Mayur Motaka, Sudhansu Sekhar Parida, Neelam Sinha, Amit Agrawal, Asit Kumar Pati
BACKGROUND: While opioids are the mainstay for post-operative analgesia after lower segment caesarean section, they are associated with various untoward effects. Ultrasound guided transversus abdominis plane (TAP) block has been postulated to provide effective analgesia for caesarean section. We evaluated the analgesic efficacy of this block for post caesarean analgesia in a randomised controlled trial. METHODS: One hundred thirty-nine mothers undergoing caesarean delivery were randomised to receive TAP block with either 20 ml 0...
May 14, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29755579/exploring-ptsd-in-emergency-operators-of-a-major-university-hospital-in-italy-a-preliminary-report-on-the-role-of-gender-age-and-education
#5
Claudia Carmassi, Camilla Gesi, Martina Corsi, Ivan M Cremone, Carlo A Bertelloni, Enrico Massimetti, Maria Cristina Olivieri, Ciro Conversano, Massimo Santini, Liliana Dell'Osso
Background: Emergency services personnel face frequent exposure to potentially traumatic events, with the potential for chronic symptomatic distress. The DSM-5 recently recognized a particular risk for post-traumatic stress disorder (PTSD) among first responders (criterion A4) but data are still scarce on prevalence rates and correlates. Objective: The aim of the present study was to explore the possible role of age, gender, and education training in a sample of emergency personnel diagnosed with DSM-5 PTSD...
2018: Annals of General Psychiatry
https://www.readbyqxmd.com/read/29752141/predictors-of-falls-in-older-survivors-of-breast-and-prostate-cancer-a-retrospective-cohort-study-of-surveillance-epidemiology-and-end-results-medicare-health-outcomes-survey-linkage
#6
Min H Huang, Jennifer Blackwood, Monica Godoshian, Lucinda Pfalzer
OBJECTIVES: To identify predictors of falls in older breast and prostate cancer survivors. METHODS: This retrospective cohort study analyzed population-based Surveillance, Epidemiology and End Results-Medicare Health Outcomes Survey (SEER-MHOS) linkage. Inclusion criteria were age >65 years at cancer diagnosis, first primary female breast or prostate cancer, cancer staging information available, completion of baseline MHOS during years 2-3 and follow-up MHOS during years 4-5 post-diagnosis, and falls information available...
May 8, 2018: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29748697/increased-symptoms-of-stiffness-1-year-after-total-knee-arthroplasty-are-associated-with-a-worse-functional-outcome-and-lower-rate-of-patient-satisfaction
#7
N D Clement, M Bardgett, D Weir, J Holland, D J Deehan
PURPOSE: Symptoms of stiffness after total knee arthroplasty (TKA) cause significant morbidity, but there is limited data to facilitate identification of those most at risk after surgery. Stratifying risk can aid earlier directed treatment options. METHODS: A retrospective cohort consisting of 2589 patients undergoing a primary TKA was 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...
May 10, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29748060/haemodynamically-derived-pulmonary-artery-pulsatility-index-predicts-mortality-in-pulmonary-arterial-hypertension
#8
Sula Mazimba, Timothy S Welch, Hunter Mwansa, Khadijah K Breathett, Jamie L W Kennedy, Andrew D Mihalek, William C Harding, Manu M Mysore, David X Zhuo, Kenneth C Bilchick
BACKGROUND: Pulmonary artery (PA) pulsitility index (PAPi) is a novel haemodynamic index shown to predict right ventricular failure in acute inferior myocardial infarction and post left ventricular assist device surgery. We hypothesised that PAPi calculated as [PA systolic pressure - PA diastolic pressure]/right atrial pressure (RAP) would be associated with mortality in the National Institutes of Health Registry for Primary Pulmonary Hypertension (NIH-RPPH). METHODS: The impact of PAPi, the Pulmonary Hypertension Connection (PHC) risk score, right ventricular stroke work, pulmonary artery capacitance (PAC), other haemodynamic indices, and demographic characteristics was evaluated in 272 NIH-RPPH patients using multivariable Cox proportional hazards (CPH) regression and receiver operating characteristic (ROC) analysis...
April 17, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29743064/patient-directed-self-management-of-pain-padsmap-compared-to-treatment-as-usual-following-total-knee-replacement-a-randomised-controlled-trial
#9
Katherine H O Deane, Richard Gray, Paula Balls, Clare Darrah, Louise Swift, Alan B Clark, Garry R Barton, Sophie Morris, Sue Butters, Angela Bullough, Helen Flaherty, Barbara Talbot, Mark Sanders, Simon T Donell
BACKGROUND: Self-administration of medicines by patients whilst in hospital is being increasingly promoted despite little evidence to show the risks and benefits. Pain control after total knee replacement (TKR) is known to be poor. The aim of the study was to determine if patients operated on with a TKR who self-medicate their oral analgesics in the immediate post-operative period have better pain control than those who receive their pain control by nurse-led drug rounds (Treatment as Usual (TAU))...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29741208/induction-of-labour-for-improving-birth-outcomes-for-women-at-or-beyond-term
#10
REVIEW
Philippa Middleton, Emily Shepherd, Caroline A Crowther
BACKGROUND: Beyond term, the risks of stillbirth or neonatal death increase. It is unclear whether a policy of labour induction can reduce these risks. This Cochrane review is an update of a review that was originally published in 2006 and subsequently updated in 2012 OBJECTIVES: To assess the effects of a policy of labour induction at or beyond term compared with a policy of awaiting spontaneous labour or until an indication for birth induction of labour is identified) on pregnancy outcomes for infant and mother...
May 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29739912/early-cerebral-vein-after-endovascular-ischemic-stroke-treatment-predicts-symptomatic-reperfusion-hemorrhage
#11
Samuel C D Cartmell, Robyn L Ball, Rajani Kaimal, Nicholas A Telischak, Michael P Marks, Huy M Do, Robert L Dodd, Gregory W Albers, Maarten G Lansberg, Jeremy J Heit
BACKGROUND AND PURPOSE: Parenchymal hemorrhage (PH) after endovascular mechanical thrombectomy in acute ischemic stroke leads to worse outcomes. Better clinical and imaging biomarkers of symptomatic reperfusion PH are needed to identify patients at risk. We identified clinical and imaging predictors of reperfusion PH after endovascular mechanical thrombectomy with attention to early cerebral veins (ECVs) on postreperfusion digital subtraction angiography. METHODS: We performed a retrospective cohort study of consecutive acute ischemic stroke patients undergoing endovascular mechanical thrombectomy at our neurovascular referral center...
May 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29738399/cost-determinants-in-the-90-day-management-of-isolated-ankle-fractures-at-a-large-urban-academic-hospital
#12
Matthew Varacallo, Patrick Mattern, Jonathan Acosta, Nader Toossi, Kevin Denehy, Susan Harding
OBJECTIVES: To determine the independent risk factors associated with increasing costs and unplanned hospital readmissions in the 90-day episode of care (EOC) for isolated operative ankle fractures at our institution. DESIGN: Retrospective cohort study SETTING:: Level I Trauma Center PATIENTS:: Two hundred ninety-nine patients undergoing open reduction internal fixation (ORIF) for the treatment of an acute, isolated ankle fracture between 2010 and 2015. INTERVENTION: none MAIN OUTCOME MEASUREMENTS:: Independent risk factors for increasing 90-day EOC costs and unplanned hospital readmission rates...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29729543/craniotomy-for-subdural-hematoma-after-deep-brain-stimulation-surgery-outcomes-and-satisfaction-in-a-case-series-of-two-patients
#13
Gordon Mao, Michael J Gigliotti, Cindy Angle, Donald Whiting, Nestor Tomycz
OBJECTIVE: To determine whether salvage of DBS hardware is beneficial for Parkinson's Disease (PD) patients by looking at follow-up patient's outcomes and satisfaction after their craniotomy operation. PATIENTS AND METHODS: This was a retrospective review of a prospective, single-center deep brain stimulation (DBS) database between 2002-2016 identifying patients with PD who developed subdural hematomas (SDH) due to trauma after their DBS surgery. Of the 636 DBS cases that were performed, 3 PD-DBS patients with significant traumatic SDH managed via craniotomy were identified...
April 27, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29715571/length-of-thromboprophylaxis-in-patients-operated-for-a-high-grade-glioma-a-retrospective-study
#14
Joeky T Senders, Tom J Snijders, Max van Essen, Gaby M van Bentum, Tatjana Seute, Filip Y de Vos, Timothy R Smith, Pierre A Robe, Marike Ld Broekman
OBJECTIVE: High-grade gliomas are associated with venous thromboembolism (VTE). This retrospective study with a parallel cohort design investigates the influence of continuing prophylactic anticoagulation post-discharge on the rate of VTE and intracranial hemorrhage (ICH) in patients operated for a high-grade glioma. METHODS: Consecutive adult patients who underwent sub- or gross-total resection for a high-grade glioma at a single institution were included. Multivariable logistic regression analysis was used to investigate the association between the duration of thromboprophylaxis (dalteparin administered 21 versus 0-7 days) and the occurrence of VTE and ICH within 21 or 90 days after surgery, corrected for known risk factors...
April 28, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29705803/lipid-lowering-pretreatment-and-outcome-following-intravenous-thrombolysis-for-acute-ischaemic-stroke-a-post-hoc-analysis-of-the-enhanced-control-of-hypertension-and-thrombolysis-stroke-study-trial
#15
Jatinder S Minhas, Xia Wang, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph P Broderick, Geoffrey A Donnan, Jong S Kim, Pablo M Lavados, Tsong-Hai Lee, Sheila Cristina Ouriques Martins, Verónica V Olavarría, Jeyaraj D Pandian, Octávio Marques Pontes-Neto, Stefano Ricci, Shoichiro Sato, Vijay K Sharma, Nguyen H Thang, Ji-Guang Wang, Mark Woodward, John Chalmers, Craig S Anderson, Thompson G Robinson
BACKGROUND: Debate exists as to whether statin pretreatment confers an increased risk of 90-day mortality and symptomatic intracranial haemorrhage (sICH) in acute ischaemic stroke (AIS) patients treated with intravenous thrombolysis. We assessed the effects of undifferentiated lipid-lowering pretreatment on outcomes and interaction with low-dose versus standard-dose alteplase in a post hoc subgroup -analysis of the Enhanced Control of Hypertension and Thrombolysis Stroke Study. METHODS: In all, 3,284 thrombolysis-eligible AIS patients (mean age 66...
April 27, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29702270/adnexal-torsion-during-pregnancy-pregnancy-outcomes-after-surgical-intervention-a-retrospective-case-control-study
#16
Yair Daykan, Rona Bogin, Merav Sharvit, Zvi Klein, Dana Josephy, Meir Pomeranz, Nissim Arbib, Tal Biron-Shental, Ron Schonman
STUDY OBJECTIVE: To investigate the pregnancy and neonatal outcomes of surgical treatment for adnexal torsion (AT) during pregnancy. DESIGN: Retrospective case-control study (Canadian Task Force classification II-2). SETTING: Tertiary care academic medical center. MEASUREMENTS AND RESULTS: The study group included all parturients who underwent surgery for suspected AT during pregnancy from January 2005 to January 2017...
April 24, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29701362/bilateral-internal-thoracic-artery-grafting-in-patients-with-diabetes-mellitus
#17
Ana Braga, Pedro Magro, Miguel Sousa Uva, Miguel Abecacis, João Pedro Neves
INTRODUCTION: Bilateral internal thoracic artery (BITA) grafting in patients with diabetes mellitus is controversial due to a higher risk for sternal infection. The purpose of this study is to compare the rates of mediastinitis as well as mortality rates of BITA grafting to that of single internal thoracic artery (SITA) grafting and saphenous vein grafts in patients with diabetes. METHODS: Between 2007 and 2015 all consecutive diabetic patients with multivessel disease who underwent primary coronary artery bypass graft surgery with BITA were compared with patients who underwent coronary artery bypass graft surgery with SITA and saphenous vein grafts (the control group)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699579/urinary-biomarkers-predict-advanced-acute-kidney-injury-after-cardiovascular-surgery
#18
Jian-Jhong Wang, Nai-Hsin Chi, Tao-Min Huang, Rory Connolly, Liang Wen Chen, Shih-Chieh Jeff Chueh, Wei-Chih Kan, Chih-Cheng Lai, Vin-Cent Wu, Ji-Tseng Fang, Tzong-Shinn Chu, Kwan-Dun Wu
BACKGROUND: Acute kidney injury (AKI) after cardiovascular surgery is a serious complication. Little is known about the ability of novel biomarkers in combination with clinical risk scores for prediction of advanced AKI. METHODS: In this prospectively conducted multicenter study, urine samples were collected from 149 adults at 0, 3, 6, 12 and 24 h after cardiovascular surgery. We measured urinary hemojuvelin (uHJV), kidney injury molecule-1 (uKIM-1), neutrophil gelatinase-associated lipocalin (uNGAL), α-glutathione S-transferase (uα-GST) and π-glutathione S-transferase (uπ-GST)...
April 26, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29697937/the-preoperative-stratification-of-patients-based-on-renal-scan-data-is-unable-to-predict-the-functional-outcome-after-partial-nephrectomy
#19
Riccardo Bertolo, Cristian Fiori, Federico Piramide, Daniele Amparore, Francesco Porpiglia
INTRODUCTION: eGFR-categories are used to predict functional outcome after partial nephrectomy (PN); no study categorized patients according to preoperative renal scan (RS) data. Aim of the study was to evaluate if stratification of patients according to RS is a reliable method to predict minor/major loss of renal function after PN. MATERIALS AND METHODS: We considered patients who underwent PN and RS pre-/post-PN for T1 tumor in our Institution (2007-2017). Demographics, perioperative and specifically functional data were analysed...
April 15, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29696572/comparison-of-early-morbidity-and-mortality-between-sleeve-gastrectomy-and-gastric-bypass-in-high-risk-patients-for-liver-disease-analysis-of-american-college-of-surgeons-national-surgical-quality-improvement-program
#20
Mohamad A Minhem, Sali F Sarkis, Bassem Y Safadi, Souha A Fares, Ramzi S Alami
INTRODUCTION: Chronic liver disease is prevalent in obese patients presenting for bariatric surgery and is associated with increased postoperative morbidity and mortality (M&M). There are no comparative studies on the safety of different types of bariatric operations in this subset of patients. OBJECTIVE: The aim of this study is to compare the 30-day postoperative M&M between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-Y-gastric bypass (LRYGB) in the subset of patients with a model of end-stage liver disease (MELD) score ≥ 8...
April 25, 2018: Obesity Surgery
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