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https://www.readbyqxmd.com/read/28088603/hospital-readmissions-after-surgery-how-important-are-hospital-and-specialty-factors
#1
Robert H Hollis, Laura A Graham, Joshua S Richman, Melanie S Morris, Hillary J Mull, Tyler S Wahl, Edith Burns, Laurel A Copeland, Gordon L Telford, Amy K Rosen, Kamal F Itani, Jeffrey Whittle, Todd H Wagner, Mary T Hawn
BACKGROUND: Hospital readmission rates after surgery may represent an overall hospital effect or a combination of specialty and patient effects. We hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital. STUDY DESIGN: For general, orthopedic, and vascular specialties at Veterans Affairs hospitals during 2008-2014, 30-day risk-adjusted readmission rates were estimated for six high-volume procedures and each specialty...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28088126/severe-hypoalbuminemia-and-steatohepatitis-leading-to-death-in-a-young-vegetarian-female-8-months-after-mini-gastric-bypass-a-case-report
#2
Mohammad Kermansaravi, Mohammad Reza Abdolhosseini, Ali Kabir, Abdolreza Pazouki
BACKGROUND: Hypoalbuminemia is an important complication after Mini Gastric Bypass (MGB) and is more frequent in vegetarians, diabetic nephropathy, and alcoholic and liver disease patients. The patients must be followed in regular intervals and serum albumin must be checked in every visit after MGB. Hypoalbuminemia must be prevented by good protein regimes. CASE SUMMARY: A 29 years old female was admitted 8 month after Laparoscopic Mini Gastric Bypass with malaise, dyspnea, icter, nausea, vomiting, diarrhea and edema of extremities from 2 weeks before admission...
December 11, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28073665/predictive-ability-of-the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-after-first-time-lower-extremity-revascularizations
#3
Jeremy D Darling, John C McCallum, Peter A Soden, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The Society for Vascular Surgery (SVS) Wound, Ischemia and foot Infection (WIfI) classification system was proposed to predict 1-year amputation risk and potential benefit from revascularization. Our goal was to evaluate the predictive ability of this scale in a real-world selection of patients undergoing a first-time lower extremity revascularization for chronic limb-threatening ischemia (CLTI). METHODS: From 2005 to 2014, 1336 limbs underwent a first-time lower extremity revascularization for CLTI, of which 992 had sufficient data to classify all three WIfI components (wound, ischemia, and foot infection)...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28049511/prepancreatic-postduodenal-portal-vein-a-case-report-and-review-of-the-literature
#4
Naeem Goussous, Steven C Cunningham
BACKGROUND: Prepancreatic postduodenal portal vein is extremely rare, with only 13 cases reported in the literature. CASE PRESENTATION: A 55-year-old white woman presented to our emergency department with abdominal pain. She underwent a computed tomography of her abdomen, which showed a portal vein coursing anterolaterally to her pancreas and posteriorly to the first portion of her duodenum, constituting a prepancreatic postduodenal portal vein. Imaging revealed choledocholithiasis, requiring endoscopic sphincterotomy, but due to a history of a gastric bypass procedure, she was lost to follow-up after being referred to an advanced endoscopist...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28042555/lower-extremity-arterial-bypass-with-arm-vein-conduits-and-literature-review
#5
Dae-Joon Park, Yang-Jin Park, Kyoung Won Yoon, Seon-Hee Heo, Dong-Ik Kim, Young-Wook Kim
PURPOSE: The superiority of autogenous vein conduits is well known in lower extremity arterial bypass (LEAB). Among various alternative conduits for LEAB, long-term results of arm vein grafts were investigated in this study. MATERIALS AND METHODS: We retrospectively reviewed clinical characteristics of 28 patients who underwent infrainguinal LEAB with autogenous arm vein grafts at a single institute between January 2003 and December 2015. All procedures were performed in the absence of adequate saphenous veins...
December 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/28031298/strengthening-government-leadership-in-family-planning-programming-in-senegal-from-proof-of-concept-to-proof-of-implementation-in-2-districts
#6
Barry Aichatou, Cheikh Seck, Thierno Souleymane Baal Anne, Gabrielle Clémentine Deguenovo, Alexis Ntabona, Ruth Simmons
Given Senegal's limited resources, the country receives substantial support from externally funded partner organizations to provide family planning and maternal and child health services. These organizations often take a strong and sometimes independent role in implementing interventions with their own structures and personnel, thereby bypassing the government district health system. This article presents findings from the Initiative Sénégalaise de Santé Urbaine (ISSU) (Senegal Urban Health Initiative) that assessed in 2 districts, Diamniadio and Rufisque, the extent to which it was feasible to create stronger government ownership and leadership in implementing a simplified package of family planning interventions from among those previously tested in other districts...
December 23, 2016: Global Health, Science and Practice
https://www.readbyqxmd.com/read/28018827/redo-operation-of-recurrent-giant-coronary-artery-aneurysm-optimizing-surgical-strategy
#7
Julia Hillebrand, Andreas Rukosujew, Sven Martens, Dirk Boese
Background Giant coronary artery aneurysms (GCAA) are extremely rare, but they can cause life-threatening complications. Indications for surgical intervention are the occurrence of complications such as fistulas, compression, embolization, or rapid enlargement. The optimal therapeutic approach is still under debate. Until now, there are no publications dealing with the follow-up after surgical treatment. Moreover, the surgical strategy in redo operations has not been described yet. Case Description We report on surgery in a 50-year-old man with a recurrent GCAA after previous dissection and reduction...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28011503/surgical-resection-of-giant-pheochromocytomas-arising-behind-the-retrohepatic-inferior-vena-cava
#8
Yuji Soejima, Tomoharu Yoshizumi, Toru Ikegami, Norifumi Harimoto, Shinji Ito, Noboru Harada, Takashi Motomura, Akihisa Nagatsu, Tetsuo Ikeda, Yoshihiko Maehara
BACKGROUND: Surgical resection of retrocaval giant pheochromocytomas (PCs) and of extra-adrenal paragangliomas (EAPs) is a technically challenging procedure but data on these procedures are scarce. The purpose of this study was to present and evaluate our surgical results for such tumors. PATIENTS AND METHODS: We retrospectively analyzed four consecutive patients who had surgery for giant retro-caval PCs and EAPs in terms of surgical technique, resectability of the tumor, requirement for bypass, and postoperative complications...
January 2017: Anticancer Research
https://www.readbyqxmd.com/read/28011005/the-enduring-patency-of-primary-inferior-vena-cava-repair
#9
Neel A Mansukhani, George E Havelka, Irene B Helenowski, Heron E Rodriguez, Andrew W Hoel, Mark K Eskandari
BACKGROUND: Inferior vena cava repair after planned and unplanned venotomy is performed by either interposition bypass, patch venopasty, or lateral venorrhaphy and primary repair. Primary repair of the inferior vena cava avoids the use of foreign material and allows an all-autologous repair in an expeditious fashion. The purpose of this study was to demonstrate the utility of inferior vena cava repair, determine the degree of inferior vena cava stenosis, and examine clinical outcomes after primary repair...
December 20, 2016: Surgery
https://www.readbyqxmd.com/read/28007264/femorofemoral-shunt-during-surgery-for-acute-debakey-type-1-dissection-to-treat-peripheral-extremity-malperfusion
#10
Eric I Jeng, Igor Voskresensky, Adam W Beck, Teng C Lee
Peripheral extremity ischemia in patients presenting with a DeBakey type 1 aortic dissection is an independent predictor for mortality. We present a patient with a DeBakey type 1 aortic dissection and peripheral extremity malperfusion that underwent simultaneous aortic repair and percutaneous femorofemoral shunt with arterial sidearm. Our approach allows for immediate peripheral extremity reperfusion and subsequent objective determination of the necessity of femorofemoral bypass via perfusion pressures.
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27994830/primary-intimal-sarcoma-of-the-left-atrium-an-incidental-finding-on-routine-echocardiography
#11
Gautam Valecha, Dhaval Pau, Nikhil Nalluri, Ying Liu, Farhan Mohammad, Jean Paul Atallah
Cardiac sarcomas are extremely rare primary malignant tumors of the heart. In this article, we present the case of a 70-year-old female, who was found to have a left atrial mass during a routine outpatient transthoracic echocardiography. Further investigation with cardiac magnetic resonance imaging confirmed the presence of a bilobulated mass with heterogeneous enhancement. Left atrial myxoma was the first diagnostic consideration, followed by other primary cardiac tumors, and thrombus. The patient subsequently underwent resection of the mass, utilizing cardiopulmonary bypass...
November 17, 2016: Rare Tumors
https://www.readbyqxmd.com/read/27951587/mrna-quality-control-is-bypassed-for-immediate-export-of-stress-responsive-transcripts
#12
Gesa Zander, Alexandra Hackmann, Lysann Bender, Daniel Becker, Thomas Lingner, Gabriela Salinas, Heike Krebber
Cells grow well only in a narrow range of physiological conditions. Surviving extreme conditions requires the instantaneous expression of chaperones that help to overcome stressful situations. To ensure the preferential synthesis of these heat-shock proteins, cells inhibit transcription, pre-mRNA processing and nuclear export of non-heat-shock transcripts, while stress-specific mRNAs are exclusively exported and translated. How cells manage the selective retention of regular transcripts and the simultaneous rapid export of heat-shock mRNAs is largely unknown...
December 12, 2016: Nature
https://www.readbyqxmd.com/read/27943281/latissimus-dorsi-flap-with-vascularized-lymph-node-transfer-for-lymphedema-treatment-technique-outcomes-indications-and-review-of-literature
#13
Amir Inbal, Chad M Teven, David W Chang
BACKGROUND AND OBJECTIVES: One of the surgical treatment options for lymphedema is vascularized lymph node transfer (VLNT). We present our experience with latissimus dorsi (LD) flap based VLNT for lymphedema treatment. METHODS: We reviewed 14 consecutive patients treated with pedicled or free LD VLNT between 2014 and 2016 for recalcitrant upper or lower extremity lymphedema. Seven patients underwent lymphovenous bypass in addition to LD VLNT. Limb volume and quality of life scores using the Lymphedema Life Impact Scale (LLIS) were analyzed for quantitative and qualitative assessment...
December 12, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27935900/-thromboangiitis-obliterans-buerger-s-disease-state-of-the-art
#14
D D Zerbino, E A Zimba, N N Bagry
Thromboangiitis obliterans (Buerger's disease) is systemic vasculitis with predominant development of thrombotic occlusions of small-to-medium diameter arteries of distal portions of both upper and lower limbs. A distinctive feature of Buerger's disease from other vasculitides is the involvement of the venous bed into the pathological process in the form of migrating thrombophlebitis. The disease is encountered more often in young adult males, predominantly tobacco smokers. The clinical pattern is presented by symptoms of increasing insufficiency of blood supply of tissues of extremities...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27935075/nerve-conduction-studies-are-safe-in-patients-with-central-venous-catheters
#15
Zachary N London, Andrew Mundwiler, Hakan Oral, Gary W Gallagher
INTRODUCTION: It is unknown if central venous catheters bypass the skin's electrical resistance and engender a risk of nerve conduction study-induced cardiac arrhythmia. OBJECTIVE: To determine if nerve conduction studies affect cardiac conduction and rhythm in patients with central venous catheters. METHODS: Under continuous 12-lead electrocardiogram monitoring, subjects with and without central venous catheters underwent a series of upper extremity nerve conduction studies...
December 9, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27928034/below-knee-endovascular-interventions-have-better-outcomes-compared-to-open-bypass-for-patients-with-critical-limb-ischemia
#16
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee. The purpose of this study was to compare outcomes following infrageniculate lower extremity open bypass (LEB) versus peripheral vascular intervention (PVI) in patients with critical limb ischemia. Using data from the 2008-2014 Vascular Quality Initiative, 1-year primary patency, major amputation, and mortality were compared among all patients undergoing LEB versus PVI at or below the knee for rest pain or tissue loss...
December 6, 2016: Vascular Medicine
https://www.readbyqxmd.com/read/27914772/vascular-reconstruction-after-retroperitoneal-and-lower-extremity-sarcoma-resection
#17
M Wortmann, I Alldinger, D Böckler, A Ulrich, A Hyhlik-Dürr
PURPOSE: Soft tissue sarcomas (STS) of the retroperitoneum and the lower limb with invasion of major blood vessels are very rare malignancies. This study analyses the outcome of patients with vascular replacement during resection of STS of the retroperitoneum and the lower extremity with either arterial or concomitant arterial and venous infiltration. METHODS: Patients with vascular replacement during resection of sarcoma of the retroperitoneum and the lower extremity between 1990 and 2014 were included in this retrospective single center study...
November 20, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27909279/-stanford-type-a-aortic-dissection-after-off-pump-coronary-artery-bypass-grafting-using-automated-proximal-anastomotic-device-report-of-a-case
#18
Toshiyuki Maeda, Taku Sakurada, Satoshi Muraki, Shinji Nakashima, Jun Sasaki, Eiji Araki
Operative mortality of Stanford type A aortic dissection( AAD) repair with previous cardiac surgery is high, especially with previous coronary artery bypass grafting. We report an extremely rare case of AAD related to the PAS-Port system. A 68-year-old male patient on dialysis was admitted to our hospital with a diagnosis of AAD. Half a year before he had undergone off-pump coronary artery bypass grafting using PAS-Port system for a proximal anastomosis of a vein graft. Urgent graft replacement of the ascending aorta was performed, and the proximal anastomotic site of the vein graft was attached to the prosthetic graft...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27903474/functional-assessment-and-evaluation-of-outcome-after-endovascular-therapy-with-coverage-of-the-left-subclavian-artery-in-case-of-blunt-thoracic-aortic-injury
#19
Alexander Gombert, Drosos Kotelis, Ulrike M Griepenkerl, Gustav Fraedrich, Josef Klocker, Bernhard Glodny, Michael J Jacobs, Andreas Greiner, Jochen Grommes
BACKGROUND: Patients suffering blunt thoracic aortic injury (BTAI) can be treated by use of thoracic endovascular aortic repair (TEVAR). In this setting, the coverage of the left subclavian artery (LSA) is frequently necessary. Nevertheless, the functionality of the upper left extremity after TEVAR had been rarely analyzed. Thus, this study intends to underline the safety of TEVAR as well as to determine the functionality of the left arm after coverage of the LSA. METHODS: All patients suffering from BTAI treated by endovascular means in 3 centers (Aachen [Germany], Maastricht [Netherlands], and Innsbruck [Austria]) between 1996 and 2009 were retrospectively analyzed...
November 27, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27884944/ruptured-abdominal-aortic-aneurysm-after-endovascular-aortic-aneurysm-repair-thrombosis
#20
Jesse Victory, Syed Ali Rizvi, Enrico Ascher, Anil Hingorani
BACKGROUND: Complete thrombosis of an aortic endograft after an endovascular aortic aneurysm repair is a rare complication. The majority of thrombotic events occur in the iliac limbs. CASE PRESENTATION: We present the case of a patient who presented with acute limb ischemia as the result of a thrombosed infra-renal aortic endograft. After restoration of blood flow to the lower extremities with an axillary to bi-femoral artery bypass, the patient was lost to follow-up...
November 24, 2016: Vascular
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