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https://www.readbyqxmd.com/read/28820554/warfarin-therapy-after-mechanical-valve-replacement-a-tool-for-predicting-bleeding-events
#1
Insil Jang, Sukjung Choo, Kyunghee Kim
BACKGROUND: Mechanical valve replacement is associated with positive outcomes, but patients must undergo life-long anticoagulation therapy with warfarin, which carries a significant risk of bleeding complications. Therefore, a systematic and continuous assessment and supervision of warfarin treatment is essential in such patients, and approaches that can predict the risk of bleeding in advance are required. The study aim was to develop a classification tool to predict bleeding events in South Korean patients with mechanical valve replacement undergoing oral warfarin therapy...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28816881/the-shikani-optical-stylet-as-an-alternative-to-awake-fiberoptic-intubation-in-patients-at-risk-of-secondary-cervical-spine-injury-a-randomized-controlled-trial
#2
Rabab S S Mahrous, Aly M M Ahmed
BACKGROUND: Conventional intubation of the trachea and consequent prone positioning of anesthetized patients with cervical spine instability may result in secondary neurological injury. Historically, flexible fiberoptics used to be the chief choice for patients presenting with cervical spine instability surgery with difficult airway. Recently, the rigid optical stylets have shown promise in assisting difficult intubations. PURPOSE: The aim of the present study was to compare the efficacy of Shikani optical stylet (SOS) with the flexible fiberscope for awake intubation in patients with cervical spine instability...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28815075/the-feeding-route-after-esophagectomy-a-review-of-literature
#3
REVIEW
Gijs H Berkelmans, Frans van Workum, Teus J Weijs, Grard A Nieuwenhuijzen, Jelle P Ruurda, Ewout A Kouwenhoven, Marc J van Det, Camiel Rosman, Richard van Hillegersberg, Misha D Luyer
Enhanced recovery programs effectively optimize perioperative care and reduce postoperative morbidity. In esophagectomy, several components of the ERAS program are successfully introduced. However, timing and type of postoperative feeding remain a matter of debate. Adequate nutritional support is essential in patients undergoing an esophagectomy. These patients often present with weight loss and their eating pattern is strongly altered by the procedure and reconstruction. Total parenteral nutrition (TPN) is associated with severe septic complications and enteral nutrition (EN) does not increase major complications...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28814581/hyperammonaemic-encephalopathy-following-an-uncomplicated-surgery
#4
Stuart McIntosh, Karima Medjoub, Kevin Deans, Sara Sexton
A 59-year-old woman who underwent an uncomplicated exploratory laparotomy, adhesiolysis, small bowel resection and anterolateral thigh flap had a complicated postoperative period characterised by wound dehiscence and poor nutritional intake. 29 days postoperatively, a tremor developed in her upper limbs associated with weakness. Her Glasgow Coma Scale (GCS) fell to 4 and she was transferred to the intensive care unit. The patient was reviewed by multiple specialists and multiple differentials were considered and eliminated...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28811110/characterizing-the-diagnosis-and-treatment-of-allergic-contact-dermatitis-to-2-octyl-cyanoacrylate-used-for-skin-closure-in-elective-orthopedic-surgery
#5
Brian P Chalmers, Heath P Melugin, Peter K Sculco, Jennifer J Schoch, Rafael J Sierra, Mark W Pagnano, Michael J Stuart, Michael J Taunton
BACKGROUND: While studies have shown that postoperative wound complications can predispose to deep infection following orthopedic surgery, the best form of skin closure has not been elucidated. Furthermore, the unique risks and benefits of each type of wound closure have not been studied. The goal of this study is to present the diagnosis and treatment of patients with allergic contact dermatitis (ACD) from 2-octyl cyanoacrylate, a skin adhesive commonly used in wound closure. METHODS: Twenty-nine patients with ACD to 2-octyl cyanoacrylate (Prineo, Ethicon, NJ) following elective orthopedic surgeries from 2013 to 2016 were retrospectively reviewed; this occurred in 29 of 6088 units of Prineo used at our institution, for an estimated incidence of 0...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28810647/limb-graft-occlusion-following-endovascular-aortic-repair-incidence-causes-treatment-and-prevention-in-a-study-cohort
#6
Guoquan Wang, Shuiting Zhai, Tianxiao Li, Xuan Li, Danghui Lu, Bo Wang, Dongbin Zhang, Shuaitao Shi, Zhidong Zhang, Kai Liang, Kewei Zhang, Xiaoyang Fu, Kun Li, Weixiao Li
The present study investigated the incidence, causes, treatment and prevention of limb graft occlusion following endovascular aortic repair (EVAR). A total of 66 cases of abdominal aortic aneurysm receiving EVAR at our department from January 2005 to December 2013 were enrolled. After EVAR, patients received routine antiplatelet therapy of 75 mg PLAVIX for 6 months and then 100 mg Aspirin for another 6 months by oral administration. According to previous clinical experiences, antiplatelet therapy is able to effectively reduce the incidence of iliac occlusion after EVAR...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28796653/surgical-treatment-of-colon-cancer-of-the-splenic-flexure-a-systematic-review-and-meta-analysis
#7
Aleix Martínez-Pérez, Francesco Brunetti, Giulio C Vitali, Solafah Abdalla, Frédéric Ris, Nicola de'Angelis
This is a systematic review and meta-analysis on the surgical treatments of splenic flexure carcinomas (SFCs). Medline, EMBASE, and Scopus were searched from January 1990 to May 2016. Studies of at least 5 patients comparing extended right colectomy (ERC) versus left colectomy (LC) and/or laparoscopy versus open surgery for SFCs were retrieved and analyzed. Overall, 12 retrospective studies were selected, including 569 patients. ERC was performed in 23.2% of patients, whereas LC in 76.8%. Pooled data suggested that ERC and LC had similar oncologic quality of resection and postoperative outcomes...
August 7, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28790283/-postoperative-atelectasis-and-pneumonia-after-general-thoracic-surgery
#8
Yasushi Hoshikawa, Daisuke Tochii
Atelectasis and pneumonia are common postoperative complications occurred in patients undergoing general thoracic surgery. Strategies to reduce the risk of postoperative pulmonary complications including these 2 disorders consist of smoking cessation, optimization of underlying chronic obstructive pulmonary disease( COPD), adequate pain control, intensive oral care, and so on. Preoperative treatments for patients with COPD are the same as those for COPD patients being not about to have surgery, which mainly consist of long-acting bronchodilators and pulmonary rehabilitation...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790282/-arrhythmia-perioperative-management-and-the-prevention
#9
Masayoshi Inoue
Perioperative/postoperative atrial fibrillation and flutter( POAF) is one of the common complications after pulmonary resection and the frequency is reported as 12.6% according to Society of Thoracic Surgeons general thoracic surgery database. We usually observed POAF 2~3 day after operation. While the etiology remains uncertain, the left atrial overload by the refilling from the 3rd space or systemic inflammation after surgery could raise this complication in addition to the right atrial overload following pulmonary resection and postoperative hypoxia status...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28782603/randomized-clinical-trial-of-epidural-compared-to-conventional-analgesia-after-minimally-invasive-colorectal-surgery
#10
Mark H Hanna, Mehraneh D Jafari, Fariba Jafari, Michael J Phelan, Joseph Rinehart, Coral Sun, Joseph C Carmichael, Steven D Mills, Michael J Stamos, Alessio Pigazzi
OBJECTIVE: The effectiveness of thoracic epidural analgesia (EA) versus conventional intravenous analgesia (IV) after minimally invasive surgery (MIS) is still unproven. We designed a randomized controlled trial comparing EA versus IV after MIS colorectal surgery. METHODS: A total of 87 patients who underwent MIS colorectal procedures at a single institution between 2011 and 2014 were enrolled. 8 patients were excluded and 38 were randomized to EA and 41 to IV. Pain was assessed with the visual analogue scale (VAS) and quality of life with the Overall Benefit of Analgesia Score (OBAS) daily until discharge...
August 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28780045/sleeve-gastrectomy-with-duodenojejunal-end-to-side-anastomosis-in-the-treatment-of-type-2-diabetes-the-initial-experiences-in-a-chinese-population-with-a-more-than-4-year-follow-up
#11
Xiaojiao Ruan, Weijian Zhang, Huajie Cai, Ru Zheng, Feizhao Jiang, Hengliang Zhu
BACKGROUND: Gastric bypass has been thought to be associated with a risk of gastric cancer, particularly in Asia. Sleeve gastrectomy with duodenojejunal end-to-side anastomosis (SG-DJESA) was suggested to be a better-designed procedure to avoid this risk, and it also has other advantages. OBJECTIVE: We aimed to evaluate the clinical efficacy and feasibility of SG-DJESA in the treatment of nonobese patients with type 2 diabetes (T2D). SETTING: University Hospital, China...
July 14, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28776922/efficacy-and-pharmacokinetics-of-subcutaneous-exendin-9-39-in-patients-with-post-bariatric-hypoglycemia
#12
Colleen M Craig, Li-Fen Liu, Thi Nguyen, Candice Price, Justus Bingham, Tracey L McLaughlin
AIM: Post-bariatric hypoglycemia (PBH) is a rare but growing complication of bariatric surgery with severe, debilitating, potentially life-threatening consequences and no safe and effective treatment. Previous studies involving continuous intravenous (IV) infusion of the glucagon-like peptide-1 (GLP-1) receptor antagonist, exendin (9-39) (Ex-9) in patients with PBH have demonstrated efficacy in preventing symptomatic postprandial hypoglycemia. Subcutaneous (SC) injection of Ex-9 would represent a more practical therapeutic approach...
August 4, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28771709/assessment-of-the-referral-system-for-surgical-removal-of-third-molars-at-the-dental-faculty-king-saud-university
#13
Randa Abdul Moein Al Fotawi, Manju Roby Philip, Sangeetah Negavara Premnath
INTRODUCTION: There is compelling evidence that prophylactic extraction of third molars is a health problem that needs to be addressed. In particular, the vast amount of evidence demonstrating complications after removal of third molars, rather than supporting the necessity of removal or the negative effects of retention, raise this concern. OBJECTIVE: The aim of this study was to investigate the referral system for third molar extraction at our institution by assessing patient opinions and the experience of the oral surgeons and the referring dentists...
August 2, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28767569/visual-loss-due-to-optic-nerve-infarction-and-central-retinal-artery-occlusion-after-spine-surgery-in-the-prone-position-a-case-report
#14
Soo Hee Lee, Inyoung Chung, Dae Seob Choi, Il-Woo Shin, Sunmin Kim, Sebin Kang, Ji-Yoon Kim, Young-Kyun Chung, Ju-Tae Sohn
RATIONALE: Visual loss after spine surgery in the prone position is a serious complication. Several cases of central retinal artery occlusion with ophthalmoplegia after spine surgery have been reported in patients with ophthalmic arteries fed by the internal carotid artery (ICA) in a normal manner. PATIENT CONCERNS: A 74-year-old man developed visual loss after undergoing a spinal decompression and fusion operation in the prone position that lasted approximately 5 hours...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28766070/prothrombin-time-international-normalized-ratio-is-a-useful-marker-for-edoxaban-efficacy-in-preventing-venous-thromboembolism-after-total-knee-arthroplasty
#15
Kazuki Kodato, Kazunari Ishida, Nao Shibanuma, Akihiko Toda, Koji Takayama, Shinya Oka, Shinya Hayashi, Shingo Hashimoto, Masahiro Kurosaka, Ryosuke Kuroda, Tomoyuki Matsumoto
BACKGROUND: Deep vein thrombosis (DVT) is one of the main complications following total knee arthroplasty (TKA). In this study, oral administration of 15 mg edoxaban (a factor Xa inhibitor) once daily for 14 days efficiently prevented the incidence of DVT. Our hypothesis was that prothrombin time-international normalized ratio (PT-INR) on the third postoperative day could predict the incidence of DVT following TKA. METHODS: In this study, 286 subjects were enrolled and divided into two groups according to the presence or absence of DVT...
August 1, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28764289/evaluation-of-donor-site-morbidity-associated-with-iliac-crest-bone-harvest-in-oral-and-maxillofacial-reconstructive-surgery
#16
K N V Sudhakar, Rajat Mohanty, Vaibhav Singh
INTRODUCTION: Iliac crest is the most common donor site for autogenous bone grafting as cortical bone, cancellous bone or combination of both can be harvested in abundance depending upon the need. Ilium provides highest concentration of osteo-component cells and greater quality of bone with less morbidity. AIM: The study was conducted to evaluate the donor site morbidity associated with autogenous iliac crest bone grafting for reconstruction in maxillofacial surgery...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28762929/-risk-factors-of-cardiovascular-complications-after-beating-heart-coronary-artery-bypass-grafting-in-patients-with-type-two-diabetes
#17
S Y Borodashkina, K V Protasov, V A Podkamennyi
AIM: to determine risk factors of early cardiovascular complications after beating-heart coronary artery bypass grafting (CABG) in patients with ischemic coronary disease (IHD) and type two diabetes (D2). MATERIALS AND METHODS: We included into this study 188 patients (mean age 59 years, 85.1% men) with IHD and D2 who underwent off-pump CABG. The following cardiovascular complications (CVC) registered within 7 days after surgery were analyzed: myocardial infarction (MI), stroke/transient ischemic attack (S/TIA), atrial fibrillation (AF)...
March 2017: Kardiologiia
https://www.readbyqxmd.com/read/28762024/risk-factors-for-prolonged-length-of-hospital-stay-and-readmissions-after-laparoscopic-sleeve-gastrectomy-and-laparoscopic-roux-en-y-gastric-bypass
#18
Piotr Major, Michał Wysocki, Grzegorz Torbicz, Natalia Gajewska, Alicja Dudek, Piotr Małczak, Michał Pędziwiatr, Magdalena Pisarska, Dorota Radkowiak, Andrzej Budzyński
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB) are most commonly performed bariatric procedures. Laparoscopic approach and enhanced recovery after surgery (ERAS) protocols managed to decrease length of hospital and morbidity. However, there are patients in whom, despite adherence to the protocol, the length of stay (LOS) remains longer than targeted. This study aimed to assess potential risk factors for prolonged LOS and readmissions. METHODS: The study was a prospective observation with a post-hoc analysis of bariatric patients in a tertiary referral university teaching hospital...
July 31, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28761375/continuous-transversus-abdominis-plane-block-vs-intermittent-bolus-for-analgesia-after-abdominal-surgery-a-randomized-trial
#19
Vasanth Rao Kadam, Roelof M Van Wijk, John L Moran, Shantan Ganesh, A Kumar, Rajesh Sethi, Patricia Williams
BACKGROUND: Continuous and intermittent bolus techniques of transversus abdominis plane (TAP) blocks have been used for analgesia after abdominal surgery. Although both are effective, there are no studies comparing them. The aim of this study is to compare analgesia and cost-effectiveness between these groups. METHODS: After obtaining ethical approval, 20 American Society of Anesthesiologists ASA grade I to III patients undergoing elective abdominal surgery were recruited with 10 patients allocated to each arm...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28750932/pulmonary-endarterectomy-in-chronic-thromboembolic-pulmonary-hypertension
#20
Mareike Lankeit, Valentin Krieg, Lukas Hobohm, Sebastian Kölmel, Christoph Liebetrau, Stavros Konstantinides, Christian W Hamm, Eckhard Mayer, Christoph B Wiedenroth, Stefan Guth
BACKGROUND: Management and outcome of patients with operable chronic thromboembolic pulmonary hypertension (CTEPH) who underwent pulmonary endarterectomy (PEA) at a large German referral center were investigated. METHODS: In Germany, 394 PEAs were performed in 2014 and 2015 with an in-hospital mortality rate of 5.8%. Of these, 253 patients (64.2%) were treated at the Kerckhoff Clinic, Bad Nauheim, and 237 (93.7%; median age, 62 years [interquartile range [IQR], 52-72 years]; 46...
July 1, 2017: Journal of Heart and Lung Transplantation
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