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Perioperative mortality

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https://www.readbyqxmd.com/read/29166702/impact-of-active-cancer-disease-on-the-outcome-of-patients-undergoing-transcatheter-aortic-valve-replacement
#1
Norman Mangner, Felix J Woitek, Stephan Haussig, David Holzhey, Georg Stachel, Florian Schlotter, Robert Höllriegel, Friedrich W Mohr, Gerhard Schuler, Axel Linke
BACKGROUND: Patients undergoing transcatheter aortic valve replacement (TAVR) are often characterized by risk factors not reflected in conventional risk scores. In this context, little is known about the outcome of patients suffering from an active cancer disease (ACD). The objective was to determine the prevalence, clinical characteristics, perioperative outcomes, and mortality of patients with ACD undergoing TAVR compared to those with a history of cancer (HCD) and controls without known tumor disease...
November 22, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29166543/transcatheter-or-surgical-aortic-valve-replacement-in-patients-with-advanced-kidney-disease-a-propensity-score-matched-analysis
#2
Rajkumar Doshi, Jay Shah, Vaibhav Patel, Varun Jauhar, Perwaiz Meraj
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR). HYPOTHESIS: TAVR is associated with better in-hospital outcomes compared with SAVR in patients with advanced kidney disease. METHODS: We identified our sample from the National Inpatient Sample between 2012 and 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification codes...
November 22, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29164559/effects-of-carvedilol-on-vascular-reactivity-in-human-left-internal-mammary-artery
#3
M Guzeloglu, E Ertuna, M Z Arun, B Reel
OBJECTIVE: Surgical treatment choice for coronary artery disease is coronary artery bypass grafting (CABG) surgery. Left internal mammary artery (LIMA) is frequently used as an arterial graft in CABG operations. Perioperative spasm of LIMA can result in increased morbidity and mortality. Pharmacological interventions are routinely used for prevention and treatment of LIMA spasm. In this study, we aimed to investigate the effects of carvedilol, an alpha- and beta-adrenergic receptor blocker, on responses to endogenous vasoconstrictors which play a role in graft spasm and the possible interaction between carvedilol and diltiazem/papaverine which are vasodilators commonly used in CABG surgery...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29163991/an-undiagnosed-paraganglioma-in-a-58-year-old-female-who-underwent-tumor-resection
#4
William C Fox, Matthew Read, Richard E Moon, Eugene W Moretti, Brian J Colin
Paragangliomas and pheochromocytomas are rare neuroendocrine tumors that can have high morbidity and mortality if undiagnosed. Here we report a case of an undiagnosed paraganglioma in a 58-year-old female who underwent tumor resection. The patient became severely hypertensive intraoperatively with paroxysmal swings in blood pressure and then later became acutely hypotensive after tumor removal. She was managed in the surgical intensive care unit (SICU) postoperatively and discharged from the hospital without acute complications...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29162977/perioperative-management-of-patients-with-diabetes
#5
REVIEW
Vivien Leung, Kristal Ragbir-Toolsie
Hyperglycemia has long been recognized to have detrimental effects on postoperative outcomes in patients undergoing surgery. The manifestations of uncontrolled diabetes are manifold and can include risk of hyperglycemic crises, postoperative infection, poor wound healing, and increased mortality. There is substantial literature supporting the role of diligent glucose control in the prevention of adverse surgical outcomes, but considerable debate remains as to the optimal glucose targets. Hence, most organizations advocate the avoidance of hypoglycemia while striving for adequate glucose control in the perioperative period...
2017: Health Services Insights
https://www.readbyqxmd.com/read/29162972/clinical-outcomes-of-upper-gastrointestinal-stents-and-review-of-current-literature
#6
Hasan Bektaş, Bünyamin Gürbulak, Yiğit Düzköylü, Şükrü Çolak, Esin Kabul Gürbulak, Ekrem Çakar, Savaş Bayrak
Background and Objectives: The self-expandable metal stent (SEMS) is an alternative for several possible surgical and palliative treatments of upper gastrointestinal obstructions that occur in several disease states. The present study was performed to describe a single-center experience with upper gastrointestinal stents. Methods: All patients at a single center who had an SEMS placed for the treatment of obstruction over a 3-year period were retrospectively evaluated...
October 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/29161397/abdominal-aortic-aneurysm-repair-in-the-united-kingdom-an-exemplar-for-the-role-of-anaesthetists-in-perioperative-medicine
#7
S J Howell
The past two decades have seen an increasing recognition that the delivery of safe surgery with low complication rates and good long-term outcomes is a team endeavour embracing the whole patient care pathway. The key role of the anaesthetist in managing the patient through the surgical process is widely understood and has driven the emergence of perioperative medicine. In parallel with these developments there has been a sea change in the organisation of the care of patients presenting for elective abdominal aortic aneurysm (AAA) repair...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161389/innovations-in-management-of-cardiac-disease-drugs-treatment-strategies-and-technology
#8
P Foëx
Within the last generation, the management of patients with heart disease has been transformed by advances in drug treatments, interventions and diagnostic technologies. The management of arterial hypertension saw beta-blockers demoted from first- to third-line treatment. Recent studies suggest that the goal of treatment may have to change to lower systolic blood pressures to prevent long-term organ damage. Today less than 15% of coronary revascularizations are surgical and more than 85% are done by interventional cardiologists inserting coronary stents...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161240/rapid-nodal-staging-of-head-and-neck-cancer-surgical-specimens-with-flow-cytometric-analysis
#9
Valtteri Häyry, Åsa Kågedal, Eric Hjalmarsson, Pedro Farrajota Neves da Silva, Cecilia Drakskog, Gregori Margolin, Susanna Kumlien Georén, Eva Munck-Wikland, Ola Winqvist, Lars Olaf Cardell
BACKGROUND: Detection of metastatic spread of head and neck cancer to cervical lymph nodes is essential for optimal design of therapy. Undetected metastases lead to mortality, which can be prevented by better detection methods. METHODS: We analysed 41 lymph nodes from 19 patients with oral squamous cell carcinoma (OSCC). Each lymph node was divided in two, one half processed for histopathology and the other half dissociated into single-cell suspension, stained for the carcinoma cell markers cytokeratin 5/8 (CK5/8), epithelial cell adhesion molecule (EpCAM) and epithelial mucin (MUC-1), and analysed with flow cytometry...
November 21, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/29159491/-algorithm-for-securing-an-unexpected-difficult-airway-user-analysis-on-a-simulator
#10
T Ott, K Truschinski, M Kriege, M Naß, S Herrmann, V Ott, S Sellin
BACKGROUND: Critical incidents in difficult airway management are still a main contributory factor for perioperative morbidity and mortality. Many national associations have developed algorithms for management of these time critical events. For implementation of these algorithms the provision of technical requirements and procedure-related training are essential. Severe airway incidents are rare events and clinical experience of the individual operators is limited; therefore, simulation is an adequate instrument for training and evaluating difficult airway algorithms...
November 20, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29158865/-anesthesiological-aspects-and-complications-of-intracranial-meningiomas-operated-at-the-sylvanus-olympio-university-hospital-center-lom%C3%A3-about-21-cases
#11
Pilakimwé Egbohou, Tabana Mouzou, Kadanga Beketi, Essossinam Kpelao, Abdel Kader Moumouni, Hamza Doles Sama, Sarakawabalo Assénouwé, Gnimdou Akala-Yoba, Kadjika Tomta
This study aimed to point to both the anesthesiological aspects and the perioperative complications of intracranial meningiomas operated at the Sylvanus Olympio University Hospital Center, Lomé. We conducted a retrospective study by reviewing the medical records of patients with intracranial meningiomas undergoing surgery over the period December 2010-December 2015 (5 years) at the Sylvanus Olympio University Hospital Center, Lomé. Out of 46 patients operated fo brain tumors, 21 (45.6%) had meningioma. The average age was 49 ±20 years, with a male predominance (52...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29157723/implantable-cardioverter-defibrillator-therapy-in-hypertrophic-cardiomyopathy-a-simple-substudy
#12
Mate Vamos, Jeff S Healey, Jia Wang, Stuart J Connolly, Philippe Mabo, Lieselot VanErven, Josef Kautzner, Michael Glikson, Jorg Neuzner, Gilles O'Hara, Xavier Vinolas, Frederik Gadler, Stefan H Hohnloser
BACKGROUND: Patients with hypertrophic cardiomyopathy (HCM) are considered to be at high risk for elevated defibrillation thresholds, peri-procedural complications, and failed appropriate shocks. OBJECTIVE: To determine the value of defibrillation testing in HCM patients undergoing ICD implantation. METHODS: Defibrillation thresholds, perioperative complications, and long-term outcomes were compared between patients with HCM, and those with ischemic or dilated cardiomyopathy (ICM/DCM) enrolled in the SIMPLE trial...
November 17, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29157682/outcomes-of-thoracic-endovascular-aortic-repair-for-chronic-aortic-dissections
#13
Allan M Conway, Khalil Qato, Laurie R Mondry, Guillaume J Stoffels, Gary Giangola, Alfio Carroccio
BACKGROUND: Open surgical repair remains the "gold standard" treatment for chronic type B aortic dissection (cTBD) with aneurysm. Thoracic endovascular aortic repair (TEVAR) has gained popularity in recent years for the treatment of thoracic aortic diseases, including cTBD. We assessed the effectiveness of TEVAR in the treatment of cTBD using the Vascular Quality Initiative (VQI) database. METHODS: The VQI registry identified 4713 patients treated with TEVAR from July 2010 to November 2015, including 125 repairs for cTBD...
November 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29157110/risk-factors-and-clinical-outcomes-of-delirium-in-osteoporotic-hip-fractures
#14
Joon Yub Kim, Jeong Hyun Yoo, Eugene Kim, Ki Bum Kwon, Byeong-Ryong Han, Yongun Cho, Jai Hyung Park
PURPOSE: This study is performed to identify risk factors for delirium in osteoporotic hip fractures and to evaluate the hospitalization cost and clinical outcomes of delirium in osteoporotic hip. METHODS: A total of 221 patients with osteoporotic hip fractures were assessed for eligibility between 2010 and 2014. Among them, 37 patients with delirium were allocated into the delirium group (group D) and 37 patients without delirium were allocated into the non-delirium group (group ND) by matching demographic factors...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29156839/the-benefit-of-immunonutrition-in-patients-undergoing-hepatectomy-a-systematic-review-and-meta-analysis
#15
Chengshuo Zhang, Baomin Chen, Ao Jiao, Feng Li, Bowen Wang, Ning Sun, Jialin Zhang
Perioperative immunonutrition in liver resection remains doubtful. A systematic review and meta-analysis was conducted to compare postoperative outcomes between patients undergoing hepatectomy who received perioperative immunonutrition and those who did not.A PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Knowledge database search was performed to retrieve all of the randomized controlled trials (RCTs) evaluating the value of perioperative immunonutrition in patients undergoing hepatectomy until the end of September 2016...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29156799/asiatic-acid-protects-against-hepatic-ischemia-reperfusion-injury-by-inactivation-of-kupffer-cells-via-ppar%C3%AE-nlrp3-inflammasome-signaling-pathway
#16
Ying Xu, Jun Yao, Chen Zou, Heng Zhang, Shouliang Zhang, Jun Liu, Gui Ma, Pengcheng Jiang, Wenbo Zhang
Hepatic ischemia/reperfusion (I/R) contributes to major complications in clinical practice affecting perioperative morbidity and mortality. Recent evidence suggests the key role of nucleotide-binding oligomerization domain-like receptor (NLR) family pyrin domain-containing 3 (NLRP3) inflammaosme activation on the pathogenesis of I/R injury. Asiatic acid (AA) is a pentacyclic triterpene derivative presented with versatile activities, including antioxidant, anti-inflammation and hepatoprotective effects. This study was designed to determine whether AA had potential hepatoprotective benefits against hepatic I/R injury, as well as to unveil the underlying mechanisms involved in the putative effects...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29156184/bariatric-surgery-for-obesity
#17
REVIEW
Carel W le Roux, Helen M Heneghan
In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156053/propensity-matched-analysis-of-outcomes-after-mitral-valve-surgery-between-trainees-and-consultants-institutional-report
#18
Vito D Bruno, Pierpaolo Chivasso, Amna Hayat, Roberto Marsico, Umberto Benedetto, Massimo Caputo, Raimondo Ascione, Gianni D Angelini, Franco Ciulli, Hunaid A Vohra
OBJECTIVES: We aimed to determine whether early outcomes and long-term survival after mitral valve surgery performed by trainee residents are equivalent in terms of safety and efficacy when compared with consultant surgeons. METHODS: Between January 2000 and December 2015, a total of 1742 patients who underwent mitral valve surgery were identified. Of these, 1622 operations were performed by consultants (Group I) and 120 operations were performed by trainees (Group II)...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155935/early-and-late-outcomes-of-open-repair-for-dissecting-aneurysms-of-the-descending-or-thoraco-abdominal-aorta
#19
Atsushi Omura, Kenji Minatoya, Jiro Matsuo, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVES: Although open repair is the standard surgical option for dissecting descending thoracic aneurysms (DTAs) and thoraco-abdominal aorta aneurysms (TAAAs), it remains a significant challenge with considerable perioperative morbidity and mortality. We retrospectively analysed early and late outcomes of open repair for these aortic aneurysms. METHODS: Early and late outcomes were investigated for 223 consecutive patients who underwent open repair for dissecting DTA or TAAA between January 2003 and December 2014 (mean age 55 ± 16 years)...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155251/the-rothman-index-as-a-predictor-of-post-discharge-adverse-events-after-elective-spine-surgery
#20
Ryan P McLynn, Nathaniel T Ondeck, Jonathan J Cui, David R Swanson, Blake N Shultz, Patawut Bovonratwet, Jonathan N Grauer
BACKGROUND CONTEXT: The Rothman Index (RI) is a comprehensive rating of overall patient condition in the hospital setting. It is used at many medical centers and calculated based on vital signs, lab values, and nursing assessments in the electronic medical record. Past research has demonstrated an association with adverse events, readmission, and mortality in other fields, but it has not been investigated in spine surgery. PURPOSE: To determine the potential utility of the RI as a predictor of adverse events after discharge following elective spine surgery...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
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