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https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#1
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28087009/improving-kidney-disease-in-obese-adolescents-a-surgical-approach
#2
Ian R Macumber
Obesity has been associated with chronic kidney disease in adult studies, but little data exist in pediatrics. Nehus et al. offer the first study to show that bariatric surgery in severely obese adolescents is associated with improved renal outcomes. Despite limitations, this study provided compelling evidence that aggressive weight loss intervention can improve renal outcomes in young, severely obese subjects. Further investigation is required to determine mechanisms by which this may occur.
February 2017: Kidney International
https://www.readbyqxmd.com/read/28079663/general-anesthesia-and-fabry-disease-a-case-report
#3
Stefan Krüger, Albina Nowak, Torben Christoph Müller
Fabry disease is an inherited X-linked disorder characterized by the absence (in men) or deficiency (in women) in α-galactosidase A activity that causes a progressive accumulation of glycosphingolipids within lysosomes of cells of all the major organ systems. The subsequent organ damage that manifests in childhood and early adulthood presents a widely variable clinical picture of pain, hypertension, and cardiac, renal, nervous system, and lung dysfunction. We present 2 female patients with Fabry disease who required general anesthesia twice for gynecological and trauma surgery, respectively, and discuss their perioperative management based on new information in the medical literature...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#4
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077531/sodium-bicarbonate-does-not-prevent-postoperative-acute-kidney-injury-after-off-pump-coronary-revascularization-a-double-blinded-randomized-controlled-trial
#5
S Soh, J W Song, J K Shim, J H Kim, Y L Kwak
BACKGROUND: Acute kidney injury (AKI) is a common morbidity after off-pump coronary revascularization. We investigated whether perioperative administration of sodium bicarbonate, which might reduce renal injury by alleviating oxidative stress in renal tubules, prevents postoperative AKI in off-pump coronary revascularization patients having renal risk factors. METHODS: Patients (n=162) having at least one of the following AKI risk factors were enrolled: (i) age >70 yr; (ii) diabetes mellitus; (iii) chronic renal disease; (iv) congestive heart failure or left ventricular ejection fraction <35%; and (v) reoperation or emergency...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077530/impact-of-balanced-tetrastarch-raw-material-on-perioperative-blood-loss-a-randomized-double-blind-controlled-trial
#6
A Joosten, R Tircoveanu, S Arend, P Wauthy, P Gottignies, P Van der Linden
BACKGROUND: As 6% hydroxyethyl starch (HES) 130/0.40 or 130/0.42 can originate from different vegetable sources, they might have different clinical effects. The purpose of this prospective, randomized, double-blind controlled trial was to compare two balanced tetrastarch solutions, one maize-derived and one potato-derived, on perioperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). METHODS: We randomly assigned 118 patients undergoing elective cardiac surgery into two groups, to receive either a maize- or a potato-derived HES solution...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077482/rare-case-of-haemoptysis
#7
Elrasheid Ali Awouda, Ahmed Anwar Elnori, AlaEldin Hassan Ahmed
We report a case of a 39-year-old man who presented with coughing up blood for 5 days. On the day of admission, he coughed up about 300 mL of fresh blood. He mentioned that he has had cough for the past 10 years. On clinical examination, he was afebrile, tachypneic, tahycardic and normotensive. Rest of the physical examination was normal. His oxygen saturation breathing room air was 96%. His full blood count showed haemoglobin 9.3 g/dL. His chest radiograph was reported as normal. CT chest showed a vascular right paracardiac soft tissue density...
January 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28076721/effect-of-tumor-complexity-and-technique-on-efficacy-and-complications-after-percutaneous-microwave-ablation-of-stage-t1a-renal-cell-carcinoma-a-single-center-retrospective-study
#8
Marki E Klapperich, E Jason Abel, Timothy J Ziemlewicz, Sara Best, Meghan G Lubner, Stephen Y Nakada, J Louis Hinshaw, Christopher L Brace, Fred T Lee, Shane A Wells
Purpose To evaluate the effects of tumor complexity and technique on early and midterm oncologic efficacy and rate of complications for 100 consecutive biopsy-proved stage T1a renal cell carcinomas (RCCs) treated with percutaneous microwave ablation. Materials and Methods This HIPAA-compliant, single-center retrospective study was approved by the institutional review board. The requirement to obtain informed consent was waived. Ninety-six consecutive patients (68 men, 28 women; mean age, 66 years ± 9.4) with 100 stage T1a N0M0 biopsy-proved RCCs (median diameter, 2...
January 11, 2017: Radiology
https://www.readbyqxmd.com/read/28075543/prognostic-value-of-tissue-based-biomarker-signature-in-clear-cell-renal-cell-carcinoma
#9
Ahmed Q Haddad, Jun-Hang Luo, Laura-Maria Krabbe, Oussama Darwish, Bishoy Gayed, Ramy Youssef, Payal Kapur, Dinesh Rakheja, Yair Lotan, Arthur Sagalowsky, Vitaly Margulis
OBJECTIVE: To improve risk stratification for recurrence prognostication in localized clear cell renal cell carcinoma (ccRCC) patients. PATIENTS AND METHODS: 367 patients with non-metastatic ccRCC were included. The cohort was divided into a training and validation set. Using tissue microarrays, immunostaining was performed for 24 biomarkers representative of key pathways in ccRCC. Using LASSO Cox regression, we identified several markers which were used to construct a risk classifier for risk of disease recurrence...
January 11, 2017: BJU International
https://www.readbyqxmd.com/read/28075435/cardiac-biomarkers-predict-1-year-mortality-in-elderly-patients-undergoing-hip-fracture-surgery
#10
Spyridon Katsanos, Andreas F Mavrogenis, Nikolaos Kafkas, Celestino Sardu, Vasileios Kamperidis, Panagiota Katsanou, Dimitrios Farmakis, John Parissis
This prospective study included 152 elderly patients (mean age, 80 years; range, 72-88 years) with a hip fracture treated surgically. Comorbidities were evaluated, and B-type natriuretic peptide was measured at baseline and at postoperative days 4 and 5 in addition to troponin I. Major cardiac events were recorded, and 1-year mortality was assessed. Comorbidity models with the important multivariate predictors of 1-year mortality were analyzed. Overall, 9 patients (6%) experienced major cardiac events postoperatively during their hospitalization...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28074703/early-surgery-after-angiography-in-patients-scheduled-for-valve-replacement
#11
Victor Dayan, Roberto Stanham, Gerardo Soca, Fernando Genta, Jorge Mariño, Alvaro Lorenzo
Background There are limited data regarding the risks of cardiac surgery early after coronary angiography in patients scheduled for isolated aortic and/or mitral valve replacement. Our aim was to evaluate the risk of early surgery after coronary angiography in these patients. Methods We retrospectively analyzed data of 1044 patients who underwent isolated aortic and/or mitral valve replacement from 2006 to 2014. Baseline, operative, and postoperative variables were collected. The patients were divided into 3 groups based on the interval between coronary angiography and surgery: ≤3 days ( n = 216), 4-7 days ( n = 109), and ≥8 days ( n = 719)...
January 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28074387/epigenetic-sampling-effects-nephrectomy-modifies-the-clear-cell-renal-cell-cancer-methylome
#12
Christophe Van Neste, Alexander Laird, Fiach O'Mahony, Wim Van Criekinge, Dieter Deforce, Filip Van Nieuwerburgh, Thomas Powles, David J Harrison, Grant D Stewart, Tim De Meyer
PURPOSE: Currently, it is unclear to what extent sampling procedures affect the epigenome. Here, this phenomenon was evaluated by studying the impact of artery ligation on DNA methylation in clear cell renal cancer. METHODS: DNA methylation profiles between vascularised tumour biopsy samples and devascularised nephrectomy samples from two individuals were compared. The relevance of significantly altered methylation profiles was validated in an independent clinical trial cohort...
January 10, 2017: Cellular Oncology (Dordrecht)
https://www.readbyqxmd.com/read/28074293/-management-of-noak-administration-during-invasive-or-surgical-interventions-when-and-how-to-pause-and-when-to-restart
#13
M Buerke, H M Hoffmeister
Many patients under oral anticoagulation therapy need percutaneous or surgical interventions/operations. For vitamin K antagonists (VKA), there are recommendations regarding preoperative or postoperative administration. Management of the new oral anticoagulants (NOAC) was supposed to be easier - but some aspects must be considered. Due to the different pharmacokinetic profiles of substances such as dabigatran, rivaroxaban, apixaban, and edoxaban, different recommendations are given.Upon periprocedural management, thromboembolic risk has to be considered in patients treated with NOACs...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28073209/the-importance-of-potassium-citrate-and-potassium-bicarbonate-in-the-treatment-of-uric-acid-renal-stones
#14
Michele Barbera, Andreas Tsirgiotis, Mauro Barbera, Quintino Paola
Uric acid calculi can also be treated without surgery, with simple medical lytic therapy. After appropriate dietary adjustments and add of mineral water, the needed amount of alkali supplementation can increase pH values of the urine in order to dissolve the stones. Treatment should be prolonged to prevent stone recurrence. A case of bilateral renal uric acid stones that were successfully treated by alakalizing treatment was presented.
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28073200/the-role-of-intraoperative-ultrasound-in-small-renal-mass-robotic-enucleation
#15
Roberta Gunelli, Massimo Fiori, Cristiano Salaris, Umberto Salomone, Marco Urbinati, Alexia Vici, Teo Zenico, Mauro Bertocco
INTRODUCTION: As a result of the growing evidence on tumor radical resection in literature, simple enucleation has become one of the best techniques associated to robotic surgery in the treatment of renal neoplasia, as it guarantees minimal invasiveness and the maximum sparing of renal tissue, facilitating the use of reduced or zero ischemia techniques during resection. The use of a robotic ultrasound probe represents a useful tool to detect and define tumor location, especially in poorly exophytic small renal mass...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28069624/external-validation-of-the-revised-cardiac-risk-index-and-update-of-its-renal-variable-to-predict-30-day-risk-of-major-cardiac-complications-after-non-cardiac-surgery-rationale-and-plan-for-analyses-of-the-vision-study
#16
Pavel S Roshanov, Michael Walsh, P J Devereaux, S Danielle MacNeil, Ngan N Lam, Ainslie M Hildebrand, Rey R Acedillo, Marko Mrkobrada, Clara K Chow, Vincent W Lee, Lehana Thabane, Amit X Garg
INTRODUCTION: The Revised Cardiac Risk Index (RCRI) is a popular classification system to estimate patients' risk of postoperative cardiac complications based on preoperative risk factors. Renal impairment, defined as serum creatinine >2.0 mg/dL (177 µmol/L), is a component of the RCRI. The estimated glomerular filtration rate has become accepted as a more accurate indicator of renal function. We will externally validate the RCRI in a modern cohort of patients undergoing non-cardiac surgery and update its renal component...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069013/decreased-physical-activity-is-a-predictor-for-a-complicated-recovery-post-cardiac-surgery
#17
Charlotte van Laar, Simone T TImman, Luc Noyez
BACKGROUND: Physical activity (PA) reduces the risk of cardiovascular disease and physically active survivors of a cardiac event are at lower risk of recurrent events. We hypothesized that patients with a decreased PA, undergoing cardiac surgery, are at higher risk for a postoperative complicated recovery (PCR). METHODS: Three thousand three hundred eighty two patients undergoing elective cardiac surgery between January 2007 and December 2013 were included. The group was divided into three subgroups: group A, aged ≤ 65 years (N = 1329); group B, aged > 65 years and ≤ 75 years (N = 1250); and group C aged >75 years (N = 803)...
January 7, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28068806/annals-express-the-cornish-experience-of-the-assist-ckd-project
#18
Anna Louise Barton, Angela Mallard, Anthea Patterson, Nicola Thomas, Stephen Dickinson, Hugh Gallagher
INTRODUCTION: The ASSIST-CKD project is a national quality improvement programme, aiming to decrease the number of patients presenting late to renal services by enabling laboratories to review up to five years of estimated glomerular filtration rate (eGFR) results graphically, and report deteriorating patients to their general practitioner (GP). AIM: To assess the impact of the project on the laboratory, and of patient reporting on GP management and the local renal service...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28068786/topical-and-low-dose-intravenous-tranexamic-acid-in-cyanotic-cardiac-surgery
#19
Jigar Patel, Mrugesh Prajapati, Hardik Patel, Hemang Gandhi, Shilpa Deodhar, Himani Pandya
Background Coagulopathy is a major problem in surgery for cyanotic congenital heart disease. Tranexamic acid has been used both topically and systemically and plays a vital role in pediatric cardiac surgery by reducing blood loss and blood product requirement. We aimed to determine the anti-fibrinolytic effectiveness of low-dose systemic or topical tranexamic acid or a combination of both. Methods Seventy-five patients were divided in 3 groups of 25. Group A patients were given tranexamic acid 20 mg kg(-1) intravenously after sternotomy and 20 mg kg(-1) after heparin reversal...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28063841/external-physical-vibration-lithecbole-promote-the-stone-clearance-of-upper-urinary-stone-after-retrograde-intrarenal-surgery-a-prospective-multi-center-randomized-controlled-trial
#20
Wenqi Wu, Zhou Yang, Changbao Xu, Xiaojian Gu, Sixing Yang, Songbai Liao, Rongjiang Wang, Wenxi Gao, Zhangqun Ye, Guohua Zeng
OBJECTIVE: To assess the efficacy and safety of External Physical Vibration Lithecbole (EPVL) for the treatment of residual stone after retrograde intrarenal surgery (RIRS). MATERIALS AND METHODS: A total of 173 patients (128 male and 45 female) were selected for the study. All the patients had residual fragments after RIRS for the renal or upper ureteral stones. They were prospectively randomized into two groups, one received EPVL one week after RIRS (group ER), another only underwent RIRS as a control (group CR)...
January 4, 2017: Journal of Urology
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