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https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#1
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
January 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28086855/postoperative-fluid-overload-is-a-risk-factor-for-adverse-surgical-outcome-in-patients-undergoing-esophagectomy-for-esophageal-cancer-a-retrospective-study-in-335-patients
#2
Torben Glatz, Birte Kulemann, Goran Marjanovic, Svenja Bregenzer, Frank Makowiec, Jens Hoeppner
BACKGROUND: Restrictive intraoperative fluid management is increasingly recommended for patients undergoing esophagectomy. Controversy still exists about the impact of postoperative fluid management on perioperative outcome. METHODS: We retrospectively examined 335 patients who had undergone esophagectomy for esophageal cancer at the University Hospital Freiburg between 1996 and 2014 to investigate the relation between intra- and postoperative fluid management and postoperative morbidity after esophagectomy...
January 13, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28079258/combined-effect-of-therapeutic-strategies-for-bleeding-injury-on-early-survival-transfusion-needs-and-correction-of-coagulopathy
#3
K Balvers, S van Dieren, K Baksaas-Aasen, C Gaarder, K Brohi, S Eaglestone, S Stanworth, P I Johansson, S R Ostrowski, J Stensballe, M Maegele, J C Goslings, N P Juffermans
BACKGROUND: The combined effects of balanced transfusion ratios and use of procoagulant and antifibrinolytic therapies on trauma-induced exsanguination are not known. The aim of this study was to investigate the combined effect of transfusion ratios, tranexamic acid and products containing fibrinogen on the outcome of injured patients with bleeding. METHODS: A prospective multicentre observational study was performed in six level 1 trauma centres. Injured patients who received at least 4 units of red blood cells (RBCs) were analysed and divided into groups receiving a low (less than 1 : 1) or high (1 or more : 1) ratio of plasma or platelets to RBCs, and in receipt or not of tranexamic acid or fibrinogen products (fibrinogen concentrates or cryoprecipitate)...
January 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28078466/does-stoma-site-specimen-extraction-increase-postoperative-ileostomy-complication-rates
#4
Wanglin Li, Cigdem Benlice, Luca Stocchi, Hermann Kessler, Emre Gorgun, Meagan Costedio
BACKGROUND: Minimizing incisions has the potential to decrease hernia formation and wound complications following laparoscopic surgery. It is currently unknown if using the stoma site for specimen extraction affects outcomes. This study aims to evaluate the impact of stoma site extraction on postoperative complication rates in laparoscopic colorectal surgery. METHODS: After IRB approval, a retrospective comparative review of 738 consecutive patients (405 M) who underwent laparoscopic colorectal surgery with ileostomy between January 2008 and December 2014 was performed...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28077819/association-between-blood-transfusions-and-12-month-mortality-after-transcatheter-aortic-valve-implantation
#5
Pawel Kleczynski, Artur Dziewierz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Jaroslaw Trebacz, Robert Sobczynski, Marek Tomala, Maciej Stapor, Dariusz Dudek
Blood transfusions are considered as an important predictor of adverse outcome in patients with severe aortic (AS) undergoing transcatheter aortic valve implantation (TAVI). We sought to investigate the association between blood transfusions and mortality after TAVI. We enrolled 101 consecutive patients with severe AS undergoing TAVI. Patients who required transfusion were defined as patients in whom at least one unit of packed red blood cells (PRBCs) was transfused in the perioperative period. Twelve-month outcomes were assessed based on Valve Academic Research Consortium definitions...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28072601/risk-factors-and-clinical-outcomes-associated-with-perioperative-transfusion-associated-circulatory-overload
#6
Leanne Clifford, Qing Jia, Arun Subramanian, Hemang Yadav, Darrell R Schroeder, Daryl J Kor
BACKGROUND: Transfusion-associated circulatory overload remains underappreciated in the perioperative environment. The authors aimed to characterize risk factors for perioperative transfusion-associated circulatory overload and better understand its impact on patient-important outcomes. METHODS: In this case-control study, 163 adults undergoing noncardiac surgery who developed perioperative transfusion-associated circulatory overload were matched with 726 transfused controls who did not develop respiratory complications...
January 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28069329/chronic-kidney-disease-is-an-independent-risk-factor-for-transfusion-cardiovascular-complication-and-thirty-day-readmission-in-minimally-invasive-total-knee-arthroplasty
#7
Feng-Chih Kuo, Po-Chun Lin, Yu-Der Lu, Mel S Lee, Jun-Wen Wang
BACKGROUND: Little is known about the relationship between chronic kidney disease (CKD) and minimally invasive total knee arthroplasty (MIS-TKA). We hypothesized that CKD was an independent risk factor for postoperative complications and increased blood transfusion in patients following MIS-TKA. METHODS: A retrospective review of a prospective database was conducted on patients who underwent MIS-TKAs at an academic medical center between 2009 and 2012. Glomerular filtration rates (GFRs) were calculated for each patient at the time of surgery and a CKD group of 205 patients (GFR < 60 mL/min) were matched at a ratio of 1:2 with 410 patients showing a GFR ≥ 60 mL/min (control group)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28068990/risk-factors-for-severe-postpartum-hemorrhage-a-case-control-study
#8
Lill Trine Nyfløt, Irene Sandven, Babill Stray-Pedersen, Silje Pettersen, Iqbal Al-Zirqi, Margit Rosenberg, Anne Flem Jacobsen, Siri Vangen
BACKGROUND: In high-income countries, the incidence of severe postpartum hemorrhage (PPH) has increased. This has important public health relevance because severe PPH is a leading cause of major maternal morbidity. However, few studies have identified risk factors for severe PPH within a contemporary obstetric cohort. METHODS: We performed a case-control study to identify risk factors for severe PPH among a cohort of women who delivered at one of three hospitals in Norway between 2008 and 2011...
January 10, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28067544/restrictive-versus-liberal-blood-transfusion-in-patients-with-coronary-artery-disease-a-meta-analysis
#9
Yushu Wang, Xiuli Shi, Meiqin Wen, Yucheng Chen, Qing Zhang
OBJECTIVES: To compare clinical outcomes between restrictive versus liberal blood transfusion strategies in patients with coronary artery disease (CAD). RESEARCH DESIGN AND METHODS: A literature search from January 1966 to May 2016 was performed in Pubmed, EMBASE and Cochrane Library to find trials evaluating a restrictive hemoglobin transfusion trigger of ≤8 g/dL, compared with a more liberal trigger. Two study authors independently extracted data from the trials...
January 9, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28066609/association-between-post-sternotomy-tracheostomy-and-deep-sternal-wound-infection-a-retrospective-analysis
#10
Yi-Chin Tsai, Kevin Phan, Andrie Stroebel, Livia Williams, Lisa Nicotra, Lesley Drake, Elizabeth Ryan, James McGree, Peter Tesar, Kiran Shekar
BACKGROUND: Tracheostomy has traditionally been used as a means of facilitated mechanical ventilation in patients requiring respiratory management following cardiac surgery. However in the clinical setting, the advantages of tracheostomy has been questioned by concerns surrounding evidence of its association with increased risk of deep sternal wound infections (DSWI). The present study sought to evaluate retrospectively our experience with post-sternotomy tracheostomy among cardiac surgery patients and association with DSWI...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065524/effects-of-age-after-laparoscopic-right-colectomy-for-cancer-are-there-any-specific-outcomes
#11
Christine Denet, David Fuks, Francesca Cocco, Sophie Chopinet, Marcel Abbas, Cyprian Costea, Hugues Levard, Thierry Perniceni, Brice Gayet
BACKGROUND: Laparoscopic approach in colorectal surgery has demonstrated to give advantages in terms of postoperative outcomes, particularly in high-risk patients. The aim was to assess the impact of patients' age on the short-term outcomes after laparoscopic right colectomy for cancer. METHODS: From January 2004 to September 2014, all patients who underwent laparoscopic right colectomy for cancer in a single institution were divided into four groups (A: <64 years; B: 65-74 years; C: 75-84 years; D ≥85 years)...
December 21, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28065237/predictors-for-massive-blood-loss-during-posterior-correction-of-congenital-scoliosis-in-pre-school-children-a-retrospective-observation
#12
Le Shen, Wei-Yun Chen, Wu-Tao Wang, Hao-Nan Xu, Xue-Rong Yu, Xiu-Hua Zhang, Yu-Guang Huang
Objective To investigate the predictors for massive blood loss during posterior correction of congenital scoliosis in pre-school children. Methods Totally 124 children under six years of age,who received posterior correction of congenital scoliosis,were divided into two groups according to the ratio of intraoperative blood loss (BL) and estimated blood volume (EBV). Massive blood loss was defined as BL/EBV>0.15,and minor or moderate blood loss as BL/EBV≤0.15. All the records,including demographics,intraoperative fluids,pre- or postoperative laboratory parameters,and the length of hospital stay,were compared between these two groups...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#13
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
January 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28058552/complications-after-hepatectomy-for-hepatocellular-carcinoma-independently-shorten-survival-a-western-single-center-audit
#14
Alexandre Doussot, Chetana Lim, Eylon Lahat, Chady Salloum, Michael Osseis, Concepción Gómez Gavara, Eric Levesque, Cyrille Feray, Philippe Compagnon, Daniel Azoulay
BACKGROUND: The impact of postoperative complications (POCs) on long-term outcomes following hepatocellular carcinoma (HCC) resection remains to be ascertained. METHODS: All consecutive HCC resected at a single center were analyzed. Patients with POCs, classified according to Clavien classification, were compared to those without in terms of demographics, pathology, management, overall survival (OS), and disease-free survival (DFS). Independent prognostic factors of POCs were identified using multivariable regression models...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28057057/is-platelet-transfusion-associated-with-hospital-acquired-infections-in-critically-ill-patients
#15
Cécile Aubron, Andrew W Flint, Michael Bailey, David Pilcher, Allen C Cheng, Colin Hegarty, Antony Martinelli, Michael C Reade, Rinaldo Bellomo, Zoe McQuilten
BACKGROUND: Platelets are commonly transfused to critically ill patients. Reports suggest an association between platelet transfusion and infection. However, there is no large study to have determined whether platelet transfusion in critically ill patients is associated with hospital-acquired infection. METHODS: We conducted a multi-centre study using prospectively maintained databases of two large academic intensive care units (ICUs) in Australia. Characteristics of patients who received platelets in ICUs between 2008 and 2014 were compared to those of patients who did not receive platelets...
January 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28054191/central-venous-pressure-drop-after-hypovolemic-phlebotomy-is-a-strong-independent-predictor-of-intraoperative-blood-loss-during-liver-resection
#16
Andries Ryckx, Claudine Christiaens, Mathias Clarysse, Franky Vansteenkiste, Pieter Jan Steelant, Gregory Sergeant, Isabelle Parmentier, Hans Pottel, Mathieu D'Hondt
BACKGROUND: Intraoperative hypovolemic phlebotomy (HP) has been suggested to reduce central venous pressure (CVP) before hepatectomy. This study aimed to analyze the impact of CVP drop after HP on intraoperative blood loss and postoperative renal function. METHODS: A retrospective review of a prospective database including 100 consecutive patients (43 males and 57 females; mean age, 65 years; range 23-89 years) undergoing liver resection with HP was performed. The primary outcome variable was estimated blood loss (EBL), and the secondary outcome was postoperative serum creatinin (Scr)...
January 4, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28048948/mechanism-of-injury-may-influence-infection-risk-from-early-blood-transfusion
#17
Charles A Karcutskie, Jonathan P Meizoso, Juliet J Ray, Davis B Horkan, Xiomara D Ruiz, Carl I Schulman, Nicholas Namias, Kenneth G Proctor
BACKGROUND: Blood transfusion is a known risk factor for infection in trauma patients. Differences based on mechanism of injury have not been well described. We hypothesize that infection risk in trauma patients with early blood transfusion is different based on blunt or penetrating mechanism of injury. PATIENTS AND METHODS: Adults admitted to the trauma intensive care unit from January 2010 through January 2015 were reviewed retrospectively. Those receiving transfusion after 24 h were excluded...
January 3, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28045760/bleeding-risk-of-anti-thrombotic-treatment-in-patients-on-haemodialysis
#18
Eduardo Vázquez, Carmen Sánchez-Perales, Sonia Ortega, Teresa Vázquez-Sánchez, Enrique Quesada, Daniel Salas, Juan Carlos Fernández-Guerrero
BACKGROUND: The risk-benefit of anti-thrombotic treatment (ATT) has not been established in patients on dialysis. Our objective was to determine the influence of ATT on the risk of haemorrhage in patients on haemodialysis. METHODS: We included patients who began dialysis between 2003 and 2007. We determined the rates of fatal bleeding or bleeding leading to hospitalisation or transfusion. RESULTS: 221 patients were included. Over the follow-up period (45...
December 28, 2016: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28045555/clinicopathologic-characteristics-of-elderly-with-gastric-cancer-and-the-risk-factors-of-postoperative-complications
#19
Yong Li, Bibo Tan, Liqiao Fan, Qun Zhao, Ming Tan, Dong Wang, Nan Jia, Qingwei Liu
PURPOSE: In China, gastric cancer (GC), which is one of the most common malignant tumors, has an increasing incidence in elderly population due to aging process. Since a considerable number of elderly patients with GC accepting surgical treatments developed postoperative complications, it is necessary to evaluate risk factors for postoperative complications. MATERIALS AND METHODS: In the present study, the clinicopathologic characteristics of 3,024 elderly patients (aged ≥65 years) with GC, who underwent surgery between 1996 and 2006, were examined and contributing factors for postoperative complications were analyzed...
January 3, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28045060/soluble-ox40l-and-jag1-induce-selective-proliferation-of-functional-regulatory-t-cells-independent-of-canonical-tcr-signaling
#20
Prabhakaran Kumar, Khaled Alharshawi, Palash Bhattacharya, Alejandra Marinelarena, Christine Haddad, Zuoming Sun, Shigeru Chiba, Alan L Epstein, Bellur S Prabhakar
Regulatory T-cells (Tregs) play a pivotal role in maintaining peripheral tolerance. Increasing Treg numbers/functions has been shown to ameliorate autoimmune diseases. However, common Treg expansion approaches use T-Cell Receptor (TCR)-mediated stimulation which also causes proliferation of effector T-cells (Teff). To overcome this limitation, purified patient-specific Tregs are expanded ex vivo and transfused. Although promising, this approach is not suitable for routine clinical use. Therefore, an alternative approach to selectively expand functional Tregs in vivo is highly desired...
January 3, 2017: Scientific Reports
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