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https://www.readbyqxmd.com/read/27921016/use-of-dexmedetomidine-and-esmolol-for-hypotension-in-lumbar-spine-surgery
#1
Ovais Nazir, Mushtaq Ahmad Wani, Nadeem Ali, Tarun Sharma, Amit Khatuja, Rajesh Misra, Mehreen Maqsood
BACKGROUND: The importance of decreasing bleeding in spine surgery is not only important to maintain the patient's hemodynamic balance but also allow a better view of the surgical field. OBJECTIVES: The current study aimed to compare dexmedetomidine and Esmolol™ as agents to induce hypotension in lumbar spine surgeries. PATIENTS AND METHODS: A total of 50 patients aged 20 to 65 years belonging to the American society of anaesthesiologist (ASA) class I - II scheduled for decompression and fixation of the lumbar spine were included and divided into two groups namely, Group I, who received Esmolol and group II, who received dexmedetomidine, intravenously...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27920230/troubleshooting-for-bleeding-in-thoracoscopic-anatomic-pulmonary-resection
#2
Hitoshi Igai, Mitsuhiro Kamiyoshihara, Takashi Ibe, Natsuko Kawatani, Fumi Osawa, Ryohei Yoshikawa
INTRODUCTION: The objective of this study was to evaluate intraoperative vessel injury and assess troubleshooting during thoracoscopic anatomic pulmonary resection. METHODS: Between April 2012 and March 2016, 240 patients underwent thoracoscopic anatomic lung resection, 26 of whom were identified as having massive bleeding intraoperatively. We analyzed the injured vessel and the hemostatic procedure employed, then compared the perioperative outcomes in patients with (n = 26) and without (n = 214) vessel injury...
December 5, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27914836/perioperative-retinal-artery-occlusion-risk-factors-in-cardiac-surgery-from-the-united-states-national-inpatient-sample-1998-2013
#3
Tyler Calway, Daniel S Rubin, Heather E Moss, Charlotte E Joslin, Katharina Beckmann, Steven Roth
PURPOSE: To study the incidence and risk factors for retinal artery occlusion (RAO) in cardiac surgery. DESIGN: Retrospective study using the National Inpatient Sample (NIS). METHODS: The NIS was searched for cardiac surgery. Retinal artery occlusion was identified by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Postulated risk factors based on literature review were included in multivariate logistic models...
November 30, 2016: Ophthalmology
https://www.readbyqxmd.com/read/27913536/reversal-of-direct-oral-anticoagulants-a-practical-approach
#4
Andrew W Shih, Mark A Crowther
Direct oral anticoagulants (DOACs) have at least noninferior efficacy compared with other oral anticoagulants and have ancillary benefits, including overall better safety profiles, lack of the need for routine monitoring, rapid onset of action, and ease of administration. Reversal of these agents may be indicated in certain situations such as severe bleeding and for perioperative management. DOAC-associated bleeding should be risk stratified: patients with moderate or severe bleeding should have the DOAC discontinued and reversal strategies should be considered...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911468/radical-cystectomy-and-cutaneous-ureterostomy-in-4-dogs-with-trigonal-transitional-cell-carcinoma-description-of-technique-and-case-series
#5
Rafael Ricardo Huppes, Leandro Z Crivellenti, Andrigo Barboza De Nardi, Bruno Roque Lima, Cristiane Alves Cintra, Jorge Luiz Costa Castro, Christopher A Adin
OBJECTIVE: To describe radical cystectomy followed by cutaneous ureterostomy as a treatment of invasive bladder neoplasia in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs with transitional cell carcinoma of the bladder trigone (n=4). METHODS: Perioperative complications and long-term outcomes of dogs that underwent cutaneous ureterostomy following radical cystectomy and lymphadenectomy for transitional cell carcinoma of the urinary bladder trigone were reviewed...
December 1, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27909512/concomitant-left-atrial-appendage-clipping-during-minimally-invasive-mitral-valve-surgery-technically-feasible-and-safe
#6
Ashraf Alqaqa Md, Shabiah Martin Md, Aiman Hamdan Md Facc, Fayez Shamoon Md Facc, Kourosh T Asgarian DO
BACKGROUND: It is believed that most of thrombi form in the left atrial appendage (LAA)before they emboli. Different surgical and percutaneouse approaches were suggested to manage the LAA. In this study we are evaluating the safety of clipping the LAA via minithoractotomy approach. METHOD: All consecutive patients who had minimally invasive mitral valve surgery with concomitant LAA clipping between December 2012 and February 2014 were included in the study. LAA exclusion was performed using AtriClip® LAA Exclusion System (Cincinnati, Ohio, AtriCure®)...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27907939/intraoperative-intermittent-blocking-of-the-common-iliac-arteries-in-cases-of-placenta-percreta-without-the-use-of-fluoroscopy
#7
S Heinze, B Filsinger, G Kastenholz, R J Schröder
Background: The number of patients with placenta accreta, percreta and increta is increasing. The morbidity and mortality are higher mostly due to hemorrhage. Therefore, new methods to reduce the risk of severe bleeding are necessary. Methods: Three patients were treated in collaboration by obstetricians, urologists, anesthesiologists, and radiologists. An MRI of the pelvis was performed and the diameters and lengths of the iliac arteries were measured to avoid fluoroscopy during the preoperative placement of catheter balloons into the iliac arteries...
December 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27904903/prediction-of-severe-bleeding-after-coronary-surgery-the-will-bleed-risk-score
#8
Fausto Biancari, Debora Brascia, Francesco Onorati, Daniel Reichart, Andrea Perrotti, Vito G Ruggieri, Giuseppe Santarpino, Daniele Maselli, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Eeva-Maija Kinnunen, Juhani K E Airaksinen, Paola D'Errigo, Stefano Rosato, Francesco Nicolini
Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m(2) (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding...
December 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27899119/clinical-outcome-and-hemodynamic-behavior-of-the-labcor-dokimos-plus-aortic-valve
#9
Torsten Christ, Konstantin Zhigalov, Wolfgang Konertz, Sebastian Holinski
BACKGROUND: The Labcor Dokimos Plus (LDP) is a stented externally mounted pericardial aortic bioprosthesis, which was recently introduced in Europe. Aims of the study are evaluation of operative and postoperative results as well as hemodynamic performance. METHODS: One hundred consecutive patients with a mean age of 65.9 ± 10.7 years (range 35-87) and a mean EuroSCORE II of 3.1 ± 3.9 (range 0.67-24.5) underwent aortic valve replacement with the LDP. Mean valve-size was 25...
November 29, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27894845/thromboelastography-demonstrates-perioperative-hypercoagulability-in-hepato-pancreato-biliary-patients-and-supports-routine-administration-of-preoperative-and-early-postoperative-venous-thromboembolism-chemoprophylaxis
#10
Anh-Thu Le, Jennifer W Harris, Erin Maynard, Sean P Dineen, Ching-Wei D Tzeng
BACKGROUND: We hypothesized hepato-pancreato-biliary (HPB) surgery patients are more likely to be hypercoagulable than hypocoagulable, and that bleeding risks from VTE chemoprophylaxis are low. This study sought to use thromboelastography (TEG) to compare coagulation profiles with bleeding/thrombotic events in HPB patients receiving standardized perioperative chemoprophylaxis. METHODS: Consecutive patients undergoing HPB resections by three surgeons at one institution (January 2014-December 2015) received preoperative and early postoperative VTE chemoprophylaxis and were evaluated with TEGs...
November 25, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27893176/desmopressin-for-treatment-of-platelet-dysfunction-and-reversal-of-antiplatelet-agents-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#11
M J R Desborough, K A Oakland, G Landoni, M Crivellari, C Doree, L J Estcourt, S J Stanworth
BACKGROUND: Platelet dysfunction, including that caused by antiplatelet agents, increases the risk of perioperative bleeding. The optimal management of patients with platelet dysfunction undergoing surgery is unclear. OBJECTIVES: To assess whether desmopressin reduces perioperative allogeneic red cell transfusion and bleeding for patients with platelet dysfunction. PATIENTS/METHODS: We searched for randomised controlled trials in The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, Embase, the Transfusion Evidence Library and ISI Web of Science to 7(th) July 2016...
November 28, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27888575/the-effect-of-fibrinogen-concentrate-on-perioperative-bleeding-in-transurethral-resection-of-the-prostate-a-double-blind-placebo-controlled-and-randomized-study
#12
Mohammad Soleimani, Navid Masoumi, Navid Nooraei, Alireza Lashay, Mohammad Reza Safarinejad
BACKGROUND: Hemorrhage during transurethral resection of the prostate (TUR-P) has always been a concern. Several studies have shown that pre-operative administration of fibrinogen concentrate has promising results in reducing hemorrhage in cardiac surgery. OBJECTIVES: This study investigated the hemostatic effect of fibrinogen concentrate administration on reducing the bleeding amount during TUR-P in patients with benign prostatic hyperplasia. METHODS: Sixty men with benign prostatic hyperplasia, who were chosen to undergo TUR-P, entered this prospective randomized double-blind placebo-controlled pilot study...
November 26, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27887981/predictors-of-mortality-in-the-critically-ill-cirrhotic-patient-is-the-model-for-end-stage-liver-disease-enough
#13
Alagappan Annamalai, Megan Y Harada, Melissa Chen, Tram Tran, Ara Ko, Eric J Ley, Miriam Nuno, Andrew Klein, Nicholas Nissen, Mazen Noureddin
BACKGROUND: Critically ill cirrhotics urgently require liver transplantation but are at high risk for perioperative mortality. The Model for End-Stage Liver Disease (MELD) score, recently updated to incorporate serum sodium, estimates survival probability in patients with cirrhosis but needs further evaluation in the critically ill. The purpose of this study was to evaluate the predictive power of intensive care unit (ICU) admission MELD scores and identify clinical risk factors associated with increased mortality...
November 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27878352/perioperative-risks-of-dietary-and-herbal-supplements
#14
Ilana Levy, Samuel Attias, Eran Ben-Arye, Lee Goldstein, Ibrahim Matter, Mostafa Somri, Elad Schiff
BACKGROUND: Patients undergoing surgery often use Dietary and Herbal Supplements (DHS). We explored the risk of DHS-drug interactions in the perioperative setting. METHODS: In this cross-sectional prospective study, participants hospitalized for surgery completed a questionnaire regarding DHS use. We used pharmacological databases to assess DHS-drug interactions. We then applied univariate and multivariate logistic regression analyses to characterize patients at risk for DHS-drug interactions...
November 22, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27872990/blood-supply-of-the-subacromial-bursa-and-rotator-cuff-tendons-on-the-bursal-side
#15
Elle Põldoja, Madis Rahu, Kristo Kask, Imke Weyers, Ivo Kolts
PURPOSE: Vascularity of the subacromial bursa and rotator cuff tendons is key factors in the pathogenesis of subacromial bursitis and impingement syndrome, rotator cuff tendinitis, and rotator cuff tears. The purpose of this study was to investigate and describe blood supply to the cranial and caudal parts of the subacromial bursa and the vascularity of the rotator cuff tendons on the bursal side. METHODS: Fourteen fresh cadaveric shoulders from six females and eight males with a mean age of 71...
November 21, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27871515/perioperative-antiplatelet-therapy-and-cardiovascular-outcomes-in-patients-undergoing-joint-and-spine-surgery
#16
Nathaniel R Smilowitz, Brandon S Oberweis, Swetha Nukala, Andrew Rosenberg, Steven Stuchin, Richard Iorio, Thomas Errico, Martha J Radford, Jeffrey S Berger
STUDY OBJECTIVE: Perioperative thrombotic complications after orthopedic surgery are associated with significant morbidity and mortality. The use of aspirin to reduce perioperative cardiovascular complications in certain high-risk cohorts remains controversial. Few studies have addressed aspirin use, bleeding, and cardiovascular outcomes among high-risk patients undergoing joint and spine surgery. DESIGN/SETTING/PATIENTS: We performed a retrospective comparison of adults undergoing knee, hip, or spine surgery at a tertiary care center during 2 periods between November 2008 and December 2009 (reference period) and between April 2013 and December 2013 (contemporary period)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27864106/transurethral-resection-of-prostate-and-bleeding-a-prospective-randomized-double-blind-placebo-controlled-trial-to-see-efficacy-of-short-term-use-of-finasteride-and-dutasteride-on-operative-blood-loss-and-prostatic-micro-vessel-density
#17
Aditi Arora, Ankur Bansal, Bimalesh Purkait, Ashok Kumar Sokhal, Ved Bhaskar, Priyank Yadav, Satyanarayan Sankhwar
OBJECTIVE: To evaluate the effects of short term use of finasteride and dutasteride on amount of intraoperative blood loss and microvessel density (MVD) of prostatic stromal and suburethral tissues in patients with benign prostatic hyperplasia (BPH) prior to TURP METHODS: The study involved 450 male patients who planned to have TURP and were prospectively randomised into three groups (150 patients each). The group 1 received no medication, group 2 received finasteride 5 mg/day and group 3 received dutasteride 0...
November 15, 2016: Urology
https://www.readbyqxmd.com/read/27863918/discontinuation-of-plavix-%C3%A2-clopidogrel-for-hip-fracture-surgery-a-systematic-review-of-the-literature
#18
REVIEW
L Mattesi, T Noailles, N Rosencher, J-L Rouvillain
: The elderly population is increasing worldwide, associated with an increase in diseases related to aging, such as hip fractures. These patients are sometimes treated with clopidogrel. There are no arguments at present to clearly determine the risk/benefit ratio of early surgical management of traumatic hip fractures in patients treated with clopidogrel (perioperative blood loss, postoperative complications). The goal of this systematic review of the literature was to show that early surgical management (<48h) of patients treated with clopidogrel does not increase postoperative morbidity or mortality...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27858861/laparoscopic-assisted-low-anterior-resection-for-advanced-rectal-cancer-in-a-kidney-transplant-recipient-a-case-report
#19
Zenan Xia, Weijie Chen, Ru Yao, Guole Lin, Huizhong Qiu
INTRODUCTION: Development of de novo malignancy has become a major cause of late mortality in solid organ transplant recipients. Surgery is currently the most important treatment of choice for transplant patients with resectable CRC. However, conventional open surgery represents a great risk to these high-risk patients. They seem to benefit more from laparoscopic surgery, based on the favorable oncological outcome and remarkable short-term advantages of this approach. PATIENT CONCERNS: In this study, we have reported a case of a 50-year-old man who had underwent kidney transplantation for 4 years...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858387/effects-of-discontinuance-of-preoperative-anti-platelet-medication-in-multi-level-thoracolumbar-spine-surgery
#20
Jun Seok Lee, Dong Wuk Son, Soon Ki Sung, Sang Weon Lee, Geun Sung Song
AIM: Our study aimed to evaluate the perioperative morbidities of patients taking anti-platelet medication prior to multi-level thoracolumbar spine surgery. MATERIAL AND METHODS: We retrospectively reviewed the medical records of 65 patients who underwent multi-level spine surgery from January 2009 to November 2014 at our institution. These patients were divided into two groups: the control group (n=45) did not take any anti-platelet medications prior to surgery; the anti-platelet group (n=20) discontinued the anti-platelet medication 7 days before the spine surgery...
October 14, 2016: Turkish Neurosurgery
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