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https://www.readbyqxmd.com/read/28109762/higher-modified-charlson-index-scores-are-associated-with-increased-incidence-of-complications-transfusion-events-and-length-of-stay-following-revision-hip-arthroplasty
#1
Nikita Lakomkin, Vadim Goz, Claudette M Lajam, Richard Iorio, Joseph A Bosco
BACKGROUND: Revision total hip arthroplasty (RHA) has been associated with greater morbidity and length of stay (LOS) compared to primary total hip arthroplasty. Despite this, few validated metrics exist for risk stratification in RHA cohorts. The Charlson Comorbidity Index (CCI) has been associated with complications in total hip arthroplasty, but its utility in revision surgery remains unexplored. The purpose of this study was to examine the relationship between preoperative CCI and a variety of outcome metrics following RHA...
November 17, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28109560/etiologies-trends-and-predictors-of-30-day-readmission-in-patients-with-heart-failure
#2
Shilpkumar Arora, Prashant Patel, Sopan Lahewala, Nilay Patel, Nileshkumar J Patel, Kosha Thakore, Aditi Amin, Byomesh Tripathi, Varun Kumar, Harshil Shah, Mahek Shah, Sidakpal Panaich, Abhishek Deshmukh, Apurva Badheka, Umesh Gidwani, Radha Gopalan
Heart failure (HF) is the most common discharge diagnosis across the United States, and these patients are particularly vulnerable to readmissions, increasing attention to potential ways to address the problem. The study cohort was derived from the Healthcare Cost and Utilization Project's National Readmission Data 2013, sponsored by the Agency for Healthcare Research and Quality. HF was identified using appropriate International Classification of Diseases, Ninth Revision, Clinical Modification codes. Readmission was defined as a subsequent hospital admission within 30 days after discharge day of index admission...
December 14, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28109314/sickle-cell-disease-and-pregnancy-outcomes-a-study-of-the-community-based-hospital-in-a-tribal-block-of-gujarat-india
#3
Gayatri Desai, Ankit Anand, Pankaj Shah, Shobha Shah, Kapilkumar Dave, Hardik Bhatt, Shrey Desai, Dhiren Modi
BACKGROUND: Sickle cell disease (SCD) is a hereditary blood disorder prevalent in tribal regions of India. SCD can increase complications during pregnancy and in turn negatively influence pregnancy outcomes. This study reports the analysis of tribal maternal admissions in the community-based hospital of SEWA Rural (Kasturba Maternity Hospital) in Jhagadia block, Gujarat. The objective of the study is to compare the pregnancy outcomes among SCD, sickle cell trait and non-SCD admissions...
January 21, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/28109111/-efficacy-of-high-versus-low-plasma-red-blood-cell-ratio-resuscitation-in-patients-with-severe-trauma-requiring-massive-blood-transfusion-a-meta-analysis
#4
Fang Yu, Tao Zhong, Gang Wu
OBJECTIVE: To evaluate the efficacy of high (≥1:2) and low (<1:2) plasma: red blood cell (RBC) ratio resuscitation in patients with severe trauma requiring massive blood transfusion. METHODS: The databases including the Cochrane Library, Pubmed, Web of Science, and EMBASE were systemically searched for relevant studies published between January, 2009 and April, 2016. The selection of studies, assessment of methodological quality and data extraction were performed by two researchers independently according to the inclusion and exclusion criteria...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28108788/outpatient-application-of-formalin-for-chronic-rectal-bleeding-after-prostate-irradiation-a-quasi-experimental-study
#5
Gustavo Arruda Viani, Aline Sakamoto
PURPOSE: The aim of this quasi-experimental study is to evaluate a novel technique for an outpatient application of formalin for chronic rectal bleeding after prostate irradiation. METHODS: This is a quasi- experimental clinical trial developed between January 2010 and July 2015, including 35 patients with chronic radiation rectitis (CRP) due to a previous prostate radiation course. The study's eligibility was (1) completed external beam radiation therapy for prostate carcinoma >6 months previously, (2) rectal bleeding, defined as a frequency of >1× per week and/or needing of blood transfusions, and (3) diagnosis of chronic proctitis at colonoscopy...
January 20, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28108634/rectal-colonic-mural-hematoma-following-enema-for-constipation-while-on-therapeutic-anticoagulation
#6
Rebecca M Rentea, Charles H Fehring
Causes of colonic and recto-sigmoid hematomas are multifactorial. Patients can present with a combination of dropping hemoglobin, bowel obstruction and perforation. Computed tomography imaging can provide clues to a diagnosis of intramural hematoma. We present a case of rectal hematoma and a review of current management literature. A 72-year-old male on therapeutic anticoagulation for a pulmonary embolism, was administered an enema resulting in severe abdominal pain unresponsive to blood transfusion. A sigmoid colectomy with end colostomy was performed...
January 19, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28108578/the-activated-clotting-time-in-cardiac-surgery-should-celite-or-kaolin-be-used
#7
Adrianus J De Vries, Annemieke Oude Lansink-Hartgring, Freek-Jan Fernhout, Rolf C G Huet, Edwin R van den Heuvel
OBJECTIVES: Both kaolin- and Celite-activated clotting times (ACT) are used to guide anticoagulation during cardiopulmonary bypass. It is unknown whether these methods lead to similar management procedures for anticoagulation in patients and are thus interchangeable in terms of bias, precision and variability. METHODS: We randomized 97 patients undergoing coronary artery bypass grafting or aortic valve replacement to either kaolin- or Celite-guided anticoagulation...
January 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28108324/the-circle-nephrostomy-tube-an-attractive-nephrostomy-drainage-system-following-complex-percutaneous-nephrolithotomy
#8
Marawan M El Tayeb, Michael S Borofsky, James E Lingeman
OBJECTIVE: To describe our experience with the circle NT (Cook® Medical), a drainage system uniquely designed for use after multiple access PNL. MATERIALS AND METHODS: A retrospective review of 1317 consecutive patients undergoing 1599 PNLs at IU Health Methodist Hospital was performed. All multiple access cases utilizing circle NTs were reviewed and analyzed. The method of insertion of circle NT is demonstrated. RESULTS: A total of 1843 accesses were obtained in 1599 renal units RUs: 380 upper, 129 mid, and 1334 lower...
January 17, 2017: Urology
https://www.readbyqxmd.com/read/28108271/comparative-effectiveness-of-busulfan-and-fludarabine-versus-fludarabine-and-400-cgy-total-body-irradiation-conditioning-regimens-for-aml-mds
#9
Moaath Mustafa Ali, Donna M Abounader, Lisa A Rybicki, Melissa A Yurch, Jamie Starn, Christina Ferraro, Victoria Winslow, Betty K Hamilton, Aaron T Gerds, Hien Liu, Robert Dean, Brian T Hill, Brad Pohlman, Steven Andresen, Rabi Hanna, Matt Kalaycio, Brian J Bolwell, Navneet S Majhail, Ronald Sobecks
Allogeneic hematopoietic cell transplantation (alloHCT) conditioning regimen intensity has varied for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). A comparative effectiveness analysis was performed to assess outcomes of busulfan and fludarabine (BuFlu) versus fludarabine and 400 cGy total body irradiation (FluTBI) conditioning. Thirty-three subjects received BuFlu and 38 had FluTBI. The BuFlu group received more red blood cell transfusions (P=0.02) and had a longer time to platelet recovery (P=0...
January 17, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28108236/comparison-between-piezosurgery-and-conventional-osteotomy-in%C3%A2-cranioplasty-with-fronto-orbital-advancement
#10
Markus Martini, Andreas Röhrig, Rudolf Hermann Reich, Martina Messing-Jünger
BACKGROUND: Cranioplasty of patients with craniosynostosis requires rapid, precise and gentle osteotomy of the skull to avoid complications and benefit the healing process. The aim of this prospective clinical study was to compare two different methods of osteotomy. Piezosurgery and conventional osteotomy were compared using an oscillating saw and high speed drill while performing cranioplasties with fronto-orbital advancement. METHODS: Thirty-four children who required cranioplasty with fronto-orbital advancement were recruited consecutively...
December 21, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28107859/dengue-fever-may-mislead-the-surgeons-when-it-presents-as-an-acute-abdomen
#11
Bingumal Jayasundara, Lalith Perera, Ajith de Silva
OBJECTIVE: To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever). METHODS: Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered...
January 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28107815/upfront-haploidentical-transplant-for-acquired-severe-aplastic-anemia-registry-based-comparison-with-matched-related-transplant
#12
Lan-Ping Xu, Song Jin, Shun-Qing Wang, Ling-Hui Xia, Hai Bai, Su-Jun Gao, Qi-Fa Liu, Jian-Min Wang, Xin Wang, Ming Jiang, Xi Zhang, De-Pei Wu, Xiao-Jun Huang
BACKGROUND: Haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT) is an alternative treatment method for severe aplastic anemia (SAA) patients lacking suitable identical donors and those who are refractory to immunosuppressive therapy (IST). The current study evaluated the feasibility of upfront haploidentical HSCT in SAA patients. METHODS: We conducted a multicenter study based on a registry database. One hundred fifty-eight SAA patients who underwent upfront transplantation between June 2012 and September 2015 were enrolled...
January 21, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28107785/blood-management-strategies-to-reduce-transfusions-after-elective-lower-extremity-joint-arthroplasty-surgeries
#13
Ankit Kansagra, Chester Andrzejewski, Robert Krushell, Andrew Lehman, Jordan Greenbaum, Paul Visintainer, Joan McGirr, Kathleen Mahoney, Darlene Cloutier, Alice Ehresman, Mihaela S Stefan
Blood loss associated with lower-extremity total joint arthroplasty (TJA) often results in anemia and the need for red blood cell transfusions (RBCTs). This article reports on a quality improvement initiative aimed at improving blood management strategies in patients undergoing TJA. A multifaceted intervention (preoperative anemia assessment, use of tranexamic acid, discouragement of autologous preoperative blood collection, restrictive RBCT protocols) was implemented. The results were stratified into 3 intervention periods: 1, pre; 2, peri; and 3, post...
January 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28106651/evaluating-the-impact-of-intraoperative-surgical-team-handoffs-on-patient-outcomes
#14
Lauren E Giugale, Sarah Sears, Erin S Lavelle, Charelle M Carter-Brooks, Michael Bonidie, Jonathan P Shepherd
OBJECTIVE: The aim of the study was to assess the impact of intraoperative personnel handoffs on clinical outcomes in patients undergoing minimally invasive sacrocolpopexy (SCP). METHODS: We retrospectively reviewed SCPs performed at an academic center between 2009 and 2014. We analyzed the number of staff handoffs, defined as any instance a scrub technician (tech) or circulating nurse handed off responsibility for a break or shift change. Outcomes included operative (OR) time and composite variables for major complications (conversion to an open procedure, bladder injury, bowel injury, blood transfusion, infection, ileus, bowel obstruction, readmission, or mesh complication) and prolapse recurrence (prolapse at or beyond the hymen or retreatment)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106619/video-assisted-thoracic-surgery-in-patients-with-previous-sternotomy-and-cardiac-surgery
#15
Derek R Serna-Gallegos, Heather E Merry, Robert J McKenna
OBJECTIVE: Although video-assisted thoracic surgery (VATS) lobectomy has become a standard approach for early-stage 1 lung cancer, concerns exist regarding potential damage to the heart or bypass grafts when VATS is performed after cardiac surgery via median sternotomy. We could find only case reports regarding VATS lobectomy after sternotomy for cardiac surgery. Therefore, we reviewed our series of patients who underwent VATS anatomic resections after sternotomy for cardiac surgery. METHODS: Between 1996 and 2010, there were 87 patients who underwent 88 pulmonary resections after sternotomy for coronary artery bypass grafting (64), valve replacement or repair (12), coronary artery bypass graft and valve replacement (6), and transplant (5)...
January 19, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28106401/transmembrane-difference-in-colloid-osmotic-pressure-affects-the-lipid-membrane-fluidity-of-liposomes-encapsulating-a-concentrated-protein-solution
#16
Tomoko Kure, Hiromi Sakai
A hemoglobin vesicle (Hb-V) is an artificial oxygen carrier encapsulating a highly concentrated hemoglobin solution (40 g/dL) in a liposome. The in vivo safety and efficacy of Hb-V suspension as a transfusion alternative and structural stability during storage have been studied extensively. Because the intra-liposomal Hb aqueous solution can possess colloid osmotic pressure (COP, 200-300 Torr), which is much higher than that of blood plasma (20-25 Torr), a question arises of whether the lipid membrane senses the transmembrane difference in COP...
January 20, 2017: Langmuir: the ACS Journal of Surfaces and Colloids
https://www.readbyqxmd.com/read/28106356/accuracy-of-non-invasive-hemoglobin-monitoring-by-pulse-co-oximeter-during-liver-transplantation
#17
Gulay Erdogan Kayhan, Yusuf Z Colak, Mukadder Sanli, Muharrem Ucar, Huseyin I Toprak
BACKGROUND: Hemoglobin level monitoring is essential during liver transplantation (LT) due to substantial blood loss. We evaluated the accuracy of noninvasive and continuous hemoglobin monitoring (SpHb) obtained by a transcutaneous spectrophotometry-based technology (Masimo Corporation, Irvine, CA) compared with conventional laboratory Hb measurement (HbL) during LT. Additionally, we made subgroup analyses for distinct surgical phases that have special features and hemodynamic problems and thus may affect the accuracy of SpHb...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28106331/a-randomized-controlled-trial-of-fresh-frozen-plasma-for-coagulopathy-in-russell-s-viper-daboia-russelii-envenoming
#18
G K Isbister, S Jayamanne, F Mohamed, A H Dawson, K Maduwage, I Gawarammana, D G Lalloo, H J de Silva, F E Scorgie, L F Lincz, N A Buckley
BACKGROUND: Russell's viper (Daboia russelii) envenoming is a major health issue in South Asia and causes venom induced consumption coagulopathy (VICC). OBJECTIVES: We investigated the effect of fresh frozen plasma (FFP) and two antivenom doses in correcting VICC. METHODS: We undertook an open-label randomized controlled trial in patients with VICC at two Sri Lankan hospitals. Patients with suspected Russell's viper bites and coagulopathy were randomly allocated (1:1) high-dose antivenom (20 vials) or low-dose antivenom (10 vials) plus 4U FFP...
January 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28105341/changes-in-blood-concentrations-of-trace-metals-in-cancer-patients-receiving-cisplatin-based-chemotherapy
#19
Tsutomu Nakamura, Minoru Takahashi, Riho Niigata, Kazuhiko Yamashita, Manabu Kume, Midori Hirai, Hiroyuki Yasui
The administration of cisplatin (CDDP) may influence trace metal concentrations in body fluids. In order to test this hypothesis, the blood concentrations of trace metals were determined during the present study in eight Japanese esophageal and lung cancer patients receiving CDDP-based chemotherapy. The levels of manganese, iron (Fe), cobalt, copper, zinc (Zn), platinum and lead in the plasma were determined by inductively coupled plasma-mass spectrometry. In addition, the serum levels of Fe, transferrin and ferritin were evaluated...
December 2016: Biomedical Reports
https://www.readbyqxmd.com/read/28105211/diagnostic-and-therapeutic-approaches-to-multiple-myeloma-patients-real-world-data-from-representative-multicentre-treatment-surveys-in-germany-between-2008-and-2011
#20
Thomas M Moehler, Maximilian Merz, Lenka Kellermann, Hartmut Goldschmidt, Wolfgang Knauf
A survey was conducted to investigate the standard of care for multiple myeloma in Germany, in order to clarify the status of implementation of international and national treatment guidelines. In addition, the changes in disease management over time were investigated by comparison with surveys conducted in 2008 and 2009. The survey captured a representative sample of 478 myeloma patients with a mean age of 67.9 years across various stages of the disease. Diagnostic approaches, prognostic aspects and treatment decisions were evaluated based on a survey conducted in 2011 in 58 representative centres in Germany, including university and non-university hospitals and office-based haematologists...
December 2016: Oncology Letters
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