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https://www.readbyqxmd.com/read/28433492/is-tavr-ready-for-the-global-aging-population
#1
REVIEW
Travis Bergmann, Partho P Sengupta, Jagat Narula
The emergence of the global pandemic of chronic diseases necessitates critical assessment of interventions that can be targeted at both the individual and population levels. Among cardiovascular diseases, the increasing prevalence of valvular heart diseases such as aortic stenosis parallels the rising burden of atherosclerotic cardiovascular diseases. As an alternative to surgical aortic valve replacement, technological innovation has allowed development of minimally invasive transcatheter aortic valve replacement (TAVR)...
April 19, 2017: Global Heart
https://www.readbyqxmd.com/read/28432830/prevalence-and-risk-factors-of-symptomatic-urinary-tract-infection-after-endoscopic-incision-for-the-treatment-of-ureterocele-in-children
#2
Kimihiko Moriya, Michiko Nakamura, Yoko Nishimura, Yukiko Kanno, Takeya Kitta, Masafumi Kon, Nobuo Shinohara
OBJECTIVE: To clarify the impact of endoscopic incision for ureterocele as an initial procedure, retrospective chart review was performed focusing on the prevalence and risk factors of symptomatic urinary tract infection after endoscopic incision. MATERIALS AND METHODS: Among children with ureterocele who were managed between September 1994 and April 2016, patients who were observed conservatively without additional surgical management after endoscopic incision were included in this study...
April 22, 2017: BJU International
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#3
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430068/caring-for-patients-or-organs-new-therapies-raise-new-dilemmas-in-the-emergency-department
#4
Arjun Prabhu, Lisa S Parker, Michael A DeVita
Two potentially lifesaving protocols, emergency preservation and resuscitation (EPR) and uncontrolled donation after circulatory determination of death (uDCDD), currently implemented in some U.S. emergency departments (EDs), have similar eligibility criteria and initial technical procedures, but critically different goals. Both follow unsuccessful cardiopulmonary resuscitation and induce hypothermia to "buy time": one in trauma patients suffering cardiac arrest, to enable surgical repair, and the other in patients who unexpectedly die in the ED, to enable organ donation...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#5
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28421900/the-magnitude-and-factors-related-to-facility-based-maternal-mortality-in-mozambique
#6
Leonardo Chavane, Martinho Dgedge, Olivier Degomme, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman
Facility-based maternal mortality remains an important public health problem in Mozambique. A number of factors associated with health system functioning can be described behind the occurrence of these deaths. This paper aimed to evaluate the magnitude of the health facility-based maternal mortality, its geographical distribution and to assess the health facility factors implicated in the occurrence of these deaths. A secondary analysis was done on data from the survey on maternal health needs performed by the Ministry of Health of Mozambique in 2008...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28416176/maternal-early-warning-systems-towards-reducing-preventable-maternal-mortality-and-severe-maternal-morbidity-through-improved-clinical-surveillance-and-responsiveness
#7
Lisa C Zuckerwise, Heather S Lipkind
Despite increasing awareness of obstetric safety initiatives, maternal mortality and severe maternal morbidity in the United States have continued to increase over the past 20 years. Since results from large-scale surveillance programs suggest that up to 50% of maternal deaths may be preventable, new efforts are focused on developing and testing early warning systems for the obstetric population. Early warning systems are a set of specific clinical signs or symptoms that trigger the awareness of risk and an urgent patient evaluation, with the goal of reducing severe morbidity and mortality through timely diagnosis and treatment...
April 14, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28411289/evaluating-automated-rules-for-rapid-response-system-alarm-triggers-in-medical-and-surgical-patients
#8
Santiago Romero-Brufau, Bruce W Morlan, Matthew Johnson, Joel Hickman, Lisa L Kirkland, James M Naessens, Jeanne Huddleston
BACKGROUND: The use of rapid response systems (RRS), which were designed to bring clinicians with critical care expertise to the bedside to prevent unnecessary deaths, has increased. RRS rely on accurate detection of acute deterioration events. Early warning scores (EWS) have been used for this purpose but were developed using heterogeneous populations. Predictive performance may differ in medical vs surgical patients. OBJECTIVE: To evaluate the performance of published EWS in medical vs surgical patient populations...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28410848/improving-access-to-image-guided-procedures-at-an-integrated-rural-critical-access-hospital-ultrasound-guided-thyroid-biopsy-program
#9
Thang Q Le, Yadiel Sánchez, Alexander S Misono, Sanjay Saini, Anand M Prabhakar
PURPOSE: Critical access hospitals face difficulty providing all services locally and may need to refer patients off-site for additional care. Providing on-site minimally invasive biopsies, may obviate visits to tertiary or quaternary care centers. This study aims to assess feasibility and outcomes of an ultrasound-guided thyroid biopsy program in a critical access hospital. METHODS: In this HIPAA compliant, IRB approved study, the Interventional Radiology (IR) database of a 19-bed, island, rural, critical access hospital without onsite pathology services affiliated with our quaternary care institution was retrospectively reviewed to identify all thyroid biopsies that were performed on site since inception of the service in April 2014 through August 2016...
February 16, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28404468/assessing-the-impact-of-a-program-for-late-surgical-intervention-in-early-blind-children
#10
A Kalia, T Gandhi, G Chatterjee, P Swami, H Dhillon, S Bi, N Chauhan, S D Gupta, P Sharma, S Sood, S Ganesh, U Mathur, P Sinha
OBJECTIVE: Many blind children in the developing world are unable to obtain timely treatment due to lack of financial and medical resources. Can public health programs that identify and treat such children several years after the onset of blindness enhance their quality of life? The notion that visual development is subject to an early 'critical period' argues against this possibility. However, there are inadequate empirical data from humans on this issue. To address this need, we examined the quality of life of children living in India and who were treated for early-onset blindness (before one year of age), due to cataracts or corneal opacities...
February 1, 2017: Public Health
https://www.readbyqxmd.com/read/28400680/changes-in-b-type-natriuretic-peptide-and-related-hemodynamic-parameters-following-a-fluid-challenge-in-critically-ill-patients-with-severe-sepsis-or-septic-shock
#11
Shahed Omar, Ahmad Ali, Yahya Atiya, Rudo Lufuno Mathivha, Joel M Dulhunty
CONTEXT: Severe sepsis or septic shock. AIMS: The aim of this study is to examine the effect of a fluid challenge on the B-type natriuretic peptide (BNP) and the hemodynamic state. SETTINGS AND DESIGN: This observational study was conducted in an intensivist-led academic, mixed medical-surgical Intensive Care Unit. SUBJECTS AND METHODS: Focused transthoracic echocardiogram, plasma BNP, and hemodynamic measurements were recorded at baseline and following a 500 ml fluid challenge in thirty patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399033/european-society-of-gynaecological-oncology-guidelines-for-the-management-of-patients-with-vulvar-cancer
#12
Maaike H M Oonk, François Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brännström, Fabio Landoni, Sven Mahner, Umesh Mahantshetty, Mansoor Mirza, Cordula Petersen, Denis Querleu, Sigrid Regauer, Lukas Rob, Roman Rouzier, Elena Ulrikh, Jacobus van der Velden, Ignace Vergote, Linn Woelber, Ate G J van der Zee
OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe)...
April 8, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28396935/state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept-english-version
#13
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate intraoperative infusion therapy is essential for the perioperative outcome of a patient. Both hypo- and hypervolemia can lead to an increased rate of perioperative complications and to a worse outcome. Perioperative infusion therapy should therefore be needs-based. The primary objective is the maintenance of preoperative normovolemia using a rational infusion strategy. Perioperative fluid losses should be differentiated from volume losses due to surgical bleeding or protein losses into the interstitial space...
April 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#14
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390770/rationale-and-design-of-the-marrowstim-pad-kit-for-the-treatment-of-critical-limb-ischemia-in-subjects-with-severe-peripheral-arterial-disease-mobile-trial-investigating-autologous-bone-marrow-cell-therapy-for-critical-limb%C3%A2-ischemia
#15
S Keisin Wang, Linden A Green, Raghu L Motaganahalli, Michael G Wilson, Andres Fajardo, Michael P Murphy
OBJECTIVE: Critical limb ischemia (CLI) continues to place a significant encumbrance on patients and the health care system as it progresses to limb loss and long-term disability. Traditional methods of revascularization offer a significant benefit; however, for one-third of CLI patients, these surgical options are not technically possible or patency is severely limited by disease burden (deemed "poor-option" for revascularization). In a previous phase I trial, we demonstrated intramuscular injection of concentrated bone marrow aspirate (cBMA) via MarrowStim (Zimmer Biomet, Warsaw, Ind) harvest is safe and may decrease major amputation in patients with CLI unfit for surgical revascularization...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390605/association-of-sleep-disordered-breathing-symptoms-with-early-postoperative-analgesic-requirement-in-pediatric-ambulatory-surgical-patients
#16
Kamie Yang, Anne Baetzel, Wilson T Chimbira, Yuliya Yermolina, Paul I Reynolds, Olubukola O Nafiu
INTRODUCTION: Sleep disordered breathing (SDB) symptoms are associated with increased rates of opioid-induced respiratory depression as well as enhanced nociception. Consequently, practitioners often withhold or administer lower intraoperative doses of opioids out of concern for postoperative respiratory depression. Therefore, SDB may be a critical determinant of analgesic requirement in the post-anesthesia care unit (PACU). We investigated whether preoperative SDB classification was independently associated with need for PACU analgesic intervention in a cross-sectional sample of 985 children who underwent elective, painful ambulatory surgical procedures...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28389295/a-meta-analysis-of-long-term-mortality-and-associated-risk-factors-following-lower-extremity-amputation
#17
REVIEW
Jordan R Stern, Christopher Kevin Wong, Marina Yerovinkina, Stephanie J Spindler, Ashley S See, Samira Panjaki, Sarah L Loven, Rick F D'Andrea, Roman Nowygrod
BACKGROUND: A majority of patients undergoing lower limb amputations have diabetes or peripheral artery disease. Despite improvements in care, there remains a substantial perioperative mortality associated with these procedures. Less well-defined is the mortality risk to these patients going forward, once outside the perioperative period. The aim of this systematic review is to summarize and pool the available data in order to determine the long term mortality associated with amputation in the diabetic and peripheral vascular patient, as well as to define specific factors associated with increased mortality risk...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28386717/co-registration-of-pre-operative-ct-with-ex-vivo-surgically-excised-ground-glass-nodules-to-define-spatial-extent-of-invasive-adenocarcinoma-on-in-vivo-imaging-a-proof-of-concept-study
#18
Mirabela Rusu, Prabhakar Rajiah, Robert Gilkeson, Michael Yang, Christopher Donatelli, Rajat Thawani, Frank J Jacono, Philip Linden, Anant Madabhushi
OBJECTIVE: To develop an approach for radiology-pathology fusion of ex vivo histology of surgically excised pulmonary nodules with pre-operative CT, to radiologically map spatial extent of the invasive adenocarcinomatous component of the nodule. METHODS: Six subjects (age: 75 ± 11 years) with pre-operative CT and surgically excised ground-glass nodules (size: 22.5 ± 5.1 mm) with a significant invasive adenocarcinomatous component (>5 mm) were included...
April 6, 2017: European Radiology
https://www.readbyqxmd.com/read/28382850/are-predictive-energy-expenditure-equations-in-ventilated-surgery-patients-accurate
#19
Christopher J Tignanelli, Allan G Andrews, Kurt M Sieloff, Melissa R Pleva, Heidi A Reichert, Jennifer A Wooley, Lena M Napolitano, Jill R Cherry-Bukowiec
BACKGROUND: While indirect calorimetry (IC) is the gold standard used to calculate specific calorie needs in the critically ill, predictive equations are frequently utilized at many institutions for various reasons. Prior studies suggest these equations frequently misjudge actual resting energy expenditure (REE) in medical and mixed intensive care unit (ICU) patients; however, their utility for surgical ICU (SICU) patients has not been fully evaluated. Therefore, the objective of this study was to compare the REE measured by IC with REE calculated using specific calorie goals or predictive equations for nutritional support in ventilated adult SICU patients...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28382678/recognising-and-responding-to-in-hospital-clinical-deterioration-an-integrative-review-of-interprofessional-practice-issues
#20
REVIEW
Emily Allen, Doug Elliott, Debra Jackson
AIMS AND OBJECTIVES: To identify, appraise and synthesise current evidence regarding organisation-wide interprofessional practice issues that facilitate or inhibit effective recognition and response to clinical deterioration, using a theoretical Rapid Response System (RRS) model. BACKGROUND: Recognition and response to clinical deterioration, in adult general medical-surgical ward patients, is embedded as a routine interprofessional practice in acute healthcare organisations worldwide...
April 5, 2017: Journal of Clinical Nursing
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