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Functional status in cardiac surgery

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https://www.readbyqxmd.com/read/29650363/chemotherapy-versus-chemoradiotherapy-after-surgery-and-preoperative-chemotherapy-for-resectable-gastric-cancer-critics-an-international-open-label-randomised-phase-3-trial
#1
Annemieke Cats, Edwin P M Jansen, Nicole C T van Grieken, Karolina Sikorska, Pehr Lind, Marianne Nordsmark, Elma Meershoek-Klein Kranenbarg, Henk Boot, Anouk K Trip, H A Maurits Swellengrebel, Hanneke W M van Laarhoven, Hein Putter, Johanna W van Sandick, Mark I van Berge Henegouwen, Henk H Hartgrink, Harm van Tinteren, Cornelis J H van de Velde, Marcel Verheij
BACKGROUND: Both perioperative chemotherapy and postoperative chemoradiotherapy improve survival in patients with resectable gastric cancer from Europe and North America. To our knowledge, these treatment strategies have not been investigated in a head to head comparison. We aimed to compare perioperative chemotherapy with preoperative chemotherapy and postoperative chemoradiotherapy in patients with resectable gastric adenocarcinoma. METHODS: In this investigator-initiated, open-label, randomised phase 3 trial, we enrolled patients aged 18 years or older who had stage IB- IVA resectable gastric or gastro-oesophageal adenocarcinoma (as defined by the American Joint Committee on Cancer, sixth edition), with a WHO performance status of 0 or 1, and adequate cardiac, bone marrow, liver, and kidney function...
April 9, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29619223/respiratory-exacerbation-in-a-young-adult-with-cystic-fibrosis-and-tricuspid-atresia
#2
Jamie Wood, Abbey Sawyer, Siobhain Mulrennan, Andrew Bullock
Tricuspid atresia (TAt) is a complex congenital heart defect (CHD) characterized by the absence of the tricuspid valve and right ventricular hypoplasia requiring surgery in childhood, the Fontan procedure. We present a case of a 21-year-old male with TAt and cystic fibrosis (CF), who underwent a Fontan procedure in childhood, presenting to an adult CF clinic with severe deterioration in his respiratory status and multi-organ dysfunction associated with CF. This report describes problems associated with the management of a CF respiratory exacerbation and extrapulmonary manifestations of CF in the unique situation of a Fontan circulation, a circulation with absence of a subpulmonary ventricle and pulsatile pulmonary arterial blood flow where maintenance of systemic cardiac output is totally dependent on good respiratory function and low pulmonary artery pressures...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29615540/can-serum-cystatin-c-predict-long-term-survival-in-cardiac-surgery-patients
#3
Valentina Rovella, Giulia Marrone, Mariarita Dessì, Michele Ferrannini, Nicola Toschi, Antonio Pellegrino, Maurizio Casasco, Nicola Di Daniele, Annalisa Noce
Renal dysfunction is a risk factor for morbidity and mortality in cardiac surgery patients. Serum Cystatin C (sCysC) is a well-recognized marker of early renal dysfunction but few reports evaluate its prognostic cardio-vascular role. The aim of the study is to consider the prognostic value of sCysC for cardiovascular mortality. Four hundred twenty-four cardiac-surgery patients (264 men and 160 women) were enrolled. At admission, all patients were tested for renal function and inflammatory status. Patients were subdivided in subgroups according to the values of the following variables: sCysC, serum Creatinine (sCrea), age, high sensitivity-C Reactive Protein, fibrinogen, surgical procedures and Kaplan-Meier cumulative survival curves were plotted...
March 27, 2018: Aging
https://www.readbyqxmd.com/read/29582429/early-intervention-mobilization-or-active-exercise-for-critically-ill-adults-in-the-intensive-care-unit
#4
REVIEW
Katherine A Doiron, Tammy C Hoffmann, Elaine M Beller
BACKGROUND: Survivors of critical illness often experience a multitude of problems that begin in the intensive care unit (ICU) or present and continue after discharge. These can include muscle weakness, cognitive impairments, psychological difficulties, reduced physical function such as in activities of daily living (ADLs), and decreased quality of life. Early interventions such as mobilizations or active exercise, or both, may diminish the impact of the sequelae of critical illness. OBJECTIVES: To assess the effects of early intervention (mobilization or active exercise), commenced in the ICU, provided to critically ill adults either during or after the mechanical ventilation period, compared with delayed exercise or usual care, on improving physical function or performance, muscle strength and health-related quality of life...
March 27, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29580777/quality-of-life-after-cardiac-surgery-based-on-the-minimal-clinically-important-difference-concept
#5
Nathalie Grand, Jean Baptiste Bouchet, Paul Zufferey, Anne Marie Beraud, Sahar Awad, Fabricio Sandri, Salvator Campisi, Jean François Fuzellier, Serge Molliex, Marco Vola, Jerome Morel
BACKGROUND: Health-related quality of life (HRQOL) is an increasingly important issue in assessing the consequences of any surgical or medical intervention. Our study aimed to evaluate change in HRQOL 6 months after elective cardiac surgery and to identify specific predictors of poor HRQOL. METHODS: In this prospective, single-center study, HRQOL was evaluated before and 6 months after surgery using the SF-36 questionnaire and its two components: the physical component summary (PCS) and the mental component summary (MCS)...
March 23, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29546292/fish-oil-supplementation-does-not-affect-cognitive-outcomes-in-cardiac-surgery-patients-in-the-omega-3-fatty-acids-for-prevention-of-post-operative-atrial-fibrillation-opera-trial
#6
James C Jackson, Dariush Mozaffarian, Amy J Graves, Nancy J Brown, Roberto Marchioli, Amy L Kiehl, E Wesley Ely
Background: Cognitive decline has been reported following cardiac surgery, leading to great interest in interventions to minimize its occurrence. Long-chain n-3 (ω-3) polyunsaturated fatty acids (PUFAs) have been associated with less cognitive decline in observational studies, yet no trials have tested the effects of n-3 PUFAs on cognitive decline after surgery. Objective: We sought to determine whether perioperative n-3 PUFA supplementation reduces postoperative cognitive decline in patients postcardiac surgery...
March 1, 2018: Journal of Nutrition
https://www.readbyqxmd.com/read/29529331/the-relationship-between-pre-operative-hypertension-and-intra-operative-haemodynamic-changes-known-to-be-associated-with-postoperative-morbidity
#7
M Crowther, K van der Spuy, F Roodt, M B Nejthardt, J G Davids, J Roos, E Cloete, T Pretorius, G L Davies, J G van der Walt, C van der Westhuizen, M Flint, J L C Swanevelder, B M Biccard
Hypertension is not consistently associated with postoperative cardiovascular morbidity and is therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with peri-operative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes...
March 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29502994/factors-affecting-patients-functional-status-and-their-impact-on-outcomes-of-ruptured-abdominal-aortic-aneurysms
#8
Arjun Agrawal, Rachael Snow, Erik Lehman, Faisal Aziz
OBJECTIVE: Despite advances in surgical techniques, ruptured abdominal aortic aneurysm (rAAA) remains associated with extremely high mortality. Several preoperative risk factors have been shown to predict poor prognosis after rAAA repair. Notably, a preoperative dependent functional status has previously been shown to be associated with poor outcomes after several vascular surgery procedures. The purpose of this study was to examine the effect of preoperative functional status on postoperative outcomes for patients undergoing repair of rAAA...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29481371/spinal-cord-stimulation-50-years-later-clinical-outcomes-of-spinal-cord-stimulation-based-on-randomized-clinical-trials-a-systematic-review
#9
Nagy Mekhail, Ogi Visnjevac, Gerges Azer, Diana Sue Mehanny, Priya Agrawal, Victor Foorsov
To assess the efficacy of spinal cord stimulation (SCS) for each indication, one must critically assess each specific clinical outcome to identify outcomes that benefit from SCS therapy. To date, a comprehensive review of clinically relevant outcome-specific evidence regarding SCS has not been published. We aimed to assess all randomized controlled trials from the world literature for the purpose of evaluating the clinical outcome-specific efficacy of SCS for the following outcomes: perceived pain relief or change pain score, quality of life, functional status, psychological impact, analgesic medication utilization, patient satisfaction, and health care cost and utilization...
February 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29456915/short-term-complications-of-anterior-fixation-of-odontoid-fractures
#10
Holt S Cutler, Javier Z Guzman, Nathan J Lee, Parth Kothari, Jun S Kim, John I Shin, Dante M Leven, Samuel K Cho
Study Design: Retrospective study. Objective: Anterior fixation of odontoid fracture has been associated with high morbidity and mortality in small, single institution series. Identifying risk factors may improve risk stratification and highlight factors that could be optimized preoperatively. The objective of this study was to determine the 30-day complication rate following anterior fixation of odontoid fractures and to identify associated risk factors among patients in a large national database...
February 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#11
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29331535/estrogen-deprivation-aggravates-cardiometabolic-dysfunction-in-obese-insulin-resistant-rats-through-the-impairment-of-cardiac-mitochondrial-dynamics
#12
Wanitchaya Minta, Siripong Palee, Duangkamol Mantor, Wissuta Sutham, Thidarat Jaiwongkam, Sasiwan Kerdphoo, Wasana Pratchayasakul, Sirinart Kumfu, Siriporn C Chattipakorn, Nipon Chattipakorn
The incidence of cardiovascular disease and metabolic syndrome increases after the onset of menopause, suggesting estrogen has a vital role in their prevention. Mitochondrial dynamics are known to play an important role in the maintenance of cardiac physiological function. However, the effects of estrogen deprivation on cardiometabolic status and cardiac mitochondrial dynamics under conditions of obese-insulin resistance have never been investigated. We hypothesized that estrogen deprivation aggravates cardiac dysfunction through increased cardiac mitochondrial fission in obese-insulin resistant rats...
March 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29231752/differences-between-slovak-and-dutch-patients-scheduled-for-coronary-artery-bypass-graft-surgery-regarding-clinical-and-psychosocial-predictors-of-physical-and-mental-health-related-quality-of-life
#13
Noha El-Baz, Daniela Ondusova, Martin Studencan, Jaroslav Rosenberger, Sijmen A Reijneveld, Jitse P van Dijk, Berrie Middel
BACKGROUND: Differences in health-related quality of life in coronary artery disease patients and associated factors between patients of central and western European descent are rarely investigated. We aim to test differences between Dutch and Slovak health-related quality of life, whether nationality predicted health-related quality of life and if standardised beta weights of health-related quality of life determinants differ across countries. DESIGN: An observational multicentre study at university cardiac centres in the Netherlands and Slovakia...
December 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29229124/mortality-after-emergency-hartmann-s-procedure-in-octogenarians-a-propensity-score-matched-analysis
#14
COMPARATIVE STUDY
Ian C Bostock, Maureen V Hill, Timothy C Counihan, Srinivas Joga Ivatury
BACKGROUND: Complicated diverticulitis is associated with a postoperative mortality rate of 20%. We hypothesized that age ≥80 was an independent risk factor for mortality after Hartmann's procedure for diverticular disease when controlling for baseline comorbidities. METHODS: Patients who underwent an urgent or emergent Hartmann's procedure (Current Procedural Terminology codes 44143 and 44206) for diverticular disease (International Classification of Diseases-9:562...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#15
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#16
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29201152/myocardial-injury-in-diabetic-patients-with-multivessel-coronary-artery-disease-after-revascularization-interventions
#17
Paulo Cury Rezende, Whady Hueb, Rosa Maria Rahmi, Thiago Luis Scudeler, Diogo Freitas Cardoso de Azevedo, Cibele Larrosa Garzillo, Carlos Alexandre Wainrober Segre, Jose Antonio Franchini Ramires, Roberto Kalil Filho
Background: Diabetic patients may be more susceptible to myocardial injury after coronary interventions. Thus, the aim of this study was to assess the release of cardiac biomarkers, CK-MB and troponin, and the findings of new late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) in patients with type 2 diabetes mellitus after elective revascularization procedures for multivessel coronary artery disease (CAD). Methods: Patients with multivessel CAD and preserved systolic ventricular function underwent either elective percutaneous coronary intervention (PCI), off-pump or on-pump bypass surgery (CABG)...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/29197079/postoperative-outcomes-following-cardiac-surgery-in-non-anaemic-iron-replete-and-iron-deficient-patients-an-exploratory-study
#18
L F Miles, S A Kunz, L H Na, S Braat, K Burbury, D A Story
Iron deficiency anaemia is strongly associated with poor outcomes after cardiac surgery. However, pre-operative non-anaemic iron deficiency (a probable anaemia precursor) has not been comprehensively examined in patients undergoing cardiac surgery, despite biological plausibility and evidence from other patient populations of negative effect on outcome. This exploratory retrospective cohort study aimed to compare an iron-deficient group of patients undergoing cardiac surgery with an iron-replete group. Consecutive non-anaemic patients undergoing elective coronary artery bypass grafting or single valve replacement in our institution between January 2013 and December 2015 were considered for inclusion...
December 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#19
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
April 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29049074/physiology-and-role-of-intraocular-pressure-in-contemporary-anesthesia
#20
Dermot J Kelly, Sinéad M Farrell
More than 26 million Americans suffer with cataracts, and with 3.6 million cataract extractions performed annually in the United States, it is the most common surgical procedure. The integrity of the delicate structures of the eye that mediate vision is dependent on the intraocular pressure (IOP). Yet, IOP acts to compress the vessels within the globe-akin to a Starling resistor-and is a key component that determines the ocular perfusion pressure, defined as the difference between arterial pressure and IOP...
October 17, 2017: Anesthesia and Analgesia
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