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Functional status in cardiac surgery

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https://www.readbyqxmd.com/read/29456915/short-term-complications-of-anterior-fixation-of-odontoid-fractures
#1
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
#2
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
#3
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...
January 10, 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
#4
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
#5
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
#6
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...
January 17, 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
#7
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
#8
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
#9
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
#10
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...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29049074/physiology-and-role-of-intraocular-pressure-in-contemporary-anesthesia
#11
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
https://www.readbyqxmd.com/read/29016439/examining-the-ability-of-artificial-neural-networks-machine-learning-models-to-accurately-predict-complications-following-posterior-lumbar-spine-fusion
#12
Jun S Kim, Robert K Merrill, Varun Arvind, Deepak Kaji, Sara D Pasik, Chuma C Nwachukwu, Luilly Vargas, Nebiyu S Osman, Eric K Oermann, John M Caridi, Samuel K Cho
STUDY DESIGN: Cross-sectional database study. OBJECTIVE: To train and validate machine learning models to identify risk factors for complications following posterior lumbar spine fusion. SUMMARY OF BACKGROUND DATA: Machine learning models such as artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex datasets. ANNs have yet to be used for risk factor analysis in orthopedic surgery. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients who underwent posterior lumbar spine fusion...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28971404/evaluating-the-homeostasis-assessment-model-insulin-resistance-and-the-cardiac-autonomic-system-in-bariatric-surgery-patients-a-meta-analysis
#13
Styliani A Geronikolou, Konstantinos Albanopoulos, George Chrousos, Dennis Cokkinos
Morbid obesity is a severe chronic disease and subject to surgical methods for losing weight. This intervention is expected to drive to better quality of life and health status. Other important aspects which may be influenced are: HOMA-IR (as insulin resistance marker) and heart rate variability (as cardiac function and autonomic nervous system marker), which are independent and valid predictors of future cardiac, neurological, metabolic health. We pooled 4 studies (646 subjects) resulting to HOMA-IR and nine HRV components-grouped in those undergone to gastric bypass (RYGP) and those operated with vertical sleeve gastrectomy (SG) method...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28967722/cardiovascular-risk-assessment-in-the-senior-population-undergoing-anesthesia-for-non-cardiac-surgery
#14
Concezione Tommasino
Older patients are underrepresented in major cardiovascular trials, and only relatively healthy elderly patients, with few comorbidities or functional impairments, have been enrolled. As a result, current guidelines are unable to provide evidence-based recommendations for anesthesia treatment of patients aged ≥75 years, undergoing non-cardiac surgical procedures. Effective strategies, aimed at reducing the risk of perioperative cardiac complications, should involve cardiac evaluation using mostly medical history...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28967164/negative-predictive-value-of-dobutamine-stress-echocardiography-for-perioperative-risk-stratification-in-patients-with-cardiac-risk-factors-and-reduced-exercise-capacity-undergoing-non-cardiac-surgery
#15
Gus Go, Kathy T Davies, Cara O'Callaghan, Wendy Senior, Karam Kostner, Narelle Fagermo, Sandhir B Prasad
BACKGROUND: Guidelines recommend functional testing for myocardial ischaemia in the perioperative setting in patients with >1 recognised cardiac risk factors and self-reported reduced exercise capacity. We sought to determine the clinical utility of dobutamine stress echocardiography (DSE) for perioperative risk stratification in patients undergoing major noncardiac surgery. METHODS: Data on 79 consecutive patients undergoing DSE for perioperative risk stratification at a single centre was retrospectively reviewed to determine rates of Major Adverse Cardiac Events (MACE) during the index hospitalisation and 30 days post discharge...
October 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28962495/is-there-a-role-for-upper-extremity-intra-aortic-balloon-counterpulsation-as-a-bridge-to-recovery-or-a-bridge-to-transplant-in-the-treatment-of-end-stage-heart-failure
#16
Nnamdi Nwaejike, Andre Y Son, Carmelo A Milano, Mani A Daneshmand
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Is there a role for upper-extremity intra-aortic balloon pump counterpulsation (UE-IABP) in the treatment of end-stage heart failure? Altogether 230 papers were found using the reported search, of which 6 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28950359/recipient-treatment-with-acetylcholinesterase-inhibitor-donepezil-attenuates-primary-graft-failure-in-rats-through-inhibiting-post-transplantational-donor-heart-ischaemia-reperfusion-injury
#17
Xin Yuan, Xiao Teng, Yin Wang, Yuntai Yao
OBJECTIVES: Ischaemia/reperfusion injury may have deleterious consequences on heart transplantation. The underlying causes such as inflammation may also contribute to the pathogenesis of primary or chronic graft failure. We hypothesize that donepezil (DO), a reversible acetylcholinesterase inhibitor that increases cholinergic receptor activation, may protect the transplanted heart through increasing the level of acetylcholine, which in turn inhibits systemic inflammation in the recipients...
August 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28888555/functional-impairment-prior-to-major-non-cardiac-surgery-is-associated-with-mortality-within-one-year-in-elderly-patients-with-gastrointestinal-gynaecological-and-urogenital-cancer-a-prospective-observational-cohort-study
#18
Maren Schmidt, Rahel Eckardt, Sarah Altmeppen, Klaus-Dieter Wernecke, Claudia Spies
OBJECTIVE: To investigate the prognostic value of elements of the Geriatric Assessment, in particular the Timed Up and Go (TUG) Test and the Barthel Index of Activities of Daily Living (ADL) for one-year post-operative mortality in elderly patients with cancer. MATERIALS AND METHODS: This prospective cohort study included patients 65years of age or older undergoing elective major surgery for cancer between June 2008 and June 2010. Preoperative functional status was measured by the TUG Test and the Barthel Index of ADL Cognitive state was assessed by the Mini Mental State Examination (MMSE)...
September 6, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28873075/intraoperative-magnesium-sulphate-decreases-agitation-and-pain-in-patients-undergoing-functional-endoscopic-surgery-a-randomised-double-blind-study
#19
Hazem E Elsersy, Magdy Ch Metyas, Hana A Elfeky, Ahmed A Hassan
BACKGROUND: Postoperative agitation is harmful for the patient as it may be associated with removal of catheters, nasal packs, oxygen masks and self-injury, and pose a danger to operating theatre staff. OBJECTIVE: The current study investigated the potential role of magnesium sulphate in treatment of postoperative agitation following functional endoscopic sinus surgery. DESIGN: A randomised, double-blinded, placebo-controlled trial. SETTING: ENT operating room, Menofia University Hospitals, Egypt...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28813234/cardiac-mr-strain-a-noninvasive-biomarker-of-fibrofatty-remodeling-of-the-left-atrial-myocardium
#20
Adrian T Huber, Jérôme Lamy, Amer Rahhal, Morgane Evin, Fabrice Atassi, Carine Defrance, Guillaume Lebreton, Karine Clément, Myriam Berthet, Richard Isnard, Pascal Leprince, Philippe Cluzel, Stéphane N Hatem, Nadjia Kachenoura, Alban Redheuil
Purpose To determine whether left atrial (LA) strain quantification with cardiac magnetic resonance (MR) imaging feature tracking is associated with the severity of LA fibrofatty myocardial remodeling at histologic analysis. Materials and Methods This prospective case-control study was approved by the institutional review board. LA strain was evaluated with cardiac MR feature tracking between January 2014 and March 2015 in 13 consecutive patients (mean age, 61 years ± 19; nine male) with mitral regurgitation in the 24 hours before mitral valve surgery and 13 age- and sex-matched healthy control subjects...
August 16, 2017: Radiology
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