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Functional status in cardiac surgery

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https://www.readbyqxmd.com/read/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#1
J Hu, W Q Lyu, Y L Guo, H W Wen, H Qiao, Y Qu
Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27908316/-frail-patients-and-surgery
#2
Nadia A Henriksen, Frederik Helgstrand, Ismail Gögenur
It is estimated that 15% of patients above 65 years of age are frail. Frail patients have significantly higher risk of post-operative complications when undergoing both elective and emergency surgery than patients who are not frail. Therefore, it is recommended that all patients above 65 years are frailty scored prior to a surgical procedure. It seems advisable to include the following items in a multimodal frailty score: evaluation of the patient's cognitive ability, functional status, nutritional status and pulmonary and cardiac function...
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27904840/surgical-experience-on-chronic-constrictive-pericarditis-in-african-setting-review-of-35-years-experience-in-cote-d-ivoire
#3
Koffi Herve Yangni-Angate, Yves Tanauh, Christophe Meneas, Florent Diby, Anicet Adoubi, Manga Diomande
BACKGROUND: Surgical experience with chronic constrictive pericarditis (CCP) is rarely documented in Africa; the aim of this study is therefore to review our African experience with CCP from 1977 to 2012 in terms of clinical and surgical outcomes and risk factors of early death after pericardiectomy. METHODS: This retrospective study is related to 120 patients with CCP; there were 72 men and 48 women with an average age at 28.8±10.4 years standard deviation (SD) (8-51 years)...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27888756/isolated-heart-transplant-and-combined-heart-liver-transplant-in-adult-congenital-heart-disease-patients-insights-from-the-united-network-of-organ-sharing
#4
Elisa A Bradley, Krong-On Pinyoluksana, Melissa Moore-Clingenpeel, Yongjie Miao, Curt Daniels
BACKGROUND/METHODS: The aging patient with severe congenital heart disease (CHD) faces many challenges: heart failure, arrhythmia, and in the Fontan patient, liver disease. Our goal was to define combined heart liver transplant (CHLT) and isolated orthotopic heart transplant (OHT) outcomes in U.S. adult CHD patients. The U.S. United Network for Organ Sharing (UNOS) thoracic and liver databases were queried for cardiac and CHD diagnoses, from inception-2014. RESULTS: In CHLT, CHD made up 22% of waitlist patients (non-CHD n=262 vs...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#5
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27831826/hospitalist-vascular-surgery-comanagement-effects-on-complications-and-mortality
#6
Colin T Iberti, Alan Briones, Erin Gabriel, Andrew S Dunn
OBJECTIVES: Hospitalized vascular surgery patients have multiple severe comorbidities, poor functional status, and high perioperative cardiac risk. Thus they may be ideal patients for a collaborative care model. However, there is little evidence for a comanagement model on clinical outcomes. METHODS: The two-year pre-post study consisted of a comanagement model where a hospitalist actively participated in the medical care of American Society of Anesthesiologist Physical Status Classification scale 3 or 4 vascular surgery patients...
November 24, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#7
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27784315/intraoperative-hemidiaphragm-electrical-stimulation-reduces-oxidative-stress-and-upregulates-autophagy-in-surgery-patients-undergoing-mechanical-ventilation-exploratory-study
#8
Robert T Mankowski, Shakeel Ahmed, Thomas Beaver, Marvin Dirain, Chul Han, Phillip Hess, Tomas Martin, Barbara K Smith, Shinichi Someya, Christiaan Leeuwenburgh, A Daniel Martin
BACKGROUND: Mechanical ventilation (MV) during a cardio-thoracic surgery contributes to diaphragm muscle dysfunction that impairs weaning and can lead to the ventilator- induced diaphragm dysfunction. Especially, it is critical in older adults who have lower muscle reparative capacity following MV. Reports have shown that the intraoperative intermittent hemidiaphragm electrical stimulation can maintain and/or improve post-surgery diaphragm function. In particular, from a molecular point of view, intermittent ES may reduce oxidative stress and increase regulatory autophagy levels, and therefore improve diaphragm function in animal studies...
October 26, 2016: Journal of Translational Medicine
https://www.readbyqxmd.com/read/27704535/the-association-between-pre-operative-variables-including-blood-pressure-and-postoperative-kidney-function
#9
S M Kendale, P N Lapis, S M Melhem, J D Blitz
We used multivariate analyses to assess the association of pre-operative variables with kidney function in 41,523 adults after scheduled surgery in a single large academic hospital. Eight variables were independently associated with a reduction in postoperative estimated glomerular filtration rate: pre-operative renal function; age; ASA physical status; cardiac failure; anaemia; cancer; type of surgery; and the lowest quartile of pre-operative mean arterial blood pressure (< 71 mmHg). The estimated glomerular filtration rate fell by a mean (95% CI) of 2...
December 2016: Anaesthesia
https://www.readbyqxmd.com/read/27703584/the-role-of-levosimendan-in-patients-with-decreased-left-ventricular-function-undergoing-cardiac-surgery
#10
Marija Bozhinovska, Gordana Taleska, Andrej Fabian, Maja Šoštarič
The postoperative low cardiac output is one of the most important complications following cardiac surgery and is associated with increased morbidity and mortality. The condition requires inotropic support to achieve adequate hemodynamic status and tissue perfusion. While catecholamines are utilised as a standard therapy in cardiac surgery, their use is limited due to increased oxygen consumption. Levosimendan is calcium sensitising inodilatator expressing positive inotropic effect by binding with cardiac troponin C without increasing oxygen demand...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27624592/assessment-of-diastolic-function-in-single-ventricle-patients-after-the-fontan-procedure
#11
Renee Margossian, Lynn A Sleeper, Gail D Pearson, Piers C Barker, Luc Mertens, Michael D Quartermain, Jason T Su, Girish Shirali, Shan Chen, Steven D Colan
BACKGROUND: Patients with functional single ventricles after the Fontan procedure have abnormal cardiac mechanics. The aims of this study were to determine factors that influence diastolic function and to describe associations of diastolic function with current clinical status. METHODS: Echocardiograms were obtained as part of the Pediatric Heart Network Fontan Cross-Sectional Study. Diastolic function grade (DFG) was assessed as normal (grade 0), impaired relaxation (grade 1), pseudonymization (grade 2), or restrictive (grade 3)...
November 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27617685/unplanned-postoperative-intubation-in-pediatric-surgical-patients-development-and-validation-of-a-multivariable-prediction-model
#12
Eric C Cheon, Hannah L Palac, Kristine H Paik, John Hajduk, Gildasio S De Oliveira, Narasimhan Jagannathan, Santhanam Suresh
BACKGROUND: To date, the independent predictors and outcomes of unplanned postoperative intubation (UPI) in pediatric patients after noncardiac surgery are yet to be characterized. The authors aimed to identify the incidence and predictors of this event and evaluated the effect of this event on postoperative mortality. METHODS: Data of 87,920 patients from the American College of Surgeons National Surgical Quality Improvement Program Pediatric database were analyzed and assigned to derivation (n = 58,614; 66...
November 2016: Anesthesiology
https://www.readbyqxmd.com/read/27610349/single-institution-experience-with-the-ladd-s-procedure-in-patients-with-heterotaxy-and-stage-i-palliated-single-ventricle
#13
Kurt D Piggott, Grace George, Harun Fakioglu, Carlos Blanco, Sukumar Saguna Narasimhulu, Kamal Pourmoghadam, Hamish Munroe, William Decampli
AIM: To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd's procedure. METHODS: We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation. A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd's procedure during this time period...
August 8, 2016: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/27548070/preoperative-frailty-assessment-and-outcomes-at-6-months-or-later-in-older-adults-undergoing-cardiac-surgical-procedures-a-systematic-review
#14
Dae Hyun Kim, Caroline A Kim, Sebastian Placide, Lewis A Lipsitz, Edward R Marcantonio
Background: Frailty assessment may inform surgical risk and prognosis not captured by conventional surgical risk scores. Purpose: To evaluate the evidence for various frailty instruments used to predict mortality, functional status, or major adverse cardiovascular and cerebrovascular events (MACCEs) in older adults undergoing cardiac surgical procedures. Data Sources: MEDLINE and EMBASE (without language restrictions), from their inception to 2 May 2016...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27509000/individualized-surgical-treatments-for-children-with-ebstein-anomaly
#15
Zheng Jinghao, Luo Kai, Huang Yanhui, Zhu Zhongqun, Gao Botao, Du Xinwei, Xu Zhiwei, Liu Jinfen
Objective Ebstein anomaly is a rare type of tricuspid malformation. The present surgical methods to resolve this anomaly include tricuspid valvuloplasty, palliative surgery, and tricuspid valve replacement. The purpose of this study was to evaluate the short- and midterm outcomes of different surgical treatments among children with Ebstein anomaly. Methods This was a retrospective study of 136 Ebstein anomaly patients undergoing surgery at our institution from January, 2006 to August, 2015. This cohort included 118 patients receiving tricuspid valvuloplasty, 14 patients receiving palliative surgery and 4 patients receiving tricuspid valve replacement...
August 10, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27497409/etiology-and-long-term-functional-swallow-outcomes-in-pediatric-unilateral-vocal-fold-immobility
#16
Kathleen M Tibbetts, Derek Wu, Jeffrey V Hsu, William B Burton, Michel Nassar, Melin Tan
OBJECTIVE: Unilateral vocal fold immobility (UVFI) results in deficits in phonatory, respiratory, and swallow function of the pediatric patient. Little is known about long-term functional swallow outcomes. METHODS: Medical records of children diagnosed with UVFI between 2005 and 2014 at a tertiary children's hospital were retrospectively reviewed. Etiology, laryngoscopy findings, and swallow status at diagnosis and follow-up were recorded. Swallow outcomes were compared by etiology using Fisher's exact test...
September 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27476223/cardiac-surgery-for-valvular-heart-disease-at-a-referral-hospital-in-ethiopia-a-review-of-cases-operated-in-the-last-30-years
#17
Senbeta Guteta, Dejuma Yadeta, Aklilu Azazh, Dufera Mekonnen
BACKGROUND: Valvular heart disease has been a significant cause of heart disease worldwide. In Ethiopia, it particularly affects young individuals and constitutes the major cause of cardiovascular disease. Factors associated with choice of treatment for advanced valvular heart disease are variable. The objective of this study is to review surgery done for Ethiopian patients with valvular heart disease. METHODS: We analyzed data on patients who had valve surgery and follow-up at the Tikur Anbessa Specialized Hospital cardiology unit...
April 2016: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/27465329/efficacy-of-bosentan-in-patients-after-fontan-procedures-a-double-blind-randomized-controlled-trial
#18
Xiao-Ke Shang, Rong Lu, Xi Zhang, Chang-Dong Zhang, Shu-Na Xiao, Mei Liu, Bin Wang, Nian-Guo Dong
Fontan surgery is a widely used palliative procedure that significantly improves the survival period of patients with complex congenital heart disease (CHD). However, it does not decrease postoperative complication rate. Previous studies suggested that elevated mean pulmonary artery pressure (mPAP) and vascular resistance lead to decreased exercise tolerance and myocardial dysfunction. Therapy with endothelial receptor antagonists (Bosentan) has been demonstrated to improve the patients' prognosis. A double-blind, randomized controlled trial was performed to explore the efficacy of Bosentan in treating patients who underwent the Fontan procedure...
August 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27457483/ct2-bladder-cancer
#19
REVIEW
Mark S Soloway
The patient is an 80-year-old man who presented with gross hematuria. His past medical history indicates he was a cigarette smoker with 50 pack/years. He was successfully treated for carcinoma of the lung 7 years ago. He received chemotherapy, radiation, and surgery. He has mild COPD but has a good performance status. His laboratory studies do not indicate any abnormalities in terms of renal function. He does not have any significant cardiac disease. He has a medium build. He had prostate cancer and underwent a successful radical prostatectomy 10 years ago...
September 2016: Current Urology Reports
https://www.readbyqxmd.com/read/27441877/the-impact-of-prehabilitation-on-postoperative-functional-status-healthcare-utilization-pain-and-quality-of-life-a-systematic-review
#20
C J Cabilan, Sonia Hines, Judy Munday
BACKGROUND: "Preoperative rehabilitation" or prehabilitation has been increasingly studied alongside the deleterious effects of surgery and functional decline. Prehabilitation is the preoperative optimization of physical functionality to enable the individual to maintain a normal level of function during and after surgery. This systematic review evaluates the effectiveness of prehabilitation on functional status, healthcare utilization, quality of life, and pain postoperatively. METHODS: Trials registries and databases of published and unpublished literature were extensively searched...
July 2016: Orthopaedic Nursing
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