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Preoperative hypertension

Hanjo Ko, Julius I Ejiofor, Jessica E Rydingsward, James D Rawn, Jochen D Muehlschlegel, Kenneth B Christopher
OBJECTIVES: Functional status prior to coronary artery bypass graft surgery may be a risk factor for post-operative adverse events. We sought to examine the association between functional status in the 3 months prior to coronary artery bypass graft surgery and subsequent 180 day mortality. DESIGN, SETTING, AND PARTICIPANTS: We performed a single center retrospective cohort study in 718 adults who received coronary artery bypass graft surgery from 2002 to 2014. EXPOSURES: The exposure of interest was functional status determined within the 3 months preceding coronary artery bypass graft surgery...
2018: PloS One
Guijun Ren, Xiaoye Yuan, Xin Zhao, Qingchun Hao, Jinglin Cao, Yang Wang, Qingjun Gao, Jian Dou, Qiang Zeng
The aim of the present study was to investigate the characteristics and progression of intestinal injury at the anhepatic phase in portal hypertensive rats. A total of 120 healthy male Wistar rats were purchased, with 15 rats in the normal control group and 105 rats were assigned to establish a prehepatic portal hypertension model. The 105 model rats were further divided into seven treatment groups following ischemia-reperfusion. Meanwhile, portal vein pressure, the area of lower esophageal mucosal vein, endotoxin levels in portal vein blood and the level of malondialdehyde (MDA) and superoxide dismutase (SOD) were measured...
December 2018: Experimental and Therapeutic Medicine
Vitorino M Santos, Marcos V Carneiro, Viviane V P Soares, Samuel A Silva, Victor M Yano, Cacilda J F S Garcia
This case study describes a 71-year-old man with signet-ring cell gastric adenocarcinoma and malignant sigmoidal polyp; and typical features of Saint's triad and Heyde syndrome. He had digestive bleeding, two types of hernia, diverticulosis, arterial hypertension, malignant polyp, and antecedent of smoking, lung tuberculosis, and surgical correction of aortic valve stenosis. There is a hypothetical inverse relationship between herniosis and development of malignancy; however, the patient herein described presented gastric and sigmoidal cancers...
July 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Lun Wang, Jinfa Wang, Tao Jiang
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has been proved to be the most effective treatment strategy for the treatment of type 2 diabetes mellitus (T2DM) with a body mass index ≥ 30 kg/m2 achieving high remission rates. However, there are few clinical studies on the treatment of T2DM patients with a body mass index less than 30 kg/m2 by LSG. This study aims to study the effect of LSG on type 2 diabetes mellitus(T2DM) in patients with a body mass index (BMI) less than 30 kg/m2 ...
December 8, 2018: Obesity Surgery
Hirokazu Inoue, Hideaki Watanabe, Hitoshi Okami, Atsushi Kimura, Katsushi Takeshita
Background: This prospective cohort study investigated the rate of venous thromboembolism (VTE) before and after spine surgery as determined with use of indirect multidetector computed tomography (MDCT). Methods: We performed a prospective study of 105 patients (36 women and 69 men ranging in age from 38 to 88 years) undergoing spine surgery at 2 institutions. Indirect MDCT was performed before and 3 days after surgery. Patients with a history of dialysis or drug allergy to contrast medium were excluded...
September 25, 2018: JB & JS open access
Patrick Hill, Avani Vaishnav, Blake Kushwaha, Steven McAnany, Todd Albert, Catherine Himo Gang, Sheeraz Qureshi
Objective: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. Methods: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery...
September 9, 2018: Neurospine
Eric C Kuo, Narek Veranyan, Cali E Johnson, Fred A Weaver, Sung Wan Ham, Vincent L Rowe, Fernando Fleischman, Michael Bowdish, Sukgu M Han
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) has become standard treatment of complicated type B aortic dissections (TBADs). Whereas adequate proximal seal is a fundamental requisite for TEVAR, what constitutes "adequate" in dissections and its impact on outcomes remain unclear. The goal of this study was to describe the proximal seal zone achieved with associated clinical outcomes and aortic remodeling. METHODS: A retrospective review was performed of TEVARs for TBAD at a single institution from 2006 to 2016...
October 24, 2018: Journal of Vascular Surgery
Michael J Chen, Abiram Bala, James I Huddleston, Stuart B Goodman, William J Maloney, Alistair J Aaronson, Derek F Amanatullah
INTRODUCTION: While statins have been found to reduce postoperative atrial fibrillation after cardiac surgery, little is known about their use in total hip arthroplasty (THA). This study investigated if statins would similarly reduce postoperative arrhythmias in patients undergoing THA. METHODS: We queried a large Medicare and private-payer database from 2005 to 2012 and identified 12,075 patients who were on a statin prior to THA. We then age and sex matched 34,446 non-statin users who underwent THA...
December 10, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Mohammad Golriz, Omid Ghamarnejad, Elias Khajeh, Mohammadsadegh Sabagh, Markus Mieth, Katrin Hoffmann, Alexis Ulrich, Thilo Hackert, Karl Heinz Weiss, Peter Schirmacher, Markus W Büchler, Arianeb Mehrabi
Background: It is a novel idea that platelet counts may be associated with postoperative outcome following liver surgery. This may help in planning an extended hepatectomy (EH), which is a surgical procedure with high morbidity and mortality. Aim: The aim of this study was to evaluate the predictive potential of platelet counts on the outcome of EH in patients without portal hypertension, splenomegaly, or cirrhosis. Methods: A series of 213 consecutive patients underwent EH (resection of ≥ five liver segments) between 2001 and 2016...
2018: Canadian Journal of Gastroenterology & Hepatology
Youliang Pei, Songshan Chai, Yuxin Zhang, Zhanguo Zhang, Xiaoping Chen, Wanguang Zhang
BACKGROUND: We aimed to explore the benefit of splenectomy combined with curative treatments (liver resection or local ablation) for patients with hepatocellular carcinoma and portal hypertension. METHODS: The records of 239 patients with hepatocellular carcinoma and portal hypertension undergoing either splenectomy combined with liver resection or local ablation were reviewed retrospectively. Perioperative complications and survival outcome were evaluated, and liver function 1 year later was reassessed according to the Child score...
December 3, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Simone Kathemann, Elke Lainka, Johannes M Ludwig, Axel Wetter, Andreas Paul, Peter F Hoyer, Michael Forsting, Thomas Schlosser
PURPOSE: Extrahepatic portal vein thrombosis (EPVT) is one major cause of portal hypertension in children. Surgical reinstallation of portal venous flow can be achieved in patients with patent intrahepatic portal venous system/Rex recess. Our study aimed to compare the ability of magnetic resonance imaging (MRI) and retrograde portography (RP) to assess patency of the intrahepatic portal venous system in children with EPVT. METHODS: All pediatric patients with EPVT who were examined with contrast enhanced MRI (1...
October 30, 2018: Journal of Pediatric Surgery
Courtney A Penn, Neil S Kamdar, Daniel M Morgan, Ryan J Spencer, Shitanshu Uppal
OBJECTIVE: Returning home after surgery is a desirable patient-centered outcome associated with decreased costs compared to non-home discharge. Our objective was to develop a preoperative risk-scoring model predicting non-home discharge after surgery for gynecologic malignancy. METHODS: Women who underwent surgery involving hysterectomy for gynecologic malignancy from 2013 to 2015 were identified from the Michigan Surgical Quality Collaborative database. Patients were divided by discharge destination, and a multivariable logistic regression model was developed to create a nomogram to assign case-specific risk scores...
November 26, 2018: Gynecologic Oncology
Brittany N Burton, Oluwakemi Okwuegbuna, Aria Jafari, Joseph Califano, Kevin T Brumund, Rodney A Gabriel
Importance: Despite the ease of preoperative anemia diagnosis and the availability of treatment options, the morbidity and mortality associated with this condition remain unacceptably high, and the literature describing the association of preoperative anemia with postoperative outcomes following thyroid surgery in patients with thyroid cancer remain sparse. Reporting outcomes in this patient population may help to facilitate preoperative optimization. Objective: To assess whether an association exists between preoperative anemia and outcomes following thyroid surgery in patients with thyroid cancer...
November 29, 2018: JAMA Otolaryngology—Head & Neck Surgery
Igor Barjaktarevic, Roxana Cortes Lopez, Randolph Steadman, Christopher Wray, Nida Qadir, Steven Y Chang, Tisha Wang
Liver transplantation (LT) has the potential to cure patients with acute and chronic liver failure as well as a number of hepatic and biliary malignancies. Over time, due to the increasing demand for organs as well as improvements in the survival of LT recipients, patients awaiting LT have become sicker, and often undergo the procedure while critically ill. This trend has made the process of preoperative assessment and planning, intraoperative management, and postoperative management even more crucial to the success of LT programs...
October 2018: Seminars in Respiratory and Critical Care Medicine
Jacopo Colombo, Iryna Arendar, Ugo Pastorino, Daniela Codazzi
INTRODUCTION: Thoracic surgery can have serious side effects. Accurate preoperative evaluation to assess which patients with anatomically resectable disease are suitable candidates for surgery is mandatory. CASE DESCRIPTION: A 58-year-old man, scheduled for left pneumonectomy for lung cancer, passed all the preoperative examinations suggested by guidelines and underwent the surgery. Three days after pneumonectomy, he experienced hemorrhagic shock and subsequent acute respiratory distress syndrome...
November 28, 2018: Tumori
X F Tang, Y L Ma, Y Song, J J Xu, H H Wang, L Jiang, P Jiang, R Liu, X Y Zhao, Z Gao, L J Gao, Y Zhang, L Song, J Chen, S B Qiao, Y J Yang, R L Gao, B Xu, J Q Yuan
Objective: To investigate the long-term prognosis of Second generation drug-eluting stents(G2-DES) in diabetic mellitus(DM) and non-DM patients. Methods: Patients with coronary heart disease(CHD) in Fuwai Hospital from January 2013 to December 2013 who had exclusively G2-DES implantation, were consecutively included the follow-up period was 2 years. Results: A total of 6 094 patients with CHD were implanted with G2-DES, of which 1 862 patients with DM, and 4 232 patients without DM.The proportion of DM patients receiving G2-DES implantation with the following characteristics: advanced age, female, hypertension, hyperlipidemia, history of previous stroke, history of peripheral artery disease, previous history of PCI, and with triple vessel, high preoperative Syntax score, high number of target lesions, B2 or C type lesions, severe calcification lesions, and chronic occlusive disease were significantly higher than those of non-DM patients( P <0...
November 20, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Bimal Bhindi, Christine M Lohse, Phillip J Schulte, Ross J Mason, John C Cheville, Stephen A Boorjian, Bradley C Leibovich, R Houston Thompson
BACKGROUND: Partial nephrectomy (PN) is generally favored for cT1 tumors over radical nephrectomy (RN) when technically feasible. However, it can be unclear whether the additional risks of PN are worth the magnitude of renal function benefit. OBJECTIVE: To develop preoperative tools to predict long-term estimated glomerular filtration rate (eGFR) beyond 30d following PN and RN, separately. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective cohort study, patients who underwent RN or PN for a single nonmetastatic renal tumor between 1997 and 2014 at our institution were identified...
November 23, 2018: European Urology
Robert J Ellis, Benjamin Kalma, Sharon J Del Vecchio, Danielle N Aliano, Keng Lim Ng, Goce Dimeski, Li Ma, David Guard, John F Bertram, Christudas Morais, Kimberley Oliver, Simon T Wood, Glenda C Gobe, Ross S Francis
This study evaluated the relationship between histological markers of chronic kidney damage in patients undergoing radical nephrectomy for kidney tumours and preoperative kidney function, degree of albuminuria, and changes in glomerular volume. A schema to grade chronic kidney damage could be used to identify patients at risk of developing CKD following nephrectomy. Non-neoplastic cortical tissue was sourced from 150 patients undergoing radical nephrectomy for suspected kidney cancer. This tissue was evaluated for indicators of chronic damage, specifically: glomerulosclerosis, arteriosclerosis, interstitial fibrosis, and tubular atrophy...
November 23, 2018: Pathology
Antoine Vallois, Benjamin Menahem, Yannick Le Roux, Adrien Lee Bion, Hugo Meunier, Thomas Gautier, Nicolas Contival, Andrea Mulliri, Jean Lubrano, Jean-Jacques Parienti, A Alves
OBJECTIVE: To evaluate the safety and efficacy of revisional Roux-en-Y gastric bypass (RYGB) after adjustable gastric banding (AGB) or sleeve gastrectomy (SG) compared with primary RYGB, in regard to early and late morbidity, weight, and resolution of obesity-related comorbidities. METHODS: The group of patients undergoing revisional RYGB was matched in a 1:1 ratio with control patient who underwent a primary RYGB, based on age, gender, American Society of Anesthesiologist (ASA) score, preoperative body mass index (BMI), and diabetes mellitus...
November 22, 2018: Obesity Surgery
Zubadiah Nor Hanipah, Michael J Mulcahy, Gautam Sharma, Suriya Punchai, Karen Steckner, Raed Dweik, Ali Aminian, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Data regarding the outcomes of bariatric surgery in patients with pulmonary hypertension (PH) is limited. The aim of this study was to review our experience on bariatric surgery in patients with PH. SETTING: An academic medical center. METHODS: Patients with PH who underwent either a primary or revisional bariatric surgery between 2005 and 2015 and had a preoperative right ventricle systolic pressure (RVSP) ≥35 mm Hg were included...
October 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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