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https://www.readbyqxmd.com/read/30095652/risk-factors-for-increased-postoperative-drainage-of-calcaneal-fractures-after-open-reduction-and-internal-fixation-an-observational-study
#1
Zitao Zhang, Zhen Wang, Yan Zhang, Xusheng Qiu, Yixin Chen
Sufficient drainage is very important for preventing wound complications after open reduction and internal fixation (ORIF) of calcaneal fractures. However, the drainage amount varies among patients. The objective of this study was to identify factors associated with increased postoperative drainage after ORIF of calcaneal fractures.A retrospective study including 87 patients with 92 calcaneal fractures in our hospital was performed. Patients were divided into 2 groups based on whether they had increased drainage, which was defined as a total drainage of ≥340 mL (50th percentile)...
August 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30094585/investigation-of-intraoperative-dosing-patterns-of-neuromuscular-blocking-agents
#2
Sarah Palsen, Albert Wu, Sascha S Beutler, Robert Gimlich, H Keri Yang, Richard D Urman
There is a growing body of literature documenting the use of deep neuromuscular block (NMB) during surgery. Traditional definitions of depth of NMB rely on train-of-four assessment, which can be less reliable in retrospective studies. The goal of our study was to investigate the real-world practice pattern of dosing of neuromuscular blocking agents (NMBA), utilizing the amount of NMBA used during the course of a case, adjusted for patient weight and case duration, as a surrogate measure of depth of NMB. We also aimed to identify case factors associated with larger NMBA doses...
August 9, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/30094271/patient-and-procedure-specific-variables-driving-total-direct-costs-of-outpatient-anterior-cruciate-ligament-reconstruction
#3
Michael R Karns, Daniel L Jones, Dane C Todd, Travis G Maak, Stephen K Aoki, Robert T Burks, Minkyoung Yoo, Richard E Nelson, Patrick E Greis
Background: Few studies have investigated the influence of patient-specific variables or procedure-specific factors on the overall cost of anterior cruciate ligament reconstruction (ACLR) in an ambulatory surgery setting. Purpose: To determine patient- and procedure-specific factors influencing the overall direct cost of outpatient arthroscopic ACLR utilizing a unique value-driven outcomes (VDO) tool. Study Design: Cohort study (economic and decision analysis); Level of evidence, 3...
August 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/30088725/impact-of-patient-position-on-the-outcomes-of-percutaneous-neprolithotomy-for-complex-kidney-stones
#4
Fabio Carvalho Vicentini, Rodrigo Perrella, Vinicius M G Souza, Marcelo Hisano, Claudio Bovolenta Murta, Joaquim Francisco de Almeida Claro
PURPOSE: To evaluate the impact of the patient position on the outcomes of PCNL among patients with complex renal stones. MATERIAL AND METHODS: From July 2011 to July 2014, we collected prospective data of consecutive patients who underwent PCNL. We included all patients with complex stones (Guy's Stone Score 3 or 4 (GSS) based on a CT scan) and divided them based on the position used during PCNL (prone or supine). The variables analyzed were gender, age, body mass index, ASA score, stone diameter, GSS, number of punctures, calyx puncture site, intercostal access and patient positioning...
July 30, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/30086145/diffusion-weighted-imaging-versus-short-tau-inversion-recovery-sequence-usefulness-in-detection-of-active-sacroiliitis-and-early-diagnosis-of-axial-spondyloarthritis
#5
Chiu Wai Shirley Chan, Helen Hoi Lun Tsang, Philip Hei Li, Kam Ho Lee, Chak Sing Lau, Pui Yan Stella Wong, Ho Yin Chung
OBJECTIVE: To compare the utility of Diffusion weighted imaging (DWI) with short tau inversion recovery (STIR) sequence in the diagnosis of early axial spondyloarthritis (SpA). METHODS: Three hundred and five patients with chronic back pain were recruited consecutively from 3 rheumatology centers. Clinical, radiological and blood parameters were recorded. Patients with back pain duration no more than 3 years were classified as having early disease. STIR sequence and DWI of the sacroiliac joints were obtained and assessed using the Spondyloarthritis Research Consortium of Canada (SPARCC) method...
2018: PloS One
https://www.readbyqxmd.com/read/30086058/management-of-large-cecal-polyps-when-can-the-ileocecal-valve-be-spared
#6
Audrey S Kulaylat, Melissa M Boltz, Matthew Moyer, Abraham Mathew, Kevin McKenna, Evangelos Messaris
BACKGROUND: Endoscopic mucosal resection comprises the first-line treatment for large cecal polyps. With up to 14% of unresectable colonic polyps harboring malignancy, the management of endoscopically unresectable cecal polyps remains an oncologic right hemicolectomy, which can be associated with substantial postoperative morbidity. OBJECTIVE: This study compares the outcomes of patients with cecal polyps who underwent either endoscopic mucosal resection, a cecectomy, or a right hemicolectomy...
September 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/30083338/screening-colonoscopy-and-risk-of-adverse-events-among-individuals-undergoing-fecal-immunochemical-testing-in-a-population-based-program-a-nested-case-control-study
#7
Eunate Arana-Arri, Natale Imaz-Ayo, Mari Jose Fernández, Isabel Idigoras, Isabel Bilbao, Luis Bujanda, Fidencio Bao, Enrique Ojembarrena, Ines Gil, Iñaki Gutiérrez-Ibarluzea, Isabel Portillo
Background: Screening by means of biennial fecal occult blood test has provided a reduction in overall colorectal cancer mortality. Notwithstanding, we should not underestimate the harms that it can produce. Aim: The aim of this article is to identify the independent risk factors of complications after a screening colonoscopy. Methods: A six-year, nested case-control study was conducted. Mortality/complications within 30 days after colonoscopy were registered and its predictors identified through logistic regression...
June 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/30082109/incidence-and-risk-factors-associated-with-infection-after-intramedullary-nailing-of-femoral-and-tibial-diaphyseal-fractures-prospective-study
#8
Priscila R Oliveira, Marcos C Leonhardt, Vladimir C Carvalho, Kodi E Kojima, Jorge S Silva, Flavia Rossi, Ana Lucia L Lima
BACKGROUND: Diaphyseal fractures of femur and tibia are prominent due to its high incidence and high economic and social impact. Intramedullary nailing (IN) is the surgical procedure of choice. Surgical site infection (SSI) related to this procedure is considered a difficult to treat complication. AIMS: Determine the incidence of SSI after IN of femoral and tibial diaphyseal fractures and evaluate possible risk factors. METHODS: Prospective observational cohort study...
July 27, 2018: Injury
https://www.readbyqxmd.com/read/30080985/hemiarthroplasty-and-total-hip-arthroplasty-in-30-830-patients-with-hip-fractures-data-from-the-dutch-arthroplasty-register-on-revision-and-risk-factors-for-revision
#9
Sophie Moerman, Nina M C Mathijssen, Wim E Tuinebreijer, Anne J H Vochteloo, Rob G H H Nelissen
Background and purpose - In the Netherlands about 40% of hip fractures are treated with a hemiarthroplasty (HA) or a total hip arthroplasty (THA). Although these procedures are claimed to have fewer complications than osteosynthesis (i.e., reoperation), complications still occur. Analyses of data from national registries with adequate completeness of revision surgery are important to establish guidelines to diminish the risk for revision. We identified risk factors for revision. Patients and methods - All patients older than 50 years of age with a hip fracture treated with arthroplasty by orthopedic surgeons and registered in the (national) Dutch arthroplasty register (LROI) were included in the study...
August 6, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/30067180/propofol-administration-by-endoscopists-versus-anesthesiologists-in-gastrointestinal-endoscopy-a-systematic-review-and-meta-analysis-of-patient-safety-outcomes
#10
Julian F Daza, Carolyn M Tan, Ryan J Fielding, Allison Brown, Forough Farrokhyar, Ilun Yang
BACKGROUND: With a growing demand for endoscopic services, the role of anesthesiologists in endoscopy units must be reassessed. The aim of this study was to compare patient outcomes in non-anesthesiologist-administered propofol (NAAP) versus anesthesiologist-administered propofol (AAP) during routine endoscopy. METHODS: We systematically searched MEDLINE, CINAHL, Embase, Web of Science, CENTRAL and the grey literature for studies comparing NAAP and AAP. Primary outcomes included endoscopy- and sedation-related complications...
August 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/30066068/the-association-of-body-mass-index-with-postoperative-outcomes-after-elective-paraesophageal-hernia-repair
#11
Samuel Torres Landa, Jordana B Cohen, Robert A Swendiman, Chris Wirtalla, Daniel T Dempsey, Kristoffel R Dumon
PURPOSE: To evaluate the association between body mass index (BMI) and postoperative outcomes in elective paraesophageal hernia (PEH) repairs. METHODS: A retrospective review of patients who underwent elective PEH repair in the ACS NSQIP database (2005-2015) was performed. Patients were stratified into BMI groups (< 18.5, 18.5-24.9, 25.0-29.9, 30.0-34.9, 35-39.9, and ≥ 40.0 kg/m2 ) according to the World Health Organization classification criteria. A multivariable logistic regression model was developed to characterize the association between BMI class and outcomes, including readmission, reoperation, postoperative complications, and mortality...
July 31, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/30065783/the-abdominal-wall-hernia-in-cirrhotic-patients-a-historical-challenge
#12
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Sofia Campanella, Nicolò Falco, Gregorio Scerrino, Sebastiano Bonventre, Girolamo Geraci, Gianfranco Cocorullo, Gaspare Gulotta
Background: The incidence rate of abdominal wall hernia is 20-40% in cirrhotic patients. A surgical approach was originally performed only if complication signs and symptoms occurred. Several recent studies have demonstrated the usefulness of elective surgery. During recent decades, the indications for surgical timing have changed. Methods: Cirrhotic patients with abdominal hernia who underwent surgical operation for abdominal wall hernia repair at the Policlinico "Paolo Giaccone" at Palermo University Hospital between January 2010 and September 2016 were identified in a prospective database, and the data collected were retrospectively reviewed; patients' medical and surgical records were collected from charts and surgical and intensive care unit (ICU) registries...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/30049676/femoral-neuropathy-following-a-psoas-hitch-vesicopexy
#13
Caspar Müller, Elvira Esmeralda van Houwelingen, Frank Huygen
A 68-year-old man classified as III on the American Society of Anaesthesiologists (ASA) physical status classification system, with a high-grade papillary urothelial cell carcinoma of the left distal ureter, underwent open retroperitoneal distal ureterectomy followed by a ureteroneocystostomy with a vesico-psoas hitch. Postoperatively, the patient complained of left proximal lower limb weakness, severe pain and hypaesthesia of the ventral left thigh suggestive of femoral neuropathy. After excluding common causes for postsurgical pain, a surgical re-exploration was eventually performed during which the sutures used in the vesicopexy were removed, resulting in almost complete resolution of the symptoms...
July 25, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/30049276/incidence-and-risk-factors-of-postoperative-delirium-in-the-elderly-patients-with-hip-fracture
#14
Chen-Guang Wang, Ya-Fei Qin, Xin Wan, Li-Cheng Song, Zhi-Jun Li, Hui Li
BACKGROUND: To investigate the incidence and related risk factors of delirium in elderly patients with hip fracture. METHODS: This is a retrospective study, performed in a medical center from October 2014 to February 2017, which enrolled all subjects aged over 65 years who were admitted for hip surgeries (hip arthroplasty, proximal femoral nail fixation). Univariate and multivariate logistic analysis was used to determine the incidence and risk factors of delirium...
July 27, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/30039388/development-of-novel-prognostic-models-for-predicting-complications-of-urethroplasty
#15
Brenton N Armstrong, Audrey Renson, Lee C Zhao, Marc A Bjurlin
INTRODUCTION AND OBJECTIVE: To identify predictors of thirty-day perioperative complications after urethroplasty and create a model to predict patients at increased risk. METHODS: We selected all patients recorded in the National Surgery Quality Improvement Program (NSQIP) from 2005 to 2015 who underwent urethroplasty, determined by Current Procedural Terminology (CPT) codes. The primary outcome of interest was a composite 30-day complication rate. To develop predictive models of urethroplasty complications we used random forest and logistic regression with tenfold cross-validation employing demographic, comorbidity, laboratory, and wound characteristics as candidate predictors...
July 23, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/30039178/-validation-of-the-german-translation-of-the-asas-health-index-a-questionnaire-to-assess-functioning-and-health-in-patients-with-spondyloarthritis
#16
U Kiltz, J Winter, M Schirmer, X Baraliakos, J Braun
INTRODUCTION: The aim of this study was the validation of the German translation of the ASAS Health Index (ASAS HI), which measures functioning and health in patients with axial and peripheral spondyloarthritis (SpA). METHOD: Patients with SpA who fulfilled the ASAS classification criteria for axial (axSpA) or peripheral SpA (pSpA) were included in this study. Constuct validity of the ASAS HI was tested by using Spearman's correlation coefficients. Reliability was analyzed by intraclass correlation coefficients (ICC) in patients with stable disease...
July 23, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/30021075/30-day-readmission-following-outpatient-rotator-cuff-repair-an-analysis-of-18-061-cases
#17
Lindsay R Kosinski, Joseph A Gil, Wesley M Durand, Steven F DeFroda, Brett D Owens, Alan H Daniels
OBJECTIVES: The purpose of this study is to identify patient characteristics that increase risk for unplanned readmission within 30 days of an initial hospital stay after outpatient rotator cuff repair (RCR). METHODS: A retrospective cohort study was performed utilizing the National Surgical Quality Improvement Program (ACS NSQIP) datasets from 2012 to 2015. Patients were preliminarily included in the study based on the presence of a primary Common Procedural Terminology code for RCR (23410, 23412, 23420, and 29827)...
July 27, 2018: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/30010068/predictors-of-nonneurologic-complications-and-increased-length-of-stay-after-cervical-spine-osteotomy
#18
J Mason DePasse, Wesley Durand, Alan H Daniels
BACKGROUND: Although previous studies have used National Surgical Quality Improvement Program (NSQIP) data to study complications of thoracolumbar spinal deformity surgery, investigation of cervical spine deformity surgery has been limited. We performed a retrospective analysis of the NSQIP database to identify predictors of complications after cervical spine osteotomy. METHODS: Patients undergoing cervical spine osteotomy were identified in the NSQIP dataset using Current Procedural Terminology codes from years 2007-2016...
August 2, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30006232/is-prophylactic-nasogastric-tube-decompression-necessary-in-patients-undergoing-laparoscopic-adrenalectomy-for-unilateral-benign-adrenal-tumor
#19
Kuan-Ting Chen, Vin-Cent Wu, Kwan-Dun Wu, Kuo-How Huang
BACKGROUND/PURPOSE: This study aims to investigate the safety and feasibility of laparoscopic adrenalectomy for benign adrenal tumor without peri-operative NGT decompression. METHODS: From July 2010 to March 2014, 82 consecutive patients with benign unilateral adrenal tumor underwent elective laparoscopic adrenalectomy by a single surgeon were recruited for this study. We compared the clinico-demographic profile, estimated blood loss, operative time, time to full diet, time to ambulate, the length of hospital staying, analgesics use and complications between two groups stratified by the use of NGT...
July 10, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/30004572/antiplatelet-and-anticoagulant-agents-for-primary-prevention-of-thrombosis-in-individuals-with-antiphospholipid-antibodies
#20
REVIEW
Malgorzata M Bala, Elżbieta Paszek, Wiktoria Lesniak, Dorota Wloch-Kopec, Katarzyna Jasinska, Anetta Undas
BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune disease characterised by the presence of antiphospholipid (aPL) antibodies that have prothrombotic activity. Antiphospholipid antibodies are associated with an increased risk of pregnancy complications (recurrent miscarriage, premature birth, intrauterine growth retardation) and thrombotic events (both arterial and venous). The most common thrombotic events include brain ischaemia (stroke or transient ischaemic attack) and deep vein thrombosis...
July 13, 2018: Cochrane Database of Systematic Reviews
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