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https://www.readbyqxmd.com/read/29792992/frailty-status-as-a-predictor-of-three-month-cognitive-and-functional-recovery-following-spinal-surgery-a-prospective-pilot-study
#1
Robert J Rothrock, Jeremy M Steinberger, Henry Badgery, Andrew C Hecht, Samuel K Cho, John M Caridi, Stacie Deiner
Background Context As increasing numbers of elderly Americans undergo spinal surgery, it is important to identify which patients are at highest risk for poor cognitive and functional recovery. Frailty is a geriatric syndrome which has been closely linked to poor outcomes, and short form screening may be a helpful tool for preoperative identification of at risk patients. Purpose To conduct a pilot study on the usefulness of a short-form screening tool to identify elderly patients at increased risk for prolonged cognitive and functional recovery following elective spine surgery...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792976/simultaneous-bilateral-ureteral-calculi-a-new-paradigm-for-management
#2
Kymora B Scotland, Scott G Hubosky, Ryuta Tanimoto, Robert Cooper, Kelly A Healy, Demetrius H Bagley
OBJECTIVES: To define the need for emergent intervention between patients with SBUC compared to unilateral ureteral calculi (UUC). Patients with simultaneous bilateral ureteral calculi (SBUC) represent a potential urological emergency due to possible anuria and/or electrolyte imbalance. While conventional practice mandates immediate intervention in these patients, little data exist to define the rate of these events. METHODS: Records of all patients with ureteral stones treated ureteroscopically over an 11-year period were reviewed to identify those with SBUC...
May 21, 2018: Urology
https://www.readbyqxmd.com/read/29792853/preoperative-obstructive-sleep-apnea-screening-in-gynecologic-oncology-patients
#3
Ross F Harrison, Erin E Medlin, Chase B Petersen, Stephen L Rose, Ellen M Hartenbach, David M Kushner, Ryan J Spencer, Laurel W Rice, Ahmed N Al-Niaimi
BACKGROUND: Women with a gynecologic cancer tend to be older, obese, and postmenopausal, characteristics that are associated with an increased risk for obstructive sleep apnea. However, there is limited investigation regarding the condition's prevalence in this population or its impact on postoperative outcomes. In other surgical populations, patients with obstructive sleep apnea have been observed to be at increased risk for adverse postoperative events. OBJECTIVES: To estimate the prevalence of obstructive sleep apnea among gynecologic oncology patients undergoing elective surgery and to investigate for a relationship between obstructive sleep apnea and postoperative outcomes...
May 21, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29792835/safety-and-efficacy-of-outpatient-parotidectomy
#4
Andrea Ziegler, Gina Lazzara, Eric Thorpe
PURPOSE: Given the increasing costs of medical care, there has been a shift to outpatient elective surgeries in certain patient populations among all surgical specialties. The goal of this study was to compare the safety and efficacy of outpatient parotidectomy with traditional inpatient parotidectomy. MATERIALS AND METHODS: This is a retrospective chart review of all patients who underwent a parotidectomy at a single tertiary academic center from 2007 through 2017...
May 7, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29792215/adding-left-atrial-appendage-closure-to-open-heart-surgery-provides-protection-from-ischemic-brain-injury-six-years-after-surgery-independently-of-atrial-fibrillation-history-the-laacs-randomized-study
#5
Jesper Park-Hansen, Susanne J V Holme, Akhmadjon Irmukhamedov, Christian L Carranza, Anders M Greve, Gina Al-Farra, Robert G C Riis, Brian Nilsson, Johan S R Clausen, Anne S Nørskov, Christina R Kruuse, Egill Rostrup, Helena Dominguez
BACKGROUND: Open heart surgery is associated with high occurrence of atrial fibrillation (AF), subsequently increasing the risk of post-operative ischemic stroke. Concomitant with open heart surgery, a cardiac ablation procedure is commonly performed in patients with known AF, often followed by left atrial appendage closure with surgery (LAACS). However, the protective effect of LAACS on the risk of cerebral ischemia following cardiac surgery remains controversial. We have studied whether LAACS in addition to open heart surgery protects against post-operative ischemic brain injury regardless of a previous AF diagnosis...
May 23, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29792102/entrusting-internal-medicine-residents-to-use-point-of-care-ultrasound-towards-improved-assessment-and-supervision
#6
Daniel J Schnobrich, Benji K Mathews, Bernard E Trappey, Brian K Muthyala, Andrew P J Olson
BACKGROUND: Internal medicine physicians and trainees are increasingly using, and seeking training in, diagnostic point of care ultrasound (POCUS). Numerous internal medicine training programs have described their curricula, but little has been written about how learners should be assessed, supervised, and allowed to progress toward independent practice, yet these practices are imperative for safe and effective use. Entrustable professional activities (EPAs) offer a practical method to assess observable units of professional work and make supervision decisions...
May 23, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29792086/risk-of-further-surgery-on-the-same-or-opposite-side-and-mortality-after-primary-total-hip-arthroplasty-a-multi-state-analysis-of-133-654-patients-from-the-swedish-hip-arthroplasty-register
#7
Peter H J Cnudde, Szilard Nemes, Erik Bülow, A John Timperley, Sarah L Whitehouse, Johan Kärrholm, Ola Rolfson
Background and purpose - The hip-related timeline of patients following a total hip arthroplasty (THA) can vary. Ideally patients will live their life without need for further surgery; however, some will undergo replacement on the contralateral hip and/or reoperations. We analyzed the probability of mortality and further hip-related surgery on the same or contralateral hip. Patients and methods - We performed a multi-state survival analysis on a prospectively followed cohort of 133,654 Swedish patients undergoing an elective THA between 1999 and 2012...
May 23, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29792077/symptoms-of-ptsd-in-frontline-journalists-a-retrospective-examination-of-18-years-of-war-and-conflict
#8
Anthony Feinstein, Jonas Osmann, Viral Patel
OBJECTIVE: The objective of the current study was to determine the frequency and severity of symptoms of posttraumatic stress disorder (PTSD) in journalists covering conflict. METHODS: PTSD data (Impact of Event Scale-Revised) collected over an 18-year period from 684 conflict journalists were analyzed retrospectively for frequency and severity of reexperiencing, avoidance, and arousal symptoms. Conflicts covered were civil wars in the Balkans ( n = 140 journalists), 9/11 attack in New York City ( n = 46), Iraq war ( n = 84), Mexico drug wars ( n = 104), civil war in Syria ( n = 59), Kenya election violence/Al-Shabab terror ( n = 57), state-sanctioned media intimidation in Iran ( n = 114), and the current migration crisis in Europe ( n = 80)...
January 1, 2018: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29791987/-management-of-patients-on-antithrombotic-agents-undergoing-endoscopy
#9
Joon Sung Kim, Byung Wook Kim
Antithrombotic agents are used increasingly in Asia. The management of patients on antithrombotics undergoing elective or emergency endoscopy has become an increasing clinical challenge for gastroenterologists. Current practice guidelines have been developed by societies from western countries. On the other hand, these guidelines cannot meet the specific needs of the Asian Pacific region, raising the need for separate guidelines in Asia. This review compares the recommendations of previous guidelines with the most recently published Asian guidelines regarding the management of patients on antithrombotic agents undergoing elective and emergency endoscopy...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29791699/a-comparative-effectiveness-study-for-non-operative-treatment-methods-for-knee-osteoarthritis
#10
Frank R Kolisek, Charles Jaggard, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Michael A Mont
A number of non-operative treatment options are commonly prescribed for patients presenting with degenerative osteoarthritis of the knee, where surgery is not yet recommended. However, there is a paucity of studies evaluating the comparative effectiveness of these treatment options to best inform both patients and providers. This study examined the comparative effectiveness of a home exercise program versus bracing or a combination of the two (brace-only, exercise-only, and brace and exercise cohorts) on the following: 1) objective functional measures (quadriceps muscle strength, Self-Paced Walk Test [SPWT], and Timed "Up & Go" [TUG] Test); 2) subjective functional measures (Lower Extremity Function Scale [LEFS] and Health Survey [VR-12] outcomes); 3) pain using Visual Analog Scale [VAS-10]; 4) patient metrics (patient treatment preference, perceptions, and compliance); and 5) progression to total knee arthroplasty (TKA) over a 12-week period...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791655/accuracy-of-sentinel-lymph-node-mapping-in-detecting-occult-neck-metastasis-in-papillary-thyroid-carcinoma
#11
Jose Higino Steck, Elaine Stabenow, Gustavo Baldove Bettoni, Samuel Steck, Claudio Roberto Cernea
OBJECTIVES: The objectives of this study were to evaluate the following: 1) the accuracy of sentinel lymph node mapping (SLNM) in detecting metastasis in papillary thyroid carcinoma (PTC), and 2) if SLNM could modify the American Joint Committee on Cancer (AJCC) staging of previous cN0 PTC patients. SUBJECTS AND METHODS: Forty SLNM were performed prospectively in 38 consecutive cN0 PTC patients, with total thyroidectomy and elective compartment neck dissection (CND)...
May 17, 2018: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29791495/early-prediction-of-contrast-induced-acute-kidney-injury-by-a-bedside-assessment-of-neutrophil-gelatinase-associated-lipocalin-during-elective-percutaneous-coronary-interventions
#12
Annunziata Nusca, Marco Miglionico, Claudio Proscia, Laura Ragni, Massimiliano Carassiti, Francesca Lassandro Pepe, Germano Di Sciascio
Contrast-induced acute kidney injury (CI-AKI) is a serious complication during percutaneous coronary interventions (PCI). Currently, the diagnosis of CI-AKI relies on serum creatinine (SCr) that is however affected by several limitations potentially leading to delayed or missed diagnoses. In this study we examined the diagnostic accuracy of a "bedside" measurement of plasma Neutrophil Gelatinase-Associated Lipocalin (NGAL) in the early detection of CI-AKI in 97 patients undergoing elective PCI. The overall incidence of CI-AKI was 3%...
2018: PloS One
https://www.readbyqxmd.com/read/29791301/the-significance-of-interleukin-6-in-the-early-detection-of-surgical-site-infections-after-definitive-operation-for-gastrointestinal-fistulae
#13
Dongming Zhang, Jianan Ren, Mohamed-Omar Arafeh, Robert G Sawyer, Qiongyuan Hu, Xiuwen Wu, Gefei Wang, Guosheng Gu, Jiang Hu, Mingzhang Li
BACKGROUND: Surgical site infections (SSIs) are among the most common complications after definitive treatment for intestinal fistulae. Serum inflammatory markers including white blood cell count (WBC), C-reactive protein (CRP), interleukin-6 (IL-6), as well as procalcitonin (PCT) have been used to help diagnosis post-operative complications. OBJECTIVE: The goal of this study was to assess the clinical value of inflammatory markers, specifically IL-6, in predicting SSIs after intestinal fistulae resection...
May 23, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29791032/social-egg-freezing-better-early-than-never
#14
Gabriel Levin, Amihai Rottenstreich
We read the commentary by Jones et al. with great interest (1). The authors describe the utilization of an elective oocyte cryopreservation as an opportunity to postpone motherhood. Although the authors delineate a comprehensive overview of the subject, several important issues need further consideration regarding the aforementioned commentary. This article is protected by copyright. All rights reserved.
May 23, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29789971/compliance-with-an-enhanced-recovery-after-a-surgery-program-for-patients-undergoing-gastrectomy-for-gastric-carcinoma-a-phase-2-study
#15
Mi Ran Jung, Seong Yeob Ryu, Young Kyu Park, Oh Jeong
BACKGROUND: Enhanced recovery after surgery (ERAS) programs have gained widespread acceptance in different fields of major surgery. However, most elements of perioperative care in ERAS are based on practices that originated from colorectal surgery. This study investigated compliance with the main elements of ERAS for patients undergoing gastrectomy for gastric carcinoma. METHODS: This phase 2 study enrolled 168 patients undergoing elective gastrectomy for gastric carcinoma...
May 22, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29789606/the-prognostic-value-of-systemic-inflammation-in-patients-undergoing-surgery-for-colon-cancer-comparison-of-composite-ratios-and-cumulative-scores
#16
Ross D Dolan, Stephen T McSorley, James H Park, David G Watt, Campbell S Roxburgh, Paul G Horgan, Donald C McMillan
INTRODUCTION: The systemic inflammatory response has been proven to have a prognostic value. There are two methods of assessing the systemic inflammatory response composite ratios (R) and cumulative scores (S). The aim of this study was to compare the prognostic value of ratios and scores in patients undergoing surgery for colon cancer. METHODS: Patients were identified prospectively in a single surgical unit. Preoperative neutrophil (N), lymphocyte (L), monocyte (M) and platelet (P) counts, CRP (C) and albumin (A) levels were recorded...
May 23, 2018: British Journal of Cancer
https://www.readbyqxmd.com/read/29788192/initial-assessment-of-the-risk-assessment-and-prediction-tool-in-a-heterogeneous-neurosurgical-patient-population
#17
Matthew Piazza, Nikhil Sharma, Benjamin Osiemo, Scott McClintock, Emily Missimer, Diana Gardiner, Eileen Maloney, Danielle Callahan, J Lachlan Smith, William Welch, James Schuster, M Sean Grady, Neil R Malhotra
BACKGROUND: Bundled care payments are increasingly being explored for neurosurgical interventions. In this setting, skilled nursing facility (SNF) is less desirable from a cost perspective than discharge to home, underscoring the need for better preoperative prediction of postoperative disposition. OBJECTIVE: To assess the capability of the Risk Assessment and Prediction Tool (RAPT) and other preoperative variables to determine expected disposition prior to surgery in a heterogeneous neurosurgical cohort, through observational study...
May 21, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29787854/the-role-of-duplex-ultrasound-in-detecting-graft-thrombosis-and-endoleak-after-endovascular-aortic-repair-for-abdominal-aneurysm
#18
Daniela Mazzaccaro, Augusto Farina, Kostantinos Petsos, Giovanni Nano
BACKGROUND: to assess the role of DUS in detecting endoleaks (EL) and graft thrombosis (GT) in a cohort of patients submitted to EVAR for elective infrarenal AAA in two centers. METHODS: Data of all consecutive patients treated in two Operative Unit of Vascular Surgery, from 01/01/2000 to 31/12/2016, were retrospectively collected and evaluated. Follow-up data were analyzed to evaluate survival and device-related complications, both at thirty-day and in the mid-term...
May 19, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29787806/factors-associated-with-post-election-psychological-distress-the-case-of-the-2016-u-s-presidential-election
#19
Shani Pitcho-Prelorentzos, Krzysztof Kaniasty, Yaira Hamama-Raz, Robin Goodwin, Lia Ring, Menachem Ben-Ezra, Michal Mahat-Shamir
This study, through the lens of Social Cognitive Theory, examined potential risk factors that may intensify election-related psychological distress. Six weeks after the 2016 U.S. election, 772 U.S. adult citizens filled out an online survey that assessed psychological distress along with sociodemographic characteristics, and a set of variables tapping various dimensions of political self-efficacy (i.e., importance of politics in one's life, preferences for different media outlets, political directness, and voting choices)...
May 12, 2018: Psychiatry Research
https://www.readbyqxmd.com/read/29787740/conservative-management-following-clinical-complete-response-to-neoadjuvant-chemotherapy-for-muscle-invasive-bladder-cancer-contemporary-outcomes-of-a-multi-institutional-cohort-study
#20
Patrick Mazza, George W Moran, Gen Li, Dennis J Robins, Justin T Matulay, Harry W Herr, Guarionex J Decastro, James M McKiernan, Christopher B Anderson
PURPOSE: We report the outcomes of patients with muscle-invasive bladder cancer from two institutions who experienced a clinical complete response to neoadjuvant platinum-based chemotherapy and opted for active surveillance. It is unknown if conservative management can be safely implemented in these patients. MATERIALS AND METHODS: We performed a retrospective review of patients at Columbia University Medical Center and Memorial Sloan Kettering Cancer Center with muscle-invasive bladder cancer who elected surveillance following a clinical complete response to transurethral resection of bladder tumors and neoadjuvant chemotherapy from 2001-2017...
May 19, 2018: Journal of Urology
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