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https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#1
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28240759/the-influence-of-residents-in-the-outcome-of-elective-laparoscopic-surgery-a-prospective-study-comparing-a-teaching-hospital-and-a-private-community-hospital-in-italy
#2
E Spaziani, A R Di Filippo, S Orelli, O Tintisona, V Di Girolamo, M Spaziani, P Narilli, M Ottaviani, M Picchio
OBJECTIVES: We compared the outcome of elective laparoscopic cholecystectomy (LC) in a teaching hospital and a private communityhospital to assess the impact of the involvement of residents. MATERIALS AND METHODS: The following parameters were studied prospectively in patients who underwent elective LC during the period from September 2014 to February 2016 in a teaching university hospital (group A) and in a private community hospital (group B): age, sex, body mass index (BMI), comorbidities, American Society of Anaesthesiologists (ASA) score, length of surgery from skin incision to skin closure, use of drain, 30-day perioperative morbidity and mortality, and length of postoperative hospital stay...
January 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28240466/liberal-transfusion-strategies-still-the-trend-in-burn-surgery
#3
N L Allorto, M D T Smith, D L Clarke
OBJECTIVE: Blood is a limited resource in middle-income countries such as South Africa. Transfusion is associated with complications and expense. We aimed to understand our transfusion practices in burn surgery as well as ascertain the opinion of a broader group of surgeons and anaesthetists regarding transfusion triggers in order to understand the rationale and bias that drives current transfusion practice in our setting. METHOD: Firstly, we investigated the current blood practices at our regional burn service through an audit of perioperative notes for all patients receiving packed cell transfusions in a 24-month period...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28240447/comparison-of-treatment-techniques-for-reduction-in-the-submandibular-gland-dose-a-retrospective-study
#4
Christopher Hoyne, Marcus Dreosti, John Shakeshaft, Siddartha Baxi
INTRODUCTION: Recent studies have suggested reducing the dose submandibular glands receive when patients undergo head and neck radiotherapy can play a crucial role in preventing xerostomia. However, they are traditionally not spared due to concern that target coverage may be compromised. We investigated the possibility of sparing the contralateral submandibular gland (cSM) by utilising modern planning techniques. METHODS: 10 head and neck patients previously treated with conformal therapy at our centre were retrospectively planned using intensity modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT)...
February 27, 2017: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/28240005/surgery-for-diverticulitis-in-the-21st-century-recent-evidence
#5
Arden M Morris, Cindy Kin
Sigmoid diverticulitis is an increasingly common disease in Western countries. As technology has led to increased knowledge about the disease and options for treatment, management strategies have become less certain. In previous years, the rationale for early elective surgery was largely preventive, due to concern that diverticulitis recurrence would result in increased risk of sepsis or the need for a colostomy. New technology has enabled diagnosis, through computed tomography scans, predictive information through clinical and administrative databases, and less invasive treatment options, through laparoscopic techniques...
February 24, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28239763/correlation-between-pre-ramadan-glycemic-control-and-subsequent-glucose-fluctuation-during-fasting-in-adolescents-with-type-1-diabetes
#6
B Afandi, W Kaplan, N Al Hassani, S Hadi, A Mohamed
BACKGROUND: Even though patients with type 1 diabetes mellitus (T1DM) are exempted from fasting, the vast majority elect to fast against the advice of their healthcare providers. We have previously reported the incidence of wide fluctuations in blood glucose (BG) along with "unrecognized" severe hypoglycemia during Ramadan fasting in adolescents with T1DM. This report compares the continuous glucose monitoring (CGM) data during fasting in adolescents with T1DM according to their Pre-Ramadan diabetes control...
February 26, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28239571/comparison-of-elective-minimally-invasive-with-conventional-surgical-tracheostomy-in-adults
#7
Rajiv Ranganath Sanji, Chandrakiran Channegowda, Sanjay B Patil
Minimally invasive techniques were used for tracheostomy including small horizontal skin incision, limited soft tissue dissection and no suturing. A Retrospective analysis of case sheets of patients who underwent elective tracheostomy by the first and second authors at M S Ramaiah Hospitals in Bangalore between 1st May 2010 and 1st May 2015 was done to compare the result of elective conventional open surgical tracheostomy using midline vertical skin incision with minimally invasive tracheostomy using a short horizontal incision...
March 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28239497/predictive-factors-for-a-long-hospital-stay-in-patients-undergoing-laparoscopic-cholecystectomy
#8
Wasana Ko-Iam, Trichak Sandhu, Sahattaya Paiboonworachat, Paisal Pongchairerks, Anon Chotirosniramit, Narain Chotirosniramit, Kamtone Chandacham, Tidarat Jirapongcharoenlap, Sunhawit Junrungsee
Background. Although the advantages of laparoscopic cholecystectomy (LC) over open cholecystectomy are immediately obvious and appreciated, several patients need a postoperative hospital stay of more than 24 hours. Thus, the predictive factors for this longer stay need to be investigated. The aim of this study was to identify the causes of a long hospital stay after LC. Methods. This is a retrospective cohort study with 500 successful elective LC patients being included in the analysis. Short hospital stay was defined as being discharged within 24 hours after the operation, whereas long hospital stay was defined as the need for a stay of more than 24 hours after the operation...
2017: International Journal of Hepatology
https://www.readbyqxmd.com/read/28238928/endovascular-and-open-repair-of-ruptured-infrarenal-aortic-aneurysms-at-a-tertiary-care-center
#9
Matthew A Schechter, Luigi Pascarella, Steven Thomas, Richard L McCann, Leila Mureebe
OBJECTIVE: The mortality of ruptured infrarenal abdominal aortic aneurysms (rAAA) has been reported as high as 90%. Loss of consciousness and a systolic blood pressure of < 80mmHg on presentation are the most important predictors of mortality after emergent open repair (OR). Endovascular repair of abdominal aortic aneurysm (EVAR) has reduced short-term operative mortality and morbidity for elective abdominal aortic aneurysm repair, and many be advocated for wider application of EVAR for rAAA...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28238489/laparoscopy-vs-robotic-surgery-for-endometriosis-larose-a-multicenter-randomized-controlled-trial
#10
Enrique Soto, Thanh Ha Luu, Xiaobo Liu, Javier F Magrina, Megan N Wasson, Jon I Einarsson, Sarah L Cohen, Tommaso Falcone
OBJECTIVE: To determine whether the use of the robot for surgical treatment of endometriosis is better than traditional laparoscopy in terms of operative length, perioperative parameters, and quality of life outcomes. DESIGN: Multicenter, randomized clinical trial. SETTING: University teaching hospitals. PATIENT(S): Women aged >18 years with suspected endometriosis who elected to undergo surgical management. INTERVENTION(S): Randomization to conventional or robot-assisted laparoscopic removal of endometriosis...
February 23, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28238321/-cord-accident-after-external-cephalic-version-reality-or-mostly-myth
#11
J Boujenah, C Fleury, I Pharisien, A Benbara, A Tigaizin, A Bricou, L Carbillon
OBJECTIVES: To study the occurrence of cords accident (nuchal cords, prolapse, and braces) after external cephalic version according to its failure or success. METHODS: Retrospective study between 1998-2015 comparing in the cord accident diagnosed at delivery (by midwife or doctors according to mode of delivery): Patients with attempt ECV: Group 1 cephalic presentation after successful ECV with trial of labor, and Group 2 failed ECV followed by elective cesarean or trial of labor...
January 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28237954/what-is-the-influence-of-single-entry-models-on-access-to-elective-surgical-procedures-a-systematic-review
#12
Zaheed Damani, Barbara Conner-Spady, Tina Nash, Henry Tom Stelfox, Tom W Noseworthy, Deborah A Marshall
BACKGROUND: Single-entry models (SEMs) for the management of patients awaiting elective surgical services are designed to increase access and flow through the system of care. We assessed scope of use and influence of SEMs on access (waiting times/throughput) and patient-centredness (patient/provider acceptability). METHODS: Systematic review of articles published in 6 relevant electronic databases included studies from database inception to July 2016. Included studies needed to (1) report on the nature of the SEM; (2) specify elective service and (3) address at least 1 of 3 research questions related to (1) scope of use of SEMs; (2) influence on timeliness and access; (3) patient-centredness and acceptability...
February 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28237645/nonelective-colon-cancer-resection-a-continued-public-health-concern
#13
Christopher T Aquina, Adan Z Becerra, Zhaomin Xu, Francis P Boscoe, Maria J Schymura, Katia Noyes, John R T Monson, Fergal J Fleming
BACKGROUND: Little is known regarding recent trends in the rate of nonelective colon cancer resection in the United States and its impact on both short-term and long-term outcomes. METHODS: The New York State Cancer Registry and Statewide Planning & Research Cooperative System identified stage I-III colon cancer resections from 2004-2011. Propensity-matched analyses assessed differences in short-term adverse outcomes and 5-year disease-specific and overall survival between elective and nonelective colon cancer operations...
February 22, 2017: Surgery
https://www.readbyqxmd.com/read/28237535/a-small-cohort-omega-3-pufa-supplement-study-implications-of-stratifying-according-to-lipid-membrane-incorporation-in-cardiac-surgical-patients
#14
Wendy T K Ip, Chanchal Chandramouli, Julian A Smith, Peter L McLennan, Salvatore Pepe, Lea M D Delbridge
BACKGROUND: Epidemiological studies and randomised clinical trials (RCTs) report disparate findings in relation to omega-3 polyunsaturated fatty acids (n-3 PUFA) benefit for cardiac patients. With RCTs interpretation is potentially confounded by background n-3 PUFA intake. The goal of this pilot, small cohort, pre-surgical supplementation study was to evaluate postoperative atrial fibrillation (AF) and cardiac molecular expression profiles employing two data analysis approaches - by treatment randomisation and by stratification using measured n-3 PUFA...
February 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28237371/pain-locations-in-the-postoperative-period-after-cardiac-surgery-chronology-of-pain-and-response-to-treatment
#15
J Roca, R Valero, C Gomar
INTRODUCTION: Postoperative pain after cardiac surgery (CS) can be generated at several foci besides the sternotomy. METHODS: Prospective descriptive longitudinal study on the chronological evolution of pain in 11 sites after CS including consecutive patients submitted to elective CS through sternotomy. The primary endpoints were to establish the main origins of pain, and to describe its chronological evolution during the first postoperative week. Secondary endpoints were to describe pain characteristics in the sternotomy area and to correlate pain intensity with other variables...
February 22, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28237215/comparison-of-outpatient-vs-inpatient-total-knee-arthroplasty-an-acs-nsqip-analysis
#16
Patawut Bovonratwet, Nathaniel T Ondeck, Stephen J Nelson, Jonathan J Cui, Matthew L Webb, Jonathan N Grauer
BACKGROUND: There has been a recent surge of interest in performing primary total knee arthroplasty (TKA) in the outpatient setting to reduce cost and increase patient satisfaction. Detailed information on the safety of outpatient TKA in large sample sizes is scarce. METHODS: Patients who underwent primary, elective TKA were identified in the 2005-2014 American College of Surgeons National Surgical Quality Improvement Program database. Outpatient procedure was defined as having a hospital length of stay of 0 days, whereas inpatient procedure was defined as having a length of stay ≥1 days...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28237047/percutaneous-cholecystostomy-in-the-management-of-high-risk-patients-presenting-with-acute-cholecystitis-timing-and-outcome-at-a-single-institution
#17
S Zarour, A Imam, G Kouniavsky, G Lin, A Zbar, E Mavor
BACKGROUND: Cholecystectomy is the standard of care in acute cholecystitis (AC). Percutaneous cholecystostomy (PC) is an effective alternative for high-risk surgical cases. METHODS: A retrospective analysis is presented of AC patients treated with PC drainage at a single tertiary institution over a 21 month period, assessing outcome and complications. RESULTS: Of 119 patients, 103 had clinical improvement after PC insertion. There were 7 peri-procedural deaths (5...
February 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28236868/effect-of-dexmedetomidine-in-children-undergoing-general-anesthesia-with-sevoflurane-a-meta-analysis
#18
Marco Aurélio Soares Amorim, Catia Sousa Govêia, Edno Magalhães, Luís Cláudio Araújo Ladeira, Larissa Govêia Moreira, Denismar Borges de Miranda
BACKGROUND AND OBJECTIVES: Sevoflurane is often used in pediatric anesthesia and is associated with high incidence of psychomotor agitation. In such cases, dexmedetomidine (DEX) has been used, but its benefit and implications remain uncertain. We assessed the effects of DEX on agitation in children undergoing general anesthesia with sevoflurane. METHOD: Meta-analysis of randomized clinical and double-blind studies, with children undergoing elective procedures under general anesthesia with sevoflurane, using DEX or placebo...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28236864/a-comparison-of-various-supraglottic-airway-devices-for-fiberoptical-guided-tracheal-intubation
#19
Thomas Metterlein, Anna Dintenfelder, Christoph Plank, Bernhard Graf, Gabriel Roth
BACKGROUND: Fiberoptical assisted intubation via placed supraglottic airway devices has been described as safe and easy procedure to manage difficult airways. However visualization of the glottis aperture is essential for fiberoptical assisted intubation. Various different supraglottic airway devices are commercially available and might offer different conditions for fiberoptical assisted intubation. The aim of this study was to compare the best obtainable view of the glottic aperture using different supraglottic airway devices...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28236863/postoperative-surveillance-in-neurosurgical-patients-usefulness-of-neurological-assessment-scores-and-bispectral-index
#20
Silvia Herrero, Enrique Carrero, Ricard Valero, Jose Rios, Neus Fábregas
BACKGROUND AND OBJECTIVES: We examined the additive effect of the Ramsay scale, Canadian Neurological Scale (CNS), Nursing Delirium Screening Scale (Nu-DESC), and Bispectral Index (BIS) to see whether along with the assessment of pupils and Glasgow Coma Scale (GCS) it improved early detection of postoperative neurological complications. METHODS: We designed a prospective observational study of two elective neurosurgery groups of patients: craniotomies (CG) and non-craniotomies (NCG)...
March 2017: Brazilian Journal of Anesthesiology
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