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https://www.readbyqxmd.com/read/28437812/infection-rate-in-1033-elective-neurosurgical-procedures-at-a-university-hospital-in-south-china
#1
Hongwei Zhu, Xiyao Liu, Zhanxiang Wang
Objective Infection following surgery is a serious complication, especially in neurosurgery. The aim of the study is to report the change of incidence rates of infection in patients undergoing elective neurosurgical procedures at a university hospital in South China as well as the risk factors. Material and Methods The medical records and postoperative courses for patients undergoing 1,033 neurosurgical procedures from 2008 to 2014 were reviewed retrospectively to determine the incidence of neurosurgical infection, the identity of the offending organisms, and the factors associated with infection...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#2
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437506/treatment-of-unstable-trochanteric-femur-fractures-proximal-femur-nail-versus-proximal-femur-locking-compression-plate
#3
Ashutosh Kumar Singh, Nidi Narsaria, Arun G R, Vivek Srivastava
Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients)...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437502/combined-anterior-posterior-decompression-and-fusion-for-cervical-spondylotic-myelopathy
#4
Richard Bram, Susan Fiore, John J Labiak, Raphael P Davis
We conducted a study to evaluate the operative details, perioperative complications, and short-term outcomes associated with combined anterior-posterior decompression and fusion (CAPDF) for treating cervical spondylotic myelopathy (CSM). We retrospectively reviewed the charts of 21 patients who underwent CAPDF at our institution. Pertinent information, including demographics, surgery indication, perioperative complications, operative time, levels fused (and number of levels fused) anteriorly and posteriorly, estimated blood loss, and length of stay, was gathered...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437372/heart-rate-modification-of-cardiac-output-following-cardiac-surgery-the-importance-of-cardiac-time-intervals
#5
Guido Tavazzi, Andy Kontogeorgis, Fabio Guarracino, Niels Bergsland, Ana Martinez-Naharro, John Pepper, Susanna Price
OBJECTIVES: Inadequate cardiac output is associated with a poor outcome following cardiac surgery and is generally modified by the use of positive inotropic agents, volume resuscitation, and pacing. Echocardiography-guided pacemaker optimization is used in the outpatient setting, using different variables including total isovolumic time and the Tei index. We sought to determine the acute impact of heart rate on cardiac electromechanics, cardiac output, and stroke volume in the perioperative setting...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437266/gelfoam-interposition-minimizes-risk-of-fistula-and-postoperative-bleeding-in-modified-furlow-palatoplasty
#6
Jing Li, Patrick A Gerety, James Johnston, Jesse A Taylor
Failure to accomplish a tension-free, watertight closure predisposes the palatoplasty patient to fistula formation. Perioperative bleeding also places the patient at risk for adverse airway events (AAE). This study introduces the incorporation of a hemostatic gelatin sponge (Gelfoam) into layered palatoplasty to minimize adverse postoperative bleeding and fistula formation. A retrospective chart review was performed to identify subjects who underwent Furlow palatoplasty with insertion of Gelfoam from 2010 to 2015...
April 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28437021/optimal-outcome-achievement-in-partial-nephrectomy-for-t1-renal-masses-a-contemporary-analysis-of-open-and-robotic-cases
#7
Matthew J Maurice, Daniel Ramirez, Önder Kara, Ercan Malkoç, Ryan J Nelson, Khaled Fareed, Robert J Stein, Amr F Fergany, Jihad H Kaouk
OBJECTIVES: To compare optimal outcome achievement between open and robotic partial nephrectomy. PATIENTS AND METHODS: Using our institutional partial nephrectomy database, we reviewed 605 cases performed for unifocal clinical T1 renal masses in non-solitary kidneys from 2011-2015. Tetrafecta, which was defined as negative surgical margins, freedom from perioperative complications, ≥80% renal functional preservation, and no chronic kidney disease upstaging, was chosen as the composite optimal outcome...
April 24, 2017: BJU International
https://www.readbyqxmd.com/read/28436355/quantification-of-risk-factors-in-500-patients-with-postoperative-urinary-retention
#8
Peter N Tsambarlis, Benjamin A Sherer, Karl F Godlewski, Rebecca M Deal, Jonathan A Myers, Leslie A Deane
INTRODUCTION: An Institutional Quality and Safety Initiative to reduce postoperative urinary retention (POUR) and improve patient safety indicators (PSIs) was undertaken after a nurse driven protocol for catheter removal lead to an increase in POUR. The aim of this study was to identify the number of risk factors present in patients with POUR while examining the prevalence of those risk factors individually. MATERIALS AND METHODS: A retrospective review of our institution's surgical database was performed to identify 500 consecutive cases of POUR between July 1, 2013 and July 1, 2014...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28436074/an-evaluation-of-the-mixed-pediatric-unit-for-blood-loss-replacement-in-pediatric-craniofacial-surgery
#9
Stefan Mogensen, Norbert Lubenow, Pelle Nilsson, Henrik Engquist, Folke Knutsson, Per Enblad, Daniel Nowinski, Peter Frykholm
BACKGROUND: Surgical correction for craniosynostosis is often associated with significant perioperative hemorrhage. We implemented a transfusion strategy with a strict protocol including transfusion triggers, frequent assessment of coagulation tests, and the use of a novel transfusion unit, the mixed pediatric unit. AIM: The aim of the study was to evaluate if the applied transfusion strategy could reduce total blood loss and number of blood donors. METHODS: Children <1 year old admitted for craniosynostosis surgery were included for the study...
April 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28435322/spinal-anesthesia-after-intraoperative-cardiac-arrest-during-general-anesthesia-in-an-infant
#10
Emmett E Whitaker, Veronica Miler, Jason Bryant, Stephanie Proicou, Rama Jayanthi, Joseph D Tobias
Although generally safe and effective, severe perioperative complications, including cardiac arrest, may occur during general anesthesia in infants. With the emergence of evidence that specific anesthetic agents may affect future neurocognitive outcomes, there has been an increased focus on alternatives to general anesthesia, including spinal anesthesia. We present a case of cardiac arrest during general anesthesia in an infant who required urologic surgery. During the subsequent anesthetic care, spinal anesthesia was offered as an alternative to general anesthesia...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28434811/predicting-and-planning-for-siea-flap-utilisation-in-breast-reconstruction-an-algorithm-combining-pre-operative-computed-tomography-analysis-and-intra-operative-angiosome-assessment
#11
Francis P Henry, Daniel P Butler, Simon H Wood, Navid Jallali
BACKGROUND: Low flap complication rates and excellent aesthetic outcomes are now commonplace in breast reconstruction. As a result, attention is now being focussed on minimising donor site morbidity. Despite its potential donor site advantages, the superficial inferior epigastric artery (SIEA) flap is often discounted, given concerns about the high flap failure rates. In this study, we present our experience of using the SIEA flap in breast reconstruction and provide an algorithm based on pre-operative computed tomography angiography (CTA) to aid pre-operative planning...
April 8, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28434547/stress-dose-corticosteroid-versus-placebo-in-neonatal-cardiac-operations-a-randomized-controlled-trial
#12
Pertti K Suominen, Juho Keski-Nisula, Tiina Ojala, Paula Rautiainen, Timo Jahnukainen, Johanna Hästbacka, Pertti J Neuvonen, Olli Pitkänen, Jussi Niemelä, Anu Kaskinen, Jukka Salminen, Risto Lapatto
BACKGROUND: Corticosteroids can improve the hemodynamic status of neonates with postoperative low cardiac output syndrome after cardiac operations. This study compared a prophylactically administered stress-dose corticosteroid (SDC) regimen against placebo on inflammation, adrenocortical function, and hemodynamic outcome. METHODS: Forty neonates undergoing elective open heart operations were randomized into two groups. The SDC group received perioperatively 2 mg/kg methylprednisolone, and 6 hours after the operation, a hydrocortisone infusion (0...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433509/transcutaneous-aortic-valve-implantation-using-the-carotid-artery-access-feasibility-and-clinical-outcomes
#13
Zacharenia Kallinikou, Alexandre Berger, Patrick Ruchat, Gregory Khatchatourov, Isabelle Fleisch, Branislav Korkodelovic, Emmanuel Henchoz, René-Andréas Marti, Stéphane Cook, Mario Togni, Jean-Jacques Goy
BACKGROUND: Transcarotid access is an alternative route for transcutaneous aortic valve implantation (TAVI) in patients with impossible transfemoral access. AIMS: We evaluated the safety, effectiveness and early and late clinical outcomes of CoreValve(®) implantation via the common carotid artery. METHODS: Eighteen patients (10 men, 8 women; mean age 84±5 years) at high surgical risk (mean EuroSCORE II 16±13%) with significant peripheral artery disease underwent TAVI via common carotid artery access under general anaesthesia...
April 19, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28433494/patterns-of-care-and-clinical-outcomes-in-primary-oesophageal-gastrointestinal-stromal-tumours-gist-a-retrospective-study-of-the-french-sarcoma-group-fsg
#14
F Duffaud, P Meeus, F Bertucci, J-B Delhorme, E Stoeckle, N Isambert, E Bompas, J Gagniere, O Bouché, M Toulmonde, S Salas, J-Y Blay, S Bonvalot
BACKGROUND: Oesophageal GIST (ESOGIST) are very rare tumours requiring special consideration regarding diagnosis, surgical management, and perioperative treatment. METHODS: A retrospective study was conducted across 9 centres in the French Sarcoma Group (FSG) to characterize all patients in the years 2000-2014. RESULTS: Seventeen patients (pts) with primary localized ESOGIST were identified, with median age 69 years (36-81) and 11 females...
April 1, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28433385/perioperative-risks-of-narcolepsy-in-patients-undergoing-general-anesthesia-a-case-control-study
#15
Alexandre N Cavalcante, Ryan E Hofer, Maja Tippmann-Peikert, Juraj Sprung, Toby N Weingarten
STUDY OBJECTIVE: To compare the perioperative outcomes between patients with narcolepsy and matched controls undergoing anesthetic management. DESIGN: Retrospective 2:1 matched study design. SETTING: Large tertiary medical center. PATIENTS: Narcoleptic patients who underwent general anesthesia from January 1, 2011, through September 30, 2015, were matched with controls by age, sex, and type and year of surgery. MEASUREMENTS: Medical records were reviewed for episodes of respiratory depression during phase I recovery and for other meaningful perioperative outcomes...
April 19, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28433338/morbidity-of-endovascular-abdominal-aortic-aneurysm-repair-is-directly-related-to-diameter
#16
Douglas M Overbey, Natalia O Glebova, Brandon C Chapman, Patrick W Hosokawa, John C Eun, Mark R Nehler
OBJECTIVE: Previous randomized controlled trials have defined specific size thresholds to guide surgical decision-making in patients presenting with an abdominal aortic aneurysm (AAA). With recent advances in endovascular techniques, the anatomic considerations of AAA repair are rapidly changing. Our specific aims were to evaluate the most recent national population data to compare anatomic differences and perioperative outcomes in patients with AAA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program was queried from 2011 to 2015 using the targeted vascular public use file...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28433337/increased-resource-utilization-and-overall-morbidity-are-associated-with-general-versus-regional-anesthesia-for-carotid-endarterectomy-in-data-collected-by-the-michigan-surgical-quality-collaborative
#17
Ahmad S Hussain, Andrew Mullard, William F Oppat, Kevin D Nolan
OBJECTIVE: Advocates for performing carotid endarterectomy (CEA) under regional anesthesia (RA) cite reduction in hemodynamic instability and the ability for neurologic monitoring, but many still prefer general anesthesia (GA) as benefits of RA have not been clearly demonstrated, reliable RA may not be available in all centers, and a certain amount of movement by the patient during the procedure may not be uniformly tolerated. We evaluated the association of anesthesia type and perioperative morbidity and mortality as well as resource utilization in patients undergoing CEA using the Michigan Surgical Quality Collaborative (MSQC) database...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28433333/effects-of-hospital-safety-net-burden-and-hospital-volume-on-failure-to-rescue-after-open-abdominal-aortic-surgery
#18
Eric B Rosero, Girish P Joshi, Abu Minhajuddin, Carlos H Timaran, J Gregory Modrall
OBJECTIVE: Failure to rescue (FTR) is defined as the inability to rescue a patient from major perioperative complications, resulting in operative mortality. FTR is a known contributor to operative mortality after open abdominal aortic surgery. Understanding the causes of FTR is essential to designing interventions to improve perioperative outcomes. The objective of this study was to determine the relative contributions of hospital volume and safety-net burden (the proportion of uninsured and Medicaid-insured patients) to FTR...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28433247/outpatient-laparoscopic-appendectomy-feasible-in-a-public-county-hospital
#19
David R Rosen, Kenji Inaba, Paul J Oh, Adam C Gutierrez, Aaron M Strumwasser, Subarna Biswas, Melody Cala, Glenn T Ault
BACKGROUND: Outpatient laparoscopic appendectomy is being used increasingly as a treatment option for acute, uncomplicated appendicitis. This was a prospective validation study in a large, urban, public safety-net hospital. STUDY DESIGN: From 2014 to 2016, all patients undergoing laparoscopic appendectomy for acute, uncomplicated appendicitis were enrolled in a prospective observational trial. Standard baseline perioperative practice (control group) was documented for 1 year...
March 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28433225/adjuvant-chemotherapy-is-associated-with-improved-survival-in-locally-invasive-node-negative-non-small-cell-lung-cancer
#20
Usman Ahmad, Traves D Crabtree, Aalok P Patel, Daniel Morgensztern, Cliff G Robinson, A Sasha Krupnick, Daniel Kreisel, David R Jones, G Alexander Patterson, Bryan F Meyers, Varun Puri
BACKGROUND: The objectives of this study are to explore factors that are associated with use of adjuvant chemotherapy and to evaluate its impact on overall survival in node-negative patients who undergo lung and chest wall resection for non-small cell lung cancer (NSCLC). METHODS: Patients who underwent concomitant lung and chest wall resection for NSCLC were abstracted from the National Cancer Database. Clinical, pathologic, treatment, and follow-up data were obtained...
April 19, 2017: Annals of Thoracic Surgery
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