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Stijn L Steunenberg, Jolanda de Vries, Jelle W Raats, Willem J Thijsse, Nathalie Verbogt, Paul Lodder, Geert-Jan van Eijck, Eelco J Veen, Hans G W de Groot, Gwan H Ho, Lijckle van der Laan
INTRODUCTION: Revascularisation to relieve ischemic pain and prevent limb loss is the cornerstone of critical limb ischemia (CLI) treatment, however not all elderly patients are deemed fit for revascularisation. Patient related outcome measurements are important in these patients. Quality of Life (QoL) results regarding the effect of endovascular, surgical, and conservative treatment on the quality of life (QoL) in the elderly are scarce in current literature. Goal of this study is to explore the outcome of the different treatment modalities in elderly patients suffering from CLI, with a specific focus on QoL...
May 14, 2018: Annals of Vascular Surgery
M H Jonsson, P Bentzer, A Turkiewicz, A Hommel
BACKGROUND: Little is known about accuracy of common risk prediction scores in elderly patients suffering from hip fractures. The objective of this study was to investigate accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) score, Portsmouth-POSSUM (P-POSSUM) score and the Nottingham Hip Fracture Score (NHFS) for prediction of mortality and morbidity in this patient group. METHODS: This was a prospective single centre observational study on 997 patients suffering out-of-hospital cervical, trochanteric or subtrochanteric fracture of the neck of the femur...
April 23, 2018: Acta Anaesthesiologica Scandinavica
K You, R Bendl, C Taut, R Sullivan, M Gachabayov, R Bergamaschi
BACKGROUND: The aim of this RCT was to determine whether elective resection following successful non-operative management of a first episode of acute sigmoid diverticulitis complicated by extraluminal air with or without abscess is superior to observation in terms of recurrence rates. METHODS: This was a single-centre, sequential design RCT. Patients were randomized to elective surgery or observation following non-operative management and colonoscopy. Non-operative management included nil by mouth, intravenous fluids, intravenous antibiotics, CT with intravenous contrast on arrival at hospital, and repeat CT with intravenous and rectal contrast on day 3 in hospital...
April 23, 2018: British Journal of Surgery
J Giles, W Johnson, G Jones, C Heuer, M Dunowska
AIMS: To develop an indirect ELISA based on recombinant nucleocapsid (rN) protein of wobbly possum disease (WPD) virus for investigation of the presence of WPD virus in Australian brushtail possums (Trichosurus vulpecula) in New Zealand. METHODS: Pre- and post-infection sera (n=15 and 16, respectively) obtained from a previous experimental challenge study were used for ELISA development. Sera were characterised as positive or negative for antibody to WPD virus based on western-blot using WPD virus rN protein as antigen...
April 18, 2018: New Zealand Veterinary Journal
David Andrew Gilhooly, Michelle Cole, Suneetha Ramani Moonesinghe
Background: As the prevalence of obesity is increasing, the number of patients requiring surgical intervention for obesity-related illness is also rising. The aim of this pilot study was to explore predictors of short-term morbidity and longer-term poor weight loss after bariatric surgery. Methods: This was a single-centre prospective observational cohort pilot study in patients undergoing bariatric surgery. We assessed the accuracy (discrimination and calibration) of two previously validated risk prediction models (the Physiological and Operative Severity Score for the enumeration of Morbidity and Mortality, POSSUM score, and the Obesity Surgical Mortality Risk Score, OS-MS) for postoperative outcome (postoperative morbidity defined using the Post Operative Morbidity Survey)...
2018: Perioperative Medicine
Sílvia Pinho, Filipa Lagarto, Blandina Gomes, Liliana Costa, Catarina S Nunes, Carla Oliveira
BACKGROUND AND OBJECTIVES: Surgical patients frequently require admission in high-dependency units or intensive care units. Resources are scarce and there are no universally accepted admission criteria, so patients' allocation must be optimized. The purpose of this study was to investigate the relationship between postoperative destination of patients submitted to colorectal surgery and the scores ColoRectal Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM) and Surgical Apgar Score (SAS) and, secondarily find cut-offs to aid this allocation...
March 31, 2018: Revista Brasileira de Anestesiologia
O Peacock, M G Bassett, A Kuryba, K Walker, E Davies, I Anderson, R S Vohra
BACKGROUND: Small bowel obstruction (SBO) is a common indication for emergency laparotomy. There are currently variations in the timing of surgery for patients with SBO and limited evidence on whether delayed surgery affects outcomes. The aim of this study was to evaluate the impact of time to operation on 30-day mortality in patients requiring emergency laparotomy for SBO. METHODS: Data were collected from the National Emergency Laparotomy Audit (NELA) on all patients aged 18 years or older who underwent emergency laparotomy for all forms of SBO between December 2013 and November 2015...
March 30, 2018: British Journal of Surgery
D G McGuckin, S Mufti, D J Turner, C Bond, S R Moonesinghe
Postoperative hospital stay is longer for frail, older patients, who are more likely to experience prolonged postoperative morbidity and reduced long-term survival. We recorded in-hospital mortality, morbidity and length of stay for 164 patients aged at least 65 years after unscheduled surgery. We evaluated pre-operative frailty with the 7-point Clinical Frailty Scale: 81 patients were 'not vulnerable' (frailty score 1-3) and 83 were 'vulnerable or frail' (frailty score ≧ 4), with mean (SD) ages of 74.7 (7...
March 23, 2018: Anaesthesia
Aleksandra Bilska, Jacek Francikowski, Aleksandra Wyglenda, Adrian Masłowski, Natalia Kaszyca, Łukasz Depa
Paper presents the phenomenon of thanatosis or death-feigning in selected aphids species. This specific reaction was predominantly analysed on the example of aphid subfamily Lachninae. Individuals of this group were used in experiments, during which a thanatotic response was induced with various results. The response differed from prolonged thanatosis, lasting for several minutes ( Eulachnus rileyi ), through shrinking behaviour (e. g. in Stomaphis graffii ) to non-responsive species such as Cinara ( Sch i zolachnus ) pineti ...
2018: Journal of Insect Behavior
Maria Emília Carvalho-E-Carvalho, Fábio Lopes DE-Queiroz, Breno Xaia Martins-DA-Costa, Marcelo Giusti Werneck-Côrtes, Vinícius Pires-Rodrigues
OBJECTIVE: to apply the POSSUM and P-POSSUM scores as a tool to predict morbidity and mortality in colorectal surgery. METHODS: we conducted a prospective cohort study of 551 patients submitted to colorectal surgery in a colorectal surgery tertiary referral hospital in Brazil. We grouped patients into pre-established risk categories for comparison between expected and observed morbidity and mortality rates by the POSSUM and P-POSSUM scores. RESULTS: in the POSSUM morbidity analysis, the overall expected morbidity was significantly higher than that observed (39...
2018: Revista do Colégio Brasileiro de Cirurgiões
Sudharsan Madhavan, Vishal G Shelat, Su-Lin Soong, Winston W L Woon, Terence Huey, Yiong H Chan, Sameer P Junnarkar
PURPOSE: Multiple models have attempted to predict morbidity of liver resection (LR). This study aims to determine the efficacy of American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator and the Physiological and Operative Severity Score in the enUmeration of Mortality and Morbidity (POSSUM) in predicting post-operative morbidity in patients who underwent LR. METHODS: A retrospective analysis was conducted on patients who underwent elective LR...
February 7, 2018: Langenbeck's Archives of Surgery
Rizwan Sultan, Hasnain Zafar
OBJECTIVE: To find outcomes of emergency bowel surgery and review the processes involved in the care of these patients on the same template used in National Emergency Laparotomy Audit (NELA). STUDY DESIGN: An audit. PLACE AND DURATION OF STUDY: Surgery Department, The Aga Khan University Hospital, Karachi, from December 2013 to November 2014. METHODOLOGY: Patients undergone emergency bowel surgery during the review period were included...
February 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Andres Mora, Yasuaki Nakajima, Takuya Okada, Yutaka Tokairin, Kenro Kawada, Tatsuyuki Kawano
BACKGROUND/AIM: Esophagectomy is still the best therapeutic option for curing resectable esophageal cancer (EC). Radical surgical resection with three-field lymphadenectomy (3FLD) is a potentially curative treatment option. We compared the predictive accuracy of 5 different scores in patients with EC who underwent 3FLD. METHODS: Five years' worth of medical records in a single institution were analyzed (January 2010 to January 2015) from 311 patients who underwent esophagectomy for EC...
January 30, 2018: Digestive Surgery
Marisa Baré, Manuel Jesús Alcantara, Maria José Gil, Pablo Collera, Marina Pont, Antonio Escobar, Cristina Sarasqueta, Maximino Redondo, Eduardo Briones, Paula Dujovne, Jose Maria Quintana
BACKGROUND: To validate and recalibrate the CR- POSSUM model and compared its discriminatory capacity with other European models such as POSSUM, P-POSSUM, AFC or IRCS to predict operative mortality in surgery for colorectal cancer. METHODS: Prospective multicenter cohort study from 22 hospitals in Spain. We included patients undergoing planned or urgent surgery for primary invasive colorectal cancers between June 2010 and December 2012 (N = 2749). Clinical data were gathered through medical chart review...
January 29, 2018: BMC Health Services Research
L Weinberg, Mhg Li, L Churilov, A Armellini, M Gibney, T Hewitt, C O Tan, R Robbins, D Tremewen, C Christophi, R Bellomo
Fluid administration has been reported to be associated with an increased risk of acute kidney injury (AKI). We assessed whether, after correction for fluid balance, amount and chloride content of fluids administered have an independent association with AKI. We performed an observational study in patients after major surgery assessing the independent association of AKI with volume, chloride content and fluid balance, after adjustment for Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) score, age, elective versus emergency surgery, and duration of surgery...
January 2018: Anaesthesia and Intensive Care
Elizabeth M St Clair, Nicholas Reback, Jonathan M G Perry
Phalangeriform marsupials have often been compared with primates because of similarity in the range of external morphology, ecological niches, and body size between the two radiations. We explore morphological convergence in the masticatory anatomy of strepsirrhine primates and phalangeriforms, through osteological measurements of the mandible and facial skeleton, and through dissection of the masticatory musculature, presenting new data on the arrangement and proportions of jaw adductors in phalangeriforms...
February 2018: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
Alex James, Jeanette C McLeod, Carlos Rouco, Kyle S Richardson, Daniel M Tompkins
While heterogeneity in social behaviour has been described in many human contexts it is often assumed to be less common in the animal kingdom even though scale-free networks are observed. This homogeneity raises the question of whether the patterns of behaviour necessary to account for scale-free social contact networks, where the degree distribution follows a power law, i.e. a few individuals are very highly connected but most have only a few connections, occur in animals, or whether other mechanisms are needed to produce realistic contact network architectures...
December 2017: Royal Society Open Science
Mie Johanne Hansen, Mads F Bertelsen, Androo Kelly, Anders Miki Bojesen
Eighty-two Pasteurellaceae isolates from marsupials characterized by phylogenetic analysis of rpoB gene sequences formed five distinct groups. Twenty-one strains from long-nosed potoroos ( Potorous tridactylus apicalis), spotted-tailed quolls ( Dasyurus maculatus), and eastern quolls ( Dasyurus viverrinus) made up group 1, which classified with Frederiksenia canicola. Group 2, 15 strains from Tasmanian devils ( Sarcophilus harrisii), common wombats ( Vombatus ursinus), common ring-tailed possums ( Pseudocheirus peregrinus), and eastern quolls, grouped with Pasteurella multocida...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Dong Hyun Chun, Do Young Kim, Sun Kyu Choi, Dong Ah Shin, Yoon Ha, Keung Nyun Kim, Do Heum Yoon, Seong Yi
OBJECTIVE: This retrospective case control study aimed to evaluate the feasibility of using Estimation of Physiological Ability and Surgical Stress (E-PASS) and Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) systems in patients undergoing spinal surgical procedures. Degenerative spine disease has increased in incidence in aging societies, as has the number of older adult patients undergoing spinal surgery. Many older adults are at a high surgical risk because of comorbidity and poor general health...
April 2018: World Neurosurgery
Melanie K Laird, Hanon McShea, Christopher R Murphy, Bronwyn M McAllan, Geoff Shaw, Marilyn B Renfree, Michael B Thompson
In mammalian pregnancy, the uterus is remodeled to become receptive to embryonic implantation. Since non-invasive placentation in marsupials is likely derived from invasive placentation, and is underpinned by intra-uterine conflict between mother and embryo, species with non-invasive placentation may employ a variety of molecular mechanisms to maintain an intact uterine epithelium and to prevent embryonic invasion. Identifying such modifications to the uterine epithelium of marsupial species with non-invasive placentation is key to understanding how conflict is mediated during pregnancy in different mammalian groups...
January 2018: Molecular Reproduction and Development
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