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https://www.readbyqxmd.com/read/28110412/prevention-of-cardiac-surgery-associated-aki-by-implementing-the-kdigo-guidelines-in-high-risk-patients-identified-by-biomarkers-the-prevaki-randomized-controlled-trial
#1
Melanie Meersch, Christoph Schmidt, Andreas Hoffmeier, Hugo Van Aken, Carola Wempe, Joachim Gerss, Alexander Zarbock
PURPOSE: Care bundles are recommended in patients at high risk for acute kidney injury (AKI), although they have not been proven to improve outcomes. We sought to establish the efficacy of an implementation of the Kidney Disease Improving Global Outcomes (KDIGO) guidelines to prevent cardiac surgery-associated AKI in high risk patients defined by renal biomarkers. METHODS: In this single-center trial, we examined the effect of a "KDIGO bundle" consisting of optimization of volume status and hemodynamics, avoidance of nephrotoxic drugs, and preventing hyperglycemia in high risk patients defined as urinary [TIMP-2]·[IGFBP7] > 0...
January 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28109762/higher-modified-charlson-index-scores-are-associated-with-increased-incidence-of-complications-transfusion-events-and-length-of-stay-following-revision-hip-arthroplasty
#2
Nikita Lakomkin, Vadim Goz, Claudette M Lajam, Richard Iorio, Joseph A Bosco
BACKGROUND: Revision total hip arthroplasty (RHA) has been associated with greater morbidity and length of stay (LOS) compared to primary total hip arthroplasty. Despite this, few validated metrics exist for risk stratification in RHA cohorts. The Charlson Comorbidity Index (CCI) has been associated with complications in total hip arthroplasty, but its utility in revision surgery remains unexplored. The purpose of this study was to examine the relationship between preoperative CCI and a variety of outcome metrics following RHA...
November 17, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28109466/definitive-proton-beam-therapy-for-adenoid-cystic-carcinoma-of-the-nasopharynx-involving-the-base-of-skull
#3
Michelle S Gentile, Darwin Yip, Norbert J Liebsch, Judith A Adams, Paul M Busse, Annie W Chan
OBJECTIVES: Management of unresectable adenocystic carcinoma (ACC) of the nasopharynx is challenging given the high dose required for tumor control while respecting dose constraints. We evaluated long-term outcomes and toxicity in patients with unresectable ACC of the nasopharynx treated with definitive proton beam therapy. METHODS: Between 2000 and 2013, 14 patients with ACC of the nasopharynx were treated. Ninety-three percent had T4 disease. All had involvement of the skull base...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28109271/influence-of-surgical-approach-on-heterotopic-ossification-after-total-hip-arthroplasty-is-minimal-invasive-better-a-case-control-study
#4
Maya Hürlimann, Filippo-Franco Schiapparelli, Niccolo Rotigliano, Enrique Testa, Felix Amsler, Michael T Hirschmann
BACKGROUND: Heterotopic ossification (HO) is a well-known complication after total hip arthroplasty (THA). Recently, the trend is to operate THA minimally invasive being less traumatic than standard approaches and promising a faster return to activity. The purpose of the study was to investigate if minimal invasive surgery (MIS), leads also to less HO after THA. METHODS: This retrospective study included 134 consecutive patients undergoing THA. In 42 (31.3%) patients a standard modified anterolateral (STD-Watson-Jones), in 28 (20...
January 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28109257/triple-therapy-versus-sequential-therapy-for-the-first-line-helicobacter-pylori-eradication
#5
Ji Young Chang, Ki-Nam Shim, Chung Hyun Tae, Ko Eun Lee, Jihyun Lee, Kang Hoon Lee, Chang Mo Moon, Seong-Eun Kim, Hye-Kyung Jung, Sung-Ae Jung
BACKGROUND: The eradication rate of Helicobacter pylori (H. pylori) with triple therapy which was considered as standard first-line treatment has decreased to 70-85%. The aim of this study is to compare 7-day triple therapy versus 10-day sequential therapy as the first line treatment. METHODS: Data of 1240 H. pylori positive patients treated with triple therapy or sequential therapy from January 2013 to December 2015 were analyzed retrospectively. The patients who had undertaken previous H...
January 21, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28108568/the-role-of-day-one-postoperative-review-of-intraocular-pressure-in-modern-vitrectomy-surgery
#6
Nicholas Brennan, Ian Reekie, Eric Ezra, Keith Barton, Ananth Viswanathan, Mahiul Mk Muqit
BACKGROUND: With the introduction of sutureless 23-gauge (23G) vitrectomy, the risks for elevated intraocular pressure (IOP) and the need for day 1 review of IOP are less certain. AIMS: To assess current practice for postoperative review in the vitreoretinal service at a large tertiary referral centre; to assess whether day 1 review detected complications altering patient management; to identify risk factors for IOP spikes postvitrectomy. METHODS: Retrospective, consecutive case note review of all patients undergoing 23G vitrectomy at the study institution between April and June 2013...
January 20, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28108076/safety-and-effectiveness-of-alveolar-recruitment-maneuvers-and-positive-end-expiratory-pressure-during-general-anesthesia-for-cesarean-section-a-prospective-randomized-trial
#7
D Aretha, F Fligou, P Kiekkas, C Messini, E Panteli, E Zintzaras, M Karanikolas
INTRODUCTION: During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. METHODS: Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH2O and peak airway inspiratory pressure gradually increased to 45-50cmH2O...
December 23, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28108038/the-effect-of-endotracheal-tubes-versus-laryngeal-mask-airways-on-perioperative-respiratory-adverse-events-in-infants-a-randomised-controlled-trial
#8
Thomas F E Drake-Brockman, Anoop Ramgolam, Guicheng Zhang, Graham L Hall, Britta S von Ungern-Sternberg
BACKGROUND: Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the incidence of PRAE in infants. METHODS: We did a randomised controlled trial at the Princess Margaret Hospital for Children in Perth (WA, Australia) by recruiting infants (aged 0-12 months) undergoing general (with or without regional or local) anaesthesia with anticipated fentanyl dose 1 μg/kg or lower for minor elective surgery...
January 17, 2017: Lancet
https://www.readbyqxmd.com/read/28107284/postsurgical-perforation-of-the-esophagus-can-be-treated-using-a-fully-covered-stent-in-children
#9
Chantal Chauvet, Arnaud Bonnard, Alexis Mosca, Marc Bellaïche, Pascale Philippe-Chomette, Jérôme Viala
OBJECTIVES: Surgery and conservative treatment of esophageal or gastric perforations are both often associated with poor results and carry a high morbidity and mortality rate. The aim of the present study was to evaluate the effectiveness and safety of using fully covered self-expending metallic stents (SEMS) in children with upper digestive leaks. METHODS: This retrospective study reviewed all children with esophageal or gastric perforation who were treated with placement of an SEMS from January 2011 to January 2015...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28107231/national-database-research-in-spine-surgery-limitations-in-the-current-literature
#10
Arjun S Sebastian
Many of the studies in the spine surgical literature using national databases have been directed at examining adverse events, readmission rates, cost, and risk factors for poorer outcomes. Although such studies allow for assessment of large cohorts taken from multiple institutions, they are limited by data collection methods, short-term follow-up, and minimal assessment of functional outcomes. Furthermore, few studies are directed at producing actionable practice changes to improve patient care. Recent work aimed at producing databases with more relevance to spine surgery represent exciting developments to the rapidly growing field of health outcomes research...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28106655/transurethral-polyacrylamide-hydrogel-injection-therapy-in-women-not-eligible-for-midurethral-sling-surgery
#11
Daniel Altman, Francesca Ghilotti, Rino Bellocco, Jan Zetterström, Helena Kopp Kallner
OBJECTIVES: This study aims to determine the effects of transurethral polyacrylamide hydrogel injection in patients considered ineligible for midurethral sling surgery. METHODS: In this prospective observational study, 81 patients received treatment with transurethral polyacrylamide hydrogel injection. Patients were considered ineligible for placement of a midurethral sling based on significant comorbidity (48%), 1 or more previously failed invasive treatments (16%), mixed urinary incontinence (27%), continuous incontinence (5%), or previous pelvic radiation therapy (4%)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106354/adding-dexmedetomidine-to-ropivacaine-for-femoral-nerve-block-inhibit-local-inflammatory-response
#12
Jing Li, Hanghui Wang, Buhuai Dong, Jianbing Ma, Xucai Wu
BACKGROUND: Peripheral nerve block has an anti-inflammatory effect that is confirmed in animal studies, while inconclusive in human studies. Dexmedetomidine (DEX), a highly selective α2-adenoceptor agonist, has a potent anti-inflammatory effect. The aim of this study was to evaluate the effect of DEX added to ropivacaine for femoral nerve block (FNB) on local inflammatory response after total knee arthroplasty (TKA). METHODS: Sixty patients scheduled for TKA were randomized into two equal groups in a prospective randomized study...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28105168/relationship-between-mir-7-expression-and-treatment-outcomes-with-gefitinib-in-non-small-cell-lung-cancer
#13
Kun Mou, Weiwei Gu, Cuihua Gu, Jinzhong Zhang, Wenjie Qwang, Gang Ren, Jing Tian
The aim of the present study was to assess the effects of gefitinib chemotherapy on the serum levels of miR-7 in patients with non-small cell lung cancer (NSCLC). A total of 126 patients were enrolled in the present study (stage I-II, n=54 and stage III-IV, n=72). Patients with stage I-II NSCLC underwent surgery in combination with gefitinib chemotherapy, whereas only gefitinib chemotherapy was administered to patients with stage III-IV disease. Serum levels of miR-7 before and after treatment were measured with quantitative polymerase chain reaction using fluorogenic probes, and miR-7 positivity and scoring in resected specimens were determined by immunohistochemistry...
December 2016: Oncology Letters
https://www.readbyqxmd.com/read/28105141/conservative-pharmacotherapy-vs-staged-percutaneous-coronary-intervention-for-non-culprit-vessels-in-patients-with-st-segment-elevation-myocardial-infarction
#14
Bo Zhao, Jianjun Peng, Lihui Ren, Licheng Lei, Zuoyan Wang, Huiming Ye
The present study aimed to compare the effect of conservative pharmacotherapy (CP) and staged percutaneous coronary intervention (SPCI) on significant non-culprit vessels in patients with ST-segment elevation myocardial infarction (STEMI). A total of 266 male and 40 female patients were divided into two groups following their first successful PCI treatment: i) Patients in the complete revascularization (CR) group undergoing SPCI; and ii) patients in the CP group undergoing CP. Follow-up data were collected at 180 or 360 days after surgery to compare the rates of major adverse cardiovascular events (MACE), recurrent myocardial infarction, recurrent angina pectoris and MACE-free survival rates between the two groups...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28104716/source-3-registry-design-and-30-day-results-of-the-european-post-approval-registry-of-the-latest-generation-of-the-sapien-3tm-transcatheter-heart-valve
#15
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Leo Ihlberg, Franz-Josef Neumann, Giuseppe Tarantini, José L Zamorano, Alec Vahanian
BACKGROUND: -The SOURCE 3 Registry is a European multicentre, observational registry of the latest generation of transcatheter heart valve, the SAPIEN 3(TM) (Edwards Lifesciences, Irvine, CA/USA). Its purpose is to document outcomes of clinical safety and performance after European approval was given. METHODS: -In this manuscript we present the 30-day outcome of the SOURCE 3 Registry. All data is self-reported and all participating centres have committed to support their consecutive experience with the SAPIEN 3(TM) transcatheter heart valve, dependent on patients consent, before the start of the study...
January 19, 2017: Circulation
https://www.readbyqxmd.com/read/28100979/late-cardiac-rupture-after-amplatzer-septal-occluder-implantation
#16
Ahmet Arnaz, Yasemin Turkekul, Yusuf Yalcinbas, Arda Saygili, Tayyar Sarioglu
Transcatheter device implantation has become an attractive alternative to surgery in the closure of atrial septal defects in selected patients. However, it can lead to early and late sequelae, some of them life threatening. For example, 79 days before her admission to our emergency department with sudden-onset respiratory distress and respiratory arrest (leading to cardiac tamponade and rupture), a 22-year-old woman had undergone percutaneous closure of an atrial septal defect. We describe the damage and its treatment...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28100522/intraoperative-dexamethasone-does-not-increase-the-risk-of-postoperative-wound-infection-a-propensity-score-matched-post-hoc-analysis-of-the-enigma-ii-trial-endex
#17
T Corcoran, J Kasza, T G Short, E O'Loughlin, M T V Chan, K Leslie, A Forbes, M Paech, P Myles
BACKGROUND: In a post hoc analysis of the ENIGMA-II trial, we sought to determine whether intraoperative dexamethasone was associated with adverse safety outcomes. METHODS: Inverse probability weighting with estimated propensity scores was used to determine the association of dexamethasone administration with postoperative infection, quality of recovery, and adverse safety outcomes for 5499 of the 7112 non-cardiac surgery subjects enrolled in ENIGMA-II. RESULTS: Dexamethasone was administered to 2178 (40%) of the 5499 subjects included in this analysis and was not associated with wound infection [189 (8...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100519/paravertebral-block-in-paediatric-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-trials
#18
E A Page, K L Taylor
The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus been recommended for open cholecystectomy and other less painful surgeries such as inguinal herniorraphy and appendectomy. We performed a systematic review of PVB in paediatric abdominal conditions to assess its clinical efficacy and side effects compared with other analgesic therapies.A search of Medline, Embase, and Web of Science and hand-searching references from inception date to May 2016 was done...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28099691/prospective-observational-study-comparing-traditional-laparoscopy-and-three-dimensional-laparoscopy-in-gynecologic-surgery
#19
Maria D Lara-Domínguez, Araceli López-Jiménez, Jacek P Grabowski, Jose E Arjona-Berral, Ignacio Zapardiel
OBJECTIVE: To compare perioperative details among patients who underwent gynecologic surgery between traditional laparoscopy and three-dimensional laparoscopy. METHOD: The present prospective non-randomized study enrolled all consecutive patients diagnosed with gynecologic pathology who underwent laparoscopic surgery at Reina Sofia Hospital, Cordoba, Spain between January 1 and April 30, 2014. Perioperative data, adverse events, and patient satisfaction were compared between patients who underwent treatment with two-dimensional and three-dimensional laparoscopic surgery techniques...
December 10, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099685/meta-analysis-comparing-the-safety-of-laparoscopic-and-open-surgical-approaches-for-suspected-adnexal-mass-during-the-second-trimester
#20
REVIEW
Yi-Xuan Liu, Yang Zhang, Jin-Feng Huang, Li Wang
BACKGROUND: The safety of laparoscopic surgery during the second trimester of pregnancy remains a controversial subject. OBJECTIVES: To compare the safety of laparoscopic surgery and laparotomy for suspected adnexal mass during the second trimester. SEARCH STRATEGY: Articles published in any language prior to April 31, 2016, were retrieved from PubMed, Scopus, EMBSCO, and the Cochrane Library using keywords including pregnant, adnexal mass, laparoscopy, laparotomy, pregnancy outcomes, and surgical outcomes...
November 25, 2016: International Journal of Gynaecology and Obstetrics
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