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Preoperative optimization

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https://www.readbyqxmd.com/read/28095024/pathologic-subtypes-of-ampullary-adenocarcinoma-value-of-ampullary-mdct-for-noninvasive-preoperative-differentiation
#1
Aleksandar M Ivanovic, Francesco Alessandrino, Ruzica Maksimovic, Marjan Micev, Slavenko Ostojic, Richard M Gore, Koenraad J Mortele
OBJECTIVE: The purpose of this study was to evaluate the utility of ampullary MDCT in the noninvasive, preoperative differentiation of pancreatobiliary and intestinal subtypes of ampullary adenocarcinoma. MATERIALS AND METHODS: This retrospective study included 32 patients (20 men, 12 women; age range, 41-81 years) with resected ampullary adenocarcinoma who underwent preoperative contrast-enhanced ampullary MDCT. Two radiologists, blinded to pathologic diagnosis of adenocarcinoma subtype, evaluated the presence of seven MDCT features independently...
January 17, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28094193/factors-associated-with-infection-after-reconstructive-shoulder-surgery-for-proximal-humerus-tumors
#2
Sjoerd Th Meijer, Nuno R Paulino Pereira, Sjoerd P F Th Nota, Marco L Ferrone, Joseph H Schwab, Santiago A Lozano Calderón
BACKGROUND: The main reconstruction techniques for proximal humerus tumors include osteoarticular allografts (OAs), endoprostheses (EPs), or allograft prosthetic composites (APCs). A common complication is infection, and constructs involving the use of allografts are believed to be at a higher risk of infection. Literature comparing infection rates between different modalities of reconstruction is scarce and underpowered. The study purposes were (1) to determine and compare the prevalence of infection in patients who underwent reconstruction of the proximal humerus including OAs, EPs, and APCs; (2) to identify preoperative, perioperative, and postoperative predictors of infection that might be modifiable; and (3) to present our protocol of treatment in patients with superficial and deep infections...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28093814/management-of-sickle-cell-disease-in-patients-undergoing-cardiac-surgery
#3
REVIEW
Todd C Crawford, Michael V Carter, Rina K Patel, Alejandro Suarez-Pierre, Sophie Z Lin, Jonathan Trent Magruder, Joshua C Grimm, Duke E Cameron, William A Baumgartner, Kaushik Mandal
Sickle cell disease is a life-limiting inherited hemoglobinopathy that poses inherent risk for surgical complications following cardiac operations. In this review, we discuss preoperative considerations, intraoperative decision-making, and postoperative strategies to optimize the care of a patient with sickle cell disease undergoing cardiac surgery.
January 16, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28092730/serum-agr2-as-a-useful-biomarker-for-pituitary-adenomas
#4
Mamatemin Tohti, Junyang Li, Chao Tang, Guodao Wen, Abdukeyum Abdujilil, Parhat Yizim, Chiyuan Ma
OBJECTIVE: This study aims to evaluate whether the serum Anterior Gradient-2 (AGR2) can be used as a potential biomarker screening in the diagnosis of Pituitary adenomas(PAs). PATIENTS AND METHODS: The serum AGR2 protein levels were preoperatively measured in 163 PA patients, 43 patients with other sellar lesions excluding PAs, 7 patients with prostate cancer as a positive control and 20 normal people(10 female and 10 male) using Enzyme-Linked ImmunoSorbent Assay (ELISA)...
January 9, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28091846/risk-factors-of-surgical-site-infections-in-patients-with-crohn-s-disease-complicated-with-gastrointestinal-fistula
#5
Kun Guo, Jianan Ren, Guanwei Li, Qiongyuan Hu, Xiuwen Wu, Zhiwei Wang, Gefei Wang, Guosheng Gu, Huajian Ren, Zhiwu Hong, Jieshou Li
PURPOSE: Surgical site infection (SSI) is the most common complication following surgical procedures. This study aimed to determine risk factors associated with SSI in patients with Crohn's disease (CD) complicated with gastrointestinal fistula. METHODS: This was a retrospective review of patients who underwent surgical resection in gastrointestinal fistula patients with CD between January 2013 and January 2015, identified from a prospectively maintained gastrointestinal fistula database...
January 16, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28089805/surgical-outcomes-of-endoscopic-endonasal-skull-base-surgery-of-craniopharyngiomas-evaluated-according-to-the-degree-of-hypothalamic-extension
#6
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Sparing the hypothalamus following craniopharyngiomas treatment is a prerequisite to ensure a good quality of life. In this study, the functional prognosis of craniopharyngioma following Endoscopic endonasal skull base surgery (EES) was examined in function of the degree of hypothalamic extension. MATERIALS AND METHODS: Twenty cases of craniopharyngioma treated by EES were categorized according to Puget's classification using preoperative and postoperative MRI...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089722/perioperative-allogenic-blood-transfusion-in-renal-cell-carcinoma-risk-factors-and-effect-on-long-term-outcomes
#7
Francesco Soria, Michela de Martino, Carmen V Leitner, Marco Moschini, Shahrokh F Shariat, Tobias Klatte
BACKGROUND: We sought to create a preoperative model to predict the risk of perioperative blood transfusion (PBT) in patients with renal cell carcinoma (RCC) undergoing nephrectomy and to evaluate the effect of PBT on long-term outcomes. PATIENTS AND METHODS: The present retrospective study included 648 consecutive patients who had undergone radical or partial nephrectomy for RCC at a single institution. The risk factors for PBT were analyzed using logistic regression analysis...
December 29, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#8
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079580/a-predictive-model-for-extended-postanesthesia-care-unit-length-of-stay-in-outpatient-surgeries
#9
Rodney A Gabriel, Ruth S Waterman, Jihoon Kim, Lucila Ohno-Machado
BACKGROUND: A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographic and comorbidities, that are already known preoperatively, and that may affect PACU length of stay for outpatient procedures requiring the care of an anesthesiologist...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079471/pre-implant-modeling-of-depth-lead-placement-in-white-matter-for-maximizing-the-extent-of-cortical-activation-during-direct-neurostimulation-therapy
#10
Leopoldo Cendejas Zaragoza, Richard W Byrne, Marvin A Rossi
INTRODUCTION: The objective of this work was to predict preoperatively the maximum extent to which direct stimulation therapy can propagate through an epileptic circuit for stabilizing refractory focal-onset epilepsy. A pre-surgical workflow is presented which comprises a computationally intensive process for calculating the volume of cortical activation (VOCA) surrounding cylindrical depth contacts virtually placed in white matter. The process employs an activation function (AF) derived from cable modeling of an axon...
January 12, 2017: Neurological Research
https://www.readbyqxmd.com/read/28079244/preoperative-multidisciplinary-program-for-bariatric-surgery-a-proposal-for-the-brazilian-public-health-system
#11
Elinton Adami Chaim, José Carlos Pareja, Martinho Antonio Gestic, Murillo Pimentel Utrini, Everton Cazzo
BACKGROUND: - Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE: - To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS: - A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28078639/low-preoperative-prognostic-nutritional-index-predicts-poor-survival-in-patients-with-newly-diagnosed-high-grade-gliomas
#12
Zhen-Qiang He, Chao Ke, Fuad Al-Nahari, Hao Duan, Cheng-Cheng Guo, Yang Wang, Xiang-Heng Zhang, Yin-Sheng Chen, Zhi-Gang Liu, Jian Wang, Zhong-Ping Chen, Xiao-Bing Jiang, Yong-Gao Mou
Preoperative prognostic nutritional index (PNI) has been widely demonstrated to predict survival of patients with malignant tumors. Its utility in predicting outcomes in patients with high-grade gliomas (HGG) remains undefined. A retrospective study of 188 HGG patients was conducted. An optimal PNI cut-off value was applied to stratify patients into high PNI (≥52.55, n = 78) and low PNI (<52.55, n = 110) groups. Univariate and multivariate analysis was performed to identify prognostic factors associated with overall survival (OS) and progression free survival (PFS)...
January 11, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28076961/total-arch-replacement-through-a-median-sternotomy-for-kommerell-s-diverticulum
#13
Yoshihiro Goto, Yutaka Koyama, Soh Hosoba, Shinji Ogawa, Shunsuke Fukaya, Yasuhide Okawa
Kommerell's diverticulum with a right aortic arch and aberrant left subclavian artery is a rare anomaly, and the optimal operative strategy has not yet been established. In particular, the approach to the diverticulum is controversial, with the greatest concern being whether or not to add a right thoracotomy to the median sternotomy for distal anastomosis. We successfully performed total arch replacement through a median sternotomy only, by referring to preoperative computed tomography. We think that if the aneurysm is in a shallow position from the tracheal bifurcation, total arch replacement is possible with a midline incision only...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28076328/albumin-to-gamma-glutamyltransferase-ratio-as-a-prognostic-indicator-in-intrahepatic-cholangiocarcinoma-after-curative-resection
#14
Chu-Yu Jing, Yi-Peng Fu, Hu-Jia Shen, Su-Su Zheng, Jia-Jia Lin, Yong Yi, Jin-Long Huang, Xin Xu, Juan Zhang, Jian Zhou, Jia Fan, Zheng-Gang Ren, Shuang-Jian Qiu, Bo-Heng Zhang
The prognosis of intrahepatic cholangiocarcinoma (ICC) remains poor whereas predictive models for survival prediction in ICC patients following curative resection are limited. Herein, we established a novel inflammation-based score derived from preoperative albumin to gamma-glutamyltransferase ratio (AGR) and evaluated its prognostic significance in ICC patients underwent curative resection. Prognostic value of AGR was retrospectively studied in a cohort comprising 206 ICC patients following curative resection...
January 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28074281/one-step-cad-cam-titanium-cranioplasty-after-drilling-template-assisted-resection-of-intraosseous-skull-base-meningioma-technical-note
#15
A Carolus, S Weihe, K Schmieder, C Brenke
INTRODUCTION: Cranial defects following intra-osseous tumor removal may be large and require adequate reconstruction. CAD/CAM implants have been used for years to achieve an optimal cosmetic result. The disadvantage is that such implants require a second surgery. A preoperative virtual planning of resection margins and the simultaneously fabrication of the cranioplasty could be a possibility to subsume the steps tumor resection and cosmetic restoration to a single procedure. METHODS: We present two cases of patients with complex intra-osseous spheno-orbital meningioma...
January 10, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28069908/clinical-and-prognostic-significance-of-anisocytosis-measured-as-a-red-cell-distribution-width-in-patients-with-colorectal-cancer
#16
Davor Kust, Marko Lucijanic, Kristina Urch, Ivan Samija, Ivana Celap, Ivan Kruljac, Marin Prpic, Ivica Lucijanic, Neven Matesa, Ante Bolanca
PURPOSE: colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide, and detection of new prognostic markers is mandatory for patients to receive optimal oncological treatment. The aim of the study was to assess clinical and prognostic value of red cell distribution width (RDW) in patients with CRC. METHODS: RDW values in 90 patients with CRC undergoing surgery for primary disease were analyzed in pre- and postoperative setting, and correlated with clinical and hematological parameters...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28069729/systematic-review-on-the-predictive-ability-of-frailty-assessment-measures-in-cardiac-surgery
#17
REVIEW
Yusuf S Abdullahi, Leonidas V Athanasopoulos, Roberto P Casula, Marco Moscarelli, Mark Bagnall, Hutan Ashrafian, Thanos Athanasiou
OBJECTIVES: Patient frailty is increasingly recognised as contributing to adverse postoperative outcomes in cardiothoracic surgery. The goal of this review is to evaluate the predictive ability of frailty scoring systems and their limitations in risk assessment of patients undergoing cardiac surgery. METHODS: Frailty studies were identified by searching electronic databases. Studies in which the measuring instrument was defined as a multidimensional tool focusing on a population undergoing cardiac operations were included...
January 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28069624/external-validation-of-the-revised-cardiac-risk-index-and-update-of-its-renal-variable-to-predict-30-day-risk-of-major-cardiac-complications-after-non-cardiac-surgery-rationale-and-plan-for-analyses-of-the-vision-study
#18
Pavel S Roshanov, Michael Walsh, P J Devereaux, S Danielle MacNeil, Ngan N Lam, Ainslie M Hildebrand, Rey R Acedillo, Marko Mrkobrada, Clara K Chow, Vincent W Lee, Lehana Thabane, Amit X Garg
INTRODUCTION: The Revised Cardiac Risk Index (RCRI) is a popular classification system to estimate patients' risk of postoperative cardiac complications based on preoperative risk factors. Renal impairment, defined as serum creatinine >2.0 mg/dL (177 µmol/L), is a component of the RCRI. The estimated glomerular filtration rate has become accepted as a more accurate indicator of renal function. We will externally validate the RCRI in a modern cohort of patients undergoing non-cardiac surgery and update its renal component...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069021/preoperative-optimization-of-patient-expectations-improves-long-term-outcome-in-heart-surgery-patients-results-of-the-randomized-controlled-psy-heart-trial
#19
Winfried Rief, Meike C Shedden-Mora, Johannes A C Laferton, Charlotte Auer, Keith J Petrie, Stefan Salzmann, Manfred Schedlowski, Rainer Moosdorf
BACKGROUND: Placebo effects contribute substantially to outcome in most fields of medicine. While clinical trials typically try to control or minimize these effects, the potential of placebo mechanisms to improve outcome is rarely used. Patient expectations about treatment efficacy and outcome are major mechanisms that contribute to these placebo effects. We aimed to optimize these expectations to improve outcome in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: In a prospective three-arm randomized clinical trial with a 6 month follow-up, 124 patients scheduled for CABG surgery were randomized to either a brief psychological pre-surgery intervention to optimize outcome expectations (EXPECT); or a psychological control intervention focusing on emotional support and general advice, but not on expectations (SUPPORT); or to standard medical care (SMC)...
January 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28068242/cost-effectiveness-analysis-of-preoperative-versus-postoperative-radiation-therapy-in-extremity-soft-tissue-sarcoma
#20
Xuanlu M Qu, Alexander V Louie, Jonathan Ashman, Nabil Wasif
PURPOSE: Surgery combined with radiation therapy (RT) is the cornerstone of multidisciplinary management of extremity soft tissue sarcoma (STS). Although RT can be given in either the preoperative or the postoperative setting with similar local recurrence and survival outcomes, the side effect profiles, costs, and long-term functional outcomes are different. The aim of this study was to use decision analysis to determine optimal sequencing of RT with surgery in patients with extremity STS...
February 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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