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https://www.readbyqxmd.com/read/29662744/postoperative-complications-associated-with-rhbmp2-use-in-posterior-posterolateral-lumbar-fusion
#1
Nabil Esmail, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Hans-Joerg Meisel, Jong-Beom Park, Jim A Youssef, Jeffrey C Wang, S Tim Yoon
Study Design: Retrospective database review. Objective: Posterior/posterolateral lumbar fusion (PLF) is an effective treatment for a variety of spinal disorders; however, variations in surgical technique have different complication profiles. The aim of our study was to quantify the frequency of various complications in patients undergoing PLF with and without human recombinant bone morphogenetic protein 2 (rhBMP2). Methods: We queried the orthopedic subset of the Medicare database (PearlDiver) between 2005 and 2011 for patients undergoing PLF procedures with and without rhBMP2...
April 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29661384/a-systematic-review-and-consensus-definitions-for-standardised-end-points-in-perioperative-medicine-pulmonary-complications
#2
REVIEW
T E F Abbott, A J Fowler, P Pelosi, M Gama de Abreu, A M Møller, J Canet, B Creagh-Brown, M Mythen, T Gin, M M Lalu, E Futier, M P Grocott, M J Schultz, R M Pearse
BACKGROUND: There is a need for robust, clearly defined, patient-relevant outcome measures for use in randomised trials in perioperative medicine. Our objective was to establish standard outcome measures for postoperative pulmonary complications research. METHODS: A systematic literature search was conducted using MEDLINE, Web of Science, SciELO, and the Korean Journal Database. Definitions were extracted from included manuscripts. We then conducted a three-stage Delphi consensus process to select the optimal outcome measures in terms of methodological quality and overall suitability for perioperative trials...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29658839/comparison-of-emergency-cholecystectomy-with-delayed-cholecystectomy-after-percutaneous-transhepatic-gallbladder-drainage-in-patients-with-moderate-acute-cholecystitis
#3
Chang-Wei Ke, Shuo-Dong Wu
INTRODUCTION: Patients with moderate (grade II) acute cholecystitis patients, as defined by the 2013 Tokyo Guidelines, were retrospectively compared with respect to emergency cholecystectomy (EC) and delayed cholecystectomy (DC) after percutaneous transhepatic gallbladder drainage (PTGBD) to determine the better treatment strategy. METHODS: Forty-nine of 103 patients with PTGBD and 47 of 54 patients with EC were assessed for eligibility from January 2013 to January 2017...
April 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29652286/anesthetic-challenges-of-a-patient-with-the-communicating-bulla-coming-for-nonthoracic-surgery
#4
Bernice Theodare, Vinolia Victory Nissy, Raj Sahajanandan, Ramamani Mariappan
Management of a patient with a giant bulla coming for a nonthoracic surgery is rare, and its anesthetic management is very challenging. It is imperative to isolate only the subsegmental bronchus, in which the bulla communicates to avoid respiratory morbidities such as pneumothorax, emphysema or atelectasis of the surrounding lung parenchyma, and postoperative respiratory failure. Herewith, we want to report the anesthetic challenges of a patient with giant bulla communicating into one of the subsegmental right upper lobe bronchus for splenectomy...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#5
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29643160/using-machine-learning-techniques-to-develop-forecasting-algorithms-for-postoperative-complications-protocol-for-a-retrospective-study
#6
Bradley A Fritz, Yixin Chen, Teresa M Murray-Torres, Stephen Gregory, Arbi Ben Abdallah, Alex Kronzer, Sherry Lynn McKinnon, Thaddeus Budelier, Daniel L Helsten, Troy S Wildes, Anshuman Sharma, Michael Simon Avidan
INTRODUCTION: Mortality and morbidity following surgery are pressing public health concerns in the USA. Traditional prediction models for postoperative adverse outcomes demonstrate good discrimination at the population level, but the ability to forecast an individual patient's trajectory in real time remains poor. We propose to apply machine learning techniques to perioperative time-series data to develop algorithms for predicting adverse perioperative outcomes. METHODS AND ANALYSIS: This study will include all adult patients who had surgery at our tertiary care hospital over a 4-year period...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29628597/anesthetic-management-in-pediatric-patient-for-percutaneous-endoscopic-gastrostomy-with-mitochondrial-myopathy-leigh-syndrome
#7
Ebru Tarikçi Kiliç, Nelgin Gerenli, Mehmet Salim Akdemir, Necmi Onur Tastan, Egemen Atag
Leigh syndrome (LS) is a rare disease mainly affecting the central nervous system due to the abnormalities of mitochondrial energy generation and seen in early childhood with progressive loss of movement, mental abilities, seizures, nystagmus, ophthalmoparesis, optic atrophy, ataxia, dystonia, or respiratory failure. Anesthesia and surgery exacerbate the risks of aspiration, wheezing, and breathing difficulties. Tracheal irritability can be stimulated with the efforts of intubation. We report the anesthetic management of a rare case of an 11-year-old boy with a severe form of LS for percutaneous endoscopic gastrostomy insertion...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628170/preoperative-assessment-of-the-risk-of-postoperative-death-in-patients-with-oral-squamous-cell-carcinoma-a-consideration-beyond-age-sex-and-stage-of-cancer
#8
A K Bartella, A-K Sander, M Kamal, J Steegmann, A Kloss-Brandstätter, J Teichmann, F Hölzle, B Lethaus
Despite improvements in the management of patients in critical care, about 3% patients who have an operation with curative intent for oral squamous cell carcinoma (SCC) do not survive their stay in hospital. Our aim was to assess the risk factors for postoperative death that were independent of the stage of the cancer, or the age and sex of the patients. We screened 4760 consecutive inpatients at a maxillofacial tertiary care centre from 2011 to 2016, and 34 of them had died within the first three months after operation...
April 5, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29623673/the-relationship-between-age-and-chronic-kidney-disease-in-patients-undergoing-pancreatic-resection
#9
Derrick Antoniak, Chandrakanth Are, Chad Vokoun, Kaeli Samson, Lynette Smith, Jason Shiffermiller
BACKGROUND: Severe chronic kidney disease (CKD) predicts adverse outcomes in patients undergoing pancreatectomy, but the impact of milder CKD is unknown. Additionally, some authors have suggested that, due to physiologic changes of aging, CKD is over-diagnosed in patients above age 65. METHODS: Patients undergoing pancreatectomy for malignancy from 2005 to 2014 were identified from the National Surgical Quality Improvement Program. Primary outcomes were all-cause mortality and major complication, defined as myocardial infarction, cardiac arrest, stroke, venous thromboembolism, respiratory failure, deep surgical site infection, pneumonia, acute kidney injury, coma > 24 h, or re-operation occurring within 30 days of surgery...
April 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29621128/can-teamwork-and-high-volume-experience-overcome-challenges-of-lymphadenectomy-in-morbidly-obese-patients-body-mass-index-of-40-kg-m2-or-greater-with-endometrial-cancer-a-cohort-study-of-robotics-and-laparotomy-and-review-of-literature
#10
Hubert Fornalik, Temeka Zore, Nicole Fornalik, Todd Foster, Adrian Katschke, Gary Wright
OBJECTIVE: This study aimed to compare surgical outcomes and the adequacy of surgical staging in morbidly obese women with a body mass index (BMI) of 40 kg/m or greater who underwent robotic surgery or laparotomy for the staging of endometrioid-type endometrial cancer. METHODS: This is a retrospective cohort study of patients who underwent surgical staging between May 2011 and June 2014. Patients' demographics, surgical outcomes, intraoperative and postoperative complications, and pathological outcomes were compared...
April 4, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29609909/-why-is-the-morbidly-obese-patient-at-high-risk-of-anesthetic-complications
#11
Audrey De Jong, Daniel Verzilli, Marie Geniez, Gérald Chanques, David Nocca, Samir Jaber
Obesity is often associated with obstructive sleep apnea (OSA), which increases the risk of intraoperative and postoperative complications. The role of preoperative screening of OSA is crucial, with adequate management based on continuous positive pressure before, during and after surgery. The obese patient is at risk of postoperative complications: difficult airway management, acute respiratory failure following extubation due to atelectasis and airway obstruction, added to morphine overdosing. Optimal management of difficult mask ventilation and intubation, protective ventilation, combined to the reduction of sedatives and analgesics and the sitting position as soon as possible with a postoperative monitoring should decrease the occurrence of complications...
March 30, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29593559/ghrelin-pre-treatment-attenuates-local-oxidative-stress-and-end-organ-damage-during-cardiopulmonary-bypass-in-anesthetized-rats
#12
Vijayakumar Sukumaran, Hirotsugu Tsuchimochi, Yutaka Fujii, Hiroshi Hosoda, Kenji Kangawa, Tsuyoshi Akiyama, Mikiyasu Shirai, Eisuke Tatsumi, James T Pearson
Cardiopulmonary bypass (CPB) induced systemic inflammation significantly contributes to the development of postoperative complications, including respiratory failure, myocardial, renal and neurological dysfunction and ultimately can lead to failure of multiple organs. Ghrelin is a small endogenous peptide with wide ranging physiological effects on metabolism and cardiovascular regulation. Herein, we investigated the protective effects of ghrelin against CPB-induced inflammatory reactions, oxidative stress and acute organ damage...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29579881/long-term-prognosis-after-lung-transplantation-a-monocentric-study-in-510-patients
#13
F Montoro Ballesteros, J J Sánchez Fernández, J M Vaquero Barrios, J Redel Montero, M J Cobos Ceballos, C Esteban Amarilla, A M Palomares Muriana, F Santos Luna
INTRODUCTION: Lung transplantation is the final treatment option in patients with respiratory failure. Morbidity and mortality rates associated with the management of complications is high despite advances. Postoperative complications include acute transplant rejection, bronchiolitis obliterans, and infections. Because of that, the success of this treatment option depends on the correct choice of donor and candidates to receive a transplant. OBJECTIVE: This study aims to perform a survival analysis of transplanted patients in our center and determine predictive variables of mortality...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29576405/a-propensity-matched-comparison-of-fenestrated-endovascular-aneurysm-repair-and-open-surgical-repair-of-pararenal-and-paravisceral-aortic-aneurysms
#14
Giovanni Tinelli, Maria Antonietta Crea, Chiara de Waure, Gian Luca Di Tanna, Jean-Pierre Becquemin, Jonathan Sobocinski, Francesco Snider, Stéphan Haulon
OBJECTIVE: This study investigated the outcomes of a current series of patients treated with fenestrated and branched endovascular aneurysm repair (F-BEVAR) or open surgical repair (OSR) for pararenal abdominal aortic aneurysms (pr-AAAs), including juxtarenal, suprarenal, and type IV thoracoabdominal aneurysms. This study compares the outcomes of these procedures from two high-volume centers without the bias induced by a learning curve. METHODS: All patients with pr-AAAs undergoing repair at two centers between January 2010 and June 2016 were included in a prospective database...
March 22, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29570152/opioid-use-disorders-and-the-risk-of-postoperative-pulmonary-complications
#15
Puneet Sayal, Brian T Bateman, Mariano Menendez, Matthias Eikermann, Karim S Ladha
BACKGROUND: As the rate of opioid use disorders continues to rise, perioperative physicians are increasingly faced with the challenge of providing analgesia to these patients after surgery. Due to the likelihood of opioid dose escalation in the perioperative period, we hypothesized that opioid-dependent patients would be at increased risk for postoperative pulmonary complications. METHODS: A retrospective cross-sectional analysis of patients undergoing 6 representative elective surgical procedures was performed using the Nationwide Inpatient Sample from 2002 to 2011...
March 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29567936/splenic-rupture-as-the-first-manifestation-of-babesia-microti-infection-report-of-a-case-and-review-of-literature
#16
Igor Dumic, Janki Patel, Melissa Hart, Eric R Niendorf, Scott Martin, Poornima Ramanan
BACKGROUND Babesiosis is an emerging, tick-borne zoonosis caused by intraerythrocytic protozoa of the genus Babesia. Babesia microti is the main pathogen causing human disease and is endemic in the northeastern and upper midwestern parts of the USA. Severity of infection ranges from mild, self-limited, febrile viral-like illness accompanied by nonspecific symptoms to life-threatening infection complicated by severe hemolytic anemia, disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), and renal or/and hepatic failure...
March 23, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29567515/in-hospital-complication-rate-following-microendoscopic-versus-open-lumbar-laminectomy-a-propensity-score-matched-analysis
#17
Takeshi Oichi, Yasushi Oshima, Hirotaka Chikuda, Junichi Ohya, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: The incidence of postoperative complications after microendoscopic laminectomy (MEL) has not been compared with that of open laminectomy in a large study, so it is not clear whether MEL is a safer procedure. PURPOSE: To compare postoperative morbidity and mortality following lumbar laminectomy between patients treated with MEL and open laminectomy. STUDY DESIGN: Retrospective cohort study with propensity score-matched analysis...
March 19, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29564587/comparison-of-outcome-of-esophagectomy-versus-nonsurgical-treatment-for-resectable-esophageal-cancer-with-clinical-complete-response-to-neoadjuvant-therapy
#18
Yu Ohkura, Junichi Shindoh, Masaki Ueno, Toshiro Iizuka, Harushi Udagawa
BACKGROUND: Treatment for patients who have achieved clinical complete response (cCR) after neoadjuvant therapy has not been established, and there is no consensus regarding the indications for either esophagectomy or nonsurgical treatment. METHODS: Among 1,545 patients with esophageal cancer at Toranomon Hospital between January 2006 and August 2017, 39 who achieved cCR after neoadjuvant treatment were divided into two groups according to treatment: esophagectomy group (n = 18) and nonsurgical treatment group (n = 21) for comparison...
March 21, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29562403/-emergency-cholecystectomy-versus-percutaneous-transhepatic-gallbladder-drainage-followed-by-delayed-cholecystectomy-in-patients-with-moderate-acute-cholecystitis
#19
C W Ke, S D Wu, Y N Li
Objective: To analysis the curative effect of emergency cholecystectomy (EC) and percutaneous transhepatic gallbladder drainage (PTGBD) followed by delayed cholecystectomy (DC) on the patients with moderate acute cholecystitis. Methods: The perioperative dataof patients in EC group ( n =47) and in PTGBD-DC group ( n =49) were compared retrospectively. Results: Compared to PTGBD+ DC group, EC patients had a significantly more postoperative abdominal drainage time [(9.0±12.9) vs (3.4±2.1) days, P =0.041], more postoperative hospital stay after cholecystectomy [(8...
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29536685/-application-of-damage-control-orthopedics-for-the-treatment-of-severe-multiple-fractures
#20
Teng-Fei Zhu, Wen-Guo Zhao, Han-Lin Zheng, Jia-Xiang Wu
OBJECTIVE: To investigate the application effect of damage control orthopedics for the treatment of severe multiple fractures. METHODS: From January 2014 to December 2016, 23 patients with severe multiple fractures were treated with the damage control orthopedics (DCO), included 14 males and 9 females with an average age of (41.57±8.29) years old ranging from 28 to 60 years old; the NISS averaged(27.70±5.44) points ranging from 18 to 40 points. As the control group, 27 patients with severe multiple fractures were treated by the early total care(ETC) technology from Jan...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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