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Morbidity and mortality

Sandra Aissou, Victoire Cartier, Antoine Hamy, Fleur Plumereau, Christophe Aube, Emilie Lermite
BACKGROUND: Liver resection is the curative treatment for patients with colorectal liver metastases (CRLMs), with five-year survival rates of 30-50%. Radiofrequency ablation (RFA) is a local and useful alternative for patients with non-resectable CRLMs to obtain complete tumor clearance. The aim of this study was to analyze survival rates with this local treatment. MATERIALS AND METHODS: All patients who underwent RFA and resection or RFA alone for unresectable CRLMs between 2001 and 2012 were included in a retrospective study...
October 26, 2016: Surgical Technology International
Yuefeng Zhang, Risheng Huang, Weihe Zhou, Qifeng Zhao, Zhenye Lü
Myocardial ischemia/reperfusion (I/R) injury is a leading cause of morbidity and mortality. In this study, we investigated the role of miR-192-5p in hypoxia/reoxygenation (H/R)-induced cardiomyocyte apoptosis. H9c2 cardiomyocytes were subjected to H/R and tested for miR-192-5p expression. Overexpression and knockdown experiments were performed to determine the effects of manipulating miR-192-5p on apoptotic responses. H/R-treated H9c2 cells exhibited a 2.2-fold increase in miR-192-5p levels. Overexpression of miR-192-5p significantly augmented apoptosis in H9c2 cells after H/R, which was accompanied by a significant increase in the ratio of Bax/Bcl-2...
October 25, 2016: Journal of Biochemical and Molecular Toxicology
Sarah B Bateni, Frederick J Meyers, Richard J Bold, Robert J Canter
BACKGROUND: The impact of surgery on end of life care for patients with disseminated malignancy (DMa) is incompletely characterized. The purpose of this study was to evaluate postoperative outcomes impacting quality of care among DMa patients, specifically prolonged length of hospital stay, readmission, and disposition. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for years 2011-2012. DMa patients were matched to non-DMa patients with comparable clinical characteristics and operation types...
2016: PloS One
Chiara Tersigni, Fiorella Di Nicuolo, Giuseppe Maulucci, Alessandro Rolfo, Domenica Giuffrida, Manuela Veglia, Marco De Spirito, Giovanni Scambia, Tullia Todros, Nicoletta Di Simone
BACKGROUND: Pre-eclampsia (PE) is a major cause of maternal and perinatal morbidity and mortality worldwide. It is defined by new onset of hypertension and proteinuria after the 20th week of gestation and characterized by systemic exaggerated inflammatory response. D6 is a chemokines scavenger receptor that binds with high affinity CC chemokines, internalizes and targets the ligands for degradation. It is expressed in trophoblast-derived tissues and prevents excessive placenta leukocyte infiltration...
2016: PloS One
Winnie Huiyan Sim, Edward Araujo Júnior, Fabricio Da Silva Costa, Penelope Marie Sheehan
AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM...
October 25, 2016: Journal of Perinatal Medicine
Seema Patel
Cardiac glycosides, the cardiotonic steroids such as digitalis have been in use as heart ailment remedy since ages. They manipulate the renin-angiotensin axis to improve cardiac output. However; their safety and efficacy have come under scrutiny in recent times, as poisoning and accidental mortalities have been observed. In order to better understand and exploit them as cardiac ionotropes, studies are being pursued using different cardiac glycosides such as digitoxin, digoxin, ouabain, oleandrin etc. Several cardiac glycosides as peruvoside have shown promise in cancer control, especially ovary cancer and leukemia...
October 22, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Charlotte J Frise, Alex Pitcher, Lucy Mackillop
The physiological and haemodynamic changes that occur in pregnancy and the postpartum period increase the risk of aortic dissection. Loeys-Dietz syndrome results from mutations in the genes encoding components of the TGF-β signalling pathway; aortic pathology is of particular concern in this condition but other vascular abnormalities can also be present. Significant maternal morbidity and mortality has been described in patients with Loeys-Dietz syndrome, but successful and uncomplicated pregnancies are still possible...
October 11, 2016: International Journal of Cardiology
Tanya Anand, Rajesh Ramnanan, Ruby Skinner, Maureen Martin
Blood transfusions cause altered immunity and the duration of storage is contributory. In the era of massive transfusion protocols (MTPs) this impact is unclear, particularly as it relates to balanced transfusions. Trauma patients requiring our MTP after admission to our Level II trauma center were studied. The average age of blood transfused was calculated; old blood was a storage time of ≥14 days versus new blood <14 days. Blood to plasma ratios of 1:1 were compared with ratios >1:1. Infections, organ dysfunction multiorgan injury (MOI), and death were compared based on ratios and blood storage times...
October 2016: American Surgeon
Reza Fazl Alizadeh, Zhobin Moghadamyeghaneh, Matthew D Whealon, Mark H Hanna, Steven D Mills, Alessio Pigazzi, Michael J Stamos, Joseph C Carmichael
There are limited data regarding the association between body mass index (BMI) and colorectal surgery outcomes. We sought to evaluate the effect of BMI on short-term surgical outcomes in colon and rectal surgery patients in the United States. The American College of Surgeons National Surgery Quality Improvement Project database was used to identify all patients who underwent colon or rectal resection from 2005 to 2013. Multivariate regression analysis was used to assess the independent effect of BMI on outcomes...
October 2016: American Surgeon
John V Gahagan, Mark H Hanna, Matthew D Whealon, Steven Maximus, Michael J Phelan, Michael Lekawa, Cristobal Barrios, Nicole P Bernal
Disparities in access to health care between white and minority patients are well described. We aimed to analyze the trends and outcomes of cholecystectomy based on racial classification. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy from 2009 to 2012. Patients were stratified as white or non-white. A total of 243,536 patients were analyzed: 159,901 white and 83,635 non-white. Non-white patients had significantly higher proportions of Medicaid (25% vs 9.3%), self-pay (14% vs 7...
October 2016: American Surgeon
Mohammed Al-Temimi, Charles Trujillo, John Agapian, Hanna Park, Ahmad Dehal, Samir Johna, Deron Tessier
Incidental appendectomy (IA) could potentially increase the risk of morbidity after abdominal procedures; however, such effect is not clearly established. The aim of our study is to test the association of IA with morbidity after abdominal procedures. We identified 743 (0.37%) IA among 199,233 abdominal procedures in the National Surgical Quality Improvement Program database (2005-2009). Cases with and without IA were matched on the index current procedural terminology code. Patient characteristics were compared using chi-squared test for categorical variables and Student t test for continuous variables...
October 2016: American Surgeon
Hem Desai, Bhupinder Natt, Samuel Kim, Christian Bime
RATIONALE: There is a paucity of data regarding the optimal surgical approach for lung lobectomy. Lobectomy performed by video-assisted thoracoscopic surgery (VATS) has been associated with lower morbidity as compared to thoracotomy. However, no multicenter studies have shown improved mortality with VATS lobectomy compared to open surgical lobectomy. OBJECTIVES: We used the United States Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) database from 2009 to 2012 to compare VATS versus open lobectomy for in-hospital mortality and other short-term outcomes...
October 25, 2016: Annals of the American Thoracic Society
Loren Fields, Alison Hathaway
Pregnancy of unknown location (PUL) is a descriptive term for when a woman with a positive pregnancy test has a transvaginal ultrasound that cannot determine the site of the pregnancy. While the majority of women with PUL are subsequently diagnosed with a spontaneous abortion or viable intrauterine pregnancy, 7% to 20% of these women have an ectopic pregnancy. The potential for morbidity and mortality related to an ectopic pregnancy means that considerable care is necessary in the evaluation and management of women with PUL...
October 25, 2016: Journal of Midwifery & Women's Health
Barbara Farquharson, Marie Johnston, Karen Smith, Brian Williams, Shaun Treweek, Stephan U Dombrowski, Nadine Dougall, Purva Abhyankar
AIMS: To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text+visual and text-only) with usual care. BACKGROUND: Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for Acute Coronary Syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions...
October 25, 2016: Journal of Advanced Nursing
Douglas F Dluzen, Nicole Noren Hooten, Yongqing Zhang, Yoonseo Kim, Frank E Glover, Salman M Tajuddin, Kimberly D Jacob, Alan B Zonderman, Michele K Evans
Systemic arterial hypertension is an important cause of cardiovascular disease morbidity and mortality. African Americans are disproportionately affected by hypertension, in fact the incidence, prevalence, and severity of hypertension is highest among African American (AA) women. Previous data suggests that differential gene expression influences individual susceptibility to selected diseases and we hypothesized that this phenomena may affect health disparities in hypertension. Transcriptional profiling of peripheral blood mononuclear cells from AA or white, normotensive or hypertensive females identified thousands of mRNAs differentially-expressed by race and/or hypertension...
October 25, 2016: Scientific Reports
Maren Paulmann, Maja Mockenhaupt
Severe cutaneous adverse reactions (SCAR) are known for a high morbidity and mortality. They may be life-threatening for the affected patient and difficult to accomplish for the patient's family and the treating physician. Such conditions include not only bullous reactions like toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), but also acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia and systemic symptoms (DRESS). Since clinical pattern, etiology, prognosis and treatment differ among these severe skin reactions, a clear diagnosis based on a comprehensive clinical examination, skin biopsy, and specific laboratory tests is necessary...
September 28, 2016: Current Pharmaceutical Design
Anibal Wood Branco
Vascular injury in accidental punctures may occur in large abdominal vessels, it is known that 76% of injuries occur during the development of pneumoperitoneum. The aim of this video is to demonstrate two cases of vascular injury oc¬curring during access in laparoscopic urologic surgery. The first case presents a 60-year old female patient with a 3cm tumor in the superior pole of the right kidney who un¬derwent a laparoscopic partial nephrectomy. After the Verres needle insertion, output of blood was verified...
October 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
I Stefani, M A Asnaghi, J J Cooper-White, S Mantero
Cardiovascular diseases represent a major global health burden, with high rates of mortality and morbidity. Autologous grafts are commonly used to replace damaged or failing blood vessels, however such approaches are hampered by the scarcity of suitable graft tissue, donor site morbidity and poor long-term stability. Tissue engineering has been investigated as a means by which exogenous vessel grafts can be produced, with varying levels of success to date, a result of mismatched mechanical properties of these vessel substitutes and inadequate ex vivo vessel tissue genesis...
October 24, 2016: Journal of Tissue Engineering and Regenerative Medicine
Eleonora Farinella, Adonis Safar, Haydar A Nasser, Fikri Bouazza, Gabriele Liberale, Marianne Paesmans, Raphael Marechal, Jean-Luc Van Laethem, Alain Hendlisz, Paul VanHoutte, Issam El Nakadi
BACKGROUND: Definitive radiochemotherapy (dRCT) in locally advanced esophageal cancer is associated with a high rate of loco-regional recurrence. In this condition, salvage esophagectomy may be considered as a therapeutic option. The aim of this analysis is to evaluate the feasibility and the morbi-mortality of this strategy. METHODS: Between January 2006 and April 2014, 208 patients underwent esophagectomy for esophageal cancer at ULB-Erasme-Bordet. Thirty-two patients received a preoperative radiochemotherapy (pRCT) followed by planned esophagectomy (Group 1) for locally advanced disease...
October 25, 2016: Journal of Surgical Oncology
Katinka Karenberg, Hannes Hudalla, David Frommhold
Impaired cellular innate immune defense accounts for susceptibility to sepsis and its high morbidity and mortality in preterm infants. Leukocyte recruitment is an integral part of the cellular immune response and follows a well-defined cascade of events from rolling of leukocytes along the endothelium to firm adhesion and finally transmigration which is concerted by a variety of adhesion molecules. Recent analytical advances such as fetal intravital microscopy have granted new insights into ontogenetic regulation and maturation of fetal immune cell recruitment...
December 2016: Molecular and Cellular Pediatrics
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