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https://www.readbyqxmd.com/read/28079799/risk-factors-for-recollapse-of-the-augmented-vertebrae-after-percutaneous-vertebroplasty-for-osteoporotic-vertebral-fractures-with-intravertebral-vacuum-cleft
#1
Weibo Yu, De Liang, Zhensong Yao, Ting Qiu, Linqiang Ye, Xuecheng Huang, Xiaobing Jiang
To determine risk factors related to recollapse of the augmented vertebrae after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral vacuum cleft (IVC).Fifty-two patients treated with PVP for single OVCFs with the IVC were retrospectively reviewed. The follow-up period was at least 2 years. Vertebral height loss ≥15% or kyphotic angle ≥10° at the final follow-up in relation to the immediately postoperative values were adopted as a definition of recollapse of the augmented vertebrae...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079776/enhanced-recovery-program-and-length-of-stay-after-laparotomy-on-a-gynecologic-oncology-service-a-randomized-controlled-trial
#2
Elizabeth L Dickson, Erica Stockwell, Melissa A Geller, Rachel Isaksson Vogel, Sally A Mullany, Rahel Ghebre, Boris J N Witherhoff, Levi S Downs, Linda F Carson, Deanna Teoh, Michelle Glasgow, Matt Gerber, Colleen Rivard, Britt K Erickson, Jacob Hutchins, Peter A Argenta
OBJECTIVE: To estimate whether a rapid recovery program would reduce length of stay among patients undergoing laparotomy on a gynecologic oncology service. METHODS: We conducted a prospective, randomized, controlled trial comparing an enhanced recovery after surgery protocol with routine postoperative care among women undergoing laparotomy on the gynecologic oncology service. Protocol elements included: preoperative counseling, regional anesthesia, intraoperative fluid restriction, and early postoperative ambulation and feeding...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28079580/a-predictive-model-for-extended-postanesthesia-care-unit-length-of-stay-in-outpatient-surgeries
#3
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/28078107/phase-ii-study-of-bevacizumab-and-preoperative-chemoradiation-for-esophageal-adenocarcinoma
#4
Geoffrey Y Ku, Manjit S Bains, Do Joong Park, Yelena Y Janjigian, Valerie W Rusch, Nabil P Rizk, Sam S Yoon, Brittanie Millang, Marinela Capanu, Karyn A Goodman, David H Ilson
BACKGROUND: A standard-of-care for locally advanced esophageal and gastroesophageal junction (GEJ) adenocarcinoma is pre-operative chemoradiation. Elevated levels of vascular endothelial growth factor (VEGF) have been associated with worse outcomes following chemoradiation and anti-VEGF therapies can potentiate radiation efficacy. METHODS: In this single-arm phase II study, we added bevacizumab to induction chemotherapy and concurrent chemoradiation with cisplatin/irinotecan for locally advanced esophageal and GEJ adenocarcinomas...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28074819/percutaneous-tracheostomy
#5
REVIEW
Chitra Mehta, Yatin Mehta
Percutaneous dilatational tracheostomy (PDT) is a commonly performed procedure in critically sick patients. It can be safely performed bedside by intensivists.This has resulted in decline in the use of surgical tracheostomy in intensive care unit (ICU) except in few selected cases. Most common indication of tracheostomy in ICU is need for prolonged ventilation. About 10% of patients requiring at least 3 days of mechanical ventilator support get tracheostomised during ICU stay. The ideal timing of PDT remains undecided at present...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#6
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074799/basic-arterial-blood-gas-biomarkers-as-a-predictor-of-mortality-in-tetralogy-of-fallot-patients
#7
Vandana Bhardwaj, Poonam Malhotra Kapoor, Kalpana Irpachi, Suruchi Ladha, Ujjwal Kumar Chowdhury
BACKGROUND: Serum lactate and base deficit have been shown to be a predictor of morbidity and mortality in critically ill patients. Poor preoperative oxygenation appears to be one of the significant factors that affects early mortality in tetralogy of Fallot (TOF). There is little published literature evaluating the utility of serum lactate, base excess (BE), and oxygen partial pressure (PO 2 ) as simple, widely available, prognostic markers in patients undergoing surgical repair of TOF...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073987/neutrophil-lymphocyte-ratio-and-risk-of-atrial-fibrillation-after-thoracic-surgery
#8
Kevin J Walsh, Kay See Tan, Hao Zhang, David Amar
OBJECTIVES: Postoperative atrial fibrillation (POAF) occurs frequently in patients after noncardiac thoracic surgery and has been associated with increased morbidity and risk of stroke. Recent studies have shown conflicting results on the role of neutrophil-lymphocyte ratio (NLR) and its association with the development of POAF after cardiac surgery. Our goal was to determine whether an association exists between NLR and the incidence of POAF after non-cardiac thoracic surgery. METHODS: Using a database of 259 consecutive patients age 60 or older who had anatomic lung resection or oesophagectomy for oncologic resection, we compared preoperative, postanaesthesia care unit and postoperative day 1 NLR between patients who did and did not develop POAF during their hospitalization using Fisher's exact test or logistic regression...
January 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28072935/the-addition-of-tick-boxes-related-to-tobacco-cessation-improves-smoking-related-documentation-in-the-anaesthesia-chart
#9
A Webb, A C Wilson
The Australian and New Zealand College of Anaesthetists (ANZCA) 'Guidelines on Smoking as Related to the Perioperative Period (PS12)' recommends that anaesthetists should always ask about smoking, advise quitting and refer patients to their general practitioner (GP) or a telephone quit-line for quit support. In this study we evaluated the effect of adding tick-boxes for 'quit advice given' and 'referral to GP/Quitline' to anaesthesia charts of elective surgical patients to assess whether this intervention changed documentation of compliance with the ANZCA guideline...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28072705/posterior-only-vertebral-column-resection-for-revision-surgery-in-post-laminectomy-rotokyphoscoliosis-associated-with-late-onset-paraplegia-a-case-report-and-literature-review
#10
Youping Tao, Jigong Wu, Huasong Ma
RATIONALE: Severe post-laminectomy spinal deformity associated with late-onset paraplegia is a complex and rare disorder. Little is known about revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia treated by the single stage posterior-only vertebral column resection (VCR) procedure. PATIENT CONCERNS AND DIAGNOSES: The patient was a 14-year-old male diagnosed as post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072563/inefficiencies-in-computed-tomography-sinus-imaging-for-management-of-sinonasal-disease
#11
Giriraj K Sharma, Allen Foulad, David Shamouelian, Naveen D Bhandarkar
Objective A subset of patients with sinonasal disease who obtain a diagnostic computed tomography (CT) sinus scan may require repeat preoperative CT due to the inadequacy of diagnostic CT for image-guided sinus surgery (IGSS). This leads to increased CT utilization, health care costs, and patient exposure to ionizing radiation. The objective of this study is to determine the frequencies of diagnostic CT sinus studies that were inadequate for IGSS and repeat CT studies for purposes of IGSS. Study Design A retrospective chart study was performed between May 2012 and August 2013...
January 1, 2017: Otolaryngology—Head and Neck Surgery
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
#12
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/28068753/retrospective-matched-pair-cohort-study-on-effect-of-bisegmental-fenestration-versus-hemilaminectomy-for-bisegmental-spinal-canal-stenosis-at-l3-l4-and-l4-l5
#13
Julia Schüppel, Friedrich Weber
Background The main symptoms of degenerative lumbar spinal canal stenosis are progressive back pain, spinal claudication, and, occasionally, sensory and motor deficits. Impairments particularly occur during walking, standing, and sitting. Thus social and vocational activities are increasingly restricted, causing considerable suffering for patients. Surgical therapies are superior to conservative ones. This article studies the outcome of 2-level fenestration versus hemilaminectomy for bisegmental spinal stenosis decompression...
January 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28067459/surgical-and-oncologic-outcomes-of-laparoscopic-radical-nephrectomy-for-non-metastatic-renal-cancer-in-long-term-dialysis-patients
#14
Kenji Omae, Tsunenori Kondo, Toshio Takagi, Junpei Iizuka, Hirohito Kobayashi, Yasunobu Hashimoto, Kazunari Tanabe
This study aimed to compare the outcomes of laparoscopic radical nephrectomy (LRN) between patients undergoing dialysis for ≤240 and >240 months. Data from all dialysis patients with non-metastatic renal cell carcinoma (RCC) treated with LRN between 2008 and 2015 in our hospital were evaluated retrospectively. Patients were divided into two groups, shorter- and longer-term dialysis patients, according to the preoperative duration of dialysis (≤240 vs. >240 months). Of 174 patients, 58 (33.3%) were on longer-term dialysis...
January 9, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28067101/promoting-a-culture-of-prehabilitation-for-the-surgical-cancer-patient
#15
Francesco Carli, Chelsia Gillis, Celena Scheede-Bergdahl
BACKGROUND: Traditional rehabilitative approaches to perioperative cancer care have focused on the postoperative period to facilitate the return to presurgical baseline conditions. However, there is some realization that the preoperative period can be a very effective time for intervention as the patients are more amenable to target their physiological condition to prepare to overcome the metabolic cost of the surgical stress. METHODS: We undertook a narrative review of the current literature on surgical prehabilitation and discussed the current evidence of preoperative interventions before cancer surgery in order to increase physiological reserve before surgery and accelerate postoperative recovery...
January 9, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28061841/supervised-neuromuscular-exercise-prior-to-hip-and-knee-replacement-12-month-clinical-effect-and-cost-utility-analysis-alongside-a-randomised-controlled-trial
#16
Linda Fernandes, Ewa M Roos, Søren Overgaard, Allan Villadsen, Rikke Søgaard
BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery...
January 6, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28061830/age-nutrition-chirugie-anc-study-impact-of-a-geriatric-intervention-on-the-screening-and-management-of-undernutrition-in-elderly-patients-operated-on-for-colon-cancer-a-stepped-wedge-controlled-trial
#17
Marine Dupuis, Elisabetta Kuczewski, Laurent Villeneuve, Sylvie Bin-Dorel, Max Haine, Claire Falandry, Thomas Gilbert, Guillaume Passot, Olivier Glehen, Marc Bonnefoy
BACKGROUND: Undernutrition prior to major abdominal surgery is frequent and increases morbidity and mortality, especially in older patients. The management of undernutrition reduces postoperative complications. Nutritional management should be a priority in patient care during the preoperative period. However undernutrition is rarely detected and the guidelines are infrequently followed. Preoperative undernutrition screening should allow a better implementation of the guidelines. METHODS/DESIGN: The ANC ("Age Nutrition Chirurgie") study is an interventional, comparative, prospective, multicenter, randomized protocol based on the stepped wedge trial design...
January 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28061535/perioperative-goal-setting-consultations-by-surgical-colleagues-a-new-model-for-supporting-patients-families-and-surgeons-in-shared-decision-making
#18
Ana Berlin, Anastasia Kunac, Anne C Mosenthal
Patients with postoperative complications are often subjected to prolonged life-sustaining treatment based on erroneous assumptions about their goals of care. Shared decision making (SDM) is an evidence-based approach that helps ensure patients' wishes and values are honored in their course of treatment. Perioperative palliative care can help create goal-concordant trajectories of care for high risk, seriously ill, or complicated patients, through sophisticated prognostication, higher-level communication, and recommendations based on the best available evidence and patients' stated goals and priorities...
November 29, 2016: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28060689/-schwannoma-of-the-upper-extremity-retrospective-analysis-of-17-cases
#19
Ângelo Sá, Leandro Nobre Azevedo, Luísa Cunha
INTRODUCTION: Schwannoma or neurilemmoma is a benign peripheric nerve tumor that usually presents as a slow growing single lesion; it has origin in Schwann cells proliferation. Although it represents a small percentage of the benign tumors of the upper arm, it is the most frequent of neural origin. We present a retrospective study of upper limb schwannomas; our aim is establish the appropriate preoperative approach, to recognise the efficiency of the treatment and the pos-operative follow-up...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28060361/preoperative-clinical-features-of-reactivated-of-graves-orbitopathy-after-orbital-decompression
#20
Y J Woo, J W Kim, J S Yoon
PurposeTo investigate the incidence and preoperative clinical features of reactivated Graves' orbitopathy (GO) after orbital decompression.MethodsThis study included patients with GO who underwent orbital decompression for disfiguring proptosis and not compressive optic neuropathy and received postoperative follow-up care for more than 12 months. Patients who experienced active inflammatory signs within 6 months of decompression were excluded from analysis. The demographic characteristics, ophthalmic manifestations, and biochemical parameters of the patients were analyzed for association with reactivation of GO by logistic regression analysis...
January 6, 2017: Eye
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