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https://www.readbyqxmd.com/read/28743178/multicenter-analysis-of-transanal-tube-placement-for-prevention-of-anastomotic-leak-after-low-anterior-resection
#1
Saori Goto, Koya Hida, Kenji Kawada, Ryosuke Okamura, Suguru Hasegawa, Takahisa Kyogoku, Shuichi Ota, Yukito Adachi, Yoshiharu Sakai
BACKGROUND: Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL. METHODS: This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal cancer at participating hospitals from 2009 to 2014. Multivariate logistic regression was used to adjust for confounding factors. RESULTS: A transanal tube was placed in 205 patients (TA group) and not placed in 123 patients (non-TA group)...
July 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28743129/fibroblast-growth-factor-23-predicts-mortality-and-end-stage-renal-disease-in-a-canadian-asian-population-with-chronic-kidney-disease
#2
Ishwarlal Jialal, Fernando Camacho, Bharat Nathoo, Paul Tam, Roma Pahwa, George G Wu
BACKGROUND: Chronic kidney disease (CKD) is a leading cause of morbidity and mortality. Biomarkers that predict end-stage renal disease (ESRD) and/or mortality could usher in new therapeutics to halt this onslaught. While fibroblast growth factor (FGF)23 can predict both ESRD and mortality, it has not been studied in North American CKD patients of Asian ethnicity. METHOD: This is a prospective investigation about the role of FGF23 in 998 Canadian patients of Asian descent with CKD defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/m2 and followed up for 3 years...
July 26, 2017: Nephron
https://www.readbyqxmd.com/read/28743097/less-is-more-an-outcome-assessment-of-patients-operated-for-gallstone-ileus-without-fistula-treatment
#3
Dario Tartaglia, Sohail Bakkar, Lorenzo Piccini, Jessica Bronzoni, Luigi Cobuccio, Andrea Bertolucci, Christian Galatioto, Massimo Chiarugi
BACKGROUND: The treatment of gallstone ileus (GI) consists of surgical removal of the impacted bilestone with or without cholecystectomy and repair of the biliodigestive fistula. The objective of this study was to assess whether sparing patients a definitive biliary procedure adversely influenced the outcome. MATERIALS AND METHODS: Patients with a diagnosis of GI were reviewed. Two groups were identified: patients who underwent a definitive biliary procedure with relieving the intestinal obstruction (group 1/G1) and those who did not have a definitive biliary procedure (group 2/G2)...
July 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28742994/unusual-case-of-a-massive-macroglossia-secondary-to-myxedema-a-case-report-and-literature-review
#4
James C Melville, Kelsey D Menegotto, Timothy C Woernley, Blake D Maida, Ibrahim Alava
Macroglossia is classified as true macroglossia, which exhibits abnormal histology with clinical findings, and relative macroglossia, in which normal histology does not correlate with pathologic enlargement. This report describes an atypical case of morbidity with massive macroglossia secondary to myxedema; the macroglossia enlarged over a 3-month period before being presented to the Department of Oral and Maxillofacial Surgery, University of Texas Health Sciences Center at Houston (Houston, TX). Substantial enlargement of the tongue (16 cm long × 10 cm wide) was first attributed to angioedema, which was refractory to the discontinuation of lisinopril and a C1 esterase inhibitor...
June 30, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28742990/employment-status-gender-and-health-in-spanish-women
#5
Sara Esteban Gonzalo, Marta Aparicio, Laura Estaban-Gonzalo
The present study analyzed relationships between employment status, gender role conformity and health among adult Spanish women from a biopsychosocial approach. We first examined the potential relationship between employment status and conformity to feminine norms, second, the relationship between employment status and general and psychological health, and finally, the relationship between conformity to feminine norms and general and psychological health. Unemployed women (n = 103), employed women (n = 144) and full-time homemakers (n = 100) aged 18-70 years completed a survey, including measures of psychological health (GHQ-12), general health (self-rated health) and conformity to feminine norms (CFNI)...
July 25, 2017: Women & Health
https://www.readbyqxmd.com/read/28742855/decreases-in-heart-rate-variability-are-associated-with-postoperative-complications-in-hip-fracture-patients
#6
Gernot Ernst, Leiv Otto Watne, Frede Frihagen, Torgeir Bruun Wyller, Andreas Dominik, Morten Rostrup
BACKGROUND: To explore relevant associations between deviations in linear and nonlinear heart rate variability (HRV) scores, and short-term morbidity and mortality in patients undergoing hip-surgery after a fracture. METHODS: 165 patients with hip fractures being admitted for surgery at two hospitals were included in a prospective cohort study. A short-term ECG was recorded within 24 hours of arrival. 15 patients had to be excluded due to insufficient quality of the ECG recordings...
2017: PloS One
https://www.readbyqxmd.com/read/28742738/necrotizing-enterocolitis-current-concepts-in-practice
#7
Alysia Agnoni, Christine Lazaros Amendola
Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in preterm infants and continues to be a major cause of morbidity and mortality. The incidence of NEC as well as mortality from the disease has persisted at unacceptably high levels for decades as current understanding of the cause remains incomplete. Identifying infants at risk and preventing NEC are mainstays of care. This article briefly examines disease presentation and treatment, identifies gaps in current understanding of disease pathology, and highlights new research that may lead to a decrease in the incidence of NEC in the future...
August 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28742708/postoperative-outcomes-of-minimally-invasive-gastrectomy-versus-open-gastrectomy-during-the-early-introduction-of-minimally-invasive-gastrectomy-in-the-netherlands-a-population-based-cohort-study
#8
Hylke J F Brenkman, Suzanne S Gisbertz, Annelijn E Slaman, Lucas Goense, Jelle P Ruurda, Mark I van Berge Henegouwen, Richard van Hillegersberg
OBJECTIVE: To compare postoperative outcomes of minimally invasive gastrectomy (MIG) to open gastrectomy (OG) for cancer during the introduction of MIG in the Netherlands. BACKGROUND: Between 2011 and 2015, the use of MIG increased from 4% to 53% in the Netherlands. METHODS: This population-based cohort study included all patients with curable gastric adenocarcinoma that underwent gastrectomy between 2011 and 2015, registered in the Dutch Upper GI Cancer Audit...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742704/racial-ethnic-disparities-in-longer-term-outcomes-among-emergency-general-surgery-patients-the-unique-experience-of-universally-insured-older-adults
#9
Cheryl K Zogg, Wei Jiang, Taylor D Ottesen, Shahid Shafi, Kevin Schuster, Robert Becher, Kimberly A Davis, Adil H Haider
OBJECTIVES: To determine whether racial/ethnic disparities in 30/90/180-day mortality, major morbidity, and unplanned readmissions exist among universally insured older adult (≥65 years) emergency general surgery patients; vary by diagnostic category; and can be explained by variations in geography, teaching status, age-cohort, and a hospital's percentage of minority patients. SUMMARY OF BACKGROUND DATA: As the US population ages and discussions surrounding the optimal method of insurance provision increasingly enter into national debate, longer-term outcomes are of paramount concern...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742701/postoperative-delirium-as-a-target-for-surgical-quality-improvement
#10
Julia R Berian, Lynn Zhou, Marcia M Russell, Melissa A Hornor, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
OBJECTIVE: To explore hospital-level variation in postoperative delirium using a multi-institutional data source. BACKGROUND: Postoperative delirium is closely related to serious morbidity, disability, and death in older adults. Yet, surgeons and hospitals rarely measure delirium rates, which limits quality improvement efforts. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Geriatric Surgery Pilot (2014 to 2015) collects geriatric-specific variables, including postoperative delirium using a standardized definition...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742698/survival-benefit-of-neoadjuvant-treatment-in-clinical-t3n0m0-esophageal-cancer-results-from-a-retrospective-multicenter-european-study
#11
Styliani Mantziari, Caroline Gronnier, Florence Renaud, Alain Duhamel, Jérémie Théreaux, Cécile Brigand, Nicolas Carrère, Jérémie H Lefevre, Arnaud Pasquer, Nicolas Demartines, Denis Collet, Bernard Meunier, Christophe Mariette
BACKGROUND: Based on current guidelines, clinical T3N0M0 esophageal tumors may or may not receive neoadjuvant treatment, according to their perception as locally advanced (cT3) or early-stage tumors (stage II). The study aim was to assess the impact of neoadjuvant treatment upon survival for cT3N0M0 esophageal cancer patients, with subgroup analyses by histological type (squamous cell carcinoma vs adenocarcinoma) and type of neoadjuvant treatment (chemotherapy vs radiochemotherapy). METHODS: Data from patients operated on for esophageal cancer in 30 European centers were collected...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742696/transanal-versus-transabdominal-minimally-invasive-completion-proctectomy-with-ileal-pouch-anal-anastomosis-in-ulcerative-colitis-a-comparative-study
#12
Anthony de Buck van Overstraeten, Anders Mark-Christensen, Karin A Wasmann, Vivian P Bastiaenen, Christianne J Buskens, Albert M Wolthuis, Koen Vanbrabant, André D'hoore, Willem A Bemelman, Anders Tottrup, Pieter J Tanis
OBJECTIVE: This study aims to compare surgical outcome of transanal ileal pouch-anal anastomosis (ta-IPAA) with transabdominal minimal invasive approach in ulcerative colitis (UC), using the comprehensive complication index (CCI). BACKGROUND: Recent evolutions in rectal cancer surgery led to transanal dissection of the rectum resulting in a better exposure of the distal rectum and presumed better outcome. The same approach was introduced for patients with UC, resulting in decreased invasiveness...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742692/oncologic-outcome-and-morbidity-in-the-elderly-rectal-cancer-patients-after-preoperative-chemoradiotherapy-and-total-mesorectal-excision-a-multi-institutional-and-case-matched-control-study
#13
Soo-Y Sung, Hong S Jang, Sung H Kim, Jae U Jeong, Songmi Jeong, Jin H Song, Mi J Chung, Hyeon M Cho, Hyung J Kim, Jun-Gi Kim, In K Lee, Jong H Lee
OBJECTIVE: To determine the toxicity and oncologic outcome of neoadjuvant chemoradiotherapy (CRT) followed by curative total mesorectal excision (TME) in the elderly (≥70 yrs) and younger (<70 yrs) rectal cancer patients. BACKGROUND: Sufficient data for elderly rectal cancer patients who received definitive trimodality have not been accumulated yet. PATIENTS AND METHODS: A total of 1232 rectal cancer patients who received neoadjuvant CRT and TME were enrolled in this study...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742677/committee-opinion-no-712-intrapartum-management-of-intraamniotic-infection
#14
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742673/practice-bulletin-no-181-prevention-of-rh-d-alloimmunization
#15
(no author information available yet)
Advances in the prevention and treatment of Rh D alloimmunization have been one of the great success stories of modern obstetrics. There is wide variation in prevalence rates of Rh D-negative individuals between regions, for example from 5% in India to 15% in North America (1). However, high birth rates in low prevalence areas means Rh hemolytic disease of the newborn is still an important cause of morbidity and mortality in countries without prophylaxis programs (1). In such countries, 14% of affected fetuses are stillborn and one half of live born infants suffer neonatal death or brain injury (1)...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742671/committee-opinion-no-712-summary-intrapartum-management-of-intraamniotic-infection
#16
(no author information available yet)
Intraamniotic infection, also known as chorioamnionitis, is an infection with resultant inflammation of any combination of the amniotic fluid, placenta, fetus, fetal membranes, or decidua. Intraamniotic infection is a common condition noted among preterm and term parturients. However, most cases of intraamniotic infection detected and managed by obstetrician-gynecologists or other obstetric care providers will be noted among term patients in labor. Intraamniotic infection can be associated with acute neonatal morbidity, including neonatal pneumonia, meningitis, sepsis, and death...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742667/practice-bulletin-no-181-summary-prevention-of-rh-d-alloimmunization
#17
(no author information available yet)
Advances in the prevention and treatment of Rh D alloimmunization have been one of the great success stories of modern obstetrics. There is wide variation in prevalence rates of Rh D-negative individuals between regions, for example from 5% in India to 15% in North America (1). However, high birth rates in low prevalence areas means Rh hemolytic disease of the newborn is still an important cause of morbidity and mortality in countries without prophylaxis programs (1). In such countries, 14% of affected fetuses are stillborn and one half of live born infants suffer neonatal death or brain injury (1)...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742642/pathway-for-the-management-of-sleep-apnea-in-the-cardiac-patient
#18
Emad F Aziz, Allison Selby, Edgar Argulian, Joshua Aziz, Eyal Herzog
Sleep-disordered breathing is a highly prevalent medical condition, which if undiagnosed leads to increased morbidity and mortality, particularly related to increased incidence of cardiovascular events. It is therefore imperative that we identify patient population at high risk for sleep apnea and refer them to the appropriate therapy as early as possible. Up-to-date there is no management guideline specifically geared towards cardiac patients. Thus, we propose a (SAP) Sleep Apnea Pathway to correctly identify and triage these patients to the appropriate therapy...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742594/cervical-evaluation-in-pregnancy-proper-measurement-evaluation-and-management
#19
Joseph R Wax, Angelina Cartin, Michael G Pinette
Preterm birth is the leading cause of perinatal morbidity and mortality in developed nations. The heterogeneous causes of spontaneous preterm birth make prediction and prevention difficult. The primary importance of transvaginal cervical sonography and cervicovaginal fetal fibronectin lies in their high negative predictive values in assessing risk for preterm birth. Cervical length may be useful in identifying women who are candidates for cervical cerclage or progesterone therapy for preterm birth prevention...
September 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742592/pregnancy-in-an-abnormal-location
#20
Ana Monteagudo, Julie A Romero, Ilan E Timor-Tritsch
Cesarean scar pregnancy and cervical pregnancy are 2 relatively rare types of abnormally implanted pregnancies. Both if unrecognized can result in significant morbidity to the patient. The most important issue regarding cesarean scar pregnancy and cervical pregnancy is to establish the diagnosis early in order for the patient to be adequately counseled and appropriate management carried out. For both of these conditions early detection and treatment can result in preservation of fertility.
September 2017: Clinical Obstetrics and Gynecology
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