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https://www.readbyqxmd.com/read/27915373/risk-factors-associated-with-postoperative-morbidity-in-over-500-colovesical-fistula-patients-undergoing-colorectal-surgery-a-retrospective-cohort-study-from-acs-nsqip-database
#1
H Hande Aydinli, Cigdem Benlice, Gokhan Ozuner, Emre Gorgun, Maher A Abbas
PURPOSE: The aim of this study was to evaluate the impact of various factors on 30-day postoperative morbidity in patients who underwent colorectal surgery (CRS) for colovesical fistula (CVF) in the elective and emergency settings. METHODS: Patients who underwent CRS for CVF between 2005 and 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program database by using current procedural terminology codes. Demographics, perioperative, and operative factors were assessed and compared between two groups classified according to the presence or absence of postoperative complications...
December 3, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27915239/emergency-cardiac-double-valve-surgery-in-active-infective-endocarditis-due-to-acinetobacter-baumannii-with-aortic-root-abscess-in-a-patient-with-dialysis-dependent-end-stage-renal-failure-a-rare-case-report
#2
Moosa Kunhi, Sachin Sanagar, N Jagadeesh, Bhima Shankar, Abi Abraham
We report an end-stage renal disease (ESRD) patient on regular haemodialysis awaiting renal transplant having native aortic valve endocarditis due to Acinetobacter baumannii complicated with aortic root abscess and severe mitral valve regurgitation with NYHA class IV symptoms. He underwent emergency aortic root abscess debridement, reconstruction with autologous pericardial patch and bioprosthetic aortic valve replacement along with mitral valve repair. This emergency intervention in active infective endocarditis due to A...
December 2, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27915066/the-impact-of-hospital-teaching-status-on-timing-of-intervention-inpatient-morbidity-and-mortality-after-surgery-for-vertebral-column-fractures-with-spinal-cord-injury
#3
Rafael De la Garza Ramos, Jonathan Nakhla, Rani Nasser, Ajit Jada, Daniel M Sciubba, Merritt D Kinon, Reza Yassari
OBJECTIVE: To investigate the impact of hospital teaching status on the timing of intervention and inpatient morbidity and mortality after surgery for acute spinal cord injury (SCI). METHODS: Data from the Nationwide Inpatient Sample (2002 - 2011) were reviewed. Patients were included if they had a diagnosis of closed vertebral column fracture with SCI, underwent spine surgery, and were admitted urgently or emergently. Early intervention (the day of or the day after admission), inpatient morbidity and mortality rates were compared between patients admitted to teaching versus nonteaching hospitals...
November 30, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27914655/crohn-s-disease
#4
REVIEW
Joana Torres, Saurabh Mehandru, Jean-Frédéric Colombel, Laurent Peyrin-Biroulet
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, with increasing incidence worldwide. Crohn's disease might result from a complex interplay between genetic susceptibility, environmental factors, and altered gut microbiota, leading to dysregulated innate and adaptive immune responses. The typical clinical scenario is a young patient presenting with abdominal pain, chronic diarrhoea, weight loss, and fatigue. Assessment of disease extent and of prognostic factors for complications is paramount to guide therapeutic decisions...
November 30, 2016: Lancet
https://www.readbyqxmd.com/read/27914584/outcome-of-poorly-functioning-kidneys-secondary-to-pujo-preserved-by-pyeloplast
#5
Yasir Ahmad Lone, Ram Samujh, Anish Bhattacharya, Ravi Prakash Kanojia
AIMS: To study the intermediate term to long-term functional status of kidneys with split renal function(SRF) <15% secondary to PUJO which are preserved by pyeloplasty and to find out whether these kidneys can recover or eventually need nephrectomy. METHODS: 24 patients with SRF<15% and undergoing pyeloplasty with or without prior percutaneous nephrostomy (PCN) were studied. Those with associated VUR, B/L disease and redo pyeloplasties were excluded. Follow up USG and EC scan were done at 3, 9 and 18months and yearly thereafter to document functional status after surgery...
November 26, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27912036/failure-to-redose-antibiotic-prophylaxis-in-long-surgery-increases-risk-of-surgical-site-infection
#6
Nongyao Kasatpibal, Joanne D Whitney, E Patchen Dellinger, Bala G Nair, Kenneth C Pike
BACKGROUND: Antibiotic prophylaxis is a key component of the prevention of surgical site infection (SSI). Failure to manage antibiotic prophylaxis effectively may increase the risk of SSI. This study aimed to examine the effects of antibiotic prophylaxis on SSI risk. METHODS: A retrospective cohort study was conducted among patients having general surgery between May 2012 and June 2015 at the University of Washington Medical Center. Peri-operative data extracted from hospital databases included patient and operation characteristics, intra-operative medication and fluid administration, and survival outcome...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27911120/new-frontiers-in-anticoagulation-non-vitamin-k-oral-anticoagulants-in-stroke-prevention
#7
Valentina Arnao, Marianna Riolo, Antonino Tuttolomondo, Antonio Pinto, Brigida Fierro, Paolo Aridon
Non vitamin-K oral anticoagulants (NOACs) are direct and specific inhibitors of the coagulation factors IIa (dabigatran) and Xa (apixaban, rivaroxaban, edoxaban) which share many pharmacokinetic properties. However, indications are lacking regarding the use of NOACs during thrombolysis, surgery and bleeding events. Areas covered: In this paper, the authors retrospectively analyzed the relevant literature on the NOACs using the PubMed and Google Scholar databases. Expert Commentary: Although warfarin is effective in cardioembolic stroke prevention, easier handling and more favorable risk-benefit profile often render NOACs a more preferable therapy choice for neurologists...
December 2, 2016: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27909825/poor-outcomes-of-gastric-cancer-surgery-after-admission-through-the-emergency-department
#8
Ian Solsky, Patricia Friedmann, Peter Muscarella, Haejin In
BACKGROUND: Outcomes after nonelective surgery for gastric cancer (GC) are poorly defined. Our objective was to compare outcomes of patients undergoing nonelective GC surgery after admission through the emergency department (EDSx) with patients receiving elective surgery or surgery after planned admission (non-EDSx) nationally. METHODS: The Nationwide Inpatient Sample (NIS) database was used to examine patients undergoing GC surgery between 2008 and 2012. Demographics and outcomes were compared between EDSx and non-EDSx...
December 1, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27909654/bone-substitutes-and-expanders-in-spine-surgery-a-review-of-their-fusion-efficacies
#9
Abhijeet Kadam, Paul W Millhouse, Christopher K Kepler, Kris E Radcliff, Michael G Fehlings, Michael E Janssen, Rick C Sasso, James J Benedict, Alexander R Vaccaro
STUDY DESIGN: A narrative review of literature. OBJECTIVE: This manuscript intends to provide a review of clinically relevant bone substitutes and bone expanders for spinal surgery in terms of efficacy and associated clinical outcomes, as reported in contemporary spine literature. SUMMARY OF BACKGROUND DATA: Ever since the introduction of allograft as a substitute for autologous bone in spinal surgery, a sea of literature has surfaced, evaluating both established and newly emerging fusion alternatives...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27909629/stereotactic-body-radiotherapy-for-hepatocellular-carcinoma-resulting-in-a-durable-relapse-free-survival-a-case-report
#10
Samual Francis, Ned Williams, Christopher J Anker, Akram Shaaban, Robin Kim, Dennis Shrieve, Jonathan Tward
The standard of care for localized hepatocellular carcinoma (HCC) is surgical resection. For patients who decline or who are unfit for surgery, stereotactic body radiotherapy (SBRT) is emerging as a viable treatment approach. We present a case of a 77-year-old female in whom an early stage HCC was incidentally discovered. Given her religious edicts as a devout Jehovah's Witness and her subsequent desire to avoid a blood transfusion, she declined surgical resection or transplant due to the risk of hemorrhage...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27909567/ovarian-reserve-may-be-compromised-after-adnexal-surgery-are-we-sufficiently-fertility-focused-in-our-surgical-training
#11
G S Kalra, S Campbell, G Nargund
There is a general trend towards delay in childbearing age amongst women. The ovarian reserve clearly falls with increasing age and the impact is greater with advancing age, particularly from late 30s. Presence of other risk factors can increase the risk of subfertility. A large number of women are exposed to pelvic surgery for various reasons, both elective and emergency. There is evidence that some of the pelvic surgery performed around ovaries and tubes has a negative impact on the ovarian reserve and in turn may cause a decline in woman's ability to conceive...
June 27, 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/27909276/-closure-of-ascending-aortic-entry-by-debranching-endovascular-management-in-an-elderly-patient-with-acute-stanford-type-a-dissection
#12
Munehiro Saiki, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Gaku Uchino, Takuya Kawabata, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida
An 85-year-old woman was hospitalized by emergency for an acute Stanford type A aortic dissection. Computed tomography showed a primary entry on the ascending aorta and pericardial effusion. Although her hemodynamics was unstable due to cardiac shock, her family wished no open surgery considering her age and frailty. A couple of days later, her condition became stabilized with antihypertensive therapy. Since the dissection was limited within the ascending aorta, closure of the entry with the stentgraft was considered appropriate and much less invasive as compared with an open surgery...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27909117/when-is-the-ideal-time-to-operate-on-a-patient-with-a-fracture-of-the-hip-a-review-of-the-available-literature
#13
REVIEW
P M Lewis, J P Waddell
Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to 'fast track' patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27909067/concept-and-evaluation-of-the-german-war-surgery-course-einsatzchirurgie-kurs-der-bundeswehr
#14
David A Back, K Waldmann, T Hauer, N Huschitt, M W Bowyer, U Wesemann, A Lieber, C Willy
INTRODUCTION: Military surgeons must be prepared to care for severe and complex life-threatening injuries rarely seen in the civilian setting. Typical civilian training and practice do not provide adequate exposure to the broad set of surgical skills required. The German Bundeswehr Medical Service has developed and refined the War Surgery Course (WSC) to meet this training gap. This article describes the recent experience with this readiness curriculum. METHODS: Run annually since 1998, WSC consists nowadays of 5 days with 20 theoretical modules...
December 1, 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27908820/true-aneurysm-of-the-inferior-thyroid-artery-a-case-report-and-literature-review
#15
Luigi Venturini, Paolo Sapienza, Raffaele Grande, Valerio Scarano Catanzaro, Fabrizio Fanelli, Luca di Marzo
Aneurysms of the inferior thyroid artery (ITA) are extremely rare and potentially determine severe sequelae. We report a case of true ITA aneurysm in a 45-year old Caucasian woman treated with endovascular embolization; postoperative course was uneventful and, at 6-month follow-up, the aneurysm is completely thrombized. A systematic review of the literature has been also performed to identify the epidemiologic and clinical characteristics and diagnostic and operative options of this disease. Size alone is not able to predict the fate of the aneurysm and an aggressive treatment seems to be justified because of the high risk of complications in case of rupture...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908815/regional-variation-in-postoperative-myocardial-infarction-in-patients-undergoing-vascular-surgery-in-the-united-states
#16
Andrea M Steely, Peter W Callas, Daniel Neal, Salvatore T Scali, Philip P Goodney, Andres Schanzer, Jack L Cronenwett, Daniel J Bertges
OBJECTIVE: To assess for regional variation in the incidence of postoperative myocardial infarction (POMI) following non-emergent vascular surgery across the United States in order to identify potential areas for quality improvement initiatives. METHODS: We evaluated POMI rates across 17 regional Vascular Quality Initiative (VQI) groups comprised of 243 centers with 1,343 surgeons who performed 75,057 vascular operations from 2010-2014. Four procedures were included in the analysis: carotid endarterectomy (CEA, n=39,118), endovascular abdominal aortic aneurysm (AAA) repair (EVAR, n=15,106), infra-inguinal bypass (INFRA, n=17,176), and open infra-renal AAA repair (OAAA, n=3,657)...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908808/emergency-hybrid-approach-to-ruptured-femoral-pseudoaneurysm-in-hiv-positive-intravenous-drug-abusers
#17
Maurizio Domanin, Giovanni Romagnoni, Silvia Romagnoli, Antonio Rolli, Livio Gabrielli
PURPOSE: Chronic traumatism of the common femoral artery due to intravenous injection in drug abusers, in association with local infections and arterial wall weakening caused by HIV, can lead to the development of pseudoaneurysms. Rupture of pseudoaneurysm is a dramatic event in such patients and its correction is difficult and controversial. Most of the cases reported describe open surgical elective options, that consist in ligation, repair or substitution of the damaged arterial segment, employing when possible biological grafts...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908765/long-term-requirement-for-pacemaker-implantation-after-cardiac-valve-replacement-surgery
#18
Francisco Leyva, Tian Qiu, David McNulty, Felicity Evison, Howard Marshall, Maurizio Gasparini
BACKGROUND: The risk of permanent pacemaker implantation (PPI) after cardiac valve replacement surgery is thought be highest in the post-operative period. Long-term risks are uncertain. OBJECTIVE: To determine rates and timing of PPI after valve replacement surgery. METHODS: We compared PPI rates patients undergoing aortic (AVR, n = 111,674), mitral (MVR, n = 18,402) valve replacement, AVR+MVR (n = 5,166) or AVR + MVR and tricuspid valve replacement (TVR, n = 114) or CABG without valve replacement (n=249,742)...
November 28, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27908619/correlation-of-dna-repair-gene-polymorphisms-with-clinical-outcome-in-patients-with-locally-advanced-non-small-cell-lung-cancer-receiving-induction-chemotherapy-followed-by-surgery
#19
Mariacarmela Santarpia, Jose Luis Ramirez, Itziar de Aguirre, Pilar Garrido, Maria Pérez Cano, Cristina Queralt, Jose Luis Gonzalez-Larriba, Amelia Insa, Mariano Provencio, Dolores Isla, Carlos Camps, Remei Blanco, Teresa Moran, Rafael Rosell
OBJECTIVE: The aim of this study was to evaluate whether xeroderma pigmentosum group D (XPD) and ribonucleotide reductase subunit M1 (RRM1) polymorphisms influenced clinical outcome in patients with stage IIIA-B non-small-cell lung cancer (NSCLC) treated with neoadjuvant gemcitabine/cisplatin/docetaxel followed by surgery. MATERIALS AND METHODS: A total of 109 patients with stage IIIA and IIIB NSCLC were prospectively genotyped to examine a potential association between XPD 312 (aspartic acid [Asp]/asparagine [Asn]), XPD 751 (lysine [Lys]/glutamine [Gln]), and RRM1 (-37 C/A) polymorphisms with response and survival...
November 9, 2016: Clinical Lung Cancer
https://www.readbyqxmd.com/read/27908316/-frail-patients-and-surgery
#20
Nadia A Henriksen, Frederik Helgstrand, Ismail Gögenur
It is estimated that 15% of patients above 65 years of age are frail. Frail patients have significantly higher risk of post-operative complications when undergoing both elective and emergency surgery than patients who are not frail. Therefore, it is recommended that all patients above 65 years are frailty scored prior to a surgical procedure. It seems advisable to include the following items in a multimodal frailty score: evaluation of the patient's cognitive ability, functional status, nutritional status and pulmonary and cardiac function...
November 21, 2016: Ugeskrift for Laeger
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