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https://www.readbyqxmd.com/read/28742789/evaluation-of-appropriate-venous-thromboembolism-prophylaxis-in-orthopaedic-trauma-patients-with-symptom-driven-vascular-and-radiographic-studies
#1
Christopher M Domes, Anneliese M Schleyer, James M McQueen, Ronald F Pergamit, Daphne M Beingessner
OBJECTIVE: To evaluate venous thromboembolism (VTE) prophylaxis adherence and effectiveness in orthopaedic trauma patients who had vascular or radiographic studies showing deep vein thromboses (DVTs) or pulmonary emboli (PEs). DESIGN: Retrospective review SETTING:: This study was conducted at a level I trauma center that independently services a 5 state region. The medical records of patients treated surgically between July 2010 and March 2013 were interrogated using a technical tool that electronically captures thrombotic event data from vascular and radiologic imaging studies via natural language processing...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28741745/venous-thromboembolism-prophylaxis-in-urology-a-review
#2
REVIEW
Manmeet Saluja, Peter Gilling
Venous thromboembolism is potentially a lethal problem, and is associated with chronic morbidity. Venous thromboembolism is frequently diagnosed after urological surgery, yet the role of perioperative venous thromboembolism prophylaxis is not clearly defined. Any current recommendations are largely based on evidence derived from other surgical specialties. Even within different guidelines, there remains significant variation, suggesting a consensus is required. The present review aims to define the problem of venous thromboembolism within the urological population, and identifies patients at risk...
July 25, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28739477/predictors-of-increased-cost-and-length-of-stay-in-the-treatment-of-postoperative-spine-surgical-site-infection
#3
Todd J Blumberg, Erik Woelber, Carlo Bellabarba, Richard Bransford, Nicholas Spina
Background Context While many risk factors are known to contribute to development of a post-operative surgical site infection (SSI) following spinal surgery, little is known regarding the costs associated management of this complication, or predictors for which patients that will require increased resources for management of SSI. Purpose The aim of this study is to identify specific risk factors for increased treatment costs and length of stay in the management of a postoperative SSI. Study Design/Setting Retrospective cohort study of all patients undergoing spine surgery at a single institution over three consecutive years...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28736350/antibiotic-prophylaxis-in-endoscopic-endonasal-pituitary-and-skull-base-surgery
#4
Laura Milanese, Matteo Zoli, Giacomo Sollini, Chiara Martone, Corrado Zenesini, Carmelo Sturiale, Paolo Farneti, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE: Postoperative infection is a potentially dramatic consequence in endoscopic endonasal surgery. The aim of this study is to assess the efficacy of our intraoperative antibiotic prophylaxis, analyzing the risk factors of postoperative meningitis in our series. METHODS: Each endoscopic endonasal procedure performed since 1998 in patients with no preoperative infections and a follow-up longer than 30 days have been included and retrospectively reviewed. Antibiotic protocol consisted in single antibiotic administration of ampicillin/sulbactam 3 g or cefazolin 2 g on induction, no postoperative administrations have been performed after 2005...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28736059/anti-factor-xa-measurements-in-acute-care-surgery-patients-to-examine-enoxaparin-dose
#5
Vanessa Wall, Kory I Fleming, Joseph E Tonna, Jade Nunez, Nick Lonardo, R Wayne Shipley, Ram Nirula, Christopher J Pannucci
BACKGROUND: The purpose of this study was to determine if fixed dose enoxaparin prophylaxis provided effective anticoagulation for acute care surgery patients and to examine whether a real-time enoxaparin dose adjustment algorithm optimized anticoagulation. METHODS: Acute care surgical patients placed on enoxaparin prophylaxis 30 mg twice daily were recruited prospectively. Peak steady state aFXa levels were drawn with a goal peak aFXa range of 0.2-0.4 IU/ml. A real time dose adjustment algorithm was implemented for patients with out-of-range levels...
July 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28735994/kidney-transplantation-using-gonadal-vein-for-venous-anastomosis-in-patients-with-iliac-vein-thrombosis-or-stenosis-a-series-of-cases
#6
J B G de Cerqueira, C M C de Oliveira, B G B Silva, L C O Santos, A G Fernandes, P F C B C Fernandes, E L Maia
BACKGROUND: Kidney transplantation is the treatment of choice for patients with end-stage renal disease. The standard surgery uses the recipient's iliac vessels for vascular anastomosis. Thrombosis and/or stenosis of the iliac vein, which are possible complications of multiple vascular access points for dialysis, can be detected intraoperatively, constituting a surgical challenge. An infrequently reported option is the use of the gonadal vein. OBJECTIVES: This study aims to evaluate the outcomes of venous anastomosis in the gonadal vein in patients with iliac vein thrombosis and/or stenosis submitted to kidney transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28733294/determining-the-worldwide-epidemiology-of-surgical-site-infections-after-gastrointestinal-resection-surgery-protocol-for-a-multicentre-international-prospective-cohort-study-globalsurg-2
#7
GlobalSurg Collaborative
INTRODUCTION: Surgical site infection (SSI) is the most common complication following major gastrointestinal surgery, affecting between 25% and 40% of patients. The rate of SSI doubles from low-income to high-income settings, persisting after risk adjustment. The relative impact of antibiotic-resistant organisms and the effectiveness of antibiotic prophylaxis globally are unknown. This study aims to determine SSI rates following gastrointestinal surgery across worldwide hospital settings...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28732590/cost-utility-of-evaluation-for-posterior-vitreous-detachment-and-prophylaxis-of-retinal-detachment
#8
Nicolas A Yannuzzi, Jonathan S Chang, Gary C Brown, William E Smiddy
PURPOSE: To evaluate the costs and cost-utility of examination for posterior vitreous detachment (PVD) and treatment of associated pathology, and of managing various other peripheral retinal disorders to prevent retinal detachment (RD). DESIGN: A decision analysis model of cost-utility. PARTICIPANTS: There were no participants. METHODS: Published retrospective data on the natural course of PVD, retinal tears, and lattice degeneration were used to quantitate the visual benefits of examination and treatment...
July 18, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28729097/post-caesarean-section-surgical-site-infection-surveillance-using-an-online-database-and-mobile-phone-technology
#9
Eliana Castillo, Corrine McIsaac, Bhreagh MacDougall, Douglas Wilson, Rosemary Kohr
BACKGROUND: Obstetric surgical site infections (SSIs) are common and expensive to the health care system but remain under reported given shorter postoperative hospital stays and suboptimal post-discharge surveillance systems. SSIs, for the purpose of this paper, are defined according to the Center for Disease Control and Prevention (1999) as infection incurring within 30 days of the operative procedure (in this case, Caesarean section [CS]). PRIMARY OBJECTIVE: Demonstrate the feasibility of real-life use of a patient driven SSIs post-discharge surveillance system consisting of an online database and mobile phone technology (surgical mobile app - how2trak) among women undergoing CS in a Canadian urban centre...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28723736/timing-of-preoperative-antibiotic-prophylaxis-in-54-552-patients-and-the-risk-of-surgical-site-infection-a-systematic-review-and-meta-analysis
#10
Stijn Willem de Jonge, Sarah L Gans, Jasper J Atema, Joseph S Solomkin, Patchen E Dellinger, Marja A Boermeester
The aim of the study was to assess the effect of timing of preoperative surgical antibiotic prophylaxis (SAP) on surgical site infection (SSI) and compare the different timing intervals.The benefit of routine use of SAP prior to surgery has long been recognized. However, the optimal timing has not been defined. For the purpose of developing recommendations for the World Health Organization guideline for SSI prevention, a systematic review and meta-analysis of all relevant evidence was conducted.Major medical databases were searched from 1990 to 2016...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28722085/-anatomical-planes-and-landmarks-of-transanal-total-mesorectal-excision-for-rectal-cancer-and-prophylaxis-of-intraoperative-complications
#11
Zhanlong Shen, Yingjiang Ye, Shan Wang
Total mesorectal excision (TME) is a mile-stone procedure in the history of rectal cancer surgery, but the exposure of surgical field of distal rectum is usually poor in patients with male, obese and narrow pelvis, which may lead to tumor residue and relative complications. Recently, a new technique called transanal TME (taTME) is considered to solve the above problems, but most medical centers are still in the learning curve of this procedure. Therefore, anatomical planes and landmarks of taTME for rectal cancer and prophylaxis of intraoperative complications are induced in this paper, which includes posterior plane: angle of anus and distal mesorectum and bleeding of mesorectum; rectosacral fascia and presacral bleeding; lateral and posterior-lateral plane: posterior branches of pelvic plexus and damage of anal function; anterior plane: vessel branches of neurovascular bundle and bleeding...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28721003/patient-compliance-with-venous-thromboembolism-prophylaxis-vte
#12
John Ross Blackwell, Parag Raval, John-Patrick Quigley, Amit Patel, Donald McBride
Venous thromboembolic disease (VTE) comprises pulmonary embolism (PE) and deep vein thrombosis (DVT), and causes morbidity and mortality, particularly in trauma and orthopaedic patients. Prevalence of 0.9% and 1.2% respectively are reported, with mortality rates up to 13.8%. Chemical thromboprophylactic agents including low molecular weight heparin (LMWH) are considered cost effective in reducing VTE risk. Evidence for anti-platelets including Aspirin for VTE prophylaxis is less compelling and is not supported as monotherapy...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28719459/coagulation-management-in-patients-undergoing-neurosurgical-procedures
#13
Chiara Robba, Rita Bertuetti, Frank Rasulo, Alessando Bertuccio, Basil Matta
PURPOSE OF REVIEW: Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures...
July 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28717841/variation-in-care-for-surgical-patients-with-colorectal-cancer-protocol-adherence-in-12-european-hospitals
#14
Ruben van Zelm, Ellen Coeckelberghs, Walter Sermeus, Anthony De Buck van Overstraeten, Arved Weimann, Deborah Seys, Massimiliano Panella, Kris Vanhaecht
PURPOSE: Surgical care for patients with colorectal cancer has become increasingly standardized. The Enhanced Recovery After Surgery (ERAS) protocol is a widely accepted structured care method to improve postoperative outcomes of patients after surgery. Despite growing evidence of effectiveness, adherence to the protocol remains challenging in practice. This study was designed to assess the adherence rate in daily practice and examine the relationship between the importance of interventions and adherence rate...
July 17, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28717532/retrograde-intrarenal-surgery-for-renal-stones-part-1
#15
REVIEW
Ben Van Cleynenbreugel, Özcan Kılıç, Murat Akand
The main aim in the treatment of renal stones is to clearance of the stones completely with the least morbidity. Parallel to the improvements in technology during recent years, new flexible ureterorenoscopes and effective lithotripters such as holmium laser have been developed, thus retrograde intrarenal surgery (RIRS) has become an efficient and safe option in the management of urinary system stone disease with a gradually increasing popularity. Therewithal, innovations in auxiliary equipment such as guide-wires, ureteral access sheath and stone baskets have made this procedure more effective...
June 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28711310/acquired-heterotopic-ossification-of-the-temporomandibular-joint
#16
REVIEW
L G Mercuri, B M Saltzman
Although the risk factors and diagnosis of heterotopic ossification (HO) are discussed in the orthopedics literature, the etiology of HO, as well as its prevention and management, remain theoretical. Furthermore, there is a lack of information in the literature regarding HO in temporomandibular joint replacement (TMJR). This article provides a qualitative review of information relative to the etiology, diagnosis, and management of HO to inform and encourage further investigation in TMJR. The orthopedic HO literature considered for this qualitative review was drawn from a comprehensive examination of the subject published previously by one of the authors...
July 12, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28708777/intraoperative-topical-antibiotics-for-infection-prophylaxis-in-pelvic-and-acetabular-surgery
#17
Matthew T Owen, Emily M Keener, Zane B Hyde, Reaves M Crabtree, Parke W Hudson, Russell L Griffin, Jason A Lowe
OBJECTIVES: Determine if topical vancomycin and tobramycin powder reduces the incidence of surgical site infection (SSI) following pelvic ring and acetabulum fracture surgery. DESIGN: Retrospective cohort study SETTING:: University of Alabama at Birmingham, Academic Level I Trauma Center PATIENTS/PARTICIPANTS:: 219 patients (140 meeting inclusion criteria) with pelvic and acetabular fractures who underwent open reduction and internal fixation (ORIF) from March 2012 to November 2013...
June 26, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28700413/venous-thromboembolism-after-major-venous-injuries-competing-priorities
#18
Brian Frank, Zoё Maher, Joshua P Hazelton, Shelby Resnick, Elizabeth Dauer, Anna Goldenberg, Andrea L Lubitz, Brian P Smith, Noelle N Saillant, Patrick M Reilly, Mark J Seamon
BACKGROUND: Venous thromboembolism (VTE) after major vascular injury (MVI) is particularly challenging as the competing risk of thrombosis and embolization after direct vessel injury must be balanced with risk of bleeding after surgical repair. We hypothesized that venous injuries, repair type and intraoperative anticoagulation would influence VTE formation after MVI. METHODS: A multi-institution, retrospective cohort study of consecutive MVI patients was conducted at 3 urban, level-I centers (2005-2013)...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28698745/new-surgical-technologies-could-facilitate-surgical-hemostasis-in-hemophilic-patients
#19
Milcho J Panovski, Igor V Fildishevski, Ljubomir Lj Ognjenovic, Violeta I Dejanova-Ilijevska
BACKGROUND: It's assumed that surgery in haemophilia can be accomplished these days safely. AIM: The aim of this study was to investigate the influence of new surgical technologies in the perioperative management and outcome of surgical procedures in haemophiliacs. METHODS: Two patients with mild haemophilia A underwent surgery (laparoscopic appendectomy and inguinal hernia repair). In both patients, the replacement therapy, with factor VIII, started 30 min before surgery...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28698538/warfarin-should-not-be-used-for-thromboprohylaxis-in-elective-major-orthopaedic-surgery-a-croatian-perspective
#20
Robert Kolundžić, Marijana Šimić Jovičić, Maja Ðinkić, Tadija Petrović, Tomislav Crnković, Vladimir Trkulja
Aim To identify modes of venous thromboembolism (VTE) prophylaxis in patients undergoing elective major orthopaedic surgery (total hip or knee arthroplasty, THA/TKA) at a single university-associated hospital in Croatia. Methods A retrospective analysis of consecutive patients subjected to THA or TKA over a two-year period (2014-2015) with a focus on anticoagulation during the first 15 post-surgical days (period of highest VTE risk). Results Of 603 identified patients three (0.5%) were not anticoagulated (haemophilia) and others received perioperative doses of low molecular weight heparins (LMWH)...
August 1, 2017: Medicinski Glasnik
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