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https://www.readbyqxmd.com/read/29353319/management-strategies-for-noncardiac-surgery-following-a-coronary-artery-event
#1
REVIEW
Thomas F Whayne, Sibu P Saha
PURPOSE OF REVIEW: Coronary artery event includes acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery. Following such an event, risk of noncardiac surgery is increased. Of major concern is what can make this surgery safer? RECENT FINDINGS: High functional capacity improves cardiovascular (CV) risk; at least 4.0 metabolic equivalents (METs) on stress test are favorable. Risk scores can suggest need for further evaluation...
January 20, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29338830/application-of-cardiopulmonary-exercise-testing-in-enhanced-recovery-after-surgery
#2
Liang Yan Zhang, Zi Jia Liu, Le Shen, Yu Guang Huang
Enhanced recovery after surgery (ERAS) is a new perioperative concept that aims to reduce perioperative stress response and accelerate rehabilitation of patients through a variety of optimized management. With the wider application of this concept,the effective implementation of ERAS program has become a new challenge. Cardiopulmonary exercise testing (CPET) has shown promising value in the preoperative assessment,perioperative optimization,and postoperative rehabilitation of ERAS. This article reviews the application of CPET in ERAS,with an attempt to provide evidence for more detailed and comprehensive ERAS program...
December 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29335811/surgical-stress-response-and-promotion-of-metastasis-in-colorectal-cancer-a-complex-and-heterogeneous-process
#3
Corina Behrenbruch, Carolyn Shembrey, Sophie Paquet-Fifield, Christina Mølck, Hyun-Jung Cho, Michael Michael, Benjamin N J Thomson, Alexander G Heriot, Frédéric Hollande
Surgery remains the curative treatment modality for colorectal cancer in all stages, including stage IV with resectable liver metastasis. There is emerging evidence that the stress response caused by surgery as well as other perioperative therapies such as anesthesia and analgesia may promote growth of pre-existing micro-metastasis or potentially initiate tumor dissemination. Therapeutically targeting the perioperative period may therefore reduce the effect that surgical treatments have in promoting metastases, for example by combining β-adrenergic receptor antagonists and cyclooxygenase-2 (COX-2) inhibitors in the perioperative setting...
January 15, 2018: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/29332254/comparison-of-adjustable-continence-therapy-periurethral-balloons-and-artificial-urinary-sphincter-in-female-patients-with-stress-urinary-incontinence-due-to-intrinsic-sphincter-deficiency
#4
Lucas Freton, Lauranne Tondut, Isabelle Enderle, Juliette Hascoet, Andrea Manunta, Benoit Peyronnet
INTRODUCTION AND HYPOTHESIS: The objective was to compare the outcomes of the ACT® device with those of the artificial urinary sphincter (AUS) AMS 800 in the treatment of stress urinary incontinence (SUI) due to sphincter deficiency in women. METHODS: All the women who underwent surgical treatment for SUI due to intrinsic sphincter deficiency from 2007 to 2017 were included in a single-center retrospective study. The primary endpoint was the functional outcome...
January 13, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29325348/-multidisciplinary-team-building-in-enhanced-recovery-after-surgery
#5
W D Jia
There has been 10 years to explore the road in line with China's actual enhanced recovery after surgery(ERAS) since Academician Li Jieshou introduced the view of ERAS into China. ERAS has been widely carried out in the field of surgery, and gradually formed with Chinese characteristics of ERAS clinical pathway.The clinical implementation of ERAS relies on the effective integration of a series of perioperative methods, and any single technique or method can't completely reduce the perioperative physiological and psychological traumatic stress of the patient, so as to achieve the patient's rapid rehabilitation patient-centered multidisciplinary team(MDT)collaboration is an inevitable trend in ERAS development...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29310598/assessing-cardiovascular-risk-in-chronic-kidney-disease-patients-prior-to-kidney-transplantation-clinical-usefulness-of-a-standardised-cardiovascular-assessment-protocol
#6
Robin Ramphul, Maria Fernandez, Sam Firoozi, Juan C Kaski, Rajan Sharma, Debasish Banerjee
BACKGROUND: Despite pre-kidney-transplant cardiovascular (CV) assessment being routine care to minimise perioperative risk, the utility of such assessment is not well established. The study reviewed the evaluation and outcome of a standardised CV assessment protocol. METHODS: Data were analysed for 231 patients (age 53.4 ± 12.9 years, diabetes 34.6%) referred for kidney transplantation between 1/2/2012-31/12/2014. One hundred forty-three patients were high-risk (age > 60 years, diabetes, CV disease, heart failure, peripheral vascular disease) and offered dobutamine stress echocardiography (DSE); 88 patients were low-risk and offered ECG and echocardiography with/without exercise treadmill test...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29303803/postoperative-eras-interventions-have-the-greatest-impact-on-optimal-recovery-experience-with-implementation-of-eras-across-multiple-hospitals
#7
Mary-Anne Aarts, Ori D Rotstein, Emily A Pearsall, J Charles Victor, Allan Okrainec, Marg McKenzie, Stuart A McCluskey, Lesley Gotlib Conn, Robin S McLeod
BACKGROUND: Enhanced recovery after surgery (ERAS) programs incorporate evidence-based practices to minimize perioperative stress, gut dysfunction, and promote early recovery. However, it is unknown which components have the greatest impact. OBJECTIVE: This study aims to determine which components of ERAS programs have the largest impact on recovery for patients undergoing colorectal surgery. METHODS: An iERAS program was implemented in 15 academic hospitals...
January 4, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29283170/perioperative-events-influence-cancer-recurrence-risk-after-surgery
#8
REVIEW
Jonathan G Hiller, Nicholas J Perry, George Poulogiannis, Bernhard Riedel, Erica K Sloan
Surgery is a mainstay treatment for patients with solid tumours. However, despite surgical resection with a curative intent and numerous advances in the effectiveness of (neo)adjuvant therapies, metastatic disease remains common and carries a high risk of mortality. The biological perturbations that accompany the surgical stress response and the pharmacological effects of anaesthetic drugs, paradoxically, might also promote disease recurrence or the progression of metastatic disease. When cancer cells persist after surgery, either locally or at undiagnosed distant sites, neuroendocrine, immune, and metabolic pathways activated in response to surgery and/or anaesthesia might promote their survival and proliferation...
December 28, 2017: Nature Reviews. Clinical Oncology
https://www.readbyqxmd.com/read/29273446/stress-hyperglycemia-in-general-surgery-why-should-we-care
#9
Georgia Davis, Maya Fayfman, David Reyes-Umpierrez, Shahzeena Hafeez, Francisco J Pasquel, Priyathama Vellanki, J Sonya Haw, Limin Peng, Sol Jacobs, Guillermo E Umpierrez
AIMS: To determine the frequency of increasing levels of stress hyperglycemia and its associated complications in surgery patients without a history of diabetes. METHODS: We reviewed hospital outcomes in 1971 general surgery patients with documented preoperative normoglycemia [blood glucose (BG) <140mg/dL] who developed stress hyperglycemia (BG >140mg/dL or >180mg/dL) within 48h after surgery between 1/1/2010 and 10/31/2015. RESULTS: A total of 415 patients (21%) had ≥1 episode of BG between 140 and 180mg/dL and 206 patients (10...
November 29, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29260691/-fast-track-hip-arthroplasty
#10
Torben Bæk Hansen, Kirill Gromov, Billy B Kristensen, Henrik Husted, Henrik Kehlet
Fast-track surgery implies a coordinated perioperative approach aimed at reducing surgical stress and facilitating post-operative recovery. The fast-track programme has reduced post-operative length of stay and has led to shorter convalescence with more rapid functional recovery and decreased morbidity and mortality in total hip arthroplasty. It should now be a standard total hip arthroplasty patient pathway, but fine tuning of the multiple factors in the fast-track pathway is still needed in patients with special needs or high comorbidity burden...
December 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29248286/perioperative-evaluation-of-regional-aortic-wall-shear-stress-patterns-in-patients-undergoing-aortic-valve-and-or-proximal-thoracic-aortic-replacement
#11
Emilie Bollache, Paul W M Fedak, Pim van Ooij, Ozair Rahman, S Chris Malaisrie, Patrick M McCarthy, James C Carr, Alex Powell, Jeremy D Collins, Michael Markl, Alex J Barker
OBJECTIVES: To assess in patients with aortopathy perioperative changes in thoracic aortic wall shear stress (WSS), which is known to affect arterial remodeling, and the effects of specific surgical interventions. METHODS: Presurgical and postsurgical aortic 4D flow MRI were performed in 33 patients with aortopathy (54 ± 14 years; 5 women; sinus of Valsalva (d_SOV)/midascending aortic (d_MAA) diameters = 44 ± 5/45 ± 6 mm) scheduled for aortic valve (AVR) and/or root (ARR) replacement...
November 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29239202/validation-of-the-trust-tool-in-a-greek-perioperative-setting
#12
Vasiliki-Eirini Chatzea, Dimitra Sifaki-Pistolla, Nilanjan Dey, Evangelos Melidoniotis
The aim of this study was to translate, culturally adapt and validate the TRUST questionnaire in a Greek perioperative setting. The TRUST questionnaire assesses the relationship between trust and performance. The study assessed the levels of trust and performance in the surgery and anaesthesiology department during a very stressful period for Greece (economic crisis) and offered a user friendly and robust assessment tool. The study concludes that the Greek version of the TRUST questionnaire is a reliable and valid instrument for measuring team performance among Greek perioperative teams...
June 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29227289/perioperative-steroid-therapy-where-s-the-evidence
#13
Leon Freudzon
PURPOSE OF REVIEW: Review of historical and current evidence of adrenal suppression in patients on chronic glucocorticoid therapy during perioperative period, and discussion of current recommendations for perioperative stress dose steroid administration. RECENT FINDINGS: Evidence suggests low incidence of perioperative adrenal insufficiency in patients receiving chronic glucocorticoid therapy. Recent studies show no difference in survival or hemodynamic sequella by withholding perioperative stress steroids; however, these studies are limited in size and universal applicability...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29223955/high-density-lipoprotein-cholesterol-concentration-and-acute-kidney-injury-after-cardiac-surgery
#14
Loren E Smith, Derek K Smith, Jeffrey D Blume, MacRae F Linton, Frederic T Billings
BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is associated with increased short- and long-term mortality. Inflammation, oxidative stress, and endothelial dysfunction and damage play important roles in the development of AKI. High-density lipoproteins (HDLs) have anti-inflammatory and antioxidant properties and improve endothelial function and repair. Statins enhance HDL's anti-inflammatory and antioxidant capacities. We hypothesized that a higher preoperative HDL cholesterol concentration is associated with decreased AKI after cardiac surgery and that perioperative statin exposure potentiates this association...
December 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29211841/perioperative-benefit-and-outcome-of-thoracic-epidural-in-esophageal-surgery-a-clinical-review
#15
P Feltracco, A Bortolato, S Barbieri, E Michieletto, E Serra, A Ruol, S Merigliano, C Ori
Surgery for esophageal cancer is a highly stressful and painful procedure, and a significant amount of analgesics may be required to eliminate perioperative pain and blunt the stress response to surgery. Proper management of postoperative pain has invariably been shown to reduce the incidence of postoperative complications and accelerate recovery. Neuraxial analgesic techniques after major thoracic and upper abdominal surgery have long been established to reduce respiratory, cardiovascular, metabolic, inflammatory, and neurohormonal complications...
December 2, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29201518/transobturator-four-arms-mesh-in-the-surgical-management-of-stress-urinary-incontinence-with-cystocele
#16
Hammouda Sherif, Tarek Soliman Othman, Amr Eldkhakhany, Hussein Elkady, Adel Elfallah
Objective: This study aims to evaluate safety and efficacy of four arms polypropylene mesh in the long- term follow-up in the management of stress urinary incontinence (SUI) associated with cystocele. Material and methods: This prospective study was conducted on 50 female patients with SUI associated with cystocele. Patients underwent placement of transobturator four-arms mesh implants. Stress incontinence was evaluated using cough stress test with and without prolapse reduction, Stamey's grading of SUI, the validated Arabic version of the International Consultation on Incontinence Questionnaire-Short Form and King Health Questionnaire forms...
December 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29183208/s100b-increases-in-cyanotic-versus-noncyanotic-infants-undergoing-heart-surgery-and-cardiopulmonary-bypass-cpb
#17
Alessandro Varrica, Angela Satriano, Antonio D W Gavilanes, Luc J Zimmermann, Hans J S Vles, Francesca Pluchinotta, Luigi Anastasia, Alessandro Giamberti, Ekaterina Baryshnikova, Diego Gazzolo
AIMS: S100B has been proposed as a consolidated marker of brain damage in infants with congenital heart disease (CHD) undergoing cardiac surgery and cardiopulmonary bypass (CPB). The present study aimed to investigate whether S100B blood levels in the perioperative period differed in infants complicated or not by cyanotic CHD (CHDc) and correlated with oxygenation status (PaO2). METHODS: We conducted a case-control study of 48 CHD infants without pre-existing neurological disorders undergoing surgical repair and CPB...
November 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29180890/a-retrospective-study-on-analgesic-requirements-for-thoracoscopic-surgery-postoperative-pain
#18
Hiroaki Kuroda, Hitomi Mizuno, Hitoshi Dejima, Kiyoe Watanabe, Tatsuya Yoshida, Yumiko Naito, Yukinori Sakao
Background: Thoracoscopic surgery (TS) has been performed as a minimally invasive procedure since the beginning of the 1990s. This has led to a dramatic change in the postoperative condition of these patients, facilitating early ambulation and easier management of postoperative pain. However, empirical evidence on postoperative pain management after TS is limited. The aims of this study were to determine the efficacy and adequacy of postoperative analgesic medications and to simplify the choice of additional drugs based on a numerical rating scale (NRS)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29180080/long-term-outcome-after-carotid-endarterectomy-in-patients-with-ischemic-heart-disease
#19
Hyo Jung Nam, Sung Hyuk Heo, Bum Joon Kim, Jin San Lee, Hyo Chul Youn, Ji Sung Lee, Sun U Kwon, Cheryl D Bushnell, Dae-Il Chang
BACKGROUND: The long-term outcome after carotid endarterectomy (CEA) is determined by many confounding factors. Ischemic heart disease (IHD) is linked to atherosclerotic stroke, and it is an important cause of death during the perioperative and follow-up periods after CEA. We aimed to investigate mortality and long-term major adverse cardiovascular events (MACEs) in patients with IHD compared with patients who do not have IHD. METHODS: We consecutively enrolled 229 patients who underwent CEA procedures from 2000 to 2011...
November 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29178899/smoking-and-alcohol-cessation-intervention-in-relation-to-radical-cystectomy-a-qualitative-study-of-cancer-patients-experiences
#20
Susanne Vahr Lauridsen, Thordis Thomsen, Gudrun Kaldan, Line Noes Lydom, Hanne Tønnesen
BACKGROUND: Despite smoking and risky alcohol drinking being modifiable risk factors for cancer as well as postoperative complications, perioperative cessation counselling is often ignored. Little is known about how cancer patients experience smoking and alcohol interventions in relation to surgery. Therefore the aim of this study was to explore how bladder cancer patients experience a perioperative smoking and alcohol cessation intervention in relation to radical cystectomy. METHODS: A qualitative study was conducted in two urology out-patient clinics...
November 25, 2017: BMC Cancer
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