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https://www.readbyqxmd.com/read/28453901/quasi-static-acoustic-tweezing-thromboelastometry
#1
R G Holt, D Luo, N Gruver, D B Khismatullin
BACKGROUND: Thromboelastography is widely used as a tool to assess the coagulation status of surgical patients. It allows observation of changes in material properties of whole blood, beginning with early stages of clot formation and ending with clot lysis. However, the contact activation of the coagulation cascade at surfaces of thromboelastographic systems leads to inherent variability and unreliability in predicting bleeding or thrombosis risks. OBJECTIVES: To develop acoustic tweezing thromboelastometry as a noncontact method for perioperative assessment of blood coagulation...
April 28, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28439634/long-term-clinical-outcomes-with-the-retropubic-tension-free-vaginal-tape-tvt-procedure-compared-to-burch-colposuspension-for-correcting-stress-urinary-incontinence-sui
#2
Bjørn Holdø, Margareta Verelst, Rune Svenningsen, Ian Milsom, Finn Egil Skjeldestad
INTRODUCTION AND HYPOTHESIS: The retropubic tension-free vaginal tape (TVT) procedure replaced Burch colposuspension as the primary surgical method for stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) in women in our department in 1998. In this study we compared the short-term and long-term clinical outcomes of these surgical procedures. METHODS: Using a case series design, we compared the last 5 years of the Burch procedure (n = 127, 1994-1999) with the first 5 years of the retropubic TVT procedure (n = 180, 1998-2002)...
April 24, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28434547/stress-dose-corticosteroid-versus-placebo-in-neonatal-cardiac-operations-a-randomized-controlled-trial
#3
Pertti K Suominen, Juho Keski-Nisula, Tiina Ojala, Paula Rautiainen, Timo Jahnukainen, Johanna Hästbacka, Pertti J Neuvonen, Olli Pitkänen, Jussi Niemelä, Anu Kaskinen, Jukka Salminen, Risto Lapatto
BACKGROUND: Corticosteroids can improve the hemodynamic status of neonates with postoperative low cardiac output syndrome after cardiac operations. This study compared a prophylactically administered stress-dose corticosteroid (SDC) regimen against placebo on inflammation, adrenocortical function, and hemodynamic outcome. METHODS: Forty neonates undergoing elective open heart operations were randomized into two groups. The SDC group received perioperatively 2 mg/kg methylprednisolone, and 6 hours after the operation, a hydrocortisone infusion (0...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28413495/perioperative-application-of-salvianolate-on-oxidative-stress-and-plasma-imd-adm2-in-patients-with-acute-myocardial-infarction-undergoing-pci
#4
Qiang Zhang, Fengjun Jiao, Chongjun Hua
The present study was conducted to investigate the effects of salvianolate on perioperative oxidative stress and plasma Intermedin/adrenomedullin 2 (IMD/ADM2) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). The clinical data of 108 patients with AMI treated by PCI were retrospectively analyzed. According to the use of salvianolate in perioperative period, the patients were divided into the study group (n=62) and the control group (n=46). The control group was given routine treatment while the study group was given routine treatment combined with intravenous infusion of salvianolate (200 mg administered once at 24 h before operation, once/day after operation, 1 week later, the curative effect was observed)...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28413278/work-related-stress-a-survey-of-indian-anesthesiologists
#5
Sumitra Ganesh Bakshi, Jigeeshu Vasishtha Divatia, Sadhana Kannan, Sheila Nainan Myatra
BACKGROUND AND AIMS: Work-related stress is common among medical caregivers and concerns all perioperative care providers. Although anesthesiologists are known to experience stress, there are limited Indian data addressing this issue. This survey was conducted among Indian anesthesiologists to determine their awareness about work stress and views regarding prevention programs. MATERIAL AND METHODS: A survey questionnaire was distributed to delegates visiting the exhibits at the national anesthesiology conference in 2011...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28407402/cirrhotic-cardiomyopathy-implications-for-liver-transplantation
#6
REVIEW
Hongqun Liu, Saumya Jayakumar, Mouhieddin Traboulsi, Samuel S Lee
The majority of the patients on a waiting list for liver transplantation have end-stage liver disease. Due to the marked peripheral vasodilatation of end stage cirrhosis that masks a latent myocardial dysfunction, cardiac abnormalities in the resting state are usually subclinical and escape the attention of physicians. However, when challenged, the systolic and diastolic contractile responses are attenuated. In addition to these contractile abnormalities, morphological changes such as enlargement or hypertrophy of cardiac chambers and electrophysiological repolarization changes including a prolonged QT interval can be observed...
April 13, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28394443/noninvasive-predictors-of-perioperative-atrial-arrhythmias-in-patients-with-tetralogy-of-fallot-undergoing-pulmonary-valve-replacement
#7
Daniel Cortez, Waseem Barham, Emily Ruckdeschel, Nandita Sharma, Anthony C McCanta, Johannes von Alvensleben, William H Sauer, Kathryn K Collins, Joseph Kay, Sonali Patel, Duy T Nguyen
BACKGROUND: Patients with tetralogy of Fallot (TOF) have increased risk of atrial arrhythmias. HYPOTHESIS: A measure of atrial dispersion, the P-wave vector magnitude (Pvm), can identify patients at risk for perioperative atrial flutter (AFL) or intra-atrial re-entrant tachycardia (IART) in a large TOF cohort. METHODS: We performed a blinded, retrospective analysis of 158 TOF patients undergoing pulmonary valve replacement between 1997 and 2015...
April 10, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28385477/espen-guideline-clinical-nutrition-in-surgery
#8
Arved Weimann, Marco Braga, Franco Carli, Takashi Higashiguchi, Martin Hübner, Stanislaw Klek, Alessandro Laviano, Olle Ljungqvist, Dileep N Lobo, Robert Martindale, Dan L Waitzberg, Stephan C Bischoff, Pierre Singer
Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidance of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, early enteral feeding is especially relevant for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e...
June 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28361743/the-role-of-nutritional-assessment-and-early-enteral-nutrition-for-combined-pancreas-and-kidney-transplant-candidates
#9
Sally Finlay, Argiris Asderakis, Adel Ilham, Doruk Elker, Dawn Chapman, Elijah Ablorsu
BACKGROUND: Early post-operative enteral nutrition is an important part of perioperative management and is strongly supported by ESPEN Guidelines. However, there is limited evidence into the use of Early Enteral Nutrition (EEN) after combined Pancreas and Kidney Transplantation (PKT). We know malnutrition in type-1 diabetics with end stage renal failure (ESRF) is a common problem and a significant risk factor. Therefore, we introduced EEN in our patients. METHOD: We monitored and recorded nutritional data on 29 PKT recipients who underwent transplantation between Oct 2007 and Jan 2010 without a nutritional assessment or EEN [Monitored Group (MG)] and on 30 PKT recipients between Feb 2010 and Dec 2013 who received a nutritional assessment and EEN (Naso-jejunal feed or oral intake with supplementation, according to their nutritional status) [Fed Group (FG)]...
February 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28357673/the-granulocyte-to-lymphocyte-ratio-as-a-marker-of-surgical-stress-and-a-predictor-of-postoperative-infectious-complications-after-gastric-cancer-surgery-an-analysis-of-patients-enrolled-in-a-prospective-randomized-trial
#10
Jun Lu, Hao Liu, Long-Long Cao, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Mi Lin, Ru-Hong Tu, Guo-Xin Li, Chang-Ming Huang
BACKGROUND: The granulocyte-to-lymphocyte ratio (GLR) in the blood may be a useful marker of surgical stress (SS) following surgery for cancer. The aim of the present study was to compare the SS by measuring the GLR, and further study the value of the GLR in predicting postoperative infectious complications (ICs). METHODS: Data from 201 gastric cancer patients at Fujian Medical University Union Hospital who were enrolled in our prospective randomized controlled trial were extracted for this study...
March 29, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28346770/a-core-outcome-set-for-localised-prostate-cancer-effectiveness-trials
#11
Steven MacLennan, Paula R Williamson, Hanneke Bekema, Marion Campbell, Craig Ramsay, James N'Dow, Sara MacLennan, Luke Vale, Philipp Dahm, Nicolas Mottet, Thomas Lam, Paul Abel, Hashim U Ahmed, Gary Akehurst, Robert Almquist, Karl Beck, David Budd, Steven Canfield, James Catto, Philip Cornford, William Cross, Alexander Ewen, Judith Grant, Rakesh Heer, David Hurst, Rob Jones, Roger Kockelbergh, Andrew Mackie, Graham MacDonald, Alan McNeill, Malcolm Mason, Sam McClinton, Duncan McLaren, Hugh Mostafid, Ian Pearce, Linda Pennet, Justine Royle, Hans Schreuder, Grant D Stewart, Henk van der Poel, Kevin Wardlaw, Thomas Wiegel
OBJECTIVE: To develop a core outcome set (COS) applicable for effectiveness trials of all interventions for localised prostate cancer. BACKGROUND: Many treatments exist for localised prostate cancer, although it is unclear which offers the optimal therapeutic ratio. This is confounded by inconsistencies in the selection, definition, measurement and reporting of outcomes in clinical trials. SUBJECTS AND METHODS: A list of 79 outcomes was derived from a systematic review of published localised prostate cancer effectiveness studies and semi-structured interviews with 15 prostate cancer patients...
March 27, 2017: BJU International
https://www.readbyqxmd.com/read/28346762/predicting-the-pain-continuum-after-adolescent-idiopathic-scoliosis-surgery-a-prospective-cohort-study
#12
V Chidambaran, L Ding, D L Moore, K Spruance, E M Cudilo, V Pilipenko, M Hossain, P Sturm, S Kashikar-Zuck, L J Martin, S Sadhasivam
BACKGROUND: Chronic postsurgical pain (CPSP) affects half a million children annually in the United States, with dire socioeconomic consequences, including long-term disability into adulthood. The few studies of CPSP in children are limited by sample size, follow-up duration, non-homogeneity of surgical procedure and factors evaluated. METHODS: In a prospective study of 144 adolescents undergoing a single major surgery (spine fusion), we evaluated demographic, perioperative, surgical and psychosocial factors as predictors of a continuum of postsurgical pain: immediate, pain maintenance at 2-3 months (chronic pain/CP) and persistence of pain a year (persistent pain/PP) after surgery...
March 27, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28346262/modeling-outcomes-modified-aortic-arch-advancement-for-neonatal-hypoplastic-arch
#13
Joseph R Nellis, Timothy K Chung, Nandita Agarwal, Jose E Torres, Sarah E Holgren, Madhavan L Raghavan, Joseph W Turek
OBJECTIVE: Numerous surgical approaches regarding aortic arch advancement for neonatal arch hypoplasia have been described. These repairs can be classified into two categories: those that incorporate a patch and those that do not. The decision between repairs remains largely experiential, rather than empirical, because of the limited number of reported outcomes. We report early outcomes from neonates undergoing modified aortic arch advancement with an anterior patch and our experience using computational fluid dynamic modeling to better understand the hemodynamic consequences associated with this repair...
March 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28344958/perioperative-administration-of-propranolol-to-women-undergoing-ovarian-cancer-surgery-a-pilot-study
#14
Hye-In Jang, Soo-Hyun Lim, Yoo-Young Lee, Tae-Joong Kim, Chel Hun Choi, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae
OBJECTIVE: This study was done to evaluate whether perioperative propranolol (ß-blocker) in ovarian cancer patients undergoing debulking surgery reduced perioperative tumor growth induced by surgical stress. METHODS: This was a prospective randomized single institution analysis. The primary objective was to compare the changes in CA 125 level (changes between preoperation day 2 and postoperative day 7). As a study arm, patients received a low dose of propranolol 40 mg/day (4×10 mg) starting two days before surgery and 40 mg twice daily for three days following surgery...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28323806/improving-pain-management-and-long-term-outcomes-following-high-energy-orthopaedic-trauma-pain-study
#15
Renan C Castillo, Srinivasa N Raja, Katherine P Frey, Heather A Vallier, Paul Tornetta, Todd Jaeblon, Brandon J Goff, Allan Gottschalk, Daniel O Scharfstein, Robert V OʼToole
Poor pain control after orthopaedic trauma is a predictor of physical disability and numerous negative long-term outcomes. Despite increased awareness of the negative consequences of poorly controlled pain, analgesic therapy among hospitalized patients after orthopaedic trauma remains inconsistent and often inadequate. The Pain study is a 3 armed, prospective, double-blind, multicenter randomized trial designed to evaluate the effect of standard pain management versus standard pain management plus perioperative nonsteroidal anti-inflammatory drugs or pregabalin in patients of ages 18-85 with extremity fractures...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28321983/chloroprocaine-for-epidural-anesthesia-in-infants-and-children
#16
REVIEW
Giorgio Veneziano, Joseph D Tobias
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28304415/vaginal-obliterative-procedures-for-pelvic-organ-prolapse-a-systematic-review
#17
REVIEW
Gunhilde M Buchsbaum, Toy Gee Lee
Importance: Pelvic organ prolapse is a common condition, the prevalence of which is likely to increase with the aging of our population. Also changing are parameters by which outcomes are assessed, shifting toward patient-centered care. Objective: To review vaginal obliterative procedures for surgical treatment of advanced pelvic organ prolapse historically and to discuss evidence on indications for colpocleisis, outcomes, and complications, as well as review pros and cons for concomitant vaginal hysterectomy and anti-incontinence procedures...
March 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28299332/relationship-between-angiotensin-converting-enzyme-apelin-and-new-onset-atrial-fibrillation-after-off-pump-coronary-artery-bypass-grafting
#18
Shu Xu, Jian Zhang, Yin-Li Xu, Hai-Bo Wu, Xiao-Dong Xue, Hui-Shan Wang
It has been shown that inflammation and oxidative stress are important factors in postoperative atrial fibrillation (POAF). Angiotensin converting enzyme (ACE) and apelin have a close relationship with inflammation and oxidative stress. The effect of ACE and apelin on POAF after off-pump coronary artery bypass grafting (OPCABG) remains a question. The concentrations of serum ACE, angiotensin II (Ang II), apelin, bradykinin (BK), malondialdehyde (MDA), and C reactive protein (CRP) were measured in the perioperative period of OPCABG...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#19
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28291129/frailty-and-anesthesia
#20
Lior Shem Tov, Idit Matot
PURPOSE OF REVIEW: This review will deliberate on contemporary concepts regarding the frailty syndrome and its association with the perioperative period. Frailty syndrome and its relevance to organ systems, scoring tools and intervention measures will be discussed in detail. RECENT FINDINGS: Frail patients have a reduced ability to respond to physical stress, similar to a decreased physiological reserve in the perioperative period. Frailty assessment is gaining popularity as a tool to guide medical interventions in the elderly population...
March 11, 2017: Current Opinion in Anaesthesiology
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