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https://www.readbyqxmd.com/read/29679726/late-presenting-dural-tear-incidence-risk-factors-and-associated-complications
#1
Wesley M Durand, J Mason DePasse, Eren O Kuris, JaeWon Yang, Alan H Daniels
BACKGROUND CONTEXT: Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), though estimates of LPDT range from 0.6 - 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29672297/preoperative-controlling-nutritional-status-score-predicts-mortality-after-hepatectomy-for-hepatocellular-carcinoma
#2
Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Takuro Fushimi, Toshiyoshi Fujiwara, Takahito Yagi
BACKGROUND: Preoperative nutritional status is reportedly associated with postoperative outcomes in patients with hepatocellular carcinoma. This study aimed to investigate the significance of the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) as predictors of postoperative outcomes. METHODS: We retrospectively reviewed data from 331 patients who underwent hepatectomy for hepatocellular carcinoma between January 2007 and December 2015...
April 19, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29662744/postoperative-complications-associated-with-rhbmp2-use-in-posterior-posterolateral-lumbar-fusion
#3
Nabil Esmail, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Hans-Joerg Meisel, Jong-Beom Park, Jim A Youssef, Jeffrey C Wang, S Tim Yoon
Study Design: Retrospective database review. Objective: Posterior/posterolateral lumbar fusion (PLF) is an effective treatment for a variety of spinal disorders; however, variations in surgical technique have different complication profiles. The aim of our study was to quantify the frequency of various complications in patients undergoing PLF with and without human recombinant bone morphogenetic protein 2 (rhBMP2). Methods: We queried the orthopedic subset of the Medicare database (PearlDiver) between 2005 and 2011 for patients undergoing PLF procedures with and without rhBMP2...
April 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29649951/biliary-ascariasis-presenting-with-gangrenous-perforation-of-the-gall-bladder-report-of-a-case-and-brief-review-of-literature
#4
Ankush Sharma, Priyansh Jariwala, Navneet Kaur
The most common cause of gallbladder perforation is calculous cholecystitis. Rarer causes include trauma, iatrogenic injuries, biliary stasis and gall bladder ischemia. We report a case of gall bladder gangrene with perforation, secondary to extensive ascariasis. A 45-year-old woman presented with acute intestinal obstruction and jaundice. She had abdominal distension and right hypochondrial tenderness. Abdominal radiography showed dilated bowel loops and ultrasonogram showed worms in the small intestine and biliary tree...
January 1, 2018: Tropical Doctor
https://www.readbyqxmd.com/read/29644069/clinical-course-after-parathyroidectomy-in-adults-with-end-stage-renal-disease-on-maintenance-dialysis
#5
Christopher Thiam Seong Lim, Thevandra Kalaiselvam, Normayah Kitan, Bak Leong Goh
Background: Parathyroidectomy (PTX) is done in cases of secondary hyperparathyroidism from chronic kidney disease to improve renal osteodystrophy. Despite this widespread practice, clinical outcomes regarding the benefits of this procedure are still lacking. Most studies in the literature have opted to report the laboratory outcome instead. Our study aimed to evaluate the postoperative clinical course for patients who had undergone total PTX without autoimplantation. Methods and results: All patients who underwent PTX between January 2010 and February 2014 in a tertiary referral center were included in this study and followed up for 12 months...
April 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29626305/prevalence-and-predictors-of-preoperative-venous-thromboembolism-in-asymptomatic-patients-undergoing-major-oncologic-surgery
#6
Melanie L Gainsbury, Jennifer Erdrich, Dani Taubman, James Mirocha, Nicholas Manguso, Farin Amersi, Allan W Silberman
BACKGROUND: Postoperative venous thromboembolism (VTE) is a leading cause of in-hospital mortality for cancer patients; however, the prevalence of preoperative VTE remains unclear. OBJECTIVE: The aim of this study was to evaluate the prevalence and risk factors associated with preoperative VTE in asymptomatic patients undergoing major oncologic surgery. METHODS: Retrospective analysis of 346 patients identified from our prospectively maintained database of patients undergoing abdominopelvic oncologic surgery from 2009 to 2016...
April 6, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29624550/urgent-pelvic-exenteration-should-the-indication-be-extended
#7
Charnjiroj Thiptanakit, Irin Chowchankit, Sirinya Panya, Prapon Kanjanasilp, Songphol Malakorn, Jirawat Pattana-Arun, Chucheep Sahakitrungruang
BACKGROUND: Pelvic exenteration carries significant risks of morbidity and mortality. Preoperative management is therefore crucial, and the exenteration procedure is usually performed in an elective setting. In cases of rectal cancer, however, tumor-related complications may cause a patient's condition to deteriorate rapidly, despite optimal management. Urgent pelvic exenteration then may be an option for these patients. OBJECTIVE: This study aims to compare the outcomes of pelvic exenteration between the urgent and elective settings...
May 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29605342/safety-and-postoperative-adverse-events-in-management-of-acute-mastoiditis-in-children-30-day-nsqip-outcomes
#8
Matthew G Crowson, Jeffrey Cheng
OBJECTIVE: To examine preoperative risk factors, postoperative 30-day outcomes and adverse events of acute mastoiditis using a national pediatric surgical database. METHODS: We explored our objectives using a cross-sectional analysis of a hospital-based reporting system database. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) pediatric database was used to identify surgical encounters for the treatment of acute mastoiditis from 2012 to 2015...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29595747/postoperative-infection-in-patients-undergoing-posterior-lumbosacral-spinal-surgery-a-pictorial-guide-for-diagnosis-and-early-treatment
#9
Shih-Hao Chen, Wen-Jer Chen, Meng-Huang Wu, Jen-Chung Liao, Chen-Ju Fu
Surgical site infections after posterior spinal surgery may lead to spondylodiscitis, pseudarthrosis, correction loss, adverse neurological sequelae, sepsis, and poor outcomes if not treated immediately. Infection rates vary depending on the type and extent of operative procedures, use of instrumentation, and patients' risk factors. Image evaluation is crucial for early diagnosis and should be complementary to clinical routes, laboratory survey, and treatment timing. Magnetic resonance imaging detects early inflammatory infiltration into the vertebrae and soft tissues, including hyperemic changes of edematous marrow, vertebral endplate, and abscess or phlegmon accumulation around the intervertebral disk, epidural, and paravertebral spaces...
March 27, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29582149/obtaining-central-access-in-challenging-pediatric-patients
#10
Cory N Criss, Jake Claflin, Matthew W Ralls, Samir K Gadepalli, Marcus D Jarboe
PURPOSE: Central catheter placement is one of the most commonly performed procedures by pediatric surgeons. Here, we present a case series of patients where central access was obtained at our institution with the utilization of a novel ultrasound-guided technique. This series represents the first of its kind where the native, parent vessels were inaccessible, resulting in a challenging situation for providers. METHODS: A retrospective chart review was performed in pediatric patients (0-17 years) at a tertiary care institution between July 2012 and November 2017 on all central line procedures where ultrasound was utilized to cannulate the brachiocephalic or superior vena cava in face of proximal occlusion...
March 26, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29579873/long-term-survival-and-evolution-of-the-kidney-function-for-liver-transplant-patients-who-required-postoperative-dialysis
#11
F Rosique, J B Cabezuelo, D Ferreras, M R González-Sánchez, J Ros, J A Pons, P A Cascales-Campos, F Sánchez-Bueno, R Robles, P Ramírez, P Parrilla
Patients who underwent orthotopic liver transplantation (OLT) frequently develop chronic kidney disease, with those who present postoperative acute kidney failure and require renal replacement therapy (RRT) at higher risk. The objective of the study was to assess the kidney function and long-term survival of patients who underwent OLT and required RRT during or in the immediate postoperative period. Medical records of OLT and postoperative RRT patients with over 6-month survival were reviewed between January 1, 2005, and December 31, 2015...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29578920/open-surgical-incisions-after-colorectal-surgery-improve-quality-metrics-but-do-patients-benefit
#12
Matthew G Mullen, Robert B Hawkins, Lily E Johnston, Puja M Shah, Florence E Turrentine, Traci L Hedrick, Charles M Friel
BACKGROUND: Surgical site infection is a frequent cause of morbidity after colorectal resection and is a quality measure for hospitals and surgeons. In an effort to reduce the risk of postoperative infections, many wounds are left open at the time of surgery for secondary or delayed primary wound closure. OBJECTIVE: The purpose of this study was to evaluate the impact of delayed wound closure on the rate of surgical infections and resource use. DESIGN: This retrospective propensity-matched study compared colorectal surgery patients with wounds left open with a cohort of patients with primary skin closure...
May 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29574180/venous-thromboembolism-related-readmission-in-emergency-general-surgery-patients-a-role-for-prophylaxis-upon-discharge
#13
Michael P DeWane, Kimberly A Davis, Kevin M Schuster, Adrian A Maung, Robert D Becher
BACKGROUND: Patients undergoing emergency general surgery (EGS) operations suffer high rates of venous thromboembolism (VTE). The rates at which thrombus formation occurs after discharge, and whether VTE prophylaxis upon discharge may be warranted to prevent readmission, is unknown. This analysis aimed to determine risk factors associated with VTE formation after discharge for EGS operations. STUDY DESIGN: An analysis of the American College of Surgeons NSQIP database from 2013 and 2014 of patients undergoing 10 common EGS operations in an emergent fashion...
March 21, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29568532/first-case-report-of-sepsis-caused-by-rhizobium-pusense-in-japan
#14
Tomokazu Kuchibiro, Katsuhisa Hirayama, Katsuyuki Houdai, Tatsuya Nakamura, Kenichirou Ohnuma, Junko Tomida, Yoshiaki Kawamura
Introduction: Species of the genus Rhizobium are opportunistic, usually saprophytic, glucose-non-fermenting, Gram-negative bacilli found in agricultural soil. Rhizobium pusense infections are the least common Rhizobium infections and have low incidence. Case presentation: Herein, we report the first case of sepsis with R. pusense in Japan in a 67-year-old Japanese woman with a history of hyperlipidaemia, hypertension, diabetes, hypothyroidism and osteoporosis. She had undergone cerebrovascular treatment because she was diagnosed with a subarachnoid haemorrhage...
January 2018: JMM Case Reports
https://www.readbyqxmd.com/read/29567029/through-knee-amputation-is-a-feasible-alternative-to-above-knee-amputation
#15
Sungho Lim, Michael J Javorski, Pegge M Halandras, Bernadette Aulivola, Paul R Crisostomo
OBJECTIVE: Through-knee amputation (TKA) is a rare amputation performed in <2% of all major lower extremity amputations in the United States. Despite biomechanical benefits and improved rehabilitation compared with above-knee amputation (AKA), TKA has largely been abandoned by vascular surgeons because of concerns for poor wound healing. The purpose of this study was to evaluate surgical outcomes of TKA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program between 2005 and 2012 was queried using Current Procedural Terminology codes indicating AKA and TKA...
March 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29560499/-epigenetics-important-aspects-for-anesthesiologists-pain-and-intensive-care-physicians
#16
REVIEW
A-K Reinhold, E Jentho, S T Schäfer, M Bauer, H L Rittner
Epigenetics, i.e. an altered reading of the genome without altering the genes themselves is a growing scientific field. A distinction is made between changes in the DNA by modification of the histones and non-coding RNA that alter the messenger (m)RNAs. Epigenetic modifications can be triggered by personal circumstances or other external factors and therefore influence the occurrence of diseases. Epigenetics are therefore of particular interest to anesthesiologists, pain specialists and intensive care physicians, as anesthetic drugs may have a long-term influence on protein transcription leading for example to alterations in neurocognition after anesthesia, chronification of postoperative pain and immune response in sepsis...
March 20, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29557528/intraoperative-red-blood-cell-transfusion-delayed-graft-function-and-infection-after-kidney-transplant-an-observational-cohort-study
#17
Michael Mazzeffi, Srikar Jonna, Natalia Blanco, Orestes Mavrothalassitis, Obi Odekwu, Magali Fontaine, Peter Rock, Kenichi Tanaka, Kerri Thom
BACKGROUND: Kidney transplant patients are frequently anemic and at risk for red blood cell (RBC) transfusion. Previous studies suggest that pre-transplant RBC transfusion may improve kidney transplant outcomes; however, RBC transfusion is also associated with infection. The purpose of our study was to characterize the relationships between intraoperative RBC transfusion, delayed graft function (DGF), postoperative surgical site infection (SSI), and sepsis. METHODS: Analysis was performed on a historical cohort of adult kidney transplant patients from a single medical center during a two-year period...
March 20, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29551302/impact-of-operative-time-on-adverse-events-following-primary-total-joint-arthroplasty
#18
Daniel D Bohl, Nathaniel T Ondeck, Brian Darrith, Charles P Hannon, Yale A Fillingham, Craig J Della Valle
BACKGROUND: Little is known regarding the impact of operative time on adverse events following arthroplasty. The present study tests for associations between a 15-minute increase in operative time and the occurrence of adverse events following primary total joint arthroplasty. METHODS: Patients undergoing primary total hip or knee arthroplasty during 2006-2013 were identified in the American College of Surgeons National Surgical Quality Improvement Program. Operative time (as a continuous variable) was tested for association with perioperative outcomes using multivariate regression...
February 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29548529/a-simple-predictor-of-post-operative-complications-after-open-surgical-adhesiolysis-for-small-bowel-obstruction
#19
David Asuzu, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Small bowel obstruction is common and often requires surgical management. Simple preoperative models are lacking to predict post-operative complications after surgical management of adhesive small bowel obstruction. METHODS: We retrospectively analyzed data from 15,036 patients who underwent open lysis of adhesions for small bowel obstruction from 2005 to 2013 using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database...
March 6, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29547910/facilitating-technologies-in-minimally-invasive-aortic-valve-replacement-a-propensity-score-analysis
#20
Konstadinos Plestis, Oleg Orlov, Vishal N Shah, Joshua Wong, Matthew Thomas, Alon Aharon, Cinthia Orlov, Georgia Panagopoulos, Scott Goldman
OBJECTIVES: Minimally invasive aortic valve replacement (MIAVR) can be technically demanding and may lead to prolonged operative time. We evaluated the intraoperative and postoperative patient outcomes following implementation of 2 facilitating technologies (FT) in MIAVR: the Cor-Knot titanium fastener and Custodiol-histidine-tryptophan-ketoglutarate solution. METHODS: A total of 299 patients underwent MIAVR from 2008 to 2016; 172 (57.5%) patients were included in the FT group and 127 (42...
March 14, 2018: Interactive Cardiovascular and Thoracic Surgery
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