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https://www.readbyqxmd.com/read/28540047/clinical-outcomes-for-the-obese-hospital-inpatient-an-observational-study
#1
K L Fusco, H C Robertson, H Galindo, P H Hakendorf, C H Thompson
OBJECTIVES: The prevalence of obesity presents a burden for Australian health care. The aim of this study was to determine whether severely obese hospital inpatients have worse outcomes. METHODS: This is an observational cohort study, using data from all adult patients admitted to hospital for all elective and emergency admissions of patients aged over 18 years to two large Australian urban hospitals. We measured their length of stay, intensive care unit admission rate, intensive care unit length of stay, mortality and readmission rates within 28 days of discharge and compared these outcomes in the severely obese and non-severely obese subjects using t-test or chi-square test as appropriate...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28537454/transfusion-requirements-in-elective-cardiopulmonary-bypass-surgery-patients-predictive-value-of-multiplate-and-thromboelastography-teg-platelet-mapping-assay
#2
Praleene Sivapalan, Anne Caroline Bäck, Sisse Rye Ostrowski, Hanne Berg Ravn, Pär Ingemar Johansson
Managing haemostasis in patients undergoing cardiopulmonary bypass (CPB) surgery remains a challenge. There is no established laboratory test to predict transfusion requirements in cardiac surgery. We investigated whether preoperative Thromboelastography (TEG) with Platelet Mapping Assay (PMA) or Multiple Electrode Aggrometry (MEA) could predict transfusion requirements in patients undergoing elective coronary artery bypass grafting (CABG) or combined CABG with aortic or mitral valve replacement. We prospectively investigated 199 patients undergoing elective CABG or combined procedures...
May 24, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28533072/relationship-between-transfusion-of-blood-products-and-the-incidence-of-thrombotic-complications-in-neonates-and-infants-undergoing-cardiac-surgery
#3
David Faraoni, Sirisha Emani, Erin Halpin, Rachel Bernier, Sitaram Emani, James A DiNardo, Juan C Ibla
OBJECTIVES: The authors hypothesized that transfusion of blood products in neonates and infants undergoing high-risk cardiac surgery in the absence of intraoperative coagulation monitoring increases the risk of thrombotic complications. DESIGN: Prospective observational study. SETTING: Neonates and infants undergoing cardiac surgery at a tertiary pediatric center. PARTICIPANTS: Neonates weighing >2.5 kg and infants ≤12 months of age undergoing elective cardiac surgery with cardiopulmonary bypass were included in this prospective observational study...
April 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28530180/red-eye-a-guide-for-non-specialists
#4
Andreas Frings, Gerd Geerling, Marc Schargus
BACKGROUND: Red eye can arise as a manifestation of many different systemic and ophthalmological diseases. The physician whom the patient first consults for this problem is often not an ophthalmologist. A correct assessment of the urgency of the situation is vitally important for the planning of further diagnostic evaluation and treatment. METHODS: This review is based on pertinent publications retrieved by a selective literature search in PubMed in August 2016 as well as on the authors' own clinical and scientific experience...
April 28, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28507580/impact-of-antenatal-oxytocin-infusion-on-neonatal-respiratory-morbidity-associated-with-elective-cesarean-section
#5
Ibrahim Abdelazim, Mohamed M M Farghali, Assem A M Elbiaa, Khaled M Abdelrazak, Mohamed Hussain, Amr H Yehia, Mona Rashad
INTRODUCTION: This study was designed to estimate respiratory morbidity associated with elective cesarean section (ECS) and to determine the effect of antenatal oxytocin exposure on this morbidity. MATERIAL AND METHODS: Nine hundred and sixty-five neonates ≥ 37 weeks' gestation delivered by cesarean section during 1 year were included in this retrospective study and classified into two groups according to oxytocin exposure before cesarean deliveries. Respiratory morbidity for each group was recorded and statistically analyzed...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#6
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28502744/effect-of-high-dose-sodium-selenite-in-cardiac-surgery-patients-a%C3%A2-randomized-controlled-bi-center-trial
#7
Tanja Schmidt, Hans Pargger, Esther Seeberger, Friedemann Eckhart, Stefanie von Felten, Christoph Haberthür
BACKGROUND & AIMS: Cardiac surgery is accompanied by oxidative stress and systemic inflammatory response, which may be associated with organ dysfunction and increased mortality. Selenium and selenoenzymes are important constituents of anti-oxidative defense. We hypothesized that high-dose sodium selenite supplementation can attenuate the postoperative inflammation and might, therefore, improve clinical outcome. METHODS: Randomized, placebo-controlled, double-blinded, bi-center study on 411 adult patients undergoing elective cardiac surgery...
May 2, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28494887/preoperative-risk-stratification-of-critically-ill-patients
#8
Curtis C Copeland, Andrew Young, Tristan Grogan, Eilon Gabel, Anahat Dhillon, Vadim Gudzenko
STUDY OBJECTIVE: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. DESIGN: Retrospective cohort analysis over a 21-month period...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28489682/personalised-prehabilitation-in-high-risk-patients-undergoing-elective-major-abdominal-surgery-a-randomized-blinded-controlled-trial
#9
Anael Barberan-Garcia, Marta Ubré, Josep Roca, Antonio M Lacy, Felip Burgos, Raquel Risco, Dulce Momblán, Jaume Balust, Isabel Blanco, Graciela Martínez-Pallí
OBJECTIVE: The aim of this study was to assess the impact of personalized prehabilitation on postoperative complications in high-risk patients undergoing elective major abdominal surgery. SUMMARY BACKGROUND DATA: Prehabilitation, including endurance exercise training and promotion of physical activity, in patients undergoing major abdominal surgery has been postulated as an effective preventive intervention to reduce postoperative complications. However, the existing studies provide controversial results and show a clear bias toward low-risk patients...
May 9, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28471523/laparoscopic-surgery-for-elective-abdominal-aortic-aneurysm-repair
#10
REVIEW
Lindsay Robertson, Sandip Nandhra
BACKGROUND: Abdominal aortic aneurysm (AAA) is an abnormal dilatation of the infradiaphragmatic aorta that is equal to or greater than 30 mm or a local dilatation of equal to or greater than 50% compared to the expected normal diameter of the artery. AAAs rarely occur in individuals under 50 years of age, but thereafter the prevalence dramatically increases with age, with men at a six-fold greater risk of developing an AAA than women. Prevalence of AAA has been reported to range from 1...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28467578/approach-to-inguinal-hernia-in-high-risk-geriatric-patients-should-it-be-elective-or-emergent
#11
Rıza Gürhan Işıl, Pınar Yazıcı, Uygar Demir, Cemal Kaya, Özgür Bostancı, Ufuk Oğuz İdiz, Canan Tülay Işıl, Mahmut Kaan Demircioğlu, Mehmet Mihmanlı
BACKGROUND: Elderly patients are more prone to have inguinal hernia due to weakened abdominal musculature. However, surgical repair of inguinal hernia (SRIH) may not be performed or may be delayed due to greater risk in presence of comorbidities. Present study is investigation of outcome of elective and emergency SRIH in geriatric patients. METHODS: Records of total of 384 high-risk (American Society of Anesthesiology classification III-IV) patients aged >65 years who underwent SRIH between January 2010 and December 2014 were reviewed...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28458732/does-the-timing-of-pre-operative-medical-evaluation-influence-perioperative-total-hip-arthroplasty-outcomes
#12
Roy H Lan, Atul F Kamath
BACKGROUND: Medical evaluation pre-operatively is an important component of risk stratification and potential risk optimization. However, the effect of timing prior to surgical intervention is not well-understood. We hypothesized that total hip arthroplasty (THA) patients seen in pre-operative evaluation closer to the date of surgery would experience better perioperative outcomes. METHODS: We retrospectively reviewed 167 elective THA patients to study the relationship between the number of days between pre-operative evaluation (range, 0-80 days) and surgical intervention...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28455602/comparison-of-the-incidences-of-hyponatremia-in-adult-postoperative-critically-ill-patients-receiving-intravenous-maintenance-fluids-with-140%C3%A2-mmol-l-or-35%C3%A2-mmol-l-of-sodium-retrospective-before-after-observational-study
#13
Masako Okada, Moritoki Egi, Yuri Yokota, Naotaka Shirakawa, Daichi Fujimoto, Shinya Taguchi, Nana Furushima, Satoshi Mizobuchi
PURPOSE: The purpose of this study was to compare the incidences of hyponatremia in adult postoperative critically ill patients receiving isotonic and hypotonic maintenance fluids. METHODS: In this single-center retrospective before/after observational study, we included patients who had undergone an elective operation for esophageal cancer or for head and neck cancer and who received postoperative intensive care for >48 h from August 2014 to July 2016. In those patients, sodium-poor solution (35 mmol/L of sodium; Na35) had been administered as maintenance fluid until July 2015...
April 28, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28449710/effects-of-colloid-pre-loading-on-thromboelastography-during-elective-intracranial-tumor-surgery-in-pediatric-patients-hydroxyethyl-starch-130-0-4-versus-5-human-albumin
#14
Yuanzhi Peng, Jianer Du, Xuan Zhao, Xueyin Shi, Yingwei Wang
BACKGROUND: Volume replacement therapy with colloid is still worth studying in major pediatric surgery with potential risk of bleeding. This study assessed the effects of 6% hydroxyethyl starch (HES) 130/0.4 and 5% Human Albumin (HA) on coagulation tested by thromboelastography (TEG) during elective intracranial tumor surgery in pediatric patients. METHODS: In this randomized controlled trial, 60 patients undergoing intracranial tumor resection under general anesthesia were assigned to HES and HA groups (n = 30), and administered preloads of 20 mL · kg(-1) HES 130/0...
April 27, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28449642/the-effectiveness-of-double-incision-technique-in-uterus-preserving-surgery-for-placenta-percreta
#15
Ibrahim Polat, Burak Yücel, Ali Gedikbasi, Halil Aslan, Aysun Fendal
BACKGROUND: Placenta percreta is a life-threatening condition that places patients at risk of massive bleeding. It necessitates very complicated surgery and can result in mortality. Caesarean hysterectomy is the accepted procedure worldwide; however, recent studies discussing conservative treatment with segmental resections have been published. Foetal extraction and segmental resection can be performed through the same incision (single uterine incision) or through two different incisions (double uterine incision)...
April 27, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28441316/hemolysis-following-intraoperative-cell-salvage-replacement-in-a-scoliosis-patient-with-sickle-cell-trait-a-case-report
#16
Daniel You, Alejandro Peiro Garcia, Fabio Ferri-de-Barros, David Parsons
STUDY DESIGN: Case Report. OBJECTIVE: To describe a novel presentation of acute renal failure associated with hemolysis following intraoperative cell salvage (ICS) in a neuromuscular scoliosis patient with sickle cell trait (SCT). SUMMARY OF BACKGROUND DATA: Hemolysis associated acute renal failure following ICS in patients with SCT has not been previously reported. Sickle cell disease is regarded as a relative contraindication for ICS due to the risk of red blood cell sickling in the hypoxic cell saver reservoir...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28431425/the-association-of-frailty-with-outcomes-and-resource-use-after-emergency-general-surgery-a-population-based-cohort-study
#17
Daniel I McIsaac, Husein Moloo, Gregory L Bryson, Carl van Walraven
BACKGROUND: Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty is an important predictor of adverse outcomes in older surgical patients. The population-level effect of frailty on EGS is poorly described. Therefore, our objective was to measure the association of preoperative frailty with outcomes in a population of older patients undergoing EGS. METHODS: We created a population-based cohort study using linked administrative data in Ontario, Canada, that included community-dwelling individuals aged >65 years having EGS...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28422948/beyond-the-uterine-environment-nonhuman-primate-model-to-investigate-maternal-fetal-and-neonatal-outcomes-following-chronic-intrauterine-infection
#18
Meredith A Kelleher, Zheng Liu, Xiaojie Wang, Christopher D Kroenke, Lisa A Houser, Brandy L Dozier, Lauren D Martin, Ken B Waites, Cindy McEvoy, Robert L Schelonka, Peta L Grigsby
BACKGROUND: Intrauterine infection is a significant cause of early preterm birth. We have developed a fetal-neonatal model in the rhesus macaque to determine the impact of chronic intrauterine infection with Ureaplasma parvum on early neonatal reflexes and brain development. METHODS: Time-mated, pregnant rhesus macaques were randomized to be inoculated with U. parvum (serovar 1; 10(5)cfu) or control media at ~120 dGA. Neonates were delivered by elective hysterotomy at 135-147 dGA (term=167d) stabilized and cared for in our nonhuman primate neonatal intensive care unit...
April 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28422917/an-adapted-clavien-dindo-scoring-system-in-trauma-as-a-clinically-meaningful-non-mortality-endpoint
#19
David N Naumann, Laura E Vincent, Nicola Pearson, Alastair Beaven, Iain M Smith, Kieran Smith, Emma Toman, Helen R Dorrance, Keith Porter, Charles E Wade, Bryan A Cotton, John B Holcomb, Mark J Midwinter
BACKGROUND: There is no consensus on reporting non-mortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery, and requires adaptation to provide meaningful data for trauma patients. In particular the original score does not account for those treated without surgery. We report an adapted Clavien-Dindo in trauma (ACDiT) scale and apply it to patients managed operatively and non-operatively. METHODS: A combined prospective and retrospective international multi-center observational study was undertaken to apply the ACDiT scale to 484 trauma patients at 3 university teaching hospitals (Birmingham, England (n=303); Houston, Texas (n=113); and Glasgow, Scotland (n=68))...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28417506/the-effect-of-intraoperative-hypothermia-upon-blood-transfusion-needs-and-length-of-stay-among-gastrointestinal-system-cancer-surgery
#20
V B Poveda, A S Nascimento
This cross-sectional study was performed to evaluate the relationship between intraoperative body temperature and the need for blood transfusion and length of stay in the post-anaesthetic care unit (PACU) or in the intensive care unit (ICU) among 79 patients undergoing elective oncology surgery of the digestive system. There was a statistically significant correlation between a lower temperature during surgery and medical diagnosis (p = .009), the use of bupivacaine anaesthesia (p = .016), anaesthesia time (p = ...
April 18, 2017: European Journal of Cancer Care
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