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https://www.readbyqxmd.com/read/28719890/effect-of-neoadjuvant-nab-paclitaxel-plus-gemcitabine-therapy-on-overall-survival-in-patients-with-borderline-resectable-pancreatic-cancer-a-prospective-multicenter-phase-ii-trial-nac-ga-trial
#1
Ken-Ichi Okada, Toshio Shimokawa, Seiko Hirono, Manabu Kawai, Masayuki Sho, Sohei Satoi, Ippei Matsumoto, Hidetoshi Eguchi, Yoshiaki Murakami, Suguru Yamada, Mariko Doi, Hiroki Yamaue
We conducted a prospective multicenter phase II trial of patients with borderline resectable pancreatic carcinoma to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (OS). The clinical trial primarily evaluated OS time from the first day of protocol therapy as a primary endpoint. The secondary endpoints were recurrence-free survival from the first day of protocol therapy, safety of the protocol therapy (adverse effect), morbidity based on the Clavien Dindo classification of more than III, response rate, preoperative/postoperative tumor marker (CA 19-9, CEA), rate of normalization, reduction rate of the maximum standardized uptake value on positron emission tomography-computed tomography (limited to institutions where positron emission tomography-computed tomography was available), chemotherapeutic effect grade based on Evans' classification, resection rate, R0 resection rate, surgical data (operative time, blood loss, transfusion, postoperative hospital day), overall morbidity rates (reoperation, rate of readmission, mortality), patient rate in postoperative adjuvant therapy (entry rate, completion rate), dose intensity, quality of life regarding fatigue and malaise assessed by the questionnaire of FACIT-F (Japanese version), and peripheral sensory neuropathy assessed by the questionnaire of the FACT/GOG-NTX subscale (version 4; Japanese version)...
July 19, 2017: Oncology
https://www.readbyqxmd.com/read/28718265/haemoglobinuria-and-portal-venous-thrombosis-in-a-young-male
#2
Zain Ul Abideen, Munnam Sohail Jafar, Nasir Hameed, Ahmad Malik
Paroxysmal nocturnal haemoglobinuria is a non-malignant stem cell disorder due to acquired somatic mutations in cell surface anchored proteins CD55 and CD59. Both have a compliment inhibitory role and their deficiency leads to intravascular haemolysis. This paper reports a challenging case of a 25 years old male who presented with generalized weakness, exertional dyspnoea and episodic early morning haematuria. Recently, he started developing progressive abdominal distention and dull generalized abdominal pain...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717867/totally-laparoscopic-living-donor-left-hepatectomy-for-liver-transplantation-in-a-child
#3
Helayel Almodhaiberi, Seok-Hwan Kim, Ki-Hun Kim
BACKGROUND: Minimally invasive surgery has been validated to be a new standard in living donor hepatectomy for adult-to-pediatric transplantation with less morbidity [1]. Laparoscopic donor hepatectomy can reduce the major concerns about pain and morbidity associated with open surgery and a slow return to daily activities of donors [2]. Herein, we present one case of totally laparoscopic living donor left hepatectomy including the middle hepatic vein (MHV). DONOR AND METHOD: A 37-year-old mother volunteered to donate to her 3-year-old son with biliary atresia (PELD score 7)...
July 17, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28717377/appropriate-blood-component-therapy-can-reduce-postcardiac-surgery-acute-kidney-injury-through-packed-cell-transfusion-reduction
#4
Kianoush Saberi, Mehrdad Salehi, Mehrzad Rahmanian, Ali Reza Bakhshandeh, Gholam Reza Massoumi
BACKGROUND: Acute kidney injury (AKI) can happen due to different factors such as anemia. Packed cell (PC) transfusion is an important cause of AKI occurrence. The aim of the study is to investigate whether appropriate blood component (BC) therapy can reduce blood transfusion and it would result in AKI decreasing. MATERIALS AND METHODS: We conducted a cohort study of 1388 patients who underwent cardiac surgery in one university hospital. A serum creatinine higher than 2 mg/dl, renal disease history, renal replacement therapy (chronic dialysis) were our exclusion criteria...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28713150/a-jehovah-s-witness-adolescent-in-the-labor-and-delivery-unit-should-patient-and-parental-refusals-of-blood-transfusions-for-adolescents-be-honored
#5
Johan Christiaan Bester, Martin Smith, Cynthia Griggins
A 15-year-old was admitted to the labor and delivery unit for induction of a 41-week-gestation pregnancy. Her parents, members of Jehovah's Witnesses, and the patient, who had been studying the religion but had not yet been baptized, were adamant that no blood transfusions would be accepted even if a life-threatening hemorrhage were to occur. In our analysis, we examine the underlying ethical conflict and issues raised by this case. We considered two important ethical questions in analyzing the dilemma: first, whether adolescents are capable of providing autonomous and authentic refusals for lifesaving interventions; and second, whether parents can refuse such interventions for their adolescent children based on their religious beliefs...
2017: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/28706382/cementless-acetabular-component-with-or-without-upward-placement-in-dysplasia-hip-early-results-from-a-prospective-randomised-study
#6
Zhiqi Zhang, Peihui Wu, Zhiyu Huang, Baoxi Yu, Hong Sun, Ming Fu, Yan Kang, Weiming Liao
BACKGROUND: Total hip arthroplasty (THA) in developmental dysplasia of hip (DDH) is difficult for the abnormal acetabulum. The purpose of this study was to evaluate the difference of anatomic and upward placement of acetabular component during early stage. METHODS: From April 2014 through June 2015, forty DDH patients (Crowe I to III, 42 hips) were prospectively randomized to either anatomic or upward group. Patient recorded diaries were collected. Radiographs were reviewed...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28703925/role-of-prophylactic-oxytocin-in-the-third-stage-of-labor-physiologic-versus-pharmacologically-influenced-labor-and-birth
#7
REVIEW
Elise N Erickson, Christopher S Lee, Cathy L Emeis
INTRODUCTION: Maternity care providers administer oxytocin prophylactically to prevent postpartum hemorrhage (PPH). Prophylactic oxytocin is generally considered effective and safe and is promoted by national organizations for standardized use. In this article, the evidence supporting prophylactic oxytocin administration for women undergoing spontaneous labor and birth compared with women whose labors included administration of exogenous oxytocin for induction or augmentation is explored...
July 13, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28702825/olfactory-dysfunction-and-quality-of-life-in-patients-with-transfusion-dependent-thalassemia
#8
Yasin Yilmaz, Zeynep Karakas, Busra Uzun, Comert Sen, Senol Comoglu, Kadir Serkan Orhan, Selime Aydogdu, Ayse Ozkan Karagenc, Deniz Tugcu, Serap Karaman, Crystal Wylie, Richard L Doty
Transfusion-dependent thalassemia (TDT) is a group of thalassemia syndromes that require regular blood transfusions for survival. It is unknown whether the sense of smell of patients with TDT is affected, and if so, whether smell loss has an adverse effect on quality of life (QOL). Olfactory thresholds were measured using Snap & Sniff(®) wands. QOL was assessed via the Short Form-36 (SF-36) questionnaire. Forty-two TDT patients from the Thalassemia Center in Istanbul Medical Faculty were tested (mean age 26...
July 12, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28702679/predictive-factors-of-bleeding-among-pediatric-patients-undergoing-percutaneous-nephrolithotomy
#9
Cagri Senocak, Ridvan Ozbek, Omer Faruk Bozkurt, Ali Unsal
The purpose of this study is to determine the perioperative risk factors for increased blood loss in children undergoing percutaneous nephrolithotomy (PCNL).We retrospectively reviewed the data on pediatric patients who had undergone PCNL for stone disease in our department. Blood loss estimation was quantified by measuring the changes in hematocrit plus the volume of red blood cells transfused. Univariate and multivariate linear regression analyses were performed to evaluate risk factors associated with increased blood loss after pediatric PCNL...
July 12, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28701190/a-novel-algorithm-for-the-treatment-strategy-for-advanced-epithelial-ovarian-cancer-consecutive-imaging-frailty-assessment-and-diagnostic-laparoscopy
#10
Kyung Jin Eoh, Jung Won Yoon, Jung-Yun Lee, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Young Tae Kim
BACKGROUND: This study aimed to evaluate the perioperative outcomes and prognostic impact of the consecutive steps of imaging, frailty assessment, and diagnostic laparoscopy (DLS) in patients with advanced epithelial ovarian cancer (EOC). METHODS: Patients diagnosed with EOC during 2012-2015 were analyzed retrospectively. Surgical and survival outcomes were compared between three treatment groups: patients without high tumor dissemination (HTD) who underwent primary debulking surgery (PDS group); patients with HTD who underwent DLS (DLS group); and patients with HTD diagnosed by cytological confirmation of malignancy followed by neoadjuvant chemotherapy (NACT group)...
July 12, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28700983/intratumoral-coagulation-by-radiofrequency-ablation-facilitated-the-laparoscopic-resection-of-giant-hepatic-hemangioma-a-surgical-technique-report-of-two-cases
#11
Shaohong Wang, Jun Gao, Mengmeng Yang, Shan Ke, Xuemei Ding, Jian Kong, Li Xu, Wenbing Sun
BACKGROUND: Traditionally, open hepatic resection is the first choice of treatment for symptomatic enlarging hepatic hemangiomas, which requires a large abdominal incision and is associated with substantial recovery time and morbidity. Minimally invasive laparoscopic resection has been used recently in liver surgery for treating selected hepatic hemangiomas. However, laparoscopic liver surgery poses the significant technical challenges and high rate of conversion. Radiofrequency (RF) ablation has been proved feasible in the treatment of hepatic hemangiomas with a size range of 5...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28700450/comparison-of-thirty-day-complications-between-navigated-and-conventional-single-level-instrumented-posterior-lumbar-fusion-a-propensity-score-matched-analysis
#12
Patawut Bovonratwet, Stephen J Nelson, Nathaniel T Ondeck, Benjamin J Geddes, Jonathan N Grauer
STUDY DESIGN: cohort comparison study. OBJECTIVE: To compare perioperative outcomes between navigated and conventional single-level instrumented posterior lumbar fusions in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: Although multiple studies have investigated the accuracy of pedicle screw placement and radiation exposure with navigation, no study has compared perioperative complications between navigated and conventional posterior lumbar fusion...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28697863/intra-articular-application-is-more-effective-than-intravenous-application-of-tranexamic-acid-in-total-knee-arthroplasty-a-prospective-randomized-controlled-trial
#13
Jin Wang, Qiaojie Wang, Xianlong Zhang, Qi Wang
BACKGROUND: The optimal administration route of tranexamic acid (TXA) in total knee arthroplasty (TKA), and the effect of TXA on hidden blood loss and total blood loss are undetermined. The purpose of this study was to compare the effectiveness of intravenous versus intra-articular application of tranexamic acid in patients undergoing knee arthroplasty. METHODS: A total of 150 patients undergoing primary unilateral total knee arthroplasty were randomly distributed to 3 groups (IV, intra-articular, and control group; each 50 patients) and administrated TXA (1 g IV and 50 mL intra-articular saline, 1 g intra-articularly and 50 mL intra-articular saline, and 0 g and 50 mL intra-articular saline, respectively)...
June 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28697860/multimodal-nutritional-management-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#14
Guorui Cao, Qiang Huang, Bin Xu, Zeyu Huang, Jinwei Xie, Fuxing Pei
BACKGROUND: This study aims at evaluating the effectiveness of a new multimodal nutritional management (MNM) on albumin (ALB) transfusion, the incidence of electrolyte disorders, blood loss, perioperative levels of ALB and electrolyte, length of hospital stay (LOH), and complications in patients following total knee arthroplasty without tourniquet. METHODS: A total of 162 patients were randomized to receive either the MNM protocol (n = 81, experimental group) or traditional protocol (n = 81, control group)...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28694078/robotic-versus-open-level-i-ii-inferior-vena-cava-thrombectomy-a-matched-group-comparative-analysis
#15
Liangyou Gu, Xin Ma, Yu Gao, Hongzhao Li, Xintao Li, Luyao Chen, Baojun Wang, Yongpeng Xie, Yang Fan, Xu Zhang
PURPOSE: To compare treatment outcomes of robotic inferior vena cava (IVC) thrombectomy (R-IVCTE) vs open IVC thrombectomy (O-IVCTE) for renal tumors with level I-II IVC tumor thrombus. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent either R-IVCTE or O-IVCTE between 2006 and 2015. To reduce the inherent biases of a nonrandomized study, robotic and open groups were matched 1:1 based on key variables. Perioperative data and oncologic outcomes were reviewed...
July 7, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28693742/impact-of-cirrhosis-in-patients-who-underwent-surgical-aortic-valve-replacement
#16
Robert J Steffen, Faisal G Bakaeen, Patrick R Vargo, Bogdan A Kindzelski, Douglas R Johnston, Eric E Roselli, A Marc Gillinov, Lars G Svensson, Edward G Soltesz
Cirrhosis is known to adversely affect cardiac surgery outcomes. Our objective was to quantify the morbidity, mortality, and cost that cirrhosis adds to surgical aortic valve replacement. From 1998 to 2011, 423,789 patients in the Nationwide Inpatient Sample Healthcare Cost Utilization Project underwent isolated aortic valve replacement; 2,769 (0.7%) had cirrhosis. Multivariable linear regression and 1:1 propensity matching were used to determine the effect of cirrhosis on postsurgical outcomes. The number of patients with cirrhosis who underwent surgical aortic valve replacement per year more than tripled during the 13-year study period...
May 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28693686/the-correlation-of-indices-in-r-teg-with-intra-operative-blood-loss-in-neurosurgical-patients
#17
Zhang Xue, Yu Xuerong, Huang Yuguang
Objective Intra-operative coagulopathy has a close relationship with blood loss and the prognosis of patients. Rapid-thrombelastography (r-TEG) is a comprehensive assessment of coagulation abnormalities and also an effective way for constructing blood transfusion. This study attempts to investigate the correlation of r-TEG indices with intra-operative hemorrhage.Methods Patients who underwent transphenoidal hypophysectomy and craniotomy from January 15 to April 30, 2013 in Peking Union Medical College hospital were recruited...
June 10, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28692467/intravenous-tranexamic-acid-bolus-plus-infusion-is-not-more-effective-than-a-single-bolus-in-primary-hip-arthroplasty-a-randomized-controlled-trial
#18
Paul J Zufferey, Julien Lanoiselée, Céline Chapelle, Dmitry B Borisov, Jean-Yves Bien, Pierre Lambert, Rémi Philippot, Serge Molliex, Xavier Delavenne, Béatrice Deygas, Mathilde Donnat, Juanita Techer, Laurent Tordella, Jean-Noël Fort, Nicolas Barbe, Julie Gavory, Sylvie Passot, Laetitia Burnol, Stéphanie Seve
BACKGROUND: Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce blood loss. METHODS: This prospective, double-blind, parallel-arm, randomized, superiority study was conducted in 168 patients undergoing unilateral primary hip arthroplasty...
July 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28692204/the-new-generation-super-mini-percutaneous-nephrolithotomy-smp-system-a-step-by-step-guide
#19
Guohua Zeng, Wei Zhu, Yang Liu, Junhong Fan, Zhijian Zhao, Chao Cai
OBJECTIVE: To present our novel miniaturized endoscopic system and describe a step-by-step guide for successful implementation of the super-mini percutaneous nephrolithotomy (SMP). METHODS: The new-generation SMP endoscopic system consists of (i) a 40,000-pixel super-mini nephroscope with an 8.0 F outer diameter and 7.5 F inner diameter dismountable sheath (ii) and a newly designed irrigation-suction sheath available in either 12 F or 14 F. The irrigation-suction sheath is a two-layered metal structure...
July 10, 2017: BJU International
https://www.readbyqxmd.com/read/28691229/desmopressin-use-for-minimising-perioperative-blood-transfusion
#20
REVIEW
Michael J Desborough, Kathryn Oakland, Charlotte Brierley, Sean Bennett, Carolyn Doree, Marialena Trivella, Sally Hopewell, Simon J Stanworth, Lise J Estcourt
BACKGROUND: Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed. OBJECTIVES: To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have inherited bleeding disorders...
July 10, 2017: Cochrane Database of Systematic Reviews
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