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https://www.readbyqxmd.com/read/28731054/does-bariatric-surgery-prevent-progression-of-diabetic-retinopathy
#1
Y Chen, J P Laybourne, M T Sandinha, N Mw de Alwis, P Avery, D H Steel
PurposeTo assess the changes in diabetic retinopathy (DR) in type 2 diabetes (T2DM) patients post bariatric surgery and report on the risk factors that may be associated with it.Patients and methodsRetrospective observational study of T2DM patients who underwent bariatric surgery in a UK specialist bariatric unit between 2009 and 2015. Preoperative and postoperative weight, HbA1c, and annual DR screening results were collected from medical records. Patients with preoperative retinal screening and at least one postoperative retinal screening were eligible for analysis...
July 21, 2017: Eye
https://www.readbyqxmd.com/read/28728160/structural-changes-of-the-macula-on-optical-coherence-tomography-after-vitrectomy-for-proliferative-diabetic-retinopathy
#2
Jong Chan Im, Jong Ho Kim, Dong Ho Park, Jae Pil Shin
PURPOSE: This study aimed to evaluate the relationship between macular structural changes and visual prognosis after pars plana vitrectomy (PPV) for proliferative diabetic retinopathy. METHODS: The study included 60 eyes that had undergone PPV. Macular optical coherence tomography (OCT) findings were classified into 5 groups preoperatively and 10 groups postoperatively. Best-corrected visual acuity (BCVA) were analyzed according to pre- and postoperative OCT. RESULTS: From the preoperative OCT, normal fovea with/without traction, normal fovea with preretinal hemorrhage, and tractional retinal detachment involving fovea showed an increase in BCVA after PPV (all p < 0...
July 21, 2017: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/28724387/risk-factors-for-acute-surgical-site-infections-after-lumbar-surgery-a-retrospective-study
#3
Qi Lai, Quanwei Song, Runsheng Guo, Haidi Bi, Xuqiang Liu, Xiaolong Yu, Jianghao Zhu, Min Dai, Bin Zhang
BACKGROUND: Currently, many scholars are concerned about the treatment of postoperative infection; however, few have completed multivariate analyses to determine factors that contribute to the risk of infection. Therefore, we conducted a multivariate analysis of a retrospectively collected database to analyze the risk factors for acute surgical site infection following lumbar surgery, including fracture fixation, lumbar fusion, and minimally invasive lumbar surgery. METHODS: We retrospectively reviewed data from patients who underwent lumbar surgery between 2014 and 2016, including lumbar fusion, internal fracture fixation, and minimally invasive surgery in our hospital's spinal surgery unit...
July 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28712580/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#4
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
BACKGROUND: The del Nido cardioplegia (DC) procedure offers prolonged cardiac protection with single-dose administration and has proven safe in adult coronary artery bypass grafting (CABG) surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: Between August 2011 and May 2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n = 101) or DC (n = 77)...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28711332/predictors-of-operating-room-extubation-in-adult-cardiac-surgery
#5
Kathirvel Subramaniam, Diana S DeAndrade, Daniel R Mandell, Andrew D Althouse, Rajan Manmohan, Stephen A Esper, Jeffrey M Varga, Vinay Badhwar
OBJECTIVE: The primary objective of the study was to identify perioperative factors associated with successful immediate extubation in the operating room after adult cardiac surgery. The secondary objective was to derive a simplified predictive scoring system to guide clinicians in operating room extubation. METHODS: All 1518 patients in this retrospective cohort study underwent standardized fast-track cardiac anesthetic protocol during adult cardiac surgery. Perioperative variables between patients who had successful extubation in the operating room versus in the intensive care unit were retrospectively analyzed using both univariate and multivariable logistic regression analyses...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28709874/analysis-of-hospital-readmissions-after-prosthetic-urologic-surgery-in-the-united-states-nationally-representative-estimates-of-causes-costs-and-predictive-factors
#6
Filippo Pederzoli, Meera R Chappidi, Sarah Collica, Max Kates, Gregory A Joice, Nikolai A Sopko, Francesco Montorsi, Andrea Salonia, Trinity J Bivalacqua
BACKGROUND: The surgical treatment of urinary incontinence and erectile dysfunction by prosthetic devices has become part of urologic practice, although sparse data exist at a national level on readmissions and hospital costs. AIM: To assess causes and costs of early (≤30 days) and late (31-90 days) readmissions after implantation of penile prostheses (PPs), artificial urinary sphincters (AUSs), or PP + AUS. METHODS: Using the 2013 and 2014 US Nationwide Readmission Databases, sociodemographic characteristics, hospital costs, and causes of readmission were compared among PP, AUS and AUS + PP surgeries...
July 12, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28703300/a-point-based-prediction-model-for-cardiovascular-risk-in-orthotopic-liver-transplantation-the-car-olt-score
#7
Lisa B VanWagner, Hongyan Ning, Maureen Whitsett, Josh Levitsky, Sarah Uttal, John T Wilkins, Michael M Abecassis, Daniela P Ladner, Anton I Skaro, Donald M Lloyd-Jones
Cardiovascular disease (CVD) complications are important causes of morbidity and mortality after orthotopic liver transplantation (OLT). There is currently no preoperative risk assessment tool that allows physicians to estimate the risk for CVD events following OLT. We sought to develop a point-based prediction model (risk score) for CVD complications after OLT, the CAR-OLT risk score, among a cohort of 1024 consecutive patients aged 18-75 years who underwent first OLT in a tertiary-care teaching hospital (2002-2011)...
July 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28699061/hydroxypropyl-methylcellulose-2-for-dry-eye-prevention-during-phacoemulsification-in-senile-and-diabetic-patients
#8
Maierhaba Yusufu, Xin Liu, Tianyu Zheng, Fan Fan, Jianjiang Xu, Yi Luo
PURPOSE: To assess the effect of hydroxypropyl methylcellulose (HPMC) 2% to prevent dry eye during phacoemulsification in senile and diabetic patients. METHODS: This prospective interventional case series comprised 60 eyes (44 patients) with age-related cataract scheduled for standardized phacoemulsification surgery. The patients were assigned to receive either balanced saline solution (BSS, 30 eyes) or HPMC 2% (30 eyes) during surgery. Preoperative and postoperative examinations (1, 3, 7 and 30 days) included measurements of automatic noninvasive tear film breakup time (NITBUT), fluorescein staining, Schirmer I test, tear meniscus height, depth and area and subjective symptoms...
July 11, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28697103/chlorhexidine-alcohol-compared-with-povidone-iodine-for-preoperative-topical-antisepsis-for-abdominal-hysterectomy
#9
Shitanshu Uppal, Ali Bazzi, R Kevin Reynolds, John Harris, Mark D Pearlman, Darrell A Campbell, Daniel M Morgan
OBJECTIVE: To compare preoperative chlorhexidine-alcohol topical antiseptic agent with povidone-iodine in patients undergoing abdominal hysterectomy for benign indications. METHODS: A retrospective cohort study of patients undergoing abdominal hysterectomy from July 2012 to February 2015 in the Michigan Surgical Quality Collaborative was performed. The primary exposure was the use of chlorhexidine-alcohol or povidone-iodine. The primary outcome was surgical site infection within 30 days...
July 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28695457/the-role-of-laboratory-testing-in-differentiating-type-1-diabetes-from-type-2-diabetes-in-patients-undergoing-bariatric-surgery
#10
Scott J Pilla, Nisa M Maruthur, Michael A Schweitzer, Thomas H Magnuson, James J Potter, Jeanne M Clark, Clare J Lee
BACKGROUND: It may be difficult to distinguish between adults with type 1 diabetes and type 2 diabetes by clinical assessment. In patients undergoing bariatric surgery, it is critical to correctly classify diabetes subtype to prevent adverse perioperative outcomes including diabetic ketoacidosis. This study aimed to determine whether testing for C-peptide and islet cell antibodies during preoperative evaluation for bariatric surgery could improve the classification of type 1 versus type 2 diabetes compared to clinical assessment alone...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28692690/risk-of-surgical-site-infection-acute-kidney-injury-and-clostridium-difficile-infection-following-antibiotic-prophylaxis-with-vancomycin-plus-a-beta-lactam-versus-either-drug-alone-a-national-propensity-score-adjusted-retrospective-cohort-study
#11
MULTICENTER STUDY
Westyn Branch-Elliman, John E Ripollone, William J O'Brien, Kamal M F Itani, Marin L Schweizer, Eli Perencevich, Judith Strymish, Kalpana Gupta
BACKGROUND: The optimal regimen for perioperative antimicrobial prophylaxis is controversial. Use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. Thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (SSIs). Potential harms associated with combination regimens, including acute kidney injury (AKI) and Clostridium difficile infection (CDI), were also considered...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28691147/gastric-bypass-simultaneously-improves-adipose-tissue-function-and-insulin-dependent-type-2-diabetes-mellitus
#12
Adrian T Billeter, Spiros Vittas, Barbara Israel, Katharina M Scheurlen, Asa Hidmark, Thomas H Fleming, Stefan Kopf, Markus W Büchler, Beat P Müller-Stich
OBJECTIVE: The underlying causes of type 2 diabetes (T2DM) remain poorly understood. Adipose tissue dysfunction with high leptin, inflammation, and increased oxidative stress may play a pivotal role in T2DM development in obese patients. Little is known about the changes in the adipose tissue after Roux-Y gastric bypass (RYGB) in non-severely obese patients (BMI < 35 kg/m(2)) and since these patients have more T2DM-associated complications than obese patients ("obesity paradox"), we investigated changes in adipose tissue function in a cohort of BMI <35 kg/m(2) with insulin-dependent T2DM after RYGB surgery which resolves T2DM...
July 9, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28689732/applying-preoperative-dipyridamole-thallium-201-scintigraphy-for-preventing-cardiac-mortality-and-complications-for-patients-with-secondary-hyperparathyroidism-undergoing-parathyroidectomy
#13
Shih-Min Yin, Fong-Fu Chou, Shao-Chun Wu, Shun-Yu Chi
BACKGROUND: To evaluate the value of preoperative dipyridamole thallium-201 scintigraphy for reducing cardiovascular complication in secondary hyperparathyroidism (SHPTH) patients. METHODS: Thallium scintigraphy was arranged for all dialysis patients who underwent parathyroidectomy from Jan 2011 to July 2015. Management of defects on thallium scintigraphy included cardiac catheterization and ultrasonography. Analysis includes 30-day mortality, morbidity and the predicting factors for thallium scintigraphy defect...
July 6, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28688860/bleeding-during-laparoscopic-gastric-bypass-surgery-as-a-risk-factor-for-less-favorable-outcome-a-cohort-study-from-the-scandinavian-obesity-surgery-registry
#14
Erik Stenberg, Eva Szabo, Ingmar Näslund, Johan Ottosson
BACKGROUND: Intraoperative adverse events are known to be associated with postoperative complications; however, little is known about whether or not blood loss during laparoscopic gastric bypass surgery affects the outcome. OBJECTIVE: To see if intraoperative bleeding was associated with a less favorable outcome, and to identify patient-specific risk factors for intraoperative bleeding. SETTING: Nationwide, Sweden. METHODS: Patients who underwent laparoscopic gastric bypass surgery between January 8, 2007, and September 15, 2015, were included in the study...
June 2, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28688657/umbilical-necrosis-rates-after-abdominal-based-microsurgical-breast-reconstruction
#15
Joseph A Ricci, Parisa Kamali, Babette E Becherer, Daniel Curiel, Winona Wu, Adam M Tobias, Samuel J Lin, Bernard T Lee
BACKGROUND: Umbilical stalk necrosis represents a rare, yet important complication after abdominal-based microsurgical breast reconstruction, which is both underrecognized and understudied in the literature. Once identified, umbilical reconstruction can be an extremely challenging problem. METHODS: All consecutive breast free flaps at a single institution from February 2004 to February 2016 were reviewed, excluding non-abdominal-based flaps. Patients were divided based on the development of umbilical necrosis postoperatively...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28687029/impact-of-metabolic-syndrome-on-early-recovery-of-continence-after-robot-assisted-radical-prostatectomy
#16
Masatomo Nishikawa, Hiromitsu Watanabe, Toshifumi Kurahashi
OBJECTIVES: To evaluate the impact of metabolic syndrome on the early recovery of urinary continence after robot-assisted radical prostatectomy. METHODS: The present study included a total of 302 consecutive Japanese patients with clinically localized prostate cancer who underwent robot-assisted radical prostatectomy. In this study, postoperative urinary continence was defined as no leak or the use of a security pad. The continence status was assessed by interviews before and 1 and 3 months after robot-assisted radical prostatectomy...
July 7, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28682728/improved-quality-of-life-after-transtibial-amputation-in-patients-with-diabetes-related-foot-complications
#17
Dane K Wukich, Junho Ahn, Katherine M Raspovic, Javier La Fontaine, Larry A Lavery
The purpose of this study was to evaluate health-related quality of life after major lower-extremity amputation in a cohort of patients with diabetes mellitus. We evaluated 81 patients with diabetes and transtibial amputation (TTA) who had a minimum of 1 year of follow-up. Of these 81 patients, 50.6% completed the Short Form Survey (SF-36) and the Foot and Ankle Ability Measure (FAAM) preoperatively and postoperatively. Outcome measures before and after TTA were compared using Welch's ANOVA for continuous variables and Fisher's exact test for categorical variables...
June 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28682678/comparison-of-the-neutrophil-lymphocyte-ratio-and-c-reactive-protein-levels-in-patients-with-amputation-for-diabetic-foot-ulcers
#18
Hasan Metineren, Turan Cihan Dülgeroğlu
This study compared the effectiveness of the neutrophil/lymphocyte ratio (NLR) versus C-reactive protein (CRP) for evaluating the prognosis and degree of inflammation in patients with amputation for a diabetic foot ulcer (DFU). This study enrolled 56 patients with amputations for DFU with gangrene and compared the CRP levels and NLR measured before and after surgery. Overall, 24 patients (42%) died within 2 weeks postoperatively. Mortality increased with a preoperative/postoperative CRP difference ≤1.5 ( P < ...
March 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28682674/free-flap-transfer-for-coverage-of-transmetatarsal-amputation-stump-to-preserve-residual-foot-length
#19
Hyung Min Hahn, Kwang Sik Jeong, Myong Chul Park, Dong Ha Park, Il Jae Lee
Surgical management of soft-tissue defects of the forefoot and midfoot caused by trauma or diabetic complications can be challenging because locoregional tissue is insufficient to provide adequate flap. This deficiency necessitates higher-level amputations, such as Chopart or even transtibial amputation, resulting in far more debilitating functional outcomes than are seen with partial foot amputation. The purpose of this study was to examine the surgical outcomes after transmetatarsal amputation and a free-flap transfer to preserve foot length...
March 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28681261/laparoscopic-ileal-interposition-with-diverted-sleeve-gastrectomy-versus-laparoscopic-transit-bipartition-with-sleeve-gastrectomy-for-better-glycemic-outcomes-in-t2dm-patients
#20
Serdar Yormaz, Huseyin Yılmaz, Ilhan Ece, Mustafa Sahin
BACKGROUND: Metabolic procedures provide better outcomes for obese patients with type 2 diabetes mellitus. Our aim was to compare the glycemic regulation in patients that have undergone the laparoscopic ileal interposition with diverted sleeve gastrectomy (II-DSG), laparoscopic transit bipartition with sleeve gastrectomy (TB-SG), and laparoscopic sleeve gastrectomy (LSG) throughout a 12-month follow-up period retrospectively. METHODS: This study considered patients with T2DM who underwent metabolic procedures...
July 5, 2017: Obesity Surgery
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