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https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#1
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte(®) ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg(-1) . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29149707/over-expression-of-cyclooxygenase-2-in-increased-reticulated-platelets-leads-to-aspirin-resistance-after-elective-off-pump-coronary-artery-bypass-surgery
#2
Xiaoxuan Gong, Xuezhong Wang, Zhuowen Xu, Tiantian Zhu, Qiu Zhang, Jinying Zhang, Xiaowei Wang, Chunjian Li
INTRODUCTION: Aspirin resistance (AR) has been reported to present after coronary artery bypass graft causing saphenous vein graft failure. We aimed to investigate the factors that affect the anti-platelet effect of aspirin after off-pump coronary artery bypass surgery (OPCAB). MATERIALS AND METHODS: Thirty OPCAB candidates were successively recruited. Platelet count, platelet aggregation, reticulated platelet (RP), platelets' cyclooxygenase (COX)-1 and COX-2 expressions were determined during the peri-operative period...
November 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29146432/predictors-of-hospital-length-of-stay-and-30-day-readmission-in-cervical-spondylotic-myelopathy-patients-an-analysis-of-3057-patients-using-the-acs-nsqip-database
#3
Peter G Passias, Cyrus M Jalai, Nancy Worley, Shaleen Vira, Saqib Hasan, Samantha R Horn, Frank A Segreto, Cole A Bortz, Andrew P White, Michael Gerling, Virginie LaFage, Thomas Errico
BACKGROUND: Hospital length of stay (LOS), 30-day readmission rate, and other metrics are increasingly being used to evaluate quality of surgical care. The factors most relevant to cervical spondylotic myelopathy (CSM) are not yet established. OBJECTIVE: To identify peri-operative factors associated with extended LOS and/or 30-day readmission following elective surgery for CSM. METHODS: Surgical CSM patients at institutions represented by the American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program (ACS-NSQIP) from 2010-2012 were included...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29145351/comparison-of-treatment-of-acute-unstable-distal-clavicle-fractures-using-anatomical-locking-plates-with-versus-without-additional-suture-anchor-fixation
#4
Jixing Fan, Yufu Zhang, Qiang Huang, Xieyuan Jiang, Liang He
BACKGROUND Surgical managements were recommended for unstable distal clavicle fracture owing to the high incidence of nonunion. The present study compared the efficacy of anatomical locking plate with versus without additional suture anchor fixation for the treatment of unstable Neer type II distal clavicle fractures. MATERIAL AND METHODS Between January 2013 to January 2015, 28 consecutive patients with unstable Neer type II  fractures were treated by using anatomical locking plate with or without additional suture anchor fixation...
November 16, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29141358/-effect-of-different-tourniquet-releasing-strategy-on-blood-loss-in-total-knee-arthroplasty
#5
Y Li, M Lu, H Tian, Z J Li, K Zhang
Objective: To explore the influences on peri-operative blood loss and postoperative blood transfusion in primary total knee arthroplasty when using different methods to release the pneumatic tourniquet. Methods: From January 2015 to December 2016, 484 patients with osteoarthritis were enrolled, undergoing primary unilateral total knee arthroplasty in the Orthopedics Department of Peking University Third Hospital. Retrospective data was used, and all the patients had been operated on by three independent working groups...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29138486/the-impact-of-a-specialized-spinal-cord-injury-center-as-compared-with-non-specialized-centers-on-the-acute-respiratory-management-of-patients-with-complete-tetraplegia-an-observational-study
#6
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Martin Albert, Jean-Marc Mac-Thiong
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the proportion of tracheostomy placement and duration of mechanical ventilation (MV) in patients with a complete cervical spinal cord injury (SCI) that were managed early or lately in a specialized acute SCI-center. The second objective was to determine the impact of the timing of admission to the SCI-center on the MV support duration. SETTING: A single Level-1 trauma center specialized in SCI care in Quebec (Canada)...
November 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29135348/development-of-a-surgical-infection-surveillance-program-at-a-tertiary-hospital-in-ethiopia-lessons-learned-from-two-surveillance-strategies
#7
Jared A Forrester, Luca Koritsanszky, Benjamin D Parsons, Menbere Hailu, Demisew Amenu, Seifu Alemu, Fekadu Jiru, Thomas G Weiser
BACKGROUND: Surgical site infections (SSIs) are a leading cause of post-operative morbidity and mortality. We developed Clean Cut, a surgical infection prevention program, with two goals: (1) Increase adherence to evidence-based peri-operative infection prevention standards and (2) establish sustainable surgical infection surveillance. Here we describe our infection surveillance strategy. PATIENTS AND METHODS: Clean Cut was piloted and evaluated at a 523 bed tertiary hospital in Ethiopia...
November 14, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29132797/cloaca-reconstruction-a-new-algorithm-which-considers-the-role-of-urethral-length-in-determining-surgical-planning
#8
Richard J Wood, Carlos A Reck-Burneo, Daniel Dajusta, Christina Ching, Rama Jayanthi, D Gregory Bates, Molly E Fuchs, Katherine McCracken, Geri Hewitt, Marc A Levitt
BACKGROUND: Cloacal malformations represent a uniquely complex challenge for surgeons. The surgical approach to date has been based on the common channel (CC) length with two patient groups considered: less than or greater than 3cm, which we believe is an oversimplification. We reviewed 19 patients, referred after surgery done elsewhere. Eight had postoperative urinary complications, 3 had constant urinary leakage and had been left after surgery with a urethra <1cm, .5 with an original 3 to 5cm common channel, who had undergone total urogenital mobilization (TUM), experienced peri-operative urethral loss needing a vesicostomy, and later, a Mitrofanoff...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29129087/surgical-management-of-esophageal-cancer
#9
Raj G Vaghjiani, Daniela Molena
Esophageal cancer (EC) is an aggressive malignancy associated with an overall poor prognosis. The specific risk factors for EC vary by histologic type as well as geographic distribution but there is no widely applicable screening strategy to date. Patients can present with vague symptoms which can prove to be a diagnostic challenge. Furthermore, cases tend to present at a late stage, making therapeutic approach difficult. Despite ongoing changes in management strategy, surgery remains the only viable option for cure in early stage malignancy...
October 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/29123664/chronic-post-amputation-pain-peri-operative-management-review
#10
Devjit Srivastava
Study design: Narrative review. Method: Eight bibliographic databases were searched for studies published in the (last five years up until Feb 2017). For the two database searches (Cochrane and DARE), the time frame was unlimited. The review involved keyword searches of the term 'Amputation' AND 'chronic pain'. Studies selected were interrogated for any association between peri-operative factors and the occurrence of chronic post amputation pain (CPAP). Results: Heterogeneity of study populations and outcome measures prevented a systematic review and hence a narrative synthesis of results was undertaken...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29121474/outcomes-following-video-assisted-thoracoscopic-lobectomy-versus-open-lobectomy-for-early-stage-lung-cancer-in-older-adults
#11
Nicole Ezer, Minal Kale, Keith Sigel, Sameer Lakha, Grace Mhango, Emily Goodman, Daniel Nicastri, Scott Swanson, Alfred Neugut, Juan P Wisnivesky
RATIONALE: Video-assisted thoracoscopic surgery and open lobectomy are both standard of care for treatment of early stage NSCLC because of equivalent long-term survival. OBJECTIVE: To evaluated whether the improved peri-operative outcomes associated with VATS are explained by differences in case volume and specialty training. METHODS: We analyzed the Surveillance, Epidemiology and End Results-Medicare linked registry to identify stage I-II NSCLC in patients above 65 years of age...
November 9, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29110930/determinants-of-acute-kidney-injury-and-renal-function-decline-after-endovascular-abdominal-aortic-aneurysm-repair
#12
Randolph G Statius van Eps, Banne Nemeth, Ronne T A Mairuhu, Jan J Wever, Hugo T C Veger, Hans van Overhagen, Lukas C van Dijk, Bob Knippenberg
OBJECTIVE/BACKGROUND: Endovascular aneurysm repair (EVAR) may be associated with renal injury and more insight is needed into potential risk factors. The aim was to identify clinical, anatomical, and peri-procedural parameters as potential risk factors for the occurrence of acute kidney injury (AKI) and to evaluate chronic kidney disease (CKD) after EVAR. METHODS: A cohort of 212 consecutive patients who underwent elective EVAR for abdominal aortic aneurysm from January 2009 to October 2016 was included...
October 27, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29109065/the-impact-of-chronic-kidney-disease-on-post-operative-outcomes-in-patients-undergoing-lumbar-decompression-and-fusion
#13
Owoicho Adogwa, Aladine A Elsamadicy, Amanda Sergesketter, Deborah Oyeyemi, Diego Galan, Victoria D Vuong, Syed Khalid, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Little is known of the impact of pre-operative chronic kidney disease (CKD) on post-operative complications in patients undergoing lumbar arthrodesis. The aim of this study is to determine whether pre-operative CKD is associated with inferior peri-operative outcomes. METHODS: The medical records of 293 adult (≥18 years-old) spine deformity patients undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed...
November 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29107130/robotic-left-sided-level-ii-caval-thrombectomy-and-nephrectomy-using-a-novel-supine-single-dock-approach-primary-description
#14
Monty A Aghazadeh, Alvin C Goh
OBJECTIVES: To demonstrate a novel supine, single-dock approach for robotic nephrectomy and Inferior Vena Cava (IVC) thrombectomy for a left-sided renal cell carcinoma (RCC) with Level II IVC thrombus. METHODS: We perform robotic nephrectomy and IVC thrombectomy in a 79 year-old male with a 6cm left renal mass and level II IVC thrombus. For this approach, the patient is placed in steep Trendelenburg, and a 6-port transperitoneal technique is used, with the robot docked such that the arms are oriented in a cephalad direction...
October 26, 2017: Urology
https://www.readbyqxmd.com/read/29105078/a-systematic-review-of-the-incidence-of-and-risk-factors-for-postoperative-atrial-fibrillation-following-general-surgery
#15
REVIEW
R Chebbout, E G Heywood, T M Drake, J R L Wild, J Lee, M Wilson, M J Lee
Atrial fibrillation is a common cardiac arrhythmia and can occur de novo following a surgical procedure. It is associated with increased inpatient and long-term mortality. There is limited evidence concerning new-onset atrial fibrillation following abdominal surgery. This study aimed to identify the prevalence of and risk factors for postoperative atrial fibrillation in the general surgical population. A systematic search of the Embase, MEDLINE and Cochrane (CENTRAL) databases was conducted. Studies were included in the review if they reported cases of new-onset atrial fibrillation within 30 days of the index operation...
November 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29100592/peri-operative-emergency-department-utilization-in-inpatient-and-outpatient-medicare-laparoscopic-cholecystectomy
#16
Susan M Nedza, Donald E Fry, Michael Pine, Agnes M Reband, Pan Chen, Gregory Pine
BACKGROUND: Preoperative emergency department (ED) visits may reflect the patient's biliary disease, or may signal unstable comorbid conditions that have relevance following inpatient laparoscopic cholecystectomy (ILC) and outpatient laparoscopic cholecystectomy (OLC) in Medicare patients. METHODS: We used the Medicare inpatient and outpatient Limited Datasets to identify elective laparoscopic cholecystectomy patients from 2011 to 2014. ED visits for 30-days before the surgical event were identified and correlated with the probability of patients returning to the ED in the 30-days following the procedure...
October 24, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29092982/multiple-boluses-of-intravenous-tranexamic-acid-to-reduce-hidden-blood-loss-and-the-inflammatory-response-following-enhanced-recovery-primary-total-hip-arthroplasty-a-randomised-clinical-trial
#17
J Xie, Q Hu, J Ma, Q Huang, F Pei
AIMS: The aim of this study was to examine the efficacy and safety of multiple boluses of intravenous (IV) tranexamic acid (TXA) on the hidden blood loss (HBL) and inflammatory response following primary total hip arthroplasty (THA). PATIENTS AND METHODS: A total of 150 patients were allocated randomly to receive a single bolus of 20 mg/kg IV TXA before the incision (group A), a single bolus followed by a second bolus of 1 g IV-TXA three hours later (group B) or a single bolus followed by two boluses of 1 g IV-TXA three and six hours later (group C)...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29089282/safety-and-efficacy-of-the-new-micromesh-covered-stent-cguard-in-patients-undergoing-carotid-artery-stenting-early-experience-from-a-single-centre
#18
Renato Casana, Valerio Tolva, Andrea Odero, Chiara Malloggi, Aldo Paolucci, Fabio Triulzi, Vincenzo Silani
OBJECTIVE/BACKGROUND: Plaque protrusion through stent struts represents one of the principal causes of cerebral embolisation during carotid artery stenting (CAS) and the stent healing period. The aim of this study was to evaluate the safety (technical success) and efficacy (clinical success) of the CGuard stent system - a new nitinol stent covered by a closed-cell polyethylene terephthalate mesh designed to prevent embolic events. METHODS: Eighty-two consecutive patients who underwent CAS with CGuard from June 2015 were included in this study...
October 28, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29083250/exploring-healthcare-professionals-perceptions-of-the-anesthesia-assistant-role-and-its-impact-on-patients-and-interprofessional-collaboration
#19
Phoebe Lam, Ana Lopez Filici, Claire Middleton, Patricia McGillicuddy
To practice interprofessional collaboration (IPC), understanding the roles of each profession in the team is key. Anesthesia assistants (AAs) are a relatively new addition to the Canadian healthcare system. As a result, its role in the delivery of anesthesia care can be misunderstood by other healthcare professionals. Using an exploratory multiple case study design, this article explores healthcare professionals' perceptions of the AA role and its impact on patients and IPC. Sixteen semi-structured, in-depth interviews were conducted with a purposive sample of nine healthcare professions from inside and outside the peri-operative care unit in two urban, acute care, university-affiliated teaching research hospitals in Ontario...
October 30, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29078677/uniportal-video-assisted-thoracoscopic-surgery-vats-technique-is-associated-with-decreased-narcotic-usage-over-traditional-vats-lobectomy
#20
Scott Gregory Louis, William James Gibson, Chase Lynn King, Nirmal Kumar Veeramachaneni
BACKGROUND: Uniportal video-assisted thoracoscopic surgery (VATS) is gaining popularity internationally, but remains an uncommon practice in the United States. One proposed benefit is a decrease in narcotic usage and peri-operative pain when compared to traditional multiple incision VATS. The purpose of this study was to determine the post-operative narcotic usage between patients undergoing anatomic lobectomy via traditional VATS as compared to patients undergoing uniportal VATS. METHODS: All consecutive patients undergoing anatomic lobectomy for presumed malignancy by a single surgeon at an academic medical institution were recorded between July 2013 and September 2015...
2017: J Vis Surg
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