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surgical risk

F Cobo, A Sampedro, J Rodríguez-Granger, L Aliaga-Martínez, J M Navarro-Marí
The clinical and microbiological characteristics of pleuro-pulmonary infection (PPI) caused by Streptococcus intermedius is described, including 6 cases in the literature and 9 cases handled at the present centre. Out of the 15 patients, 12 were male; mean age at diagnosis was 62.06 ± 15 years. Twelve had risk factors for S. intermedius infection such as alcoholism in 5 (35.7%) patients, periodontal disease in 3 (24.6%) cases, chronic obstructive pulmonary disease in 3 (24.6%), and diabetes mellitus in 2 (14...
March 22, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
S M Shiels, M Bouchard, H Wang, J C Wenke
BThe use of internal intramedullary nails for long bone fracture fixation is a common practice among surgeons. Bacteria naturally attach to these devices, increasing the risk for wound infection, which can result in non- or malunion, additional surgical procedures and extended hospital stays. Intramedullary nail surface properties can be modified to reduce bacterial colonisation and potentially infectious complications. In the current study, a coating combining a non-fouling property with leaching chlorhexidine for orthopaedic implantation was tested...
March 22, 2018: European Cells & Materials
Yibo Li, Jenelle L Pederson, Thomas A Churchill, Adrian S Wagg, Jayna M Holroyd-Leduc, Kannayiram Alagiakrishnan, Raj S Padwal, Rachel G Khadaroo
BACKGROUND: Frailty is a state of vulnerability to diverse stressors. We assessed the impact of frailty on outcomes after discharge in older surgical patients. METHODS: We prospectively followed patients 65 years of age or older who underwent emergency abdominal surgery at either of 2 tertiary care centres and who needed assistance with fewer than 3 activities of daily living. Preadmission frailty was defined according to the Canadian Study of Health and Aging Clinical Frailty Scale as "well" (score 1 or 2), "vulnerable" (score 3 or 4) or "frail" (score 5 or 6)...
February 20, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Pei-Ying Yeh, Hsiao-Ping Chen, Jing-Yi Wu
Simultaneous pancreas-kidney (SPK) transplantation is the primary surgical treatment for type I diabetes mellitus with end-stage renal disease. However, this transplant surgery has a high-risk of surgical complications, including duodenal anastomotic leakage, which may lead to pancreas transplantation failure if the leakage worsens. This case report describes a patient who suffered from duodenal anastomotic leakage after SPK transplantation. The digestive enzymes eroded the wound and skin around the wound, resulting in periwound moisture-associated dermatitis...
April 2018: Hu Li za Zhi the Journal of Nursing
Teresa S Henriques, Madalena D Costa, Pooja Mathur, Priyam Mathur, Roger B Davis, Murray A Mittleman, Kamal R Khabbaz, Ary L Goldberger, Balachundhar Subramaniam
Complexity measures are intended to assess the cardiovascular system's capacity to respond to stressors. We sought to determine if decreased BP complexity is associated with increased estimated risk as obtained from two standard instruments: the Society of Thoracic Surgeons' (STS) Risk of Mortality and Morbidity Index and the European System for Cardiac Operative Risk Evaluation Score (EuroSCORE II). In this observational cohort study, preoperative systolic, diastolic, mean (MAP) and pulse pressure (PP) time series were derived in 147 patients undergoing cardiac surgery...
March 21, 2018: Journal of Clinical Monitoring and Computing
S He, M Blombäck, F Boström, H Wallen, J Svensson, A Östlund
Acute traumatic coagulopathy (ATC) diagnosed by prolongation of APTT and/or PT/INR involves alterations in platelet activity, coagulation and fibrinolysis. However, data showing the haemostatic situation in injured patients without ATC are scarce. To assess whether haemostatic impairment is also present in injured patients without ATC, ten injured patients without ATC and ten normal individuals were examined. The patients were sampled on arrival at the emergency department 0, 2, 12 h after surgical or other intervention...
March 21, 2018: Journal of Thrombosis and Thrombolysis
Frederic Picard, Angela Deakin, Navin Balasubramanian, Alberto Gregori
In this review, we outlined the definition of minimally invasive surgery (MIS) in total knee replacement (TKR) and described the different surgical approaches reported in the literature. Afterwards, we went through the most recent studies assessing MIS TKR. Next, we searched for potential limitations of MIS knee replacement and tried to answer the following questions: Are there selective criteria and specific patient selection for MIS knee surgery? If there are, then what are they? After all, a discussion and conclusion completed this article...
March 22, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Patrick J McCormick, Hung-Mo Lin, Stacie G Deiner, Matthew A Levin
The All Patient Refined Diagnosis Related Group (APR-DRG) is an inpatient visit classification system that assigns a diagnostic related group, a Risk of Mortality (ROM) subclass and a Severity of Illness (SOI) subclass. While extensively used for cost adjustment, no study has compared the APR-DRG subclass modifiers to the popular Charlson Comorbidity Index as a measure of comorbidity severity in models for perioperative in-hospital mortality. In this study we attempt to validate the use of these subclasses to predict mortality in a cohort of surgical patients...
March 22, 2018: Journal of Medical Systems
Qinyu Chen, Fabio Bagante, Katiuscha Merath, Jay Idrees, Eliza W Beal, Jordan Cloyd, Mary Dillhoff, Carl Schmidt, Adrian Diaz, Susan White, Timothy M Pawlik
BACKGROUND: The association of hospital teaching status and overall expenditures has not been studied among patients undergoing hepato-pancreato-biliary (HPB) surgery. We sought to define the impact of hospital teaching intensity on payments and charges associated with (HPB) surgery from the payer perspective. METHODS: Surgical patients undergoing HPB procedures were identified using 2013-2015 Medicare Provider Analysis and Review (MEDPAR) data. Hospital teaching intensity was categorized based on hospital resident-to-bed ratio: non-teaching (NTH: 0), minor teaching (minor-TH: 0-0...
March 21, 2018: World Journal of Surgery
S Blecha, H J Schlitt, B M Graf, M Leitzmann, T Bein
BACKGROUND: In critical illnesses low socioeconomic status (SES) is associated with higher morbidity and mortality. In addition to the SES, further factors at an individual level (e.g., sex, health insurance status and place of residence) may influence the severity of illness and medical treatment. We investigated these additional parameters in a secondary analysis of the ECSSTASI data. METHODS: Within the framework of the ECSSTASI study, 996 patients were recruited from a surgical intensive care unit...
March 21, 2018: Der Anaesthesist
John S M Chang
Background: Astigmatic keratotomy (AK) remains an accessible means to correct surgically induced or naturally occurring astigmatism. The advantages of femtosecond laser-assisted astigmatic keratotomy (FSAK) over conventional methods have been recognized recently. Main text: This review evaluates the efficacy, complications, and different methods of FSAK for correction of astigmatism in native eyes and those that underwent previous penetrating keratoplasty (PKP)...
2018: Eye and Vision (London, England)
Matthias Waldner, Holger J Klein, Walter Künzi, Merlin Guggenheim, Jan A Plock, Pietro Giovanoli
Objectives: Patients undergoing reduction mammoplasty (RM) bear the risk of having occult breast cancer nests. The detection rate of malignant neoplasms in the resected specimens, varies greatly in the literature. The aim of our present study was to analyze risk factors and evaluate histopathological findings in our cohort of patients who underwent RM towards our center. Material and methods: In this retrospective single center study we analyzed 559 female patients [median age 35...
2018: Frontiers in Surgery
Young Bin Won, Hyun Jin Lee, Kyung Jin Eoh, Young Shin Chung, Yong Jae Lee, Seon Hee Park, Jee Whan Kim, Jung Yoon Lee, Eun Ji Nam, Sunghoon Kim, Young Tae Kim, Sang Wun Kim
Objective: This study introduces and evaluates the feasibility, safety, and surgical outcomes of the in-bag power morcellation technique during single-port assisted (SPA) laparoscopic myomectomy in comparison with manual scalpel morcellation. Methods: This is a retrospective review of a total of 58 patients who underwent SPA laparoscopic myomectomy employing in-bag power morcellation (n=27) or manual scalpel morcellation (n=31), performed between December 2014 and December 2016...
March 2018: Obstetrics & Gynecology Science
Brian L Dial, Alexander J Lampley, Cynthia L Green, Rhett Hallows
Purpose: Total hip arthroplasty (THA) is a successful surgery for the treatment of hip osteoarthritis; however, the risk of a post-operative prosthetic joint infection (PJI) remains at 1% to 2%. The purpose of this study was to investigate the safety profile of using vancomycin powder (VP) to reduce infection rates by reviewing acute postoperative complications. Materials and Methods: A retrospective review of 265 consecutive patients undergoing THA was performed...
March 2018: Hip & Pelvis
Philip Sutera, Mark E Bernard, Hong Wang, Nathan Bahary, Steven Burton, Herbert Zeh, Dwight E Heron
Introduction: Pancreatic adenocarcinoma is an aggressive malignancy that has consistently demonstrated poor outcomes despite aggressive treatments. Despite multimodal treatment, local disease progression and local recurrence are common. Management of recurrent or progressive pancreatic carcinomas proves a further challenge. In patients previously treated with radiation therapy, stereotactic body radiation therapy (SBRT) is a promising modality capable of delivering high dose to the tumor while limiting dose to critical structures...
2018: Frontiers in Oncology
Jessica Y Ng, Jennie Gu
Acute acalculous cholecystitis is an uncommon disease in children and is usually associated with trauma, burns, and infections. Whereas acute acalculous cholecystitis is only seen in 10% of cholecystitis in adults, it is uncommon in the paediatric population. A seven-year-old male presented to the emergency department of a regional hospital with a 36-hour history of right-upper-quadrant abdominal pain. He had associated symptoms of anorexia, nausea, and vomiting. He was septic with raised white cell count and inflammatory markers...
January 20, 2018: Curēus
Guilherme Naccache Namur, Anna Carolina Batista Dantas, Ricardo Jureidini, Thiago Costa Ribeiro, Ulysses Ribeiro Junior, Estela Figueira, Ivan Cecconello, Telesforo Bacchella
Background: Due to rising life expectancy of population, very complex surgical procedures such as pancreaticoduodenectomy (PD), are more commonly being performed in elderly patients. The objective of this study was to evaluate the safety of PD in patients older than 75 years old and the risk factors associated with severe complications. Methods: Patients who underwent PD for periampullary tumors were retrospectively reviewed and divided into two groups, A (<75 years) and B (>75 years)...
February 2018: Journal of Gastrointestinal Oncology
Turki A Al-Ajmi, Khalid H Al-Faryan, Naif F Al-Kanaan, Abdulmalik A Al-Khodair, Thamer H Al-Faryan, Maher I Al-Oraini, Abdulelah F Bassas
Background: Surgical and conservative methods have been reported by various studies for high rates of fracture union and subsequent regain of function among patients with undisplaced or minimally-displaced scaphoid fractures. Hence, this study aims to analyze the best available evidence to comprehend the relative benefits and risks of these therapeutic options. Methods: A systematic search of the literature from different databases and search engines was performed with strict eligibility criteria to obtain the highest quality of evidence...
March 2018: Clinics in Orthopedic Surgery
Nayef Aslam-Pervez, Osman Riaz, Shivkumar Gopal, Fahad Hossain
Background: The aim of our study was to determine the rate and preoperative predictors of intraoperative fracture (IOF) during hip hemiarthroplasty (HA) in patients who have sustained a fragility hip fracture injury. Methods: We reviewed 626 patients who underwent HA at our institution using the National Hip Fracture Database. Various patient- and surgery-related data including demographic information, cement usage, surgeon grade, time to surgery, and operative duration were collected...
March 2018: Clinics in Orthopedic Surgery
Sang Jun Song, Cheol Hee Park, Hu Liang, Sang Jun Kim
Noise in the knee joint is a common symptom that often leads to outpatient clinic visits. However, there have been no previous review articles regarding noise around the knee despite its high prevalence. We will review the noise characteristics according to sound nature and onset as well as factors for differentiation between physiological and pathological noises. In addition, we will describe causes of the physiological and pathological noises and management of noise in the knee. An appropriate review of the characteristics of noise, its pathophysiology, and factors for differentiation between physiological and pathological noises can facilitate patient guidance...
March 2018: Clinics in Orthopedic Surgery
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