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Perioperative evaluation

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https://www.readbyqxmd.com/read/28240619/the-anterior-intra-pelvic-approach-for-acetabular-fractures-utilizing-approach-specific-instruments-and-an-antatomical-preshaped-three-dimensional-suprapectineal-plate
#1
Florian Gras, Ivan Marintschev, Lars Grossterlinden, Markus Rossmann, Isabel Graul, Gunther O Hofmann, Johannes M Rueger, Wolfgang Lehmann
OBJECTIVES: Anatomical acetabular plates were recently introduced to fix acetabular fractures via the intra-pelvic approach. Therefore we asked: I.) Does the preshaped three dimensional suprapectineal plate interfere with or even impair the fracture reduction quality? II.) How often does the anterior intra-pelvic approach need to be extended by the first (lateral) window of the ilioinguinal approach? DESIGN: Observational case series SETTING:: Two Level one Trauma centresPatients / Participants: Patients with unstable acetabular fractures in 2014 INTERVENTION:: Fracture fixation with anatomical-preshaped, three-dimensional suprapectineal plates via the anterior intra-pelvic approach ± the first window of the ilioinguinal approach...
February 23, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28239802/anesthetic-management-of-patients-with-dilated-cardiomyopathy-for-noncardiac-surgery
#2
C-Q Chen, X Wang, J Zhang, S-M Zhu
Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. This review describes the preoperative evaluation and anesthesia considerations of patients with DCM undergoing non-cardiac surgery. Patient pathophysiology and clinical status, such as ventricular function, degree of myocardial fibrosis, resting heart rate and high-sensitivity C-reactive protein can affect survival rates...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28238929/comparison-between-open-and-endovascular-repair-for-the-treatment-of-juxtarenal-abdominal-aortic-aneurysms-a-single-center-experience-with-midterm-results
#3
Koji Maeda, Takao Ohki, Yuji Kanaoka, Takeshi Baba, Kenjirou Kaneko, Kota Shukuzawa
PURPOSE: To evaluate the optimal treatment for juxtarenal abdominal aortic aneurysm (JAAA) we compared outcomes of open surgical repair (OSR) with endovascular aortic repair (EVAR) utilizing a variety of fenestrated and snorkel EVARs. METHODS: We evaluated overall survival, aneurysm-related death, re-intervention and renal impairment in 152 JAAAs retrospectively, excluding cases of aortic dissection and rupture. Cox models were used to assess survival and assessed postoperative dialysis rates following surgery...
February 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28237734/respective-role-of-surface-electrocardiogram-and-his-bundle-recordings-to-assess-the-risk-of-atrioventricular-block-after-transcatheter-aortic-valve-replacement
#4
N Badenco, C Chong-Nguyen, C Maupain, C Himbert, G Duthoit, X Waintraub, T Chastre, E Gandjbakhch, F Hidden-Lucet, P Le Prince, J-P Collet, R Frank
BACKGROUND: Atrioventricular block (AVB) is common after transcatheter aortic valve replacement (TAVR) and permanent pacemaker (PPM) implantation is needed in up to 30% of patients. Main predictors of long term AVB are electrocardiographic. The purpose of this study is to assess the prognostic value of serial HV intervals measured before and after TAVR to shorten the timing of PPM implantation. METHODS: His bundle recordings were performed before (HV1), immediately after TAVR (HV2) and at day 2 for Edwards Sapien (ES) and 5 for Medtronic CoreValve (CV) (HV3)...
February 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28237682/the-influence-of-demeanor-on-scores-from-two-validated-feline-pain-assessment-scales-during-the-perioperative-period
#5
Mandy Buisman, Michelle M M Hasiuk, Marta Gunn, Daniel S J Pang
OBJECTIVE: To evaluate the effects of demeanor on validated pain assessment scales. STUDY DESIGN: Prospective, blind, clinical trial. ANIMAL POPULATION: Thirty three adult domestic cats scheduled for orchiectomy. METHODS: Cats were assessed for pain pre (baseline) and 1, 2, 4 hours postoperatively using two validated pain scales [Composite Measures Pain Scale-Feline (rCMPS-F) and UNESP-Botucatu multidimensional composite pain scale (psychomotor and pain expression subscales; U-B MCPS-psych and -painex)], and a demeanor scale...
January 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28236982/prognostic-and-predictive-value-of-loss-of-nuclear-rad51-immunoreactivity-in-resected-non-small-cell-lung-cancer-patients
#6
Mariam Gachechiladze, Josef Škarda, Vítězslav Kolek, Ivona Grygárková, Kateřina Langová, Jan Bouchal, Zdeněk Kolář, Florent Baty, Rolf Stahel, Walter Weder, Alex Soltermann, Markus Joerger
OBJECTIVES: In response to DNA damage, recombination proteins are relocalized into sub-nuclear complexes that are microscopically detected as RAD51-containing nuclear foci. We aimed for assessing the prognostic and predictive value of loss of nuclear RAD51 immunoreactivity ('RAD51 loss') in 2 independent stage I to III non-small cell lung cancer (NSCLC) patient cohorts undergoing surgical resection and eventual perioperative chemo-/radiotherapy (CT/RT). MATERIALS AND METHODS: The discovery set included 69 evaluable patients (19 adenocarcinomas, ADC, 50 squamous cell carcinomas, SCC) from Palacky University Hospital, 45/69 (65...
March 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28236547/screening-for-beta-lactam-allergy-in-joint-arthroplasty-patients-to-improve-surgical-prophylaxis-practice
#7
Deanna L McDanel, Antoine E Azar, Amy M Dowden, Samantha Murray-Bainer, Nicolas O Noiseux, Melissa Willenborg, Charles R Clark, John J Callaghan, Ambar Haleem
BACKGROUND: The reliability of patient-reported penicillin allergies has been disputed. A Drug Allergy Clinic (DAC) was established at our institution in combination with an electronic best practice alert (BPA) in the Orthopedic Clinic. Joint arthroplasty patients with a reported history of beta-lactam allergy (HOBA) were preoperatively referred via the BPA to the DAC. The purpose of this study was to determine the effectiveness of beta-lactam allergy screening in enabling the surgical team to optimize antimicrobial prophylaxis...
January 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28235532/massive-blood-loss-in-elective-spinal-and-orthopedic-surgery-retrospective-review-of-intraoperative-transfusion-strategy
#8
Demicha Rankin, Alix Zuleta-Alarcon, Suren Soghomonyan, Mahmoud Abdel-Rasoul, Karina Castellon-Larios, Sergio D Bergese
OBJECTIVE: To evaluate the perioperative dynamics of hematologic changes and transfusion ratio in patients undergoing a major spinal surgery accompanied with massive bleeding defined as blood loss >5 liters. DESIGN: Retrospective cohort study. SETTING: Operating room of a university-affiliated hospital. PATIENTS: Adult patients who underwent elective neurosurgical, orthopedic, or combined spinal surgical procedure between 2008 and 2012...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235523/fast-track-anesthesia-in-patients-undergoing-outpatient-laparoscopic-cholecystectomy-comparison-of-sevoflurane-with-total-intravenous-anesthesia
#9
Ceyda Özhan Çaparlar, Mehmet Özgür Özhan, Mehmet Anıl Süzer, Dilek Yazicioğlu, Mehmet Burak Eşkin, Serkan Şenkal, Mehmet Ali Çaparlar, Ersin Özkan Imren, Bülent Atik, Nedim Çekmen
BACKGROUND: The use of short-acting anesthetics has introduced a "fast-track anesthesia" concept in outpatient surgery which provides discharge of the patients from operation room directly to the phase II recovery area without entering into postanesthesia care unit. The aim of this prospective and randomized study was to compare general anesthesia using sevoflurane with propofol-remifentanil-based total intravenous anesthesia (TIVA) for fast-track eligibility in patients undergoing outpatient laparoscopic cholecystectomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28230615/the-effect-of-intravenous-acetaminophen-on-postoperative-pain-and-narcotic-consumption-after-vaginal-reconstructive-surgery-a-double-blind-randomized-placebo-controlled-trial
#10
Catrina C Crisp, Madiha Khan, Donna L Lambers, Lauren B Westermann, Donna M Mazloomdoost, Jennifer J Yeung, Steven D Kleeman, Rachel N Pauls
OBJECTIVE: This study aimed to determine the effect of intravenous acetaminophen versus placebo on postoperative pain, satisfaction with pain control, and narcotic use after vaginal reconstructive surgery. METHODS: This was an institutional review board-approved, double-blind placebo-controlled randomized trial. Women scheduled for reconstructive surgery including vaginal hysterectomy and vaginal vault suspension were enrolled. Subjects received 1000 mg of intravenous acetaminophen or 100 mL placebo every 6 hours for 24 hours...
March 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28226995/a-daytime-obstructive-sleep-apnea-severity-assessment-framework
#11
Lauren Samy, Paul M Macey, Majid Sarrafzadeh, Lauren Samy, Paul M Macey, Majid Sarrafzadeh, Majid Sarrafzadeh, Lauren Samy
Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated episodes of complete or partial blockage of the upper airway. These episodes can interfere with sound sleep and have fatal health consequences. They can also reduce the flow of oxygen to vital organs, like the brain, and lead to brain damage. In this paper, we leverage the correlation between brain damage and OSA to design a prediction framework that can assess the severity level of the OSA condition, as well as estimate the Apnea-Hypopnea Index (AHI) using only features obtained during wakefulness...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226343/-diagnosis-and-risk-assessment-of-postoperative-complications-of-gastric-cancer-in-japan-and-korea
#12
Xiang Hu, Chi Zhang
Radical surgery of gastric cancer (D2 lymph node dissection) as the standard operation is widely used in clinical practice and satisfactory prognosis can be obtained in patients who receive radical gastrectomy. But surgical invasion can cause high morbidity of complications and mortality. The data of large-scale evidence-based medical clinical trials and large databases in Japan and Korea showed that anastomotic leakage, pancreatic leakage and abdominal abscess were the most common complications after gastrectomy, and the morbidity of complication was about 20% and mortality was about 1%...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226339/current-concepts-of-phenylpiperidine-derivatives-use-in-the-treatment-of-acute-and-chronic-pain
#13
Nidal Elbaridi, Alan D Kaye, Stephanie Choi, Richard D Urman
Phenylpiperidines are a chemical class of drugs with a phenyl moiety directly attached to piperidine. These agents have an important role in many aspects of medicine including anesthesia and pain medicine. After the development of meperidine, fentanyl, which is a second generation synthetic phenylpiperidine series opioid, was synthesized and introduced into clinical anesthesia practice as fentanyl citrate in 1968. Fentanyl-mediated or modulated responses involve action at the mu-opioid receptor as an agonist at the dorsal horn inhibiting ascending pain pathways in the rostral ventral medulla, increasing pain threshold, and producing both analgesic and sedative effects...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28225552/potential-clinical-significance-of-perioperative-levels-of-mrna-in-plasma-from-patients-with-cancer-of-the-larynx-or-hypopharynx
#14
Dolores C García-Olmo, J Diego Contreras, María G Picazo, Jesús López-Torres, Damián García-Olmo
BACKGROUND: The use of plasma as a "liquid biopsy" has gained increasing attention. The purpose of the present study was to evaluate the diagnostic and prognostic utility of the perioperative detection and quantitation of mRNAs encoding human telomerase reverse transcriptase (hTERT) and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) in plasma from patients with cancer of the larynx or hypopharynx. METHODS: We recruited 47 patients with laryngeal cancer and 2 patients with hypopharyngeal cancer, plus 27 healthy subjects...
February 22, 2017: Head & Neck
https://www.readbyqxmd.com/read/28224214/predictors-of-the-outcome-of%C3%A2-lumbar-disc-herniation-following-classical-surgery-laminotomy-with-discectomy
#15
Augustine Balaara, Xiao-Feng Xu, Young-Hui Huang, Li Dapeng
BACKGROUND: Several surgical variables and patient characteristics play an influential role in the prognosis of lumbar disc herniation following laminotomy with discectomy. This paper seeks to evaluate the perioperative predictor variables for the outcome of lumbar disc herniation. PATIENTS AND METHODS: From October 2013 to July 2016, 166 surgical patients were evaluated using prospectively collected data. Patients' preoperative independent variables (age, sex, body mass index, level of disc herniation, pain duration, and American Society of Anesthesiologists Physical Score) were correlated with functional outcome measures such as primary outcome measures (length of hospital stay; postoperative visual analog scale, VAS; Oswestry disability index, ODI) and secondary outcome measures (operation room time; estimated intraoperative blood loss, EBL; complications; readmission) as dependent variables...
February 21, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28224201/dexmedetomidine-protects-against-cisplatin-induced-acute-kidney-injury-in-mice-through-regulating-apoptosis-and-inflammation
#16
H Liang, H-Z Liu, H-B Wang, J-Y Zhong, C-X Yang, B Zhang
OBJECTIVE AND DESIGN: Cisplatin-based chemotherapy has been widely used in the perioperative period of cancer surgery, which exacerbates the risk of renal injury. In this study, we examined whether dexmedetomidine (DEX), a commonly used anesthetic adjuvant, shows a protective effect against cisplatin-induced acute kidney injury. MATERIALS: Acute kidney injury in mice was induced by cisplatin. TREATMENTS: Mice were administered with DEX 25 μg/kg or atipamezole 250 μg/kg (once a day, for 3 days) after cisplatin treatment...
February 21, 2017: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
https://www.readbyqxmd.com/read/28223055/plasma-monocyte-chemotactic-protein-1-is-associated-with-acute-kidney-injury-and-death-after-cardiac-operations
#17
Dennis G Moledina, Selin Isguven, Eric McArthur, Heather Thiessen-Philbrook, Amit X Garg, Michael Shlipak, Richard Whitlock, Peter A Kavsak, Steven G Coca, Chirag R Parikh
BACKGROUND: Monocyte chemotactic protein-1 (MCP-1; chemokine C-C ligand-2 [CCL-2]) is upregulated in ischemia-reperfusion injury and is a promising biomarker of inflammation in cardiac operations. METHODS: We measured preoperative and postoperative plasma MCP-1 levels in adults undergoing cardiac operations to evaluate the association of perioperative MCP-1 levels with acute kidney injury (AKI) and death in Translational Research Investigating Biomarker Endpoints in AKI (TRIBE-AKI), a prospective, multicenter, observational cohort...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28222985/concurrent-renal-artery-stent-during-endovascular-infrarenal-aortic-aneurysm-repair-confers-higher-risk-for-30-day-acute-renal-failure
#18
Besma Nejim, Isibor Arhuidese, Muhammmad Rizwan, Lana Khalil, Satinderjit Locham, Devin Zarkowsky, Philip Goodney, Mahmoud B Malas
OBJECTIVE: Concurrent renal artery angioplasty and stenting (RAAS) during endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysm (AAA) has been practiced in an attempt to maintain renal perfusion. The aim of this study was to identify the current practice of RAAS during EVAR and its effect on perioperative renal outcome. METHODS: Patients with infrarenal AAA were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP, 2011-2014) database...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#19
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28220199/-novel-pharmaceutical-treatment-approaches-for-gastric-cancer
#20
F Lordick
This review article delineates novel approaches for the pharmaceutical treatment of gastric cancer. A newly developed molecular classification of gastric cancer based on histology, genetic, epigenetic and proteomic characteristics has evolved. It provides a road map for development of new drugs and combinations as well as for patient stratification in clinical research and it is expected to be introduced into clinical practice in the near future. Anti-HER2 targeted treatment is a validated strategy for treatment of metastatic gastric cancer and is now also being studied in the perioperative setting to increase response rates and ultimately survival in patients undergoing curative surgery; however, the resistance mechanisms of HER2-targeted treatment are poorly understood and optimal patient selection remains challenging...
February 20, 2017: Der Pathologe
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