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https://www.readbyqxmd.com/read/28927188/measuring-the-quality-of-perioperative-care-in-cardiac-surgery
#1
Tim G Coulson, Daniel V Mullany, Christopher M Reid, Michael Bailey, David Pilcher
Quality of care is of increasing importance in health and surgical care. In order to maintain and improve quality, we must be able to measure it and identify variation. In this narrative review, we aim to identify measures used in the assessment of quality of care in cardiac surgery and to evaluate their utility. The electronic databases Pubmed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, and CINAHL were searched for original published studies using the terms 'cardiac surgery' and 'quality or outcome or process or structure' as either keywords in the title or text or MeSH terms...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28927119/effect-of-glutamine-enriched-nutritional-support-on-intestinal-mucosal-barrier-function-mmp-2-mmp-9-and-immune-function-in-patients-with-advanced-gastric-cancer-during-perioperative-chemotherapy
#2
Juan Wang, Yanfen Li, Yuanling Qi
We studied the effects of glutamine-enriched nutritional support on intestinal mucosal barrier, matrix metalloproteinase (MMP)-2, MMP-9 and immune function during perioperative chemotherapy in patients with advanced gastric cancer. The study was conducted on 94 patients with advanced gastric cancer admitted from April 2015 to March 2016. They were randomly divided into observation and control groups, n=47. Control group was given basic nutritional support whereas glutamine-enriched nutritional support was given to patients in observation group...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28926782/enterprise-stent-in-recanalizing-non-acute-atherosclerotic-intracranial-internal-carotid-artery-occlusion
#3
Xiaofei Wang, Zhigang Wang, Yong Ji, Xuan Ding, Yizheng Zang, Chengwei Wang
OBJECTIVE: To investigate the safety and effectiveness of recanalization in non-acute occlusion of intracranial internal carotid arteries using the flexible Enterprise self-expanding stent. PATIENTS AND METHODS: From June 2014 to June 2016, 12 consecutive patients with non-acute occlusion of intracranial internal carotid arteries received endovascular recanalization with Enterprise stenting. All patients received medication for anti-platelet aggregation therapy before and after the operation...
June 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28924368/the-effects-of-perioperative-anesthesia-and-analgesia-on-immune-function-in-patients-undergoing-breast-cancer-resection-a-prospective-randomized-study
#4
Jin Sun Cho, Mi-Hyang Lee, Seung Il Kim, Seho Park, Hyung Seok Park, Ein Oh, Jong Ho Lee, Bon-Nyeo Koo
Introduction: Perioperative anesthesia and analgesia exacerbate immunosuppression in immunocompromised cancer patients. The natural killer (NK) cell is a critical part of anti-tumor immunity. We compared the effects of two different anesthesia and analgesia methods on the NK cell cytotoxicity (NKCC) in patients undergoing breast cancer surgery. Methods: Fifty patients undergoing breast cancer resection were randomly assigned to receive propofol-remifentanil anesthesia with postoperative ketorolac analgesia (Propofol-ketorolac groups) or sevoflurane-remifentanil anesthesia with postoperative fentanyl analgesia (Sevoflurane-fentanyl group)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28924138/perioperative-ketorolac-use-a-potential-risk-factor-for-renal-dysfunction-after-live-donor-nephrectomy
#5
Kazuhiro Takahashi, Anita K Patel, Shunji Nagai, Mohamed Safwan, Krishna G Putchakayala, William J Kane, Lauren E Malinzak, Jason E Denny, Atsushi Yoshida, Dean Y Kim
BACKGROUND Ketorolac is a nonsteroidal anti-inflammatory drug indicated for pain control after surgeries in many fields. The aim of this study was to evaluate the impact of ketorolac use after live-donor nephrectomy (LDN). MATERIAL AND METHODS We reviewed data on 251 patients who underwent laparoscopic LDN from April 2008 to March 2016. Ketorolac was given to 167 patients intraoperatively or postoperatively within 24 h after LDN. Glomerular filtration rate (GFR) percentage was defined as postoperative GFR/preoperative GFR...
September 19, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28923700/venous-thromboembolism-risk-in-patients-with-locoregional-urothelial-tract-tumors
#6
Jorge D Ramos, Jonathan T Wingate, Roman Gulati, Elizabeth R Plimack, Lauren C Harshman, Thomas Powles, Simon J Crabb, Guenter Niegisch, Joaquim Bellmunt, Sylvain Ladoire, Ugo De Giorgi, Syed Hussain, Ajjai S Alva, Jack Baniel, Neeraj Agarwal, Jonathan E Rosenberg, Ulka N Vaishampayan, Matthew D Galsky, Evan Y Yu
BACKGROUND: Venous thromboembolism (VTE) is common in cancer patients, but there is limited data on patients with urothelial tract tumors (UTT). We previously identified several associative factors for increased VTE rates in patients with metastatic UTT. In this study, we assessed the frequency, associative factors, and impact on survival of VTE in patients with locoregional UTT. METHODS: Patients with locoregional bladder, upper urinary tract, or urethral cancer were included in this multi-center study from 29 academic institutions...
August 24, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28922684/-rbc-transfusion-triggers-in-orthopaedic-lower-limb-arthroplasty
#7
Dirk Holten, Peter Zaar, Stefan Kessler
Introduction We implemented a hospital-wide mandatory RBC transfusion trigger checklist based on the haemoglobin level transfusion thresholds recommended by the German federal physicians board. Transfusion triggers, transfusion rates and hospital LOS in orthopaedic lower limb arthroplasty were compared before and after implementation of the transfusion trigger checklist. The goal was to evaluate the effect of this single and easy-to-implement intervention on transfusion rates in orthopaedic lower limb arthroplasty...
September 18, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28922233/endoscopic-versus-open-repair-for-craniosynostosis-in-infants-using-propensity-score-matching-to-compare-outcomes-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#8
Douglas R Thompson, David Zurakowski, Charles M Haberkern, Paul A Stricker, Petra M Meier
BACKGROUND: The North American Pediatric Craniofacial Collaborative Group (PCCG) established the Pediatric Craniofacial Surgery Perioperative Registry to evaluate outcomes in infants and children undergoing craniosynostosis repair. The goal of this multicenter study was to utilize this registry to assess differences in blood utilization, intensive care unit (ICU) utilization, duration of hospitalization, and perioperative complications between endoscopic-assisted (ESC) and open repair in infants with craniosynostosis...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28921529/metastatic-spine-tumor-surgery-does-perioperative-blood-transfusion-influence-postoperative-complications
#9
Aye Sandar Zaw, Shashidhar B Kantharajanna, Karthikeyan Maharajan, Barry Tan, Amarasinghe A Saparamadu, Naresh Kumar
BACKGROUND: The question of independent association between allogeneic blood transfusion (ABT) and postoperative complications in cancer surgeries has been controversial and remains so. In metastatic spine tumor surgery (MSTS), previous studies investigated the influence of ABT on survival, but not on postoperative complications. We aimed to evaluate the influence of perioperative ABT on postoperative complications and infections in patients undergoing MSTS. STUDY DESIGN AND METHODS: This retrospective study included 247 patients who underwent MSTS at a single tertiary institution between 2005 and 2014...
September 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28920634/outcomes-analysis-of-stent-graft-repair-for-thoracic-aorta-emergencies
#10
Mourad Boufi, Florent Vernet, Bianca Dona, Olivier Hartung, Anderson D Loundou, Martine Haccoun, Marc Leone, Yves S Alimi
BACKGROUND: This study aimed to identify patient, pathology and procedure-related factors affecting perioperative and mid-term mortality of thoracic aorta emergencies. METHODS: Between 2007 and 2014, patients treated emergently with thoracic stent-graft were retrospectively reviewed. Variables analyzed were: age, renal insufficiency, shock, cardiac arrest, transfer status, pathology, debranching procedures, operation duration, vascular access and European System for Cardiac Operative Risk Evaluation (EuroSCORE)...
December 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28919771/the-challenge-of-perioperative-pain-management-in-opioid-tolerant-patients
#11
REVIEW
Flaminia Coluzzi, Francesca Bifulco, Arturo Cuomo, Mario Dauri, Claudio Leonardi, Rita Maria Melotti, Silvia Natoli, Patrizia Romualdi, Gennaro Savoia, Antonio Corcione
The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28919229/early-outcomes-of-endoscopic-contralateral-foraminal-and-lateral-recess-decompression-via-an-interlaminar-approach-in-patients-with-unilateral-radiculopathy-from-unilateral-foraminal-stenosis
#12
Hyeung Sung Kim, Ravish Patel, Byapak Paudel, Jee-Soo Jang, Il-Tae Jang, Seong-Hoon Oh, Jae Eun Park, Sol Lee
OBJECTIVE: Percutaneous endoscopic contralateral interlaminar lumbar foraminotomy (PECILF) for lumbar degenerative spinal stenosis is an established procedure. Better preservation of contralateral facet joint compared to that of the approach side has been demonstrated with uniportal bilateral decompression. The aim of this retrospective case series was to analyze the early clinical and radiological outcomes of standalone contralateral foraminotomy and lateral recess decompression using PECILF...
September 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28919069/impact-of-discontinuation-of-antiplatelet-therapy-prior-to-isolated-valve-and-combined-coronary-artery-bypass-graft-and-valve-procedures-on-short-and-intermediate-term-outcomes
#13
James Meneguzzi, Matthew Kilpin, Ying Yan Zhu, Atsuo Doi, Christopher Reid, Lavinia Tran, Philip Hayward, Julian Smith
BACKGROUND: A change in cardiac surgery practice over the past decade has seen an increase in urgent or inpatient referrals for surgery, with antiplatelet therapy often continued up until surgery. This study aims to identify the optimal timing for administration of aspirin to minimise risk of perioperative morbidity and mortality. METHODS: From a prospectively compiled database collected by the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, we identified 8,294 patients undertaking combined CABG and valve or isolated valve procedures while discontinuing aspirin...
September 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28918204/serum-glial-cell-line-derived-neurotrophic-factor-levels-and-postoperative-cognitive-dysfunction-after-surgery-for-rheumatic-heart-disease
#14
Xiaoxia Duan, Tao Zhu, Chan Chen, Guanpeng Zhang, Junhui Zhang, Lin Wang, Luye Zhang, Maohua Wang, Xiaobin Wang
OBJECTIVE: Postoperative cognitive dysfunction is an important complication of cardiac surgery with poor outcomes. Serum glial cell line-derived neurotrophic factor levels are decreased in patients with Alzheimer's disease, but the association between glial cell line-derived neurotrophic factor levels and postoperative cognitive dysfunction is poorly understood. The present study aimed to investigate the prognostic value of postoperative serum glial cell line-derived neurotrophic factor levels to predict postoperative cognitive dysfunction in patients with rheumatic heart disease undergoing heart valve replacement...
August 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28917595/perioperative-and-oncologic-outcomes-of-nephrectomy-and-caval-thrombectomy-using-extracorporeal-circulation-and-deep-hypothermic-circulatory-arrest-for-renal-cell-carcinoma-invading-the-supradiaphragmatic-inferior-vena-cava-and-or-right-atrium
#15
Alessandro Nini, Umberto Capitanio, Alessandro Larcher, Paolo Dell'Oglio, Federico Dehò, Nazareno Suardi, Fabio Muttin, Cristina Carenzi, Massimo Freschi, Roberta Lucianò, Giovanni La Croce, Alberto Briganti, Renzo Colombo, Andrea Salonia, Alessandro Castiglioni, Patrizio Rigatti, Francesco Montorsi, Roberto Bertini
BACKGROUND: Radical nephrectomy (RN) and caval thrombectomy (CT) for renal cell carcinoma, with extracorporeal circulation (ECC) and deep hypothermic circulatory arrest (DHCA) is a challenging surgical approach. OBJECTIVE: To assess peri-operative and oncologic outcomes of renal cell carcinoma patients treated with RN and CT, using ECC and DHCA. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively evaluated 46 patients who underwent RN and CT using ECC and DHCA...
September 13, 2017: European Urology
https://www.readbyqxmd.com/read/28917016/predictors-of-outpatient-resource-utilization-following-ventral-and-incisional-hernia-repair
#16
Alex Wade, Margaret A Plymale, Daniel L Davenport, Sara E Johnson, Vashisht V Madabhushi, Erica Mastoroudis, Charlie Tancula, John Scott Roth
INTRODUCTION: Little is known about the predictors of increased ambulatory costs following open ventral and incisional hernia repair (VIHR); however, postoperative complications would be expected to be associated with an increased burden on outpatient resources. The purpose of this study is to evaluate the impact of perioperative factors on outpatient resource utilization following VIHR. METHODS: With IRB approval, the surgery scheduling system was queried to identify all cases of VIHR done at our institution over 3 years...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28917000/routine-use-of-mesh-during-hiatal-closure-is-safe-with-no-increase-in-adverse-sequelae
#17
Walid K Abu Saleh, Lee M Morris, Nabil Tariq, Min P Kim, Edward Y Chan, Leonora M Meisenbach, Brian J Dunkin, Vadim Sherman, Wade Rosenberg, Barbara L Bass, Edward A Graviss, Duc T Nguyen, Patrick Reardon, Puja G Khaitan
BACKGROUND: Primary laparoscopic hiatal repair with fundoplication is associated with a high recurrence rate. We wanted to evaluate the potential risks posed by routine use of onlay-mesh during hiatal closure, when compared to primary repair. METHODS: Utilizing single-institutional database, we identified patients who underwent primary laparoscopic hiatal repair from January 2005 through December 2014. Retrospective chart review was performed to determine perioperative morbidity and mortality...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916991/higher-physical-activity-and-lower-pain-levels-before-surgery-predict-non-improvement-of-knee-pain-1%C3%A2-year-after-tka
#18
Nikolai Kornilov, Maren Falch Lindberg, Caryl Gay, Alexander Saraev, Taras Kuliaba, Leiv Arne Rosseland, Anners Lerdal
PURPOSE: The purpose of this study was to describe patterns of pain during the first year following total knee arthroplasty (TKA) and evaluate pre- and postoperative factors associated with pain and patient satisfaction at 1 year. It was hypothesized that more severe preoperative pain would be associated with more residual pain and lower patient satisfaction 1 year after surgery. METHODS: A longitudinal cohort study was performed with repeated measures of pain (0-10 numeric rating scale) and evaluation of other self-reported symptoms (Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Fatigue Severity Score), daily functioning (Lawton Instrumental Activities of Daily Living Scale), quality of life (EQ-5D-3L), knee function (KSS Knee and Function Score), perioperative and clinical characteristics (e...
September 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28916979/ventral-hernia-repair-with-poly-4-hydroxybutyrate-mesh
#19
Margaret A Plymale, Daniel L Davenport, Adam Dugan, Amanda Zachem, John Scott Roth
BACKGROUND: Biomaterial research has made available a biologically derived fully resorbable poly-4-hydroxybutyrate (P4HB) mesh for use in ventral and incisional hernia repair (VIHR). This study evaluates outcomes of patients undergoing VIHR with P4HB mesh. METHODS: An IRB-approved prospective pilot study was conducted to assess clinical and quality of life (QOL) outcomes for patients undergoing VIHR with P4HB mesh. Perioperative characteristics were defined. Clinical outcomes, employment status, QOL using 12-item short form survey (SF-12), and pain assessments were followed for 24 months postoperatively...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916960/a-novel-approach-using-the-enhanced-view-totally-extraperitoneal-etep-technique-for-laparoscopic-retromuscular-hernia-repair
#20
Igor Belyansky, Jorge Daes, Victor Gheorghe Radu, Ramana Balasubramanian, H Reza Zahiri, Adam S Weltz, Udai S Sibia, Adrian Park, Yuri Novitsky
BACKGROUND: The enhanced-view totally extraperitoneal (eTEP) technique has been previously described for Laparoscopic Inguinal Hernia Repair. We present a novel application of the eTEP access technique for the repair of ventral and incisional hernias. METHODS: Retrospective review of consecutive laparoscopic retromuscular hernia repair cases utilizing the eTEP access approach from five hernia centers between August 2015 and October 2016 was conducted. Patient demographics, hernia characteristics, operative details, perioperative complications, and quality of life outcomes utilizing the Carolina's Comfort Scale (CCS) were included in our data analysis...
September 15, 2017: Surgical Endoscopy
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