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Perioperative assessment

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https://www.readbyqxmd.com/read/29164830/changes-in-erectile-function-after-photoselective-vaporization-of-the-prostate-with-a-120-w-greenlight-high-performance-system-laser-2-year-follow-up
#1
Juhyun Park, Sung Yong Cho, Min Chul Cho, Hyeon Jeong, Hwancheol Son
PURPOSE: To evaluate the impact of photoselective vaporization of the prostate (PVP) with a 120-W GreenLight high-performance system on erectile function in a 2-year follow-up study. MATERIALS AND METHODS: One hundred seventy-seven patients who underwent PVP during 2008 to 2012 were analyzed retrospectively. The patients were divided into 5 groups according to their preoperative 5-item International Index of Erectile Function (IIEF-5) scores: Group I (IIEF-5: 5~7, n=28), II (IIEF-5: 8~11, n=47), III (IIEF-5: 12~16, n=43), IV (IIEF-5: 17~21, n=34), and V (IIEF-5: 22~25, n=25)...
November 16, 2017: World Journal of Men's Health
https://www.readbyqxmd.com/read/29164774/task-related-changes-in-degree-centrality-and-local-coherence-of-the-posterior-cingulate-cortex-after-major-cardiac-surgery-in-older-adults
#2
Jeffrey N Browndyke, Miles Berger, Patrick J Smith, Todd B Harshbarger, Zachary A Monge, Viral Panchal, Tiffany L Bisanar, Donald D Glower, John H Alexander, Roberto Cabeza, Kathleen Welsh-Bohmer, Mark F Newman, Joseph P Mathew
OBJECTIVES: Older adults often display postoperative cognitive decline (POCD) after surgery, yet it is unclear to what extent functional connectivity (FC) alterations may underlie these deficits. We examined for postoperative voxel-wise FC changes in response to increased working memory load demands in cardiac surgery patients and nonsurgical controls. EXPERIMENTAL DESIGN: Older cardiac surgery patients (n = 25) completed a verbal N-back working memory task during MRI scanning and cognitive testing before and 6 weeks after surgery; nonsurgical controls with cardiac disease (n = 26) underwent these assessments at identical time intervals...
November 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/29161402/fit-for-surgery-perspectives-on-preoperative-exercise-testing-and-training
#3
K Richardson, D Z H Levett, S Jack, M P W Grocott
There is a consistent relationship between physical activity, physical fitness, and health across almost all clinical contexts, including the perioperative setting. Physiological measurements obtained during physical exercise may be used to infer the risk of adverse outcome after major surgery. In particular, data obtained from perioperative cardiopulmonary exercise testing have an expanding role in perioperative care. Such information may be used to inform a variety of changes in clinical practice, including interventions that may reduce the risk of perioperative adverse events...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161397/abdominal-aortic-aneurysm-repair-in-the-united-kingdom-an-exemplar-for-the-role-of-anaesthetists-in-perioperative-medicine
#4
S J Howell
The past two decades have seen an increasing recognition that the delivery of safe surgery with low complication rates and good long-term outcomes is a team endeavour embracing the whole patient care pathway. The key role of the anaesthetist in managing the patient through the surgical process is widely understood and has driven the emergence of perioperative medicine. In parallel with these developments there has been a sea change in the organisation of the care of patients presenting for elective abdominal aortic aneurysm (AAA) repair...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160366/erdosteine-ameliorates-the-harmful-effects-of-ischemia-reperfusion-injury-on-the-liver-of-rats
#5
Aziz Mutlu Barlas, Kemal Kismet, Serap Erel, Serdar Kuru, Turgut Cavusoglu, Mehmet Senes, Zeynep Adiyaman, Pinar Celepli, Sema Hucumenoglu, Recep Pekcici
PURPOSE: To investigate the potential protective effects of erdosteine against the harmful effects of ischemia-reperfusion injury on the liver in an experimental rat model. METHODS: Forty rats were divided into 4 groups. In the sham group, only the hepatic pedicle was mobilized. No other manipulation or treatment was performed. In the other groups, ischemia was achieved by clamping the hepatic pedicle for 60 min. After that, 90 min reperfusion was provided. In the control group, no treatment was given...
October 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29159892/reliability-of-body-weight-scalars-on-the-assessment-of-propofol-induction-dose-in-obese-patients
#6
A M Araújo, H S Machado, A C Falcão, P Soares-da-Silva
BACKGROUND: Obese patients require specific perioperative care when compared with non-obese patients. The present study aimed to analyse the ability of size descriptors to estimate propofol induction dose in class II and III obese patients. METHODS: A cross-sectional study on adult patients with body mass index (BMI) equal to or greater than 35 kg/m(2) and on adult patients with BMI lower than 35 kg/m(2) was carried out. General anaesthesia was induced with remifentanil, propofol and rocuronium...
November 21, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29159840/cognitive-outcomes-after-transcatheter-aortic-valve-implantation-a-metaanalysis
#7
Maisha M Khan, Nathan Herrmann, Damien Gallagher, Dov Gandell, Stephen E Fremes, Harindra C Wijeysundera, Sam Radhakrishnan, Yue Ran Sun, Krista L Lanctôt
OBJECTIVES: To quantitatively summarize changes in cognitive performance in individuals with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). DESIGN: Metaanalysis. PARTICIPANTS: Individuals undergoing TAVI (N = 1,065 (48.5% male) from 18 studies, average age ≥80). MEASUREMENTS: The MEDLINE, EMBASE, and Cochrane Central databases were searched for original peer-reviewed reports assessing cognitive performance using standardized cognitive tests before and after TAVI...
November 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29158975/assessment-of-perioperative-stress-in-colorectal-cancer-by-use-of-in-vitro-cell-models-a-systematic-review
#8
Tove Kirkegaard, Mikail Gögenur, Ismail Gögenur
Background: The perioperative period is important for patient outcome. Colorectal cancer surgery can lead to metastatic disease due to release of disseminated tumor cells and the induction of surgical stress response. To explore the overall effects on surgically-induced changes in serum composition, in vitro model systems are useful. Methods: A systematic search in PubMed and EMBASE was performed to identify studies describing in vitro models used to investigate cancer cell growth/proliferation, cell migration, cell invasion and cell death of serum taken pre- and postoperatively from patients undergoing colorectal tumor resection...
2017: PeerJ
https://www.readbyqxmd.com/read/29157765/the-effect-of-preoperative-oral-carbohydrate-solution-intake-on-patient-comfort-a-randomized-controlled-study
#9
Emel Çakar, Emel Yilmaz, Ekrem Çakar, Hakan Baydur
PURPOSE: The study was conducted to investigate the effect of preoperative oral carbohydrate loading on the preoperative discomforts and postoperative complications of patients undergoing elective thyroidectomy. DESIGN: A randomized controlled clinical trial. METHODS: Ninety patients scheduled for thyroidectomy were divided into three groups: (1) those receiving a carbohydrate-rich drink (CHD), (2) those receiving an overnight 5% glucose intravenous infusion, and (3) those fasting from midnight...
December 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29157682/outcomes-of-thoracic-endovascular-aortic-repair-for-chronic-aortic-dissections
#10
Allan M Conway, Khalil Qato, Laurie R Mondry, Guillaume J Stoffels, Gary Giangola, Alfio Carroccio
BACKGROUND: Open surgical repair remains the "gold standard" treatment for chronic type B aortic dissection (cTBD) with aneurysm. Thoracic endovascular aortic repair (TEVAR) has gained popularity in recent years for the treatment of thoracic aortic diseases, including cTBD. We assessed the effectiveness of TEVAR in the treatment of cTBD using the Vascular Quality Initiative (VQI) database. METHODS: The VQI registry identified 4713 patients treated with TEVAR from July 2010 to November 2015, including 125 repairs for cTBD...
November 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29157110/risk-factors-and-clinical-outcomes-of-delirium-in-osteoporotic-hip-fractures
#11
Joon Yub Kim, Jeong Hyun Yoo, Eugene Kim, Ki Bum Kwon, Byeong-Ryong Han, Yongun Cho, Jai Hyung Park
PURPOSE: This study is performed to identify risk factors for delirium in osteoporotic hip fractures and to evaluate the hospitalization cost and clinical outcomes of delirium in osteoporotic hip. METHODS: A total of 221 patients with osteoporotic hip fractures were assessed for eligibility between 2010 and 2014. Among them, 37 patients with delirium were allocated into the delirium group (group D) and 37 patients without delirium were allocated into the non-delirium group (group ND) by matching demographic factors...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29156839/the-benefit-of-immunonutrition-in-patients-undergoing-hepatectomy-a-systematic-review-and-meta-analysis
#12
Chengshuo Zhang, Baomin Chen, Ao Jiao, Feng Li, Bowen Wang, Ning Sun, Jialin Zhang
Perioperative immunonutrition in liver resection remains doubtful. A systematic review and meta-analysis was conducted to compare postoperative outcomes between patients undergoing hepatectomy who received perioperative immunonutrition and those who did not.A PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Knowledge database search was performed to retrieve all of the randomized controlled trials (RCTs) evaluating the value of perioperative immunonutrition in patients undergoing hepatectomy until the end of September 2016...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29156481/-why-and-how-should-i-assess-frailty-a-guide-for-the-preoperative-anesthesia-clinic
#13
Oliver Birkelbach, Rudolf Mörgeli, Felix Balzer, Maria Olbert, Sascha Treskatsch, Rainer Kiefmann, Ursula Müller-Werdan, Anett Reisshauer, Christine Schwedtke, Bruno Neuner, Claudia Spies
Introduction: Frailty is a condition of decreased physiological reserves seen in approx. one third of elderly anesthesiological patients, and affecting many aspects of treatment as well as outcome. Although there are over 60 measurement instruments, frailty assessment is still poorly implemented. Understanding why and how to assess frailty is key to its implementation in preoperative anesthesia clinics. Method: After presenting the impact of perioperative frailty and the benefits of an early diagnosis on health related quality of life, we present an overview of the most important tools that can be used in the preoperative frailty assessment...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29155251/the-rothman-index-as-a-predictor-of-post-discharge-adverse-events-after-elective-spine-surgery
#14
Ryan P McLynn, Nathaniel T Ondeck, Jonathan J Cui, David R Swanson, Blake N Shultz, Patawut Bovonratwet, Jonathan N Grauer
BACKGROUND CONTEXT: The Rothman Index (RI) is a comprehensive rating of overall patient condition in the hospital setting. It is used at many medical centers and calculated based on vital signs, lab values, and nursing assessments in the electronic medical record. Past research has demonstrated an association with adverse events, readmission, and mortality in other fields, but it has not been investigated in spine surgery. PURPOSE: To determine the potential utility of the RI as a predictor of adverse events after discharge following elective spine surgery...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29154237/results-of-home-parenteral-nutrition-in-patients-with-severe-inflammatory-bowel-disease-an-alternative-for-surgery-of-malnourished-patients
#15
Maryla Turkot, Jacek Sobocki
INTRODUCTION: In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition. AIM: The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications...
October 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29154042/oncological-outcomes-of-laparoscopic-nephroureterectomy-versus-open-radical-nephroureterectomy-for-upper-tract-urothelial-carcinoma-an-european-association-of-urology-guidelines-systematic-review
#16
REVIEW
Benoit Peyronnet, Thomas Seisen, Jose-Luis Dominguez-Escrig, Harman Max Bruins, Cathy Yuhong Yuan, Thomas Lam, Steven Maclennan, James N'dow, Marko Babjuk, Eva Comperat, Richard Zigeuner, Richard J Sylvester, Maximilian Burger, Hugh Mostafid, Bas W G van Rhijn, Paolo Gontero, Joan Palou, Sharokh F Shariat, Morgan Roupret
CONTEXT: Most series have suggested better perioperative outcomes of laparoscopic radical nephroureterectomy (RNU) over open RNU. However, the oncological safety of laparoscopic RNU remains controversial. OBJECTIVE: To systematically review all relevant literature comparing oncological outcomes of open versus laparoscopic RNU. EVIDENCE ACQUISITION: A systematic literature search using the Medline, Embase, and Cochrane databases and clinicaltrial...
November 15, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29153918/nursing-music-protocol-and-postoperative-pain
#17
REVIEW
Michael J Poulsen, Jeffrey Coto
Pain has always been a major concern for patients and nurses during the postoperative period. Therapies, medicines, and protocols have been developed to improve pain and anxiety but have undesirable risks to the patient. Complementary and alternative medicine therapies have been studied but have not been applied as regular protocols in the hospital setting. Music is one type of complementary and alternative medicine therapy that has been reported to have favorable results on reducing postoperative pain, anxiety, and opioid usage...
November 16, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152936/gastric-ultrasound-to-guide-anesthetic-management-in-elective-surgical-patients-non-compliant-with-fasting-instructions-a-retrospective-cohort-study
#18
Peter van de Putte, Jonathan van Hoonacker, Anahi Perlas
BACKGROUND: Perioperative aspiration leads to significant morbidity and mortality. Standard fasting periods are used to ensure an empty stomach in patients. Anesthesiologists are frequently confronted with cases of dubious adherence to these guidelines. Point-of-care gastric ultrasound is a diagnostic tool that offers information on the type and volume of gastric contents. METHODS: We performed a retrospective analysis of a departmental database containing clinical and sonographic information on elective surgical patients who had been non- compliant to the fasting guidelines...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29152709/perioperative-gastrointestinal-problems-in-the-icu
#19
Annika Reintam Blaser, Joel Starkopf, Pieter-Jan Moonen, Manu L N G Malbrain, Heleen M Oudemans-van Straaten
Gastrointestinal (GI) problems after surgery are common and are not limited to patients undergoing abdominal surgery. GI function is complicated to monitor and is not included in organ dysfunction scores widely used in the ICUs. In most cases, it recovers after surgery, if systemic and local inflammation and perfusion improve, gut oedema resolves, and analgosedation is reduced. However, perioperative GI problems may have severe consequences and increase the risk of death if not recognized and managed in a timely manner...
November 20, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29151453/diastolic-dysfunction-is-a-risk-of-perioperative-myocardial-injury-assessed-by-high-sensitivity-cardiac-troponin-t-in-elderly-patients-undergoing-non-cardiac-surgery
#20
Hironobu Toda, Kazufumi Nakamura, Koji Nakagawa, Atsuyuki Watanabe, Toru Miyoshi, Nobuhiro Nishii, Kazuyoshi Shimizu, Masao Hayashi, Hiroshi Morita, Hiroshi Morimatsu, Hiroshi Ito
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is useful for detecting myocardial injury and is expected to become a prognostic marker in patients undergoing non-cardiac surgery. The aim of this pilot study evaluating the efficacy of β-blocker therapy in a perioperative setting (MAMACARI study) was to assess perioperative myocardial injury (PMI) in elderly patients with preserved ejection fraction (EF) undergoing non-cardiac surgery.Methods and Results:In this prospective observational cohort study of 151 consecutive patients with preserved EF and aged >60 years who underwent non-cardiac surgery, serum levels of hs-cTnT were measured before and on postoperative days 1 and 3 after surgery...
November 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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