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Perioperative assessment

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https://www.readbyqxmd.com/read/28346681/obstructive-sleep-apnea-and-postoperative-complications-among-patients-undergoing-gynecologic-oncology-surgery
#1
Olumuyiwa A Bamgbade, Rong R Khaw, Raisah S Sawati, Cathrine M Holland
OBJECTIVE: To investigate the prevalence of obstructive sleep apnea (OSA), physiological or risk factors associated with OSA, and OSA-associated postoperative complications among patients undergoing gynecologic oncology surgery. METHODS: A prospective observational study was done of gynecologic oncology patients undergoing abdominal surgery at a center in the UK between August 2009 and January 2013. All patients underwent perioperative sleep oximetry for the diagnosis of OSA...
March 27, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28345356/dysregulation-of-tissue-factor-thrombin-activatable-fibrinolysis-inhibitor-and-fibrinogen-in-patients-undergoing-total-joint-arthroplasty
#2
Christopher Wanderling, Jeffrey Liles, Elissa Finkler, Peter Carlsgaard, William Hopkinson, Nil Guler, Debra Hoppensteadt, Jawed Fareed
Total joint arthroplasty (TJA) of the hip or knee (THA, TKA) has become an increasingly common procedure. While TJA is a successful treatment for individuals experiencing degenerative joint diseases, it is well known that one of the most common perioperative complications of TJA is deep venous thrombosis (DVT). To profile tissue factor (TF), microparticle-tissue factor (MP-TF), thrombin-activatable fibrinolysis inhibitor (TAFI), and fibrinogen levels in patients undergoing TJA to determine potential preexisting Hemostatic dysregulation...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28344617/twelve-months-follow-up-after-retrograde-recanalization-of-superficial-femoral-artery-chronic-total-occlusion
#3
Joanna Wojtasik-Bakalarz, Salech Arif, Michał Chyrchel, Tomasz Rakowski, Krzysztof Bartuś, Dariusz Dudek, Stanisław Bartuś
INTRODUCTION: Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO) of the superficial femoral artery (SFA). Ten-fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. AIM: To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28343046/perioperative-hemoglobin-a1c-as-a-predictor-of-deep-infection-following-single-level-lumbar-decompression-in-patients-with-diabetes
#4
Jourdan M Cancienne, Brian C Werner, Dennis Q Chen, Hamid Hassanzadeh, Adam L Shimer
BACKGROUND CONTEXT: Although multiple studies have cited diabetes mellitus as a risk factor decreased functional outcomes, increased infectious complications, and overall increased reoperation rate following degenerative lumbar spinal surgery, few have investigated how perioperative glycemic control influences such complications. PURPOSE: The primary goal of the present study was to use a national database to evaluate the association of perioperative glycemic control as demonstrated by Hemoglobin A1c levels in patients with diabetes undergoing primary, single level decompression without concomitant fusion with the incidence of deep postoperative infection following requiring operative irrigation and debridement...
March 22, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28342705/comparison-of-20-mannitol-and-3-hypertonic-saline-on-intracranial-pressure-and-systemic-hemodynamics
#5
Navdeep Sokhal, Girija Prasad Rath, Arvind Chaturvedi, Manmohan Singh, Hari Hara Dash
Mannitol and hypertonic saline (HS) are most commonly used hyperosmotic agents for intraoperative brain relaxation. We compared the changes in ICP and systemic hemodynamics after infusion of equiosmolar solutions of both agents in patients undergoing craniotomy for supratentorial tumors. Forty enrolled adults underwent a standard anesthetic induction. Apart from routine monitoring parameters, subdural ICP with Codmann catheter and cardiac indices by Vigileo monitor, were recorded. The patients were randomized to receive equiosmolar solutions of either 20% mannitol (5ml/kg) or 3% HS (5...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28341949/complications-and-outcomes-after-gynecomastia-surgery-analysis-of-204-pediatric-and-1583-adult-cases-from-a-national-multi-center-database
#6
Dmitry Zavlin, Kevin T Jubbal, Jeffrey D Friedman, Anthony Echo
BACKGROUND: Gynecomastia is a common disease that is prevalent across all age groups of boys and men. Although benign in nature, it can lead to psychological and social distress, prompting affected patients to seek medical attention. Management strategies include observation and drug therapy, yet surgical procedures remain the hallmark of treatment. The goal of this study was to analyze patient demographics, outcomes, and complication rates of gynecomastia surgery in a large multi-institutional cohort...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341107/comparison-of-clinical-effects-of-epidural-levobupivacaine-morphine-versus-bupivacaine-morphine-in-dogs-undergoing-elective-pelvic-limb-surgery
#7
Ilaria Cerasoli, Alexandru Tutunaru, Alessia Cenani, Juan Ramirez, Johann Detilleux, Marc Balligand, Charlotte Sandersen
OBJECTIVE: To evaluate the efficacy, in terms of the amount of rescue analgesia required, and the clinical usefulness of epidural injection of morphine with bupivacaine or levobupivacaine for elective pelvic limb surgery in dogs during a 24-hour perioperative period. STUDY DESIGN: Prospective, blinded, randomized clinical study. ANIMALS: A group of 26 dogs weighing 31.7 ± 14.2 (mean ± standard deviation) kg and aged 54 ± 36 months. METHODS: All dogs were premedicated with methadone intravenously (0...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28339431/perioperative-ketamine-administration-for-thoracotomy-pain
#8
Daniel W Moyse, Alan D Kaye, James H Diaz, Muhammad Y Qadri, David Lindsay, Srinivas Pyati
BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28338551/standardizing-robotic-lobectomy-feasibility-and-safety-in-128-consecutive-lobectomies-within-a-single-healthcare-system
#9
John F Lazar, Laurence N Spier, Alan R Hartman, Richard S Lazzaro
OBJECTIVE: Single-surgeon cohorts assessing robotically assisted video-assisted thoracic (RA-VATS) lobectomy have reported good outcomes, but there are little data regarding multiple surgeons applying a standard technique in separate hospitals. The purpose of this study was to show how a standardized robotic technique is both safe and reproducible between surgeons and institutions. METHODS: From July 1, 2012, to October 1, 2013, patients undergoing RA-VATS lobectomy for both benign and malignant disease were identified from a prospectively collected database of two thoracic surgeons from different hospitals within the same healthcare system and retrospectively analyzed...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28338504/ventilation-with-high-or-low-tidal-volume-with-peep-does-not-influence-lung-function-after-spinal-surgery-in-prone-position-a-randomized-controlled-trial
#10
Sarah Soh, Jae-Kwang Shim, Yoon Ha, Young-Sam Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: Spinal surgery in the prone position is accompanied by increased intrathoracic pressure and decreased respiratory compliance. This study investigated whether intraoperative lung protective mechanical ventilation improved lung function evaluated with pulmonary function tests in patients at risk of postoperative pulmonary complications (PPCs) after major spinal surgery in the prone position. METHODS: Seventy-eight patients at potential risk of PPCs were randomly assigned to the protective group (tidal volume; 6 mL/kg predicted body weight, 6 cm H2O positive end-expiratory pressure with recruitment maneuvers) or the conventional group (10 mL/kg predicted body weight, no positive end-expiratory pressure)...
March 23, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28338025/preventing-perioperative-bleeding-in-patients-with-inherited-bleeding-disorders
#11
Colin Watterson, Nicholas Beacher
Data sourcesCochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, a regularly updated database informed by trials identified within electronic databases including MEDLINE. Further defined searches were undertaken in PubMed, Embase, The Cochrane Library, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform. Additional hand searching of relevant journals and books of conference proceedings was undertaken.Study selectionRandomised and quasi-randomised controlled trials in people of all ages with haemophilia or VWD undergoing oral or dental procedures using antifibrinolytic agents (tranexamic acid (TXA) or epsilon aminocaproic acid (EACA)) to prevent perioperative bleeding compared to no intervention with or without placebo...
March 2017: Evidence-based Dentistry
https://www.readbyqxmd.com/read/28337660/topgear-a-randomized-phase-iii-trial-of-perioperative-ecf-chemotherapy-with-or-without-preoperative-chemoradiation-for-resectable-gastric-cancer-interim-results-from-an-international-intergroup-trial-of-the-agitg-trog-eortc-and-cctg
#12
Trevor Leong, B Mark Smithers, Karin Haustermans, Michael Michael, Val Gebski, Danielle Miller, John Zalcberg, Alex Boussioutas, Michael Findlay, Rachel L O'Connell, Jaclyn Verghis, David Willis, Tomas Kron, Melissa Crain, William K Murray, Florian Lordick, Carol Swallow, Gail Darling, John Simes, Rebecca Wong
BACKGROUND: Postoperative chemoradiation and perioperative chemotherapy using epirubicin/cisplatin/5-fluorouracil (ECF) represent two standards of care for resectable gastric cancer. In the TOPGEAR (Trial Of Preoperative therapy for Gastric and Esophagogastric junction AdenocaRcinoma) trial, we hypothesized that adding preoperative chemoradiation to perioperative ECF will improve survival; however, the safety and feasibility of preoperative chemoradiation have yet to be determined. METHODS: TOPGEAR is an international phase III trial in which patients with adenocarcinoma of the stomach were randomized to perioperative ECF alone or with preoperative chemoradiation...
March 23, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28334592/using-an-electronic-perioperative-documentation-tool-to-identify-returns-to-operating-room-ror-in-a-tertiary-care-academic-medical-center
#13
Robert R Cima, Sarah R Dhanorker, Christopher L Ostendorf, Mfonabasi Ntekpe, Raghu V Mudundi, Elizabeth B Habermann, Claude Deschamps
BACKGROUND: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. METHOD: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334471/the-clinical-applicability-of-a-daily-summary-of-patients-self-reported-postoperative-pain-a-repeated-measure-analysis
#14
Lotta Wikström, Kerstin Eriksson, Bengt Fridlund, Mats Nilsson, Kristofer Årestedt, Anders Broström
AIM AND OBJECTIVES: (I) to determine if a central tendency, median, based on patients' self-rated pain is a clinically applicable daily measure to show patients' postoperative pain on the first day after major surgery (II) and to determine the number of self-ratings required for the calculation of this measure. BACKGROUND: Perioperative pain traits in medical records are difficult to overview. The clinical applicability of a daily documented summarising measure of patients' self-rated pain scores is little explored...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28334436/impact-of-neoadjuvant-chemoradiation-on-perioperative-outcomes-in-patients-with-rectal-cancer
#15
Brandon C Chapman, Patrick Hosokawa, William Henderson, Alessandro Paniccia, Douglas M Overbey, Wells Messersmith, Christopher Lieu, Greg V Stiegmann, Richard D Schulick, Csaba Gajdos
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation for rectal cancer is associated with lower local recurrence rates. The objective of this study is to assess the impact of neoadjuvant therapy on perioperative complications in patients with rectal cancer. METHODS: Using the ACS-NSQIP database (2005-2012), a propensity score was used to match 3592 patients with rectal cancer receiving neoadjuvant therapy to 3592 patients undergoing surgery alone. The association between neoadjuvant chemoradiation and perioperative outcomes was evaluated...
March 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28333178/age-as-a-risk-factor-in-abdominoplasty
#16
Rafael A Couto, Gregory A Lamaris, Todd A Baker, Ahmed M Hashem, Kashyap Tadisina, Paul Durand, Steven Rueda, Susan Orra, James E Zins
Background: Recent studies reviewing large patient databases suggested that age may be an independent risk factor for abdominoplasty. However, these investigations by design considered only short-term major complications. Objectives: The purpose of this investigation was: (1) to compare the safety of abdominoplasty in an elderly and younger patient population; (2) to determine the complication rates across all spectrums: major, minor, local, and systemic; and (3) to evaluate complications occurring both short and long term...
January 20, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28333038/detecting-colorectal-cancer-using-electrical-impedance-spectroscopy-an-ex-vivo-feasibility-study
#17
Angela Pathiraja, Paul Ziprin, Arsam Shiraz, Reza Mirnezami, Andrew Tizzard, Brian Brown, Andreas Demosthenous, Richard H Bayford
OBJECTIVE: Colorectal cancer is the fourth most common cancer worldwide, with a lifetime risk of around 20%. Current solutions do not allow clinicians to objectively assess tissue abnormality during endoscopy and perioperatively. A solution capable of objectively assessing samples in real time could greatly improve the treatment process. A solution that can be integrated in minimally invasive diagnostics and management strategies to provide real-time point-of-care information would be greatly transformative...
March 23, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28331173/laparoscopic-gastrectomy-with-enhanced-recovery-after-surgery-protocol-single-center-experience
#18
Magdalena Pisarska, Michał Pędziwiatr, Piotr Major, Michał Kisielewski, Marcin Migaczewski, Mateusz Rubinkiewicz, Piotr Budzyński, Krzysztof Przęczek, Anna Zub-Pokrowiecka, Andrzej Budzyński
BACKGROUND Surgery remains the mainstay of gastric cancer treatment. It is, however, associated with a relatively high risk of perioperative complications. The use of laparoscopy and the Enhanced Recovery After Surgery (ERAS) protocol allows clinicians to limit surgically induced trauma, thus improving recovery and reducing the number of complications. The aim of the study is to present clinical outcomes of patients with gastric cancer undergoing laparoscopic gastrectomy combined with the ERAS protocol. MATERIAL AND METHODS Fifty-three (21 female/32 male) patients who underwent elective laparoscopic total gastrectomy due to cancer were prospectively analyzed...
March 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28330739/the-impact-of-metabolic-syndrome-and-its-components-on-perioperative-outcomes-after-elective-laparotomy-a-prospective-observational-study
#19
Eleni Laou, Haralampos Milionis, Anastasios Petrou, Eleni Arnaoutoglou, Georgios Glantzounis, Eleni Bairaktari, Dimitrios Mavridis, Dimitri P Mikhailidis, Georgios Papadopoulos, Petros Tzimas
BACKGROUND: Metabolic syndrome (MetS) represents a constellation of risk factors, including central obesity, elevated fasting blood glucose, high blood pressure and atherogenic dyslipidemia. This prospective observational study aimed to assess the impact of MetS on perioperative outcomes of patients undergoing elective abdominal surgery with laparotomy. METHODS: We included 105 consecutive non-diabetic patients undergoing elective abdominal surgery with laparotomy...
March 14, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28327981/long-term-outcome-after-multiple-burr-hole-surgery-in-children-with-moyamoya-angiopathy-a-single-center-experience-in-108-hemispheres
#20
Thomas Blauwblomme, Bertrand Mathon, Olivier Naggara, Manoelle Kossorotoff, Marie Bourgeois, Stéphanie Puget, Philippe Meyer, Valentine Brousse, Marianne de Montalembert, Francis Brunelle, Michel Zerah, Christian Sainte-Rose
BACKGROUND: Multiple burr hole (MBH) surgery is a simple, safe, and effective indirect technique of revascularization in moyamoya angiopathy (MM). However, it is not yet recognized as a first-line treatment. OBJECTIVE: To assess the long-term outcome and perioperative complications in a large single-center cohort of children with MM who underwent burr hole surgery. METHODS: This study is a retrospective analysis of children who underwent surgery for MM in a national reference center for pediatric stroke between 1999 and 2015...
February 20, 2017: Neurosurgery
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