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https://www.readbyqxmd.com/read/27908316/-frail-patients-and-surgery
#1
Nadia A Henriksen, Frederik Helgstrand, Ismail Gögenur
It is estimated that 15% of patients above 65 years of age are frail. Frail patients have significantly higher risk of post-operative complications when undergoing both elective and emergency surgery than patients who are not frail. Therefore, it is recommended that all patients above 65 years are frailty scored prior to a surgical procedure. It seems advisable to include the following items in a multimodal frailty score: evaluation of the patient's cognitive ability, functional status, nutritional status and pulmonary and cardiac function...
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27898350/cronkhite-canada-syndrome-complicated-by-pulmonary-embolism-a-case-report
#2
Neha L Nemade, Urvi B Shukla, Gajanan D Wagholikar
INTRODUCTION: Cronkhite Canada Syndrome (CCS) is a rare syndrome, described in 1955 by Americans, Leonard Wolsey Cronkhite and Wilma Jeanne Canada in the New England Journal of Medicine [1]. About 450 cases have been reported. Complications, like malignant transformation, unprovoked thromboembolism is known. Since there is wide variability in medical presentation, no definitive diagnostic and treatment protocol s have been set. The mortality remains at 55%. CASE PRESENTATION: We report a case of a 50 year old male patient presenting with diarrhea, weight loss, abdominal pain, ectodermal features...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27894885/metabolic-rates-are-elevated-and-influenced-by-maternal-identity-during-the-early-yolk-dependent-post-hatching-period-in-an-estuarine-turtle-the-diamondback-terrapin-malaclemys-terrapin
#3
Christopher L Rowe, Ryan J Woodland, Sarah A Funck
Non-genetic maternal effects, operating through a female's physiology or behavior, can influence offspring traits and performance. Here we examined potential maternal influences on metabolic rates (MR) of offspring in an estuarine turtle, the diamondback terrapin (Malaclemys terrapin). Females and their eggs were collected from the field and the eggs incubated in the laboratory for subsequent measurement of MR of females, late-stage embryos, newly-hatched individuals that were nutritionally dependent on yolk, and older hatchlings that had depleted their yolk reserves and thus were independent of energetic contributions from the female...
November 25, 2016: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
https://www.readbyqxmd.com/read/27888808/prognostic-nutritional-index-as-a-prognostic-biomarker-for-survival-in-digestive-system-carcinomas
#4
Yang Zhao, Peng Xu, Huafeng Kang, Shuai Lin, Meng Wang, Pengtao Yang, Cong Dai, Xinghan Liu, Kang Liu, Yi Zheng, Zhijun Dai
The prognostic nutritional index (PNI) has been reported to correlate with the prognosis in patients with various malignancies. We performed a meta-analysis to determine the predictive potential of PNI in digestive system cancers. Twenty-three studies with a total of 7,384 patients suffering from digestive system carcinomas were involved in this meta-analysis. A lower PNI was significantly associated with the shorter overall survival (OS) [Hazard Ratio (HR) 1.83, 95% Confidence Interval (CI) 1.62-2.07], the poorer disease-free survival (DFS) (HR 1...
November 19, 2016: Oncotarget
https://www.readbyqxmd.com/read/27863481/association-of-nutritional-status-related-indices-and-chemotherapy-induced-adverse-events-in-gastric-cancer-patients
#5
Seung Hee Seo, Sung-Eun Kim, Yoon-Koo Kang, Baek-Yeol Ryoo, Min-Hee Ryu, Jae Ho Jeong, Shin Sook Kang, Mihi Yang, Jung Eun Lee, Mi-Kyung Sung
BACKGROUND: Malnutrition in gastrectomized patients receiving chemotherapy is associated with the susceptibility to chemotherapy-related adverse events. This study evaluated pre-operative nutritional status-related indices associated with adverse events in post-operation gastric cancer patients receiving chemotherapy. METHODS: Medical records of 234 gastrectomized patients under adjuvant tegafur/gimeracil/oteracil chemotherapy with extended lymph node dissection were analyzed...
November 18, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27842926/a-randomised-trial-of-post-discharge-enteral-feeding-following-surgical-resection-of-an-upper-gastrointestinal-malignancy
#6
Farid Froghi, Grant Sanders, Richard Berrisford, Tim Wheatley, Paul Peyser, Jo Rahamim, Stephen Lewis
BACKGROUND: Patients undergoing upper gastrointestinal surgery often eat poorly post-operatively, despite dietetic input. A pilot study was conducted to examine the benefit of a 6 week nutritional supplementation via a feeding jejunostomy on fatigue, quality of life and independent living. METHODS: A feeding jejunostomy was placed routinely at oesophagectomy or total gastrectomy for cancer. At discharge, patients were randomised to nutritional supplementation (600 kcal/day) via their feeding jejunostomies or no jejunal supplement...
November 5, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27831968/poor-nutrition-status-and-lumbar-spine-fusion-surgery-in-the-elderly-readmissions-complications-and-mortality
#7
Varun Puvanesarajah, Amit Jain, Khaled Kebaish, Christopher I Shaffrey, Daniel M Sciubba, Rafael De la Garza-Ramos, A Jay Khanna, Hamid Hassanzadeh
STUDY DESIGN: Retrospective database review. OBJECTIVE: To quantify the medical and surgical risks associated with elective lumbar spine fusion surgery in patients with poor pre-operative nutritional status and to assess how nutritional status alters length of stay and readmission rates. SUMMARY OF BACKGROUND DATA: There has been recent interest in quantifying the increased risk of complications caused by frailty, an important consideration in elderly patients that is directly related to comorbidity burden...
November 9, 2016: Spine
https://www.readbyqxmd.com/read/27789263/postoperative-cerebral-dysfunction-in-the-elderly-diagnosis-and-prophylaxis
#8
D Benhamou, A Brouquet
Post-operative cerebral dysfunction includes delirium, usually occurring early and reversible, and post-operative cognitive disorders, usually occurring later and prolonged. This is a frequent complication in patients older than 75 years old. The two neurological pictures are often inter-related. The pathophysiology of both entities is similar and related to post-operative neuro-inflammation; therefore onset may occur independently of any surgical complication. Post-operative cerebral dysfunction is a serious organic complication...
October 24, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27785551/the-effect-of-pre-operative-optimization-on-post-operative-outcome-in-crohn-s-disease-resections
#9
Alaa El-Hussuna, Igors Iesalnieks, Nir Horesh, Sabah Hadi, Yael Dreznik, Oded Zmora
BACKGROUND: The timing of surgical intervention in Crohn's disease (CD) may depend on pre-operative optimization (PO) which includes different interventions to decrease the risk for unfavourable post-operative outcome. The objective of this study was to investigate the effect of multi-model PO on the post-operative outcome in CD. METHOD: This is a multicentre retrospective cohort study. The primary outcome was 30-day post-operative complications. Secondary outcomes were intra-abdominal septic complications, surgical site infection (SSI), re-operation, length of post-operative stay in a hospital and re-admission...
October 26, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27733448/dietary-factors-during-early-life-program-bone-formation-in-female-rats
#10
Jin-Ran Chen, Oxana P Lazarenko, Michael L Blackburn, Kartik Shankar
Nutritional status during intrauterine and early postnatal life impacts the risk of chronic diseases; however, evidence for an association between early life dietary factors and bone health in adults is limited. Soy protein isolate (SPI) may be one such dietary factor that promotes bone accretion during early life with persistent effects into adulthood. In the present study, we fed postnatal day (PND) 24 weanling female rats an SPI diet for 30 d [short-term SPI (ST-SPI)], and on PND 55, we switched SPI diet to control casein diet until age 6 mo...
October 12, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/27732587/pediatric-kidney-transplantation-a-historical-review
#11
REVIEW
Priya S Verghese
Successful renal transplantation is the optimal treatment for chronic kidney failure, but this was not always so for children. Beginning with the first kidney transplants in the 1950s, children experienced poorer patient and graft survival rates than adult patients. But over the last 6 decades, an improved understanding of the immune system which has steered pediatric multi-center clinical/pharmacokinetic and mechanistic studies that have sculpted our immunosuppression with markedly better patient and graft survivals...
November 16, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27722071/statistical-optimization-for-enhanced-yields-of-probiotic-bacillus-coagulans-and-its-phage-resistant-mutants-followed-by-kinetic-modelling-of-the-process
#12
Kavita R Pandey, Chetan Joshi, Babu V Vakil
Probiotics are microorganisms which when administered in adequate amounts confer health benefits to the host. A leading pharmaceutical company producing Bacillus coagulans as a probiotic was facing the problem of recurring phage attacks. Two mutants viz. B. co PIII and B. co MIII that were isolated as phage resistant mutants after UV irradiation and MMS treatment of phage sensitive B. coagulans parental culture were characterized at functional and molecular level and were noted to have undergone interesting genetic changes...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27720223/bariatric-surgery-and-intellectual-disability-furthering-evidence-based-practice
#13
REVIEW
Emma Gibbons, Amanda Faith Casey, Keith Z Brewster
BACKGROUND: Rates of morbid obesity are higher for individuals with intellectual disability (ID). Individuals with ID may find nutritional guidelines difficult to follow and many face personal and environmental barriers for physical activity. Bariatric surgery may reduce obesity related health comorbidities while promoting sustained weight loss in diverse populations. Yet no study has reviewed the feasibility of conducting bariatric surgery on individuals with ID. OBJECTIVES: To conduct a scoping review of literature on bariatric procedures performed on individuals with ID...
January 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/27716696/early-enteral-nutrition-therapy-in-congenital-cardiac-repair-postoperatively-a-randomized-controlled-pilot-study
#14
Manoj Kumar Sahu, Anuradha Singal, Ramesh Menon, Sarvesh Pal Singh, Alka Mohan, Mala Manral, Divya Singh, V Devagouru, Sachin Talwar, Shiv Kumar Choudhary
BACKGROUND AND OBJECTIVES: Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge. Critically ill infants in the early postoperative period are in a catabolic stress. The mismatch between estimated energy requirement (EER) and the intake in the postoperative period is multifactorial, predisposing them to complications such as immune deficiency, more infection, and growth failure. This study aimed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27709718/body-composition-assessed-by-dual-energy-x-ray-absorptiometry-predicts-early-infectious-complications-after-liver-transplantation
#15
C Lindqvist, A Majeed, S Wahlin
BACKGROUND: It is challenging to identify malnutrition, which is a risk factor for poor outcome in patients with liver cirrhosis. In the present study, we aimed to investigate the prevalence of malnutrition among patients listed for liver transplantation, as assessed by different methods, and also to relate dual-energy X-ray absorptiometry (DXA) to short-term post-transplant outcomes. METHODS: In this retrospective cohort study, we reviewed the medical records of 106 patients who underwent liver transplantation in 2009-2012...
October 6, 2016: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/27676858/guidelines-from-perse-and-sofmer-for-neurological-pressure-ulcer-medical-and-surgical-coverage
#16
Brigitte Barrois, Brigitte Perrouin-Verbe, Xavier De-Boissezon, Djamel Ben Smail, Dominique Casanova, Anthony Gelis, Denis Colin
Surgical indication is recommended for specific locations (pelvic stage 3 and 4 pressure ulcers) and if medical treatment is impossible: - global patient assessment is recommended before surgical indication with benefits and risks analysis; - analysis is conducted on several stages; - risk factors analysis and control level; - efficiency analysis about medical and preventive coverage; - pressure ulcer origin analysis; - compliance patient assessment (care contract); - systematic pre operative procedure is recommended: - multi-disciplinary et pluriprofessionnal consultation; - psychological assessment and follow up; - radiological assessment (systematical, no systematical IRM except if osteitis, no TDM, no scintigraphy); - biological assessment (inflammatory nutritional, micro biological); - no pre-operative antibiotherapy; - specify definition of surgical type - realize pre-operative micro biological taking is recommended:(according to bone aspect): - enforce systematic post operative procedures is recommended: - plan patient installation: every patient must have a preventive mattress and book curative mattress for multiple scrap; - plan total immediate post operative dumped according to patient compliance in PRM ward (during at least 3 weeks, often 4); - organize seated station progressive recharging in PRM ward (during at least 3 weeks); - extend patient supervision and allow seated station; - plan further supervision...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27660631/role-of-proteomics-in-crop-stress-tolerance
#17
REVIEW
Parvaiz Ahmad, Arafat A H Abdel Latef, Saiema Rasool, Nudrat A Akram, Muhammad Ashraf, Salih Gucel
Plants often experience various biotic and abiotic stresses during their life cycle. The abiotic stresses include mainly drought, salt, temperature (low/high), flooding and nutritional deficiency/excess which hamper crop growth and yield to a great extent. In view of a projection 50% of the crop loss is attributable to abiotic stresses. However, abiotic stresses cause a myriad of changes in physiological, molecular and biochemical processes operating in plants. It is now widely reported that several proteins respond to these stresses at pre- and post-transcriptional and translational levels...
2016: Frontiers in Plant Science
https://www.readbyqxmd.com/read/27601761/orthopaedic-enhanced-recovery-programme-for-elective-hip-and-knee-arthroplasty-could-a-regional-programme-be-beneficial
#18
Adam Tucker, Darren McCusker, Nidhi Gupta, Jonathon Bunn, Mark Murnaghan
INTRODUCTION: Arthroplasty is commonplace in orthopaedic practice, and post operative pain has been shown to substantially hinder recovery and discharge from hospital. OBJECTIVES: The current study assessed a multidisciplinary, multimodal Orthopaedic ERP in terms of its effect on patient perceived post operative pain in hip and knee arthroplasty. Secondary outcome was in the form of a cost analysis. METHODS: A prospective study was performed on consecutive arthroplasty patients across a 6 week period in a district orthopaedic unit...
May 2016: Ulster Medical Journal
https://www.readbyqxmd.com/read/27569957/severe-sepsis-after-living-donor-liver-transplantation-risk-factors-and-outcomes
#19
K Takeda, Y Sawada, T Kumamoto, K Tanaka, I Endo
BACKGROUND: The post-operative mortality and morbidity rates associated with living-donor liver transplantation (LDLT) are still relatively high. Several papers have reported the risk factors associated with post-operative infectious complications, but few have analyzed the risk factors with respect to the severity of sepsis. The aim of this study was to clarify the risk factors that affect severe sepsis after LDLT. METHODS: For 63 LDLT patients at our institute, we compared peri-operative characteristics in 29 patients who developed sepsis after surgery and 34 patients who did not...
July 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27540247/application-of-pharmaceutical-knowledge-to-the-unconventional-use-of-a-rarely-used-anaesthetic-agent
#20
Caroline Cole
CASE SUMMARY: A 6 yr old 45 kg child with severe Cushinoid features was admitted to PICU with probable hypertensive encephalopathy. She presented with increasing headaches, vomiting and seizures becoming unresponsive with a GCS of 3. She was profoundly hypertensive and her cortisol levels were significantly elevated (>2000 nmol/L). Rapid reduction in cortisol levels was required to stabilise her condition prior to surgery. Etomidate is the only readily available intravenous preparation which reliably suppresses adrenocortical function...
September 2016: Archives of Disease in Childhood
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