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https://www.readbyqxmd.com/read/28650410/identification-of-risk-factors-in-lymphatic-surgeries-for-melanoma-a-national-surgical-quality-improvement-program-review
#1
Mona Ascha, Mustafa S Ascha, Brian Gastman
INTRODUCTION: Sentinel lymph node biopsy (SLNB) and lymphadenectomy (LAD) are commonly performed in the staging and care of patients with malignant melanoma. These procedures are accompanied by complications that may result in hospital readmission, negatively affecting patient outcomes and potentially affecting surgical procedure reimbursement. The National Surgical Quality Improvement Program (NSQIP) database offers a large data set allowing physicians to evaluate 30-day readmission for surgical complications...
June 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28639730/evaluation-of-thoracic-radiographs-as-a-screening-test-for-dogs-and-cats-admitted-to-a-tertiary-care-veterinary-hospital-for-noncardiopulmonary-disease
#2
Christine L Keyserling, Yekaterina Buriko, Bridget M Lyons, Kenneth J Drobatz, Anthony J Fischetti
Thoracic radiographs are used as a screening tool for dogs and cats with a variety of disorders that have no clinical signs associated with thoracic structures. However, this practice has never been supported by an evidence-based study. The objective of this retrospective observational study was to determine if certain canine and feline populations have a higher proportion of radiographic abnormalities, and whether any of these abnormalities are associated with patient hospitalization and outcome. Patients were excluded if current or previous examinations revealed evidence of primary respiratory or cardiac disease, malignant neoplasia, or an abnormal breathing pattern consistent with pulmonary pathology...
June 22, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28638156/goal-directed-perfusion-methodology-for-determining-oxygenator-performance-during-clinical-cardiopulmonary-bypass
#3
Alfred H Stammers, Randi Miller, Stephen G Francis, Laszlo Fuzesi, Anthony Nostro, Eric Tesdahl
New generation oxygenators incorporate arterial line filtration either sequential to, or directly in, the gas exchange module. This unique design may affect gas exchange performance by altering the operational characteristics of the device. The present study was designed to evaluate three oxygenators in a clinical setting using a goal-directed perfusion algorithm during cardiopulmonary bypass (CPB). After institutional review board approval, 60 adult patients undergoing cardiac surgery for acquired heart disease were matched for disease state and body size into three groups based on oxygenator type: Terumo SX18(™) (n = 20), Terumo FX15(™) (n = 20), and LivaNova Inspire6F(™) 6 Dual (n = 20)...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28630012/assessing-passeriforme-health-in-south-texas-via-select-venous-analytes
#4
J Pistone, J J Heatley, T A Campbell, G Voelker
The handheld point of care analyzer is a quick and feasible option to obtain hematology data from individuals. The iSTAT-1® was used to evaluate select venous blood analytes obtained via jugular venipuncture from 238 passerine birds from South Texas. These data were used to assess the health of birds in the area while taking into consideration life history (migratory or sedentary), locale, seasonality, sex, and age. We attributed increased values of pO2 and hematocrit, in addition to hemoglobin and glucose concentrations of migratory birds compared to sedentary birds as the increased need of oxygen carrying capacity and energy for long duration flights...
June 16, 2017: Comparative Biochemistry and Physiology. Part B, Biochemistry & Molecular Biology
https://www.readbyqxmd.com/read/28625233/-elevation-of-red-cell-distribution-width-during-hospitalization-predicts-mortality-in-patients-with-sepsis
#5
Yan Gong, Xianming Long, Jun Jin, Xinjing Yang, Jianhong Fu, Fang Huang, Jian Huang, Qiang Guo, Jun Wang
OBJECTIVE: To investigate the association of red cell distribution width (RDW) with prognosis in patients with sepsis. METHODS: Patients with sepsis admitted to intensive care unit (ICU) of the First Hospital of Soochow University from January 2011 to December 2016 were enrolled. All clinical data were collected for participants, which mainly included basic data, main underlying disease, site of infection, acute physiology and chronic health evaluation II(APACHE II) score, blood routine test, biochemical test, blood gas analysis, coagulation index, procalcitonin (PCT), hospitalization days, and 28-day and 90-day mortality...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28618765/the-influence-of-intraabdominal-pressure-on-the-mortality-rate-of-patients-with-acute-pancreatitis
#6
Petar Svorcan, Maja Stojanovic, Predrag Stevanovic, Aleksadar Karamarkovic, Radmilo Jankovic, Nebojsa Ladjevic
BACKGROUND/AIM: Intraabdominal hypertension (IAH) is a common clinical finding in patients with acute pancreatitis and is associated with poor prognosis. This study aimed to determine the impact of intraabdominal pressure (IAP) on the mortality rate in patients with acute pancreatitis in an intensive care unit. MATERIALS AND METHODS: A total of 50 patients with acute pancreatitis were included in this prospective cohort study. Based on the obtained values of IAP, the patients were divided into two groups: those with normal IAP (n = 14) and increased IAP (n = 36)...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28598047/awareness-and-outcome-of-changing-trends-in-clinical-profile-of-dengue-fever-a-retrospective-analysis-of-dengue-epidemic-from-january-to-december-2014-at-a-tertiary-care-hospital
#7
Jitendra Singh, Anju Dinkar, Virendra Atam, D Himanshu, Kamlesh Kumar Gupta, Kauser Usman, Ravi Misra
BACKGROUND: Dengue fever is caused by mosquito-borne arboviral infection that has become a public health concern globally. Recently, an alarming rise of dengue has also been seen in India. Hence the study was undertaken to know profile of clinical manifestations and laboratory findings during the evolution of dengue fever. METHODS: In this study, retrospective data analysis was done in 216 seropositive dengue patients admitted between January to December 2014 in department of medicine at a north Indian care hospital...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28587719/clinical-audits-to-improve-critical-care-part-2-analyse-benchmark-and-feedback
#8
Gillian Ray-Barruel, Amanda J Ullman, Claire M Rickard, Marie Cooke
Clinical audits are an essential part of the cycle designed to ensure that patients receive the best quality of care. By measuring the care delivered against established best practice standards, it becomes possible to identify shortcomings and to plan targeted strategies and processes for continuous improvement. The success of a clinical audit depends upon defined goals, motivation of stakeholders, appropriate tools and resources, and clear communication. In part 1 of this series, an overview of the structures and processes needed to prepare and collect data for clinical audits in the critical care setting was provided [A...
June 3, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28575484/comprehensive-analysis-of-liberal-and-restrictive-transfusion-strategies-in-pediatric-intensive-care-unit
#9
Basak Akyildiz, Nazan Ulgen Tekerek, Ozge Pamukcu, Adem Dursun, Musa Karakukcu, Nazmi Narin, Mehmet Yay, Ferhan Elmali
Background: We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters. Methods: A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger < 10 g/dL, Group 1) and the restrictive transfusion strategy group (transfusion trigger ≤ 7 g/dL, Group 2). Basal variables including venous/arterial hemoglobin, hematocrit and lactate levels; stroke volume; and cardiac output were recorded at the beginning and end of the transfusion...
May 30, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28556786/elevated-hemoglobin-level-is-associated-with-advanced-fibrosis-in-pediatric-non-alcoholic-fatty-liver-disease
#10
Valentina Giorgio, Antonella Mosca, Arianna Alterio, Anna Alisi, Antonio Grieco, Valerio Nobili, Luca Miele
OBJECTIVES: Hemoglobin (Hb) and red blood cell distribution width (RDW) have been reported to be a risk marker of metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD). No study exists on pediatric populations. We aimed to determine the association between hematological parameters, and the severity of disease in children with biopsy proven NAFLD. METHODS: 117 children (85 males, mean age 12 years) with ultrasound (US) evidence of NAFLD undergoing liver biopsy for diagnosis of non alcoholic steatohepatitis (NASH), were prospectively enrolled between January 2011 and May 2013 in the setting of a tertiary care centre...
April 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28537971/reliability-of-point-of-care-hematocrit-measurement-during-liver-transplantation
#11
Won Ho Kim, Hyung-Chul Lee, Ho-Geol Ryu, Eun-Jin Chung, Borim Kim, Hoiin Jung, Chul-Woo Jung
BACKGROUND: Although point-of-care (POC) analyzers are commonly used during liver transplantation (LT), the accuracy of hematocrit measurement using a POC analyzer has not been evaluated. In this retrospective observational study, we aimed to evaluate the accuracy of hematocrit measurement using a POC analyzer and identify potential contributors to the measurement error and their influence on mistransfusion during LT. METHODS: We retrospectively collected 6461 pairs of simultaneous intraoperative hematocrit measurements using POC analyzers and laboratory devices during LTs in 901 patients...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28536929/inferior-pedicle-reduction-mammoplasty-with-or-without-tourniquet-a-comparative-study
#12
Canser Yilmaz Demir, Yılmaz Sultanoglu, Omer Faruk Kocak, Muhammet Eren Ersoz
OBJECTIVE: To compare the perioperative findings of inferior pedicle reduction mammoplasty (IPRM) performed with or without a tourniquet. METHODS: This study was carried out in the plastic and reconstructive surgery department at a tertiary care center on a total of 42 consecutive women scheduled for IPRM. Patients in Group I (n = 21) underwent surgery using a tourniquet, whereas patients in Group II (n = 21) were operated on without a tourniquet. Levels of hemoglobin (Hb), hematocrit (Hct), Hct/Hb ratio, and platelet counts were noted preoperatively and on postoperative 24th and 48th h...
May 23, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28506458/impact-of-postoperative-hypothermia-on-outcomes-in-coronary-artery-bypass-surgery-patients
#13
Pey-Jen Yu, Hugh A Cassiere, Nina Kohn, Allan Mattia, Alan R Hartman
OBJECTIVES: To determine the impact of postoperative hypothermia on outcomes in coronary artery bypass graft surgery (CABG) patients. DESIGN: A retrospective study was performed on patients who underwent isolated CABG between 2011 and 2014. SETTING: Single-center study at a university hospital. PARTICIPANTS: All patients who underwent isolated CABG with cardiopulmonary bypass between 2011 and 2014. INTERVENTIONS: Patients underwent isolated CABG on cardiopulmonary bypass...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28500639/comparison-of-transfusion-thresholds-during-neonatal-extracorporeal-membrane-oxygenation
#14
Alexandra A Sawyer, Linda Wise, Santu Ghosh, Jatinder Bhatia, Brian K Stansfield
BACKGROUND: The objective of this study was to assess complications and patient outcomes associated with a lower reflexive red blood cell (RBC) transfusion threshold for neonates undergoing extracorporeal membrane oxygenation (ECMO) for hypoxic respiratory failure. STUDY DESIGN AND METHODS: A retrospective cohort study was conducted at a single tertiary neonatal intensive care unit of neonates undergoing ECMO support for refractory hypoxic respiratory failure for more than 24 hours between December 2009 and December 2014...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28498095/risk-factors-for-development-of-postoperative-cerebellar-mutism-syndrome-in-children-after-medulloblastoma-surgery
#15
San Y C V Pols, Marie Lise C van Veelen, Femke K Aarsen, Antonia Gonzalez Candel, Coriene E Catsman-Berrevoets
OBJECTIVE Postoperative cerebellar mutism syndrome (pCMS) occurs in 7%-50% of children after cerebellar tumor surgery. Typical features include a latent onset of 1-2 days after surgery, transient mutism, emotional lability, and a wide variety of motor and neurobehavioral abnormalities. Sequelae of this syndrome usually persist long term. The principal causal factor is bilateral surgical damage (regardless of tumor location) to any component of the proximal efferent cerebellar pathway, which leads to temporary dysfunction of cerebral cortical regions as a result of diaschisis...
May 12, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28460592/anticoagulation-and-transfusions-management-in-veno-venous-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-assessment-of-factors-associated-with-transfusion-requirements-and-mortality
#16
Gennaro Martucci, Giovanna Panarello, Giovanna Occhipinti, Veronica Ferrazza, Fabio Tuzzolino, Diego Bellavia, Filippo Sanfilippo, Cristina Santonocito, Alessandro Bertani, Patrizio Vitulo, Michele Pilato, Antonio Arcadipane
PURPOSE: We describe an approach for anticoagulation and transfusions in veno-venous-extracorporeal membrane oxygenation (VV-ECMO), evaluating factors associated with higher transfusion requirements, and their impact on mortality. METHODS: Observational study on consecutive adults supported with VV-ECMO for acute respiratory distress syndrome (ARDS). We targeted an activated partial thromboplastin time of 40 to 50 seconds and a hematocrit of 24% to 30%. Univariate and multiple analyses were done to evaluate factors associated with transfusion requirements and the influence of increasing transfusions on mortality during ECMO...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28452795/association-between-allogeneic-blood-transfusion-and-postoperative-infection-in-major-spine-surgery
#17
Christian Fisahn, Shiveindra Jeyamohan, Daniel C Norvell, Richard S Tubbs, Marc Moisi, Jens R Chapman, Jeni Page, Rod J Oskouian
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study is to compare the incidence of infection in patients who do and do not receive blood transfusions in major deformity surgery (>8 levels). SUMMARY OF BACKGROUND DATA: Postoperative infections increase morbidity and mortality rates in spine surgery and generate additional costs for the health care system. It has been proposed that blood transfusions increase the risk of wound infection, urinary tract infection, pneumonia, and sepsis...
April 27, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28435491/agreement-between-serum-assays-performed-in-ed-point-of-care-and-hospital-central-laboratories
#18
Meir Dashevsky, Steven L Bernstein, Carol L Barsky, Richard A Taylor
INTRODUCTION: Point-of-care (POC) testing allows for more time-sensitive diagnosis and treatment in the emergency department (ED) than sending blood samples to the hospital central laboratory (CL). However, many ED patients have blood sent to both, either out of clinical custom, or because clinicians do not trust the POC values. The objective of this study was to examine the level of agreement between POC and CL values in a large cohort of ED patients. METHODS: In an urban, Level I ED that sees approximately 120,000 patients/year, all patients seen between March 1, 2013, and October 1, 2014, who had blood sent to POC and CL labs had levels of agreement measured between serum sodium, potassium, blood urea nitrogen (BUN), creatinine, and hematocrit...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28426457/race-differences-in-initial-presentation-early-treatment-and-1-year-outcomes-of-pediatric-crohn-s-disease-results-from-the-improvecarenow-network
#19
Jennifer L Dotson, Michele Cho, Josh Bricker, Michael D Kappelman, Deena J Chisolm, Gitit Tomer, Wallace V Crandall
BACKGROUND: Racially disparate care has been shown to contribute to suboptimal health care outcomes for minorities. Using the ImproveCareNow network, we investigated differences in management and outcomes of pediatric patients with Crohn's disease at diagnosis and 1-year postdiagnosis. METHODS: ImproveCareNow is a learning health network for pediatric inflammatory bowel disease. It contains prospective, longitudinal data from outpatient encounters. This retrospective study included all patients with Crohn's disease ≤21 years, September 2006 to October 2014, with the first recorded encounter ≤90 days from date of diagnosis and an encounter 1 year ±60 days...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28422699/hemorrhage-prediction-models-in-surgical-intensive-care-bedside-monitoring-data-adds-information-to-lab-values
#20
Marco De Pasquale, Travis Moss, Sergio Cerutti, James Calland, Douglas Lake, Randall Moorman, Manuela Ferrario
Hemorrhage is a frequent complication in surgery patients; its identification and management have received increasing attention as a target for quality improvement in patient care in the Intensive Care Unit (ICU). The purposes of this work were i) to find an early detection model for hemorrhage by exploring the range of data mining methods that are currently available, and ii) to compare prediction models utilizing continuously measured physiological data from bedside monitors to those using commonly obtained laboratory tests...
April 12, 2017: IEEE Journal of Biomedical and Health Informatics
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