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Irfan Ashraf, Yasir Mohib, Obada Hasan, Amina Malik, Khabir Ahmad, Shahryar Noordin
Introduction: Surgical Site Infection (SSI) after knee arthroplasty is a major cause of morbidity and mortality that increases the hospital stay, financial burden and mental anguish of the patient. Infection Control Unit at Aga Khan University Hospital (AKUH) incorporated total knee arthroplasty in its surgical care surveillance program and started collecting data in June 2012. The purpose of this study is to review Surgical Site Infection (SSI) rates in patients undergoing primary total knee replacement (TKR) surgery...
July 2018: Annals of Medicine and Surgery
Miles J Levy, Iain J Robertson, Naima Khalk, Sabrina Vitello, Narendra Reddy, Ragini Bhake, Trevor A Howlett
OBJECTIVE: To assess the clinical outcome of a strategy of conservative monitoring of patients with non-functioning pituitary adenomas (NFPA) after pituitary surgery and in patients without surgery. DESIGN: Retrospective study of outcomes, using a clinical information system. PATIENTS: An unselected, clinical series of patients seen in a single centre between 1989 and 2015. MEASUREMENTS: Review of clinical information system data to obtain details and dates of surgery, radiotherapy, pituitary imaging and outcomes...
June 19, 2018: Clinical Endocrinology
Ameet Kumar, Sumesh Kaistha, Rajesh Gangavatiker
Two major issues with laparoscopic inguinal hernia (IH) repair are recurrences and chronic groin pain (CGP). The procedure involves fixing the mesh with the tackers which is believed to increase the rate of CGP due to nerve injuries. Thus, non-fixation of mesh is being proposed but concerns remain regarding increased recurrences. We sought to look at our outcomes after we switched over to non-fixation of mesh in totally extraperitoneal repair (TEP). Retrospective review of prospectively maintained database of 171 repairs was done on 122 patients (fixation 59 and non-fixation 112) during a period of 4 years with an endeavor to complete a minimum of 1 year of clinical follow-up...
April 2018: Indian Journal of Surgery
Charelle M Carter-Brooks, Angela L Du, Kristine M Ruppert, Anna L Romanova, Halina M Zyczynski
OBJECTIVES: ERAS protocols were developed for colorectal surgery to hasten post-op recovery. Variations of the protocol are being adopted for gynecologic procedures despite limited population and procedure-specific outcome data. Our objective was to evaluate if implementation of an ERAS pathway would facilitate reduced length of admission in an urogynecology population. MATERIALS AND METHODS: In this retrospective analysis of patients undergoing pelvic floor reconstructive surgery by 7 female pelvic medicine and reconstructive surgeons we compared same day discharge, length of admission and post-op complications before and after implementation of an ERAS pathway at a tertiary-care hospital...
June 15, 2018: American Journal of Obstetrics and Gynecology
Paolo Caravaggi, Giada Lullini, Lisa Berti, Sandro Giannini, Alberto Leardini
BACKGROUND: Flexible flatfoot (FFF) is a common alteration of the foot diagnosed in the pediatric population causing pain and decreased quality of life. Surgical treatment via arthroereisis of the subtalar joint can be recommended when non-invasive options do not result in sufficient pain relief. While clinical outcome of subtalar joint arthroereisis is generally positive, no functional evaluation has thus far been reported following surgery. RESEARCH QUESTION: The aim of this study was to assess the effects of two arthroereisis implants for the correction of bilateral FFF on foot and lower limb biomechanics during gait...
June 11, 2018: Gait & Posture
Bassel G Diebo, Jared C Tishelman, Samantha Horn, Gregory W Poorman, Cyrus Jalai, Frank A Segreto, Cole A Bortz, Michael C Gerling, Virginie Lafage, Andrew P White, James M Mok, Thomas D Cha, Robert K Eastlack, Kris E Radcliff, Carl B Paulino, Peter G Passias
Optimizing functional outcomes and disability status are essential for effective surgical treatment of cervical spine disorders. Mental impairment is common among patients with cervical spine complaints; yet little is known about the impact of baseline mental status with respect to overall patient-reported outcomes. This was a retrospective analysis of patients with cervical spondylosis with myelopathy(CM) or radiculopathy(CR: cervical disc herniation, stenosis, or spondylosis without myelopathy) at 2-year follow-ups...
June 12, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ashleigh Long, Paul Mahoney
BACKGROUND: Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement has shown early promise in patients deemed poor surgical candidates as a less invasive alternative to conventional reoperative mitral valve (MV) replacement. OBJECTIVE: This retrospective, single-center study reviewed the procedural outcomes of all TMVIV and TMVIR procedures between 2013-2018 at a large tertiary referral center serving the southeastern United States. An analysis of patient safety measures was also performed, with a retrospective assessment of relative procedural safety that included preoperative risk stratification and postoperative mortality predictors, operative time, average blood loss, length of hospital stay, and readmission rates...
June 15, 2018: Journal of Invasive Cardiology
Abhiraj D Bhimani, Ankit Indravadan Mehta
BACKGROUND: Intradural extramedullary (IDEM) spinal cord tumors account for two thirds of all intraspinal neoplasms. Surgery for IDEM tumors carries risk for many different complications, which to date have been poorly described and quantified. OBJECTIVE: To better characterize risk factors and complications for IDEM tumors, stratifying by spinal cord level and malignancy. METHODS: The ACS-NSQIP database was queried to determine 30-day outcomes following surgery for IDEM tumors between 2005 and 2016...
June 11, 2018: World Neurosurgery
Francesco Esposito, Marco Freddolini, Massimiliano Marcucci, Leonardo Latella, Andrea Corvi
BACKGROUND: Crutch use is prescribed early in the rehabilitation process following total hip replacement (THR) surgery to improve safety and promote return to active living. RESEARCH QUESTION: Purpose of this study was to understand mid-term effects of crutch length setup on quiet standing and walking two months post-op when crutch use was no longer required. METHODS: Thirty patients were evaluated 2 months post-surgery when they had been walking without crutch for a month...
June 5, 2018: Gait & Posture
Alev Kılıcgedik, Abdulrahman Naser, Ahmet Seyfeddin Gurbuz, Seyhmus Kulahcioglu, Ruken Bengi Bakal, Tuba Unkun, Fatih Yilmaz, Gokhan Kahveci, Cevat Kirma
BACKGROUND: The use of the CHA2DS2-VASc scoring system and red cell distribution width (RDW) as post-op Atrial Fibrillation (POAF) predictors may be promising for the identification of patients that are at a higher risk of POAF. METHODS: A total of 358 patients (57 patients with POAF, and 301 patients with non-POAF ) with sinus rhythm undergoing a coronary artery bypass graft (CABG) operation were included in the study retrospectively. Preoperative RDW levels and electrocardiograms with sinus rhythm were recorded...
May 16, 2018: Heart Surgery Forum
Kumar Vinchurkar, Vishwanath M Pattanshetti, Manoj Togale, Santosh Hazare, Varadraj Gokak
Currently, pancreaticoduodenectomy (PD) is considered a common and feasibly performed surgery for periampullary tumours, but it is still a high-risk surgical procedure with potential morbidity and mortality rates. Previously, it was emphasised for the need of high-volume centres to perform specialised surgery such as PD. The authors have made an attempt to know the relation between low-volume centre and outcomes of PD. The study was conducted in a Tier-II city referral hospital located in Karnataka, India. A total of 37 patients with suspected periampullary neoplasms underwent surgical exploration with curative intent over a period of 4 years, i...
June 2018: Indian Journal of Surgical Oncology
Patrick G Robinson, Conor S Rankin, Jonathan Lavery, Iain Anthony, Mark Blyth, Bryn Jones
We aim to validate the "Modified Forgotten Joint Score" (MFJS) as a new patient-reported outcome measure (PROM) in hip and knee arthroplasty, against the UK's gold standard Oxford Hip and Knee Scores (OHS/OKS). The original Forgotten Joint Score (FJS) (12 items) was created to assess post-arthroplasty joint awareness. We modified the FJS to 10-items to improve its reliability. Postal questionnaires were sent out to 400 total hip or knee replacement (THR/TKR) patients who were 1-2 years' post-op, along with the OHS/OKS...
June 2018: Journal of Orthopaedics
Fay Kazzi, Noha Daher, Grenith Zimmerman, Manuel Garcia, Nicholas Schmidt, Keith Scharf
BACKGROUND: The purpose of this study was to examine the effect of probiotics and prebiotics (LactoWise®) on weight loss, blood pressure, and clinical lab values in morbidly obese patients undergoing laparoscopic sleeve gastrectomy (LSG). Materials Methods: Sixty patients undergoing LSG were recruited to participate in the study and randomized into either a LactoWise® or placebo group. The LactoWise® group (LWG) received 4.5 billion live cells of bacillus coagulans and galactomannans (300 mg); the placebo group received 600 mg of calcium citrate yielding 126 mg of elemental calcium...
June 6, 2018: Alternative Therapies in Health and Medicine
Stanley Hoang, Michael J Ortiz Torres, Arnaldo L Rivera, N Scott Litofsky
BACKGROUND: Temporal bone tegmen defects may be associated with cerebrospinal fluid (CSF) otorrhea. A variety of techniques have been used for repair. We report our experience with skull base reconstruction for tegmen defects using either autologous or alloplastic grafts. METHODS: A retrospective chart review was performed on patients with tegmen defects treated from 2007 to 2017 at the University Hospital in Columbia, MO. Primary outcome measures were analyzed...
June 2, 2018: World Neurosurgery
Kimberly A Johnston, Angela J Westover, Alvaro Rojas-Pena, Jonathan W Haft, John M Toomasian, Thomas Johnson, Deborah A Buffington, H David Humes
Leukocyte activation during cardiopulmonary bypass (CPB) promotes a systemic inflammatory response that contributes to organ injury and postoperative organ dysfunction. A leukocyte modulatory device (L-MOD) for use during (and after) CPB to limit leukocyte-mediated organ injury was tested in a preclinical model. Twenty-two pigs underwent 180 minutes of CPB and 5 hours postoperative observation. Pigs received no intervention (group 1, n = 9), 3 hours of therapy by incorporation of L-MOD into the CPB circuit (group 2, n = 6), or 8 hours of therapy using a femoral venovenous L-MOD circuit during and after CPB (group 3, n = 7)...
May 23, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Robert T Swanson, Jane R Schubart, Michele M Carr
OBJECTIVE: Evaluate post-tonsillectomy outcomes in children discharged with ibuprofen versus those without. METHODS: This was a retrospective review of children who underwent tonsillectomy ± adenoidectomy from 2012 to 2016 at a tertiary care children's hospital. Main outcome measures included bleed rates, ER visits, and nurse phone calls. RESULTS: Seven hundred and seventy-three patients were included; 504 had ibuprofen at discharge (ID) and 269 did not (NID)...
May 21, 2018: American Journal of Otolaryngology
Heyman Luckraz, Na'ngono Manga, Eshan L Senanayake, Mahmoud Abdelaziz, Shameer Gopal, Susan C Charman, Ramesh Giri, Raymond Oppong, Lazaros Andronis
Background: Ventilator-associated pneumonia is associated with significant morbidity, mortality and healthcare costs. Most of the cost data that are available relate to general intensive care patients in privately remunerated institutions. This study assessed the cost of managing ventilator-associated pneumonia in a cardiac intensive care unit in the National Health Service in the United Kingdom. Methods: Propensity-matched study of prospectively collected data from the cardiac surgical database between April 2011 and December 2014 in all patients undergoing cardiac surgery (n = 3416)...
May 2018: Journal of the Intensive Care Society
Rennier A Martinez, Michelle Shnayder, Joshua Parreco, Lukas Gaffney, Marcus Eby, Nicholas Cortolillo, Michael Lopez, Jack Zeltzer
INTRODUCTION: Hospital readmissions are not only associated with increased mortality, morbidity and costs but also, with current healthcare reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide Readmission Database (NRD) is the most comprehensive national source of readmission data, gathering discharge information from 22 geographically dispersed states, accounting for 51...
May 16, 2018: Annals of Vascular Surgery
Matteo Palmisani, Eugenio Dema, Stefano Cervellati, Rosa Palmisani
PURPOSE: To compare the 2-year minimum postoperative results of posterior correction and spinal arthrodesis using translational correction with hybrid (sublaminar bands on concave side and pedicle screw) constructs versus correction with intermediate density pedicle screw-only constructs in the treatment of AIS (Lenke 1). METHODS: A total of 37 patients with AIS at single institutions who underwent posterior spinal arthrodesis pedicle screw with sublaminar bands at the apex (19 patients) (Group A) or pedicle screw-only (18) constructs (Group B) were selected and matched according to similar age at surgery 13...
May 17, 2018: European Spine Journal
S Samaneh Lashkarinia, Senol Piskin, Tijen A Bozkaya, Ece Salihoglu, Can Yerebakan, Kerem Pekkan
Surgical treatment of congenital heart disease (CHD) involves complex vascular reconstructions utilizing artificial and native surgical materials. A successful surgical reconstruction achieves an optimal hemodynamic profile through the graft in spite of the complex post-operative vessel growth pattern and the altered pressure loading. This paper proposes a new in silico patient-specific pre-surgical planning framework for patch reconstruction and investigates its computational feasibility. The proposed protocol is applied to the patch repair of main pulmonary artery (MPA) stenosis in the Tetralogy of Fallot CHD template...
May 14, 2018: Annals of Biomedical Engineering
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