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https://www.readbyqxmd.com/read/28445286/remote-ischemic-preconditioning-improves-the-cognitive-function-of-elderly-patients-following-colon-surgery-a-randomized-clinical-trial
#1
Zhenqiu He, Nan Xu, Sihua Qi
BACKGROUND: Cognitive function impairment is one of the most common complications in elderly patients after surgery, and an ideal nonpharmacological therapy has not yet been identified. Thus, we hypothesized that remote ischemic preconditioning could improve cognitive functions in elderly patients after surgery and investigated the mechanism underlying this effect. METHODS: Ninety patients classified as American Society of Anaesthesiologists (ASA) physical status of 2 or 3 and aged 65 to 75 years who were scheduled for elective colon surgery under general anesthesia were randomly allocated to either a remote ischemic preconditioning group (Group R, n = 45) or a control group (Group C, n = 45)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28443376/remote-ischemic-conditioning-and-renal-protection
#2
Georgios Giannopoulos, Dimitrios A Vrachatis, Vasiliki Panagopoulou, Manolis Vavuranakis, Michael W Cleman, Spyridon Deftereos
Over the course of the last 2 decades, the concept of remote ischemic conditioning (RIC) has attracted considerable research interest, because RIC, in most of its embodiments offers an inexpensive way of protecting tissues against ischemic damage inflicted by a number of medical conditions or procedures. Acute kidney injury (AKI) is a common side effect in the context of various medical procedures, and RIC has been suggested as a means of reducing its incidence. Outcomes regarding kidney function have been reported in numerous studies that evaluated the effects of RIC in a variety of settings (eg, cardiac surgery, interventions requiring intravenous administration of contrast media)...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28434264/exploring-effects-of-remote-ischemic-preconditioning-in-a-pig-model-of-hypothermic-circulatory-arrest
#3
Johanna Herajärvi, Tuomas Anttila, Elitsa Y Dimova, Tuomas Laukka, Mikko Myllymäki, Henri Haapanen, Benjamin A Olenchock, Hannu Tuominen, Ulla Puistola, Peeter Karihtala, Kai Kiviluoma, Peppi Koivunen, Vesa Anttila, Tatu Juvonen
OBJECTIVES: During aortic and cardiac surgery, risks for mortality and morbidity are inevitable. Surgical setups involving deep hypothermic circulatory arrest (DHCA) are effective to achieve organ protection against ischemic injury. The aim of this study was to identify humoural factors mediating additive protective effects of remote ischemic preconditioning (RIPC) in a porcine model of DHCA. DESIGN: Twenty-two pigs were randomized into the RIPC group (n = 11) and the control group (n = 11)...
April 24, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28433845/clinical-outcome-after-extended-endoscopic-endonasal-resection-of-craniopharyngiomas-two-institution-experience
#4
Hye Ran Park, Varun R Kshettry, Christopher J Farrell, Jae Meen Lee, Yong Hwy Kim, Tae Bin Won, Doo Hee Han, Hyunwoo Do, Gurston Nyguist, Marc Rosen, Dong Gyu Kim, James J Evans, Sun Ha Paek
BACKGROUND: The extended endoscopic endonasal approach (EEA) to the anterior cranial base is used for the resection of craniopharyngiomas. OBJECTIVE: We present clinical experience and outcomes utilizing EEA for craniopharyngiomas. METHODS: A total of 116 patients in two remote institutions were enrolled in this retrospective study. Surgical, endocrinological and ophthalmological outcomes were assessed. RESULTS: The mean follow-up was 35 months (range, 1-115)...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28418365/-surgical-strategy-for-locally-advanced-right-sided-colonic-cancer
#5
M I Davydov, Yu I Patyutko, A O Rasulov, A G Kotel'nikov, I A Fainshtein, M G Abgaryan, V A Aliev, N E Kudashkin
AIM: To present early and remote surgical outcomes in patients with locally-advanced right-sided colonic cancer, invasion of pancreatic head and/or duodenal wall. MATERIAL AND METHODS: Early and remote surgical outcomes were analyzed in 27 patients who underwent gastropancreatoduodenectomy combined with right-sided hemicolectomy (ileotransversostomy extirpation) for locally-advanced right-sided colonic cancer. RESULTS: Mean time of surgery was 300 (240-460) minutes, intraoperative blood loss - 2000 (500-7200) ml...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28418361/-intraoperative-formation-of-the-valved-conduit-in-aortic-root-surgery
#6
Yu V Belov, A V Lysenko, R N Komarov, A V Stonogin
AIM: To present an experience of intraoperative manufacture of the valved conduit in aortic root surgery in the Department of Cardiac Surgery of Sechenov First Moscow State Medical University. MATERIAL AND METHODS: In our department aortic valve and ascending aortic replacement using intraoperatively manufactured valved conduit was performed in 11 patients for the period 2012-2016. Technical aspects, choice of vascular prosthesis size and type of fixation to achieve optimal hemodynamics and adequate impermeability of stitches are described...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28409372/primary-hyperparathyroidism-treated-by-transoral-endoscopic-parathyroidectomy-vestibular-approach-toepva
#7
Thanyawat Sasanakietkul, Tobias Carling
BACKGROUND: Bilateral open cervical exploration with identifying all parathyroid glands and removing one or more enlarged parathyroid tumor(s) was the standard of care in primary hyperparathyroidism (pHPT). With the introduction of preoperative imaging and intraoperative parathyroid hormone (IOPTH) measurements [1, 2], various minimally invasive parathyroidectomy approaches have been developed, both open and endoscopic [3-8]. The most commonly used approach currently in the USA is the minimally invasive open parathyroidectomy (MIP), which can be performed in the ambulatory setting with excellent cure and minimal complication rates [9-12]...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28397253/are-women-s-needs-being-met-by-specialist-health-services-managing-urinary-incontinence-in-the-remote-top-end-nt
#8
Alexandra Bonner, Jacqueline Boyle
BACKGROUND: Urinary incontinence (UI) is likely to be high in Aboriginal women in rural Australia due to risk factors including high body mass index, parity and diabetes. However, UI appears to be under-reported with limited information on whether women access appropriate care. AIMS: To assess whether women who access specialist gynaecological services in rural and remote Top End Northern Territory (NT) through the specialist outreach program (SONT) are receiving care for UI aligned with best practice...
April 10, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28391201/using-wearable-technology-to-generate-objective-parkinson-s-disease-dyskinesia-severity-score-possibilities-for-home-monitoring
#9
Mehdi Delrobaei, Navid Baktash, Greydon Gilmore, Kenneth McIsaac, Mandar Jog
A variety of clinical scales are available to assess dyskinesia severity in Parkinson's disease patients; however, such assessments are subjective, do not provide long term monitoring, and their use is subject to inter- and intra-rater variability. In this study, an objective dyskinesia score was developed using an IMU-based motion capture system. Deep brain stimulation (DBS) surgery is currently the only acute intervention that results in rapidly progressive reduction of dyskinesia's severity, hence this form of therapy was selected as a model to validate the proposed method...
April 3, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28390649/abbreviated-closure-for-remote-damage-control-laparotomy-in-extreme-environments-a-randomized-trial-of-sutures-versus-wound-clamps-comparing-terrestrial-and-weightless-conditions
#10
Andrew W Kirkpatrick, Jessica Lynn McKee, Colonel Homer Tien, Anthony J LaPorta, Kit Lavell, Tim Leslie, Paul B McBeth, Derek J Roberts, Chad G Ball
INTRODUCTION: Far-Forward Damage Control Laparotomies (DCLs) might provide direct-compression of visceral hemorrhage, however, suturing is a limiting factor, especially for non-physicians. We thus compared abbreviated skin closures comparing skin-suture (SS) versus wound-clamp (WC), on-board a research aircraft in weightlessness (0g) and normal gravity (1g). METHODS: Surgeons conducted DCLs on a surgical-simulator; onboard the hangered-aircraft (1g), or during parabolic flight (0g), randomized to either WC or SS...
March 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28383477/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-tele-mentoring-tele-diagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#11
Andrew W Kirkpatrick, Jessica McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather Wright-Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of post-traumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or Resuscitative-surgery in austere-environments. Revolutions in technology for remote-mentoring of ultrasound and surgery may enhance capabilities to utilize the skill-sets of non-physicians. Thus, our Research-Collaborative explored remote-mentoring to empower non-physicians to address junctional and torso hemorrhage-control in Austere-environments...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28381098/remote-preconditioning-and-vascular-surgery
#12
Donagh A Healy, Stewart R Walsh
Remote ischemic preconditioning (RIPC) is a theoretically attractive strategy for organ protection; and phase 2 studies in a variety of settings have yielded promising results. In this article, we review the existing clinical studies on RIPC in vascular surgery. We examine aspects of design that may potentially be optimized in future vascular surgery studies and we highlight some challenges that have emerged since the publication of the Remote Ischaemic Preconditioning for Heart Surgery (RIPHeart) trial and the Effect of Remote Ischaemic Preconditioning on Clinical Outcomes in Patients Undergoing Coronary Artery Bypass Surgery (ERICCA) trial...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28380638/when-is-a-meta-analysis-conclusive-a-guide-to-trial-sequential-analysis-with-an-example-of-remote-ischemic-preconditioning-for-renoprotection-in-patients-undergoing-cardiac-surgery
#13
Pavel S Roshanov, Brittany B Dennis, Nicholas Pasic, Amit X Garg, Michael Walsh
Regardless of whether a randomized trial finds a statistically significant effect for an intervention or not, readers often wonder if the trial was large enough to be conclusive. To answer this question, we can estimate the required sample size for a trial by considering how commonly the outcome occurs, the smallest effect of clinical importance and the acceptable risk of falsely detecting or rejecting that effect. But when is a meta-analysis conclusive? We explain and illustrate the interpretation of Trial Sequential Analysis (TSA), a method increasingly used to answer this question...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28368090/bypass-surgery-for-chronic-lower-limb-ischaemia
#14
REVIEW
George A Antoniou, George S Georgiadis, Stavros A Antoniou, Ragai R Makar, Jonathan D Smout, Francesco Torella
BACKGROUND: Bypass surgery is one of the mainstay treatments for patients with critical lower limb ischaemia (CLI). This is the second update of the review first published in 2000. OBJECTIVES: To assess the effects of bypass surgery in patients with chronic lower limb ischaemia. SEARCH METHODS: For this update, the Cochrane Vascular Group searched its trials register (last searched October 2016) and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (last searched Issue 9, 2016)...
April 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28360491/remote-physiotherapy-monitoring-using-the-novel-d-r-therapy-iphone-application
#15
Abhishek Vaish, Saif Ahmed, Anan Shetty
BACKGROUND: Patient compliance to physiotherapy after surgical intervention is key to optimal functional outcome. This has been recognised by published literature over a number of decades. Improving and monitoring patient compliance remains a challenge. This paper explores the use of a website linked iPhone application that may be used to address this issue. PURPOSE: The purpose of this case study was to assess if the D+R Therapy application was of benefit to a patient and to assess the advantages and disadvantages of such a system...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28357585/uneven-cerebral-hemodynamic-change-as-a-cause-of-neurological-deterioration-in-the-acute-stage-after-direct-revascularization-for-moyamoya-disease-cerebral-hyperperfusion-and-remote-ischemia-caused-by-the-watershed-shift
#16
Xian-Kun Tu, Miki Fujimura, Sherif Rashad, Shunji Mugikura, Hiroyuki Sakata, Kuniyasu Niizuma, Teiji Tominaga
Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is the standard surgical treatment for moyamoya disease (MMD). The main potential complications of this treatment are cerebral hyperperfusion (CHP) syndrome and ischemia, and their managements are contradictory to each other. We retrospectively investigated the incidence of the simultaneous manifestation of CHP and infarction after surgery for MMD. Of the 162 consecutive direct revascularization surgeries performed for MMD, we encountered two adult cases (1...
March 29, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28356068/a-randomized-trial-of-remote-ischemic-preconditioning-and-control-treatment-for-cardioprotection-in-sevoflurane-anesthetized-cabg-patients
#17
Rianne Nederlof, Nina C Weber, Nicole P Juffermans, Bas A M J de Mol, Markus W Hollmann, Benedikt Preckel, Coert J Zuurbier
BACKGROUND: Remote ischemic preconditioning (RIPC) efficacy is debated. Possibly, because propofol, which has a RIPC-inhibiting action, is used in most RIPC trials. It has been suggested that clinical efficacy is, however, present with volatile anesthesia in the absence of propofol, although this is based on one phase 1 trial only. Therefore, in the present study we further explore the relation between RIPC and cardioprotection with perioperative anesthesia restricted to sevoflurane and fentanyl, in CABG patients without concomitant procedures...
March 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28337576/robotic-video-assisted-thoracoscopy-minimally-invasive-approach-for-management-of-mediastinal-tumors
#18
Pejman Radkani, Devendra Joshi, Tushar Barot, Roy Williams
In spite of difficult anatomic access for tumors of mediastinum, surgical resection remains the best diagnostic and therapeutic approach. Widespread acceptance of video-assisted thoracoscopy (VATS) is restricted by the limiting nature of instruments and suboptimal visualization. Robotic assisted minimally invasive surgery seems to hold most promise in remote, narrow anatomical regions. After obtaining approval from Institutional Review Board (IRB), a retrospective review of prospectively collected database on patients that underwent Robotic VATS between 2009 and 2013 was conducted...
March 23, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28333828/prehospital-blood-transfusion-programs-capabilities-and-lessons-learned
#19
Martin D Zielinski, James R Stubbs, Kathleen S Berns, Elon Glassberg, Alan D Murdock, Eilat Shinar, Geir Arne Sunde, Steve Williams, Mark H Yazer, Scott Zietlow, Donald H Jenkins
The Trauma and Hemostasis Oxygenation Research (THOR) network has met in Bergen, Norway every summer over the past six years in an effort to have experts in transfusion, blood banking, military medicine, and trauma surgery exchange ideas, share their experiences, and set an agenda to move the science of remote damage control resuscitation forward. In this manuscript, we supply the lessons shared from the authors/speakers to the reader. These lessons include the experiences of the Norwegian Military with freeze dried plasma and whole blood resuscitation, lessons from extreme remote damage control resuscitation situations on oceanic cruises, and remote blood product resuscitation techniques at Mayo Clinic and the University of Pittsburgh...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28329336/remote-ischaemic-preconditioning-reduces-acute-kidney-injury-in-adult-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-meta-analysis
#20
Bin Yi, Xiang Chen, Han Shi, Tiao Lin, Haifeng Lin, Yi Xu, Jian Rong
This article represents the first attempt to perform a pooled analysis about remote ischaemic preconditioning (RIPC) in reduction of acute kidney injury (AKI) of adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A systematic search was performed using PubMed (1966-5 January 2016), the Cochrane Library (1996-5 January 2016), the Web of Science (1986-5 January 2016) and Chinese database (SinoMed) (1978-5 January 2016) to identify studies that have described the effect of RIPC on AKI in adult patients undergoing cardiac surgery with CPB...
April 1, 2017: European Journal of Cardio-thoracic Surgery
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