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https://www.readbyqxmd.com/read/28334798/risk-factors-for-postoperative-delirium-in-patients-undergoing-major-head-and-neck-cancer-surgery-a-meta-analysis
#1
Yun Zhu, Gangpu Wang, Shengwen Liu, Shanghui Zhou, Ying Lian, Chenping Zhang, Wenjun Yang
Objective: Postoperative delirium is common after extensive surgery. This study aimed to collate and synthesize published literature on risk factors for delirium in patients with head and neck cancer surgery. Methods: Three databases were searched (MEDLINE, Embase, and Cochrane Library) between January 1987 and July 2016. The Newcastle Ottawa Scale (NOS) was adopted to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods...
February 24, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28333183/machine-learning-algorithms-for-objective-remission-and-clinical-outcomes-with-thiopurines
#2
Akbar K Waljee, Kay Sauder, Anand Patel, Sandeep Segar, Boang Liu, Yiwei Zhang, Ji Zhu, Ryan W Stidham, Ulysses Balis, Peter D R Higgins
Background and Aims: Big data analytics leverage patterns in data to harvest valuable information, but are rarely implemented in clinical care. Optimising thiopurine therapy for inflammatory bowel disease [IBD] has proved difficult. Current methods using 6-thioguanine nucleotide [6-TGN] metabolites have failed in randomized controlled trials [RCTs], and have not been used to predict objective remission [OR]. Our aims were to: 1) develop machine learning algorithms [MLA] using laboratory values and age to identify patients in objective remission on thiopurines; and 2) determine whether achieving algorithm-predicted objective remission resulted in fewer clinical events per year...
March 14, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28332577/absence-of-role-of-dietary-protein-sensing-in-the-metabolic-benefits-of-duodenal-jejunal-bypass-in-the-mouse
#3
Aude Barataud, Daisy Goncalves, Jennifer Vinera, Carine Zitoun, Adeline Duchampt, Amandine Gautier-Stein, Gilles Mithieux
Roux-en-Y gastric bypass (RYGB) induces remission or substantial improvement of type 2 diabetes mellitus (T2D) but underlying mechanisms are still unclear. The beneficial effects of dietary proteins on energy and glucose homeostasis are mediated by the antagonist effects of peptides toward mu-opioid receptors (MORs), which are highly expressed in the distal gut. We hypothesized that the beneficial effects of RYGB could depend at least in part on the interaction of peptides from food with intestinal MORs. Duodenal-jejunal bypass (DJB) was performed in obese and lean wild-type (WT) or MOR deficient (MOR(-/-)) mice...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28331295/evaluating-the-patient-experience-after-implantation-of-a-0-4-mg-sustained-release-dexamethasone-intracanalicular-insert-dextenza%C3%A2-results-of-a-qualitative-survey
#4
Joseph P Gira, Reginald Sampson, Steven M Silverstein, Thomas R Walters, Jamie Lynne Metzinger, Jonathan H Talamo
PURPOSE: The purpose of this study is to evaluate the patient experience of sustained release dexamethasone intracanalicular insert (Dextenza™) following cataract surgery as part of a Phase III clinical trial program. METHODS: This cross-sectional, qualitative evaluation involved individual interviews lasting approximately 45 minutes. Patients from four US investigational study sites who had previously received an insert were enrolled. There were no predesignated end points; this was a qualitative survey seeking a deeper understanding of patient experience...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28329292/surgical-septal-myectomy-or-alcohol-septal-ablation-which-approach-offers-better-outcomes-for-patients-with-hypertrophic-obstructive-cardiomyopathy
#5
Shi Sum Poon, Mark Field, Dhiraj Gupta, Duke Cameron
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether surgical septal myectomy (SM) is more beneficial than alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy. Altogether 218 articles were found using the reported search, of which 15 studies represented the best evidence to answer the clinical question. There were 14 observational studies and 1 meta-analysis study. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these articles are tabulated...
February 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28328563/patients-without-intraoperative-neuromonitoring-ionm-alerts-during-veptr-implantation-did-not-sustain-neurological-injury-during-subsequent-routine-expansions-a-retrospective-multicenter-cohort-study
#6
Jaren LaGreca, Tara Flynn, Patrick J Cahill, Amer Samdani, Michael G Vitale, Ron El-Hawary, John T Smith, Jonathan H Phillips, John M Flynn, Michael Glotzbecker, Sumeet Garg
BACKGROUND: The purpose of this study was to determine the rate of intraoperative neurological monitoring (IONM) alerts and neurological injury during vertical expandable prosthetic titanium rib (VEPTR) treatment and evaluate the utility of IONM during VEPTR expansion procedures in patients who have not previously had neurological injury or IONM alerts. METHODS: After institutional review board approval, VEPTR procedures and IONM records were reviewed at 17 institutions for patients treated with VEPTR from 2005 to 2011...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28324746/denosumab-in-advanced-unresectable-giant-cell-tumour-of-bone-gctb-for-how-long
#7
E Palmerini, N S Chawla, S Ferrari, M Sudan, P Picci, E Marchesi, M Piccinni Leopardi, I Syed, K K Sankhala, P Parthasarathy, W E Mendanha, M Pierini, A Paioli, S P Chawla
BACKGROUND: Giant-cell tumours of bone (GCTB) are RANK/RANK-ligand (RANKL) positive, aggressive and progressive osteolytic tumours. Denosumab, a RANKL inhibitor, was FDA-approved for adults and skeletally mature adolescents with unresectable GCTB or when surgical resection is likely to result in severe morbidity. Data on long-term toxicity and activity of denosumab monthly 'GCTB-schedule' (120 mg per 12/year, 1440 mg total dose/year) are lacking. METHODS: Patients with GCTB receiving denosumab, 120 mg on days 1, 8, 15, 29 and every 4 weeks thereafter, from 2006 to 2015 treated in two centres were included...
March 16, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#8
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28321428/high-grade-partial-and-retracted-2-cm-proximal-hamstring-ruptures-nonsurgical-treatment-revisited
#9
Jonathan R Piposar, Amrit V Vinod, Joshua R Olsen, Edward Lacerte, Suzanne L Miller
BACKGROUND: High-grade partial proximal hamstring tears and complete tears with retraction less than 2 cm are a subset of proximal hamstring injuries where, historically, treatment has been nonoperative. It is unknown how nonoperative treatment compares with operative treatment. HYPOTHESIS: The clinical and functional outcomes of nonoperative and operative treatment of partial/complete proximal hamstring tears were compared. We hypothesize that operative treatment of these tears leads to better clinical and functional results...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#10
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28320052/soft-tissue-infections-from-fish-spike-wounds-normal-commensal-bacteria-are-more-common-than-marine-pathogens
#11
Hannah Collins, Kin Mun Lee, Paul T-Y Cheng, Sarah Hulme
BACKGROUND: A fish spike injury can be sustained by anyone handling fish; during fishing, meal preparation or in retail. Case reports of fish spikes inoculating victims with virulent marine-specific pathogens and causing systemic illness led us to question whether empirical treatment of these injuries with amoxicillin and clavulanic acid is adequate. METHODS: This 2-year prospective observational study was conducted at Middlemore Hospital, Auckland, New Zealand...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28319468/the-impact-of-cage-dimensions-positioning-and-side-of-approach-in-extreme-lateral-interbody-fusion
#12
Marjan Alimi, Gernot Lang, Rodrigo Navarro-Ramirez, Moritz Perrech, Connor Berlin, Christoph P Hofstetter, Yu Moriguchi, Eric Elowitz, Roger Härtl
STUDY DESIGN: This is a retrospective single-center study. OBJECTIVE: The aim of the study was to evaluate the impact of cage characteristics and position toward clinical and radiographic outcome measures in patients undergoing extreme lateral interbody fusion (ELIF). SUMMARY OF BACKGROUND DATA: ELIF is utilized for indirect decompression and minimally invasive surgical treatment for various degenerative spinal disorders. However, evidence regarding the influence of cage characteristics in patient outcome is minimal...
March 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28318749/experience-and-outcomes-of-micrografting-for-major-paediatric-burns
#13
H Rode, R Martinez, D Potgieter, S Adams, A D Rogers
BACKGROUND: The deficit of donor sites in major burns over 50% of the total body surface area has necessitated the application of methods besides traditional meshed autografting to achieve definitive skin cover. The Meek micrografting technique was introduced at this hospital in 2011, especially in the absence of a reliable source of deceased donor allograft skin. The purpose of this study was to evaluate this strategy with reference to its technical execution, efficacy and indications in the context of major paediatric burn surgery...
March 15, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28315066/failure-patterns-according-to-molecular-subtype-in-patients-with-invasive-breast-cancer-following-postoperative-adjuvant-radiotherapy-long-term-outcomes-in-contemporary-clinical-practice
#14
Yu Jin Lim, Sea-Won Lee, Noorie Choi, Jeanny Kwon, Keun-Yong Eom, Eunyoung Kang, Eun-Kyu Kim, Sung-Won Kim, Jee Hyun Kim, Yu Jung Kim, Se Hyun Kim, So Yeon Park, Jae-Sung Kim, In Ah Kim
PURPOSE: Although gene expression profiling provides critical information, knowledge remains limited regarding the differential effects of molecular subtype on clinical course. This study evaluated the impact of molecular status on long-term patterns of failure in patients with non-metastatic breast cancer. METHODS: We analyzed data from 1181 individuals with invasive breast cancer undergoing surgery plus PORT from 2003 to 2011. Molecular subtypes were defined as luminal A (LA), luminal B (LB)-HER2(-), LB-HER2(+), HER2, and triple-negative (TN) based on the 2013 St...
March 17, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28314801/characterization-of-foci-and-breakthrough-sites-during-persistent-and-long-standing-persistent-atrial-fibrillation-in-patients-studies-using-high-density-510-512-electrodes-biatrial-epicardial-mapping
#15
Seungyup Lee, Jayakumar Sahadevan, Celeen M Khrestian, Alan Markowitz, Albert L Waldo
BACKGROUND: We previously demonstrated that persistent and long-standing persistent atrial fibrillation is maintained by activation emanating from foci and breakthrough sites of different cycle lengths (CLs). The purpose of this study was to characterize the behavior of focal and nonrandom breakthrough activation identified during high-density mapping of atrial fibrillation in these patients. METHODS AND RESULTS: During open heart surgery, we recorded activation from both atria simultaneously using 510 to 512 epicardial electrodes along with ECG lead II in 12 patients with persistent and long-standing persistent atrial fibrillation...
March 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28314214/gait-biomechanics-following-lower-extremity-trauma-amputation-vs-reconstruction
#16
Elizabeth Russell Esposito, Daniel J Stinner, John R Fergason, Jason M Wilken
BACKGROUND: Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. PURPOSE: To compare gait biomechanics after lower limb reconstruction and transtibial amputation. METHODS: Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length...
February 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28306736/identifying-predictive-motor-factors-for-falls-in-post-menopausal-breast-cancer-survivors
#17
Marek Zak, Malgorzata Biskup, Pawel Macek, Halina Krol, Szymon Krupnik, Anna Opuchlik
OBJECTIVE: Breast cancer treatment, including radical surgery, is also pursued as late as the 7th - 8th decade of women's lives. Standard physical rehabilitation procedures offered to those women are predominantly focused on attenuating specific functional deficits of the upper limb and trunk. Seldom do they entail any regimens specifically aimed at recovering overall functionality, and reducing exposure to falls-risk. The study aimed to assess potential interrelationships between the self-reported falls, individual functional capabilities and appreciably reducing exposure to falls-risk in a group of post-menopausal, post-surgical breast cancer survivors...
2017: PloS One
https://www.readbyqxmd.com/read/28304248/sustained-release-buprenorphine-improves-postsurgical-clinical-condition-but-does-not-alter-survival-or-cytokine-levels-in-a-murine-model-of-polymicrobial-sepsis
#18
Nicole L Herndon, Sheila Bandyopadhyay, Eldad A Hod, Kevin A Prestia
Cecal ligation and perforation (CLP) is a common technique for studying sepsis in mice. Because of the invasiveness of the procedure and its effects on clinical condition, many animal care and use committees require the use of analgesics with CLP. However, some analgesics have immunomodulatory effects and thus can hinder the overall research outcomes of a project. Here we sought to determine the effects of buprenorphine hydrochloride (Bup HCl) compared with sustained-release buprenorphine (Bup SR) on clinical condition, plasma concentrations of monocyte chemoattractant protein (MCP) 1 and IL6, and overall mortality in a murine CLP model of sepsis...
December 1, 2016: Comparative Medicine
https://www.readbyqxmd.com/read/28303525/failed-epilepsy-surgery-is-this-the-end
#19
REVIEW
Riëm El Tahry, Irene Zhong Wang
Resective epilepsy surgery can lead to sustained seizure control in 70-80% of patients evaluated for epilepsy surgery, indicating that up to 30% of patients still have recurrent seizures after surgery. Definitions of failed epilepsy surgery vary amongst studies. This review focuses on seizure outcome predictors after reoperation, possible mechanisms of failure and best management for this difficult patient population.
March 16, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28303505/patient-reported-outcomes-10%C3%A2-years-after-roux-en-y-gastric-bypass
#20
Florence E Turrentine, James H Mehaffey, Rachel L Mehaffey, Matthew G Mullen, Bruce D Schirmer, Peter T Hallowell
BACKGROUND: Following weight-loss surgery, patients who failed to achieve or sustain weight loss have nevertheless reported high satisfaction with their long-term bariatric experience. Understanding this phenomenon better will likely improve patients' experiences. OBJECTIVE: The purpose of this study was to explore patients' long-term experiences following bariatric surgery. SETTING: A 604-bed academic health system in the USA. METHODS: Participants rated satisfaction and shared spontaneous comments regarding their gastric bypass experience...
March 16, 2017: Obesity Surgery
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