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https://www.readbyqxmd.com/read/28224648/impacts-of-disease-severity-on-postoperative-complications-in-children-with-sleep-disordered-breathing
#1
Kun-Tai Kang, I-Sheng Chang, Chia-Chen Tseng, Wen-Chin Weng, Tzu-Yu Hsiao, Pei-Lin Lee, Wei-Chung Hsu
OBJECTIVES/HYPOTHESIS: To investigate the effects of diseases severity on postoperative complications following adenotonsillectomy (T&A) in children with sleep-disordered breathing (SDB). STUDY DESIGN: Retrospective study. METHODS: Children aged <18 years were enrolled and underwent T&A for treating SDB. Polysomnography was used to classify the disease severity: primary snoring (apnea-hypopnea index [AHI] <1), mild (AHI = 1-5), moderate (AHI = 5-10), and severe obstructive sleep apnea [OSA] (AHI ≥10)...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28224214/predictors-of-the-outcome-of%C3%A2-lumbar-disc-herniation-following-classical-surgery-laminotomy-with-discectomy
#2
Augustine Balaara, Xiao-Feng Xu, Young-Hui Huang, Li Dapeng
BACKGROUND: Several surgical variables and patient characteristics play an influential role in the prognosis of lumbar disc herniation following laminotomy with discectomy. This paper seeks to evaluate the perioperative predictor variables for the outcome of lumbar disc herniation. PATIENTS AND METHODS: From October 2013 to July 2016, 166 surgical patients were evaluated using prospectively collected data. Patients' preoperative independent variables (age, sex, body mass index, level of disc herniation, pain duration, and American Society of Anesthesiologists Physical Score) were correlated with functional outcome measures such as primary outcome measures (length of hospital stay; postoperative visual analog scale, VAS; Oswestry disability index, ODI) and secondary outcome measures (operation room time; estimated intraoperative blood loss, EBL; complications; readmission) as dependent variables...
February 21, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28222991/perioperative-clopidogrel-is-associated-with-increased-bleeding-and-blood-transfusion-at-the-time-of-lower-extremity-bypass
#3
Douglas W Jones, Marc L Schermerhorn, Benjamin S Brooke, Mark F Conrad, Philip P Goodney, Mark C Wyers, David H Stone
OBJECTIVE: Controversy persists surrounding the perceived bleeding risk associated with perioperative clopidogrel use in patients undergoing lower extremity bypass (LEB). The purpose of this study was to examine the LEB bleeding risk and clinical sequelae associated with clopidogrel. METHODS: All LEBs in the Vascular Quality Initiative (VQI) from 2008 to 2014 were studied. The exposure was perioperative clopidogrel. Primary outcomes were blood transfusion, estimated blood loss ≥500 mL, and reoperation for bleeding...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216359/fenestrated-endovascular-aneurysm-repair-among-octogenarians-at-high-and-standard-risk-for-open-repair
#4
David E Timaran, Martyn Knowles, Tarik Ali, Carlos H Timaran
BACKGROUND: Octogenarians with complex abdominal aortic aneurysms are at higher risk of death and morbidity after open repair. Fenestrated endovascular aneurysm repair (FEVAR) is an alternative to open repair for high-risk patients, such as octogenarians. The aim of this study was to evaluate perioperative and midterm outcomes of FEVAR among octogenarians at high and standard risk for open repair. METHODS: During a 2-year period, 85 patients (68 men [78%] and 17 women [22%]) underwent FEVAR using Zenith (Cook Medical, Bloomington, Ind) Fenestrated AAA Endovascular Grafts (70%), Zenith p-Branch (7%), and fenestrated custom-made devices (22%)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216352/outcome-of-endovascular-repair-for-intact-and-ruptured-thoracic-aortic-aneurysms
#5
Tina Hellgren, Anders Wanhainen, Johnny Steuer, Kevin Mani
OBJECTIVE: The objective of this study was to assess long-term outcome after thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysm (TAA). METHODS: All patients who underwent TEVAR for TAA at Uppsala University Hospital from December 1999 to December 2014 were included. Characteristics of the patients and outcome data were collected from medical records, national population registry, and cause of death registry. Perioperative survival was analyzed with the χ(2) test, and 5-year survival was estimated with Kaplan-Meier analysis...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28215964/implementation-of-the-surgical-safety-checklist-at-a-tertiary-academic-center-impact-on-safety-culture-and-patient-outcomes
#6
Areg Zingiryan, Jennifer L Paruch, Turner M Osler, Neil H Hyman
BACKGROUND: The impact and efficacy of the World Health Organization Surgery Safety Checklist (SSC) is uncertain. We sought to determine if the SSC decreases complications and examined the attitudes of the surgical team members following implementation of the SSC. METHODS: A 28-question survey was developed to assess perspectives of surgical team members at the University of Vermont Medical Center (UVMC). The University Health System Consortium database was examined to compare the rates of nine complications before and after SSC implementation using Chi square analysis and Fisher's exact test...
November 30, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28214256/is-there-a-threshold-value-of-hemoglobin-a1c-that-predicts-risk-of-infection-following-primary-total-hip-arthroplasty
#7
Jourdan M Cancienne, Brian C Werner, James A Browne
BACKGROUND: There remains little evidence to support a perioperative hemoglobin A1c (HbA1c) level that could serve as a threshold for a significantly increased risk of deep postoperative infection in patients with diabetes mellitus (DM) following total hip arthroplasty (THA). METHODS: A national administrative database was queried for patients who underwent primary THA with DM. Patients with an HbA1c level within 3 months of surgery were identified and were stratified based on HbA1c level in 0...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214220/comparison-of-the-hanging-drop-technique-and-running-drip-method-for-identifying-the-epidural-space-in-dogs
#8
Fernando Martinez-Taboada, José I Redondo
OBJECTIVE: To compare the running-drip and hanging-drop techniques for locating the epidural space in dogs. STUDY DESIGN: Prospective, randomized, clinical trial. ANIMALS: Forty-five healthy dogs requiring epidural anaesthesia. METHODS: Dogs were randomized into four groups and administered epidural anaesthesia in sternal (S) or lateral (L) recumbency. All blocks were performed by the same person using Tuohy needles with either a fluid-prefilled hub (HDo) or connected to a drip set attached to a fluid bag elevated 60 cm (RDi)...
January 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28203505/bilateral-sciatic-neuropathy-after-an-autologous-breast-reconstruction-in-a-massive-weight-loss-patient
#9
Ramy Abdel-Naby, Michael Ablavsky, Aleksandr Shteynberg
Perioperative compression neuropathy is a known potential complication of prolonged surgical procedures. Sciatic postoperative neuropathy has rarely been reported. We present a 34-year-old woman who underwent right breast reconstruction with supercharged (venous anastomosis) transverse rectus abdominis flap and developed bilateral sciatic compression neuropathy. Her history was remarkable for sleeve gastrectomy 2 years earlier resulting in 105 pound weight loss 1 year before breast reconstruction. During the procedure, the patient was in the supine position for 8 hours and in the semirecumbent position for an additional 2 hours with the torso flexed at 30 degrees and knees flexed at approximately 45 degrees in addition to standard padding...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28197727/perioperative-morbidity-oncological-outcomes-and-predictors-of-pt3a-upstaging-for-patients-undergoing-partial-nephrectomy-for-ct1-tumors
#10
Pascal Mouracade, Onder Kara, Julien Dagenais, M J Maurice, R J Nelson, Ercan Malkoc, J H Kaouk
OBJECTIVES: To evaluate perioperative morbidity, oncological outcome and predictors of pT3a upstaging after partial nephrectomy (PN). MATERIALS AND METHODS: Retrospective study of 1042 patients who underwent PN for cT1N0M0 renal cell carcinoma between 2007 and 2015. A total of 113 cT1 patients were upstaged to pT3a, while 929 were staged as pT1. Demographic, perioperative and pathological variables were reviewed. We compared the clinico-pathological characteristics, perioperative morbidity and oncological outcomes between pT3a and pT1 groups...
February 14, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28194756/chlorhexidine-allergy-in-4-specialist-allergy-centres-in-the-uk-2009-2013-clinical-features-and-diagnostic-tests
#11
William Egner, Matthew Helbert, Ravishankar Sargur, Kirsty Swallow, Nigel Harper, Tomaz Garcez, Sinisa Savic, Louise Savic, Eren Effren
We describe an observational survey of diagnostic pathways in 104 patients attending four specialist allergy clinics in the UK following perioperative hypersensitivity reactions to chlorhexidine reactions. The majority were life threatening. Men undergoing urological or cardiothoracic surgery predominated. Skin prick testing and sIgE testing were the most common tests used for diagnosis. Fifty-three % of diagnoses were made on the basis of a single positive test. Where multiple tests were performed the sensitivity of intradermal, basophil activation and skin prick testing was 68% (50-86%), 50% (10-90%) and 35% (17-55%) respectively...
February 14, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28190720/endarterectomy-versus-stenting-in-patients-with-prior-ipsilateral-carotid-artery-stenting
#12
Isibor J Arhuidese, Besma Nejim, Susruth Chavali, Satinderjit Locham, Tammam Obeid, Caitlin W Hicks, Mahmoud B Malas
OBJECTIVE: In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perform an evaluation of redo-CAS vs CEA in a large contemporary cohort of patients who underwent prior ipsilateral CAS. METHODS: We studied all patients in the Vascular Quality Initiative (VQI) database, who underwent CEA or CAS between January 1, 2003, and April 30, 2016, after prior ipsilateral CAS...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28186424/defining-local-nerve-blocks-for-feline-distal-pelvic-limb-surgery-a-cadaveric-study
#13
Masataka Enomoto, B Duncan X Lascelles, Mathew P Gerard
Objectives Anatomical and methodological detail is lacking regarding local anesthetic peripheral nerve block techniques for distal pelvic limb surgery in cats. The aim of this study was to develop, describe and test nerve block methods based on cadaveric dissections and dye injections. Methods Ten pairs of feline pelvic limbs (n = 20) were dissected and the tibial nerve (T n.), common fibular (peroneal) nerve (CF n., and its two branches, the superficial fibular [peroneal] nerve [SpF n.] and the deep fibular [peroneal] nerve [DpF n...
February 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28185968/the-value-of-diagnostic-bilateral-intracranial-eeg-in-treatment-resistant-focal-epilepsy
#14
Travis C Hill, Benjamin A Rubin, Vineet Tyagi, Jason Theobald, Alyson Silverberg, Mary Miceli, Patricia Dugan, Chad Carlson, Werner K Doyle
OBJECTIVES: We assessed the efficacy and risks of diagnostic bilateral intracranial EEG (bICEEG) in treatment-resistant epilepsy (TRE) patients with poorly lateralized epileptogenic zone (EZ) on non-invasive studies as reflected by progress to resection, Engel outcome and complication rate. METHODS: This is a retrospective chart review of 199 patients with TRE who had diagnostic bICEEG at New York University Medical Center between 1994 and 2013. Study endpoints were progress to resection, surgical outcome and perioperative complications...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28169844/standard-setting-for-clinical-performance-of-basic-perioperative-transesophageal-echocardiography-moving-beyond-the-written-test
#15
Julian S Bick, Jonathan P Wanderer, Conrad S Myler, Andrew D Shaw, Matthew D McEvoy
BACKGROUND: Credible methods for assessing competency in basic perioperative transesophageal echocardiography examinations have not been reported. The authors' objective was to demonstrate the collection of real-world basic perioperative transesophageal examination performance data and establish passing scores for each component of the basic perioperative transesophageal examination, as well as a global passing score for clinical performance of the basic perioperative transesophageal examination using the Angoff method...
February 7, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28169116/utilization-and-effectiveness-of-desmopressin-acetate-after-cardiac-surgery-supplemented-with-point-of-care-hemostatic-testing-a-propensity-score-matched-analysis
#16
David Orlov, Stuart A McCluskey, Jeannie Callum, Vivek Rao, Jacobo Moreno, Keyvan Karkouti
OBJECTIVES: To explore the utilization pattern and hemostatic effectiveness of desmopressin acetate (DDAVP) supplemented with point-of-care (POC) hemostatic testing in contemporary cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single quaternary care university hospital. PARTICIPANTS: The study comprised 2,468 consecutive patients undergoing cardiac surgery-1,237 before and 1,231 after the introduction of POC testing...
November 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28162943/impact-of-intra-and-postoperative-blood-transfusion-on-the-incidence-timing-and-pattern-of-disease-recurrence-after-radical%C3%A2-cystectomy
#17
Marco Moschini, Francesco Soria, Mohammad Abufaraj, Beat Foerster, David D'Andrea, Rocco Damiano, Tobias Klatte, Francesco Montorsi, Alberto Briganti, Renzo Colombo, Andrea Gallina, Shahrokh F Shariat
BACKGROUND: The administration of blood transfusion (BT) has been associated with a decrease in survival expectancies in patients treated with radical cystectomy (RC), as a consequence of the immunosuppressive effect mediated by BT. We sought therefore to evaluate if the usage of BT may influence the risk and pattern location of distant recurrences after RC, which may be influenced by this effect. METHODS: Data from 2 independent cohorts of consecutive patients with bladder cancer treated with RC were analyzed...
January 11, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28162922/efficacy-and-safety-of-pharmacological-venous-thromboembolism-prophylaxis-following-liver-resection-a-systematic-review-and-meta-analysis
#18
REVIEW
Minas Baltatzis, Ryan Low, Panagiotis Stathakis, Aali J Sheen, Ajith K Siriwardena, Saurabh Jamdar
BACKGROUND: Current guidelines recommend pharmacological prophylaxis for patients undergoing abdominal surgery for malignancy. Liver resection exposes patients to risk factors for venous thromboembolism, but there is a risk of bleeding. The aim of this study is to evaluate the evidence base supporting the use of pharmacological thromboprophylaxis in liver surgery. METHODS: An electronic search was carried out for studies reporting the incidence of VTE following liver resection comparing patients receiving pharmacological prophylaxis with those who did not...
February 2, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28162173/-clinical-effect-of-double-layer-vacuum-sealing-drainage-in-the-treatment-of-delayed-severe-infection-after-calcaneal-fracture-operation
#19
H D Ma, J Bai, X J Du, H D Liu, Y Gao, J J Li, W D Liang, L H Cao, J F Qu
Objective: To observe the clinical effect of vacuum sealing drainage (VSD) technique and simple dressing change in the treatment of delayed severe infection after calcaneal fracture surgery. Methods: From August 2008 to July 2015 , 73 patients with delayed severe infection were treated after calcaneal fractures 3 months in Department of Foot and Ankle, the Second Hospital of Tangshan City, according to the treatment methods are divided into vacuum sealing drainage group of 38 cases, 35 cases of simple dressing group...
January 17, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28159076/preventing-unplanned-perioperative-hypothermia-in-children
#20
Susan E Beedle, Amy Phillips, Shirley Wiggins, Leeza Struwe
Unplanned perioperative hypothermia is a common surgical risk. Unplanned hypothermia is defined as a body temperature below 36° C (96.8° F) during any phase of the perioperative period. Perioperative nurses at a Midwestern tertiary pediatric hospital developed an evidence-based clinical practice guideline (CPG) designed to maintain normothermia for the pediatric surgical population. This CPG outlined standard thermoregulation nursing interventions and required the consistent use of a temporal artery thermometer...
February 2017: AORN Journal
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