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https://www.readbyqxmd.com/read/29227173/changes-in-platelet-function-with-inflammation-in-patients-undergoing-vascular-surgery
#1
Bartosz Olechowski, Vikram Khanna, Mark Mariathas, Alexander Ashby, Richard T Dalton, Ian Nordon, Nicola Englyst, Scott Harris, Zoe Nicholas, Kala Thayalasamy, Michael Mahmoudi, Nick Curzen
The role of platelets in ischaemic events is well established. Aspirin represents the default antiplatelet and blocks the metabolism of arachidonic acid (AA) at the cyclo-oxygenase enzyme (COX). AA is commonly used as a test of response to aspirin, but recent data raise uncertainty about the validity of this approach. Specifically, in some patients AA-induced clotting is not suppressed, but the level of COX-dependent AA metabolite, thromboxane B2 (TXB2) is negligible. Furthermore, AA-induced whole blood clotting varies dynamically in individuals, who are aspirin responsive according to TXB2 levels...
December 11, 2017: Platelets
https://www.readbyqxmd.com/read/29224750/blood-transfusion-in-children-with-sickle-cell-disease-undergoing-tonsillectomy
#2
Carlyn M Atwood, Sharon H Gnagi, Ronald J Teufel, Shaun A Nguyen, David R White
INTRODUCTION: Tonsillectomy is the second most common surgery in children with sickle cell disease. These children are at an increased risk of perioperative complications due to vaso-occlusive events. Although controversial, preoperative blood transfusions are sometimes given in an effort to prevent such complications. The purpose of this study is to analyze trends in the use of blood transfusion for management of children with sickle cell disease (SCD) undergoing tonsillectomy in a national database...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29223955/high-density-lipoprotein-cholesterol-concentration-and-acute-kidney-injury-after-cardiac-surgery
#3
Loren E Smith, Derek K Smith, Jeffrey D Blume, MacRae F Linton, Frederic T Billings
BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is associated with increased short- and long-term mortality. Inflammation, oxidative stress, and endothelial dysfunction and damage play important roles in the development of AKI. High-density lipoproteins (HDLs) have anti-inflammatory and antioxidant properties and improve endothelial function and repair. Statins enhance HDL's anti-inflammatory and antioxidant capacities. We hypothesized that a higher preoperative HDL cholesterol concentration is associated with decreased AKI after cardiac surgery and that perioperative statin exposure potentiates this association...
December 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29221748/hydroxyethyl-starch-is-associated-with-early-postoperative-delirium-in-patients-undergoing-esophagectomy
#4
Dae Myung Jung, Hyun Joo Ahn, Mikyung Yang, Jie Ae Kim, Duck Kyung Kim, Sangmin Maria Lee, Joo Hyun Park
OBJECTIVE: Postoperative delirium is associated with longer hospital stay and increased morbidities. Patients undergoing esophagectomy have a high chance of developing postoperative delirium because of their advanced age, comorbidities, and intensive care unit care. In this study, we investigated the risk factors of early postoperative delirium in patients undergoing esophagectomy, focusing on perioperative fluid type to test the hypothesis that colloids with high oncotic pressure and anti-inflammatory action would decrease the incidence of postoperative delirium compared with crystalloids...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29218666/transition-from-laparoscopic-to-retroperitoneoscopic-approach-for-live-donor-nephrectomy
#5
Zi Qin Ng, Gabrielle Musk, Alethea Rea, Bulang He
BACKGROUND: Laparoscopic donor nephrectomy has become the standard of care due to multiple benefits. Currently, there are various techniques employed with two different approaches: transperitoneal (TLDN) or retroperitoneoscopic (RLDN) approach. There is a lack of data to determine which technique is superior, although the RLDN offers an anatomical advantage by avoidance of manipulation of the intraperitoneal organs. The aims of this study were to explore the merits of RLDN to TLDN and assess the learning curve of transition from TLDN to RLDN...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29216818/neuroprotective-effects-of-amiodarone-in-a-mouse-model-of-ischemic-stroke
#6
Masakazu Kotoda, Tadahiko Ishiyama, Kazuha Mitsui, Sohei Hishiyama, Takashi Matsukawa
BACKGROUND: Ion channels play a crucial role in the development of ischemic brain injury. Recent studies have reported that the blockade of various types of ion channels improves outcomes in experimental stroke models. Amiodarone, one of the most effective drugs for life-threatening arrhythmia, works as a multiple channel blocker and its characteristics cover all four Vaughan-Williams classes. Although it is known that amiodarone indirectly contributes to preventing ischemic stroke by maintaining sinus rhythm in patients with atrial fibrillation, the direct neuroprotective effect of amiodarone has not been clarified...
December 8, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29214543/comparison-of-biological-and-alloplastic-meshes-in-ventral-incisional-hernia-repair
#7
A Koscielny, S Widenmayer, T May, J Kalff, P Lingohr
PURPOSE: The aim of our retrospective analysis was to compare the results of incisional hernia repair by porcine small intestinal submucosa-derived (SIS) meshes with those obtained by alloplastic polypropylene-based (PP) meshes in comparable surgical indications by matched-pair design. We hypothesized that in incisional hernia, SIS mesh repair is associated with fewer recurrences and SSO than PP mesh repair in incisional hernias. METHODS: Twenty-four matched pairs (SIS vs...
December 6, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29211220/blood-transfusion-and-increased-perioperative-risk-in-coronary-artery-bypass-grafts
#8
Igor C Campos, Valessa Tanganelli, Hugo P Maues, Marcio C M Coelho, Fernanda A Martins, Giovana Munhoz, Julyana G T Egito, Hayala C C Souza, Cássio M C Giannini, Pedro S Farsky
OBJECTIVE: To correlate blood transfusions and clinical outcomes during hospitalization in coronary artery bypass grafting surgery (CABG). METHODS: Transfusion, clinical and hematological data were collected for 1,378 patients undergoing isolated or combined CABG between January 2011 and December 2012. The effect of blood transfusions was evaluated through multivariate analysis to predict three co-primary outcomes: composite ischemic events, composite infectious complications and hospital mortality...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#9
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29205668/cerebrovascular-blood-pressure-autoregulation-monitoring-and-postoperative-transient-ischemic-attack-in-pediatric-moyamoya-vasculopathy
#10
Jennifer K Lee, Monica Williams, Michael Reyes, Edward S Ahn
BACKGROUND: Children with moyamoya vasculopathy are at high risk of perioperative cerebral ischemia or hyperperfusion. Maintaining blood pressure within the range of functional cerebrovascular blood pressure autoregulation might reduce the risk of perioperative neurologic injury. AIMS: We tested whether blood pressure autoregulation is associated with postoperative transient ischemic attack in a study of patients with pediatric moyamoya vasculopathy. METHODS: We conducted an observational study of 15 pediatric patients undergoing surgical revascularization with pial synangiosis...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29205061/does-advancing-technology-improve-outcomes-comparison-of-the-da-vinci-standard-s-si-to-the-xi-robotic-platforms-during-robotic-nephroureterctomy
#11
Manish Navnitlal Patel, Ashok Hemal
INTRODUCTION: With the introduction of laparoscopy and now robotics, more patients are able to reap benefit from minimally invasive techniques during urologic surgery. With these advancing technologies it is important to evaluate whether the outlay of hospital capital actually improves patient care. To date, there has been very little literature regarding the impact of these advances on patient outcomes. In this paper, we directly compare perioperative outcomes and hospital costs between the older da Vinci Standard/S/Si platform the newer Xi robotic platform during nephroureterectomy...
December 5, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29204776/implications-of-hyperthermic-intraperitoneal-chemotherapy-perfusion-related-hyperglycemia
#12
Camille L Stewart, Ana Gleisner, Alison Halpern, Irada Ibrahim-Zada, Rodrigo Asturias Luna, Nathan Pearlman, Csaba Gajdos, Barish Edil, Martin McCarter
BACKGROUND: Hyperthermic intraperitoneal chemotherapy (HIPEC) administration can be associated with hyperglycemia during perfusion. Little is known about this effect, and no previous studies have examined patient characteristics associated with perfusion-related hyperglycemia. METHODS: We retrospectively identified consecutive patients at a single institution treated with HIPEC from 8/2003 to 10/2016 who had intraoperative blood glucose measured. Hypertonic 1.5% dextrose-containing peritoneal dialysate was used as carrier solution in all patients...
December 4, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29203976/laparoscopic-versus-open-approach-for-intersphincteric-resection-results-from-a-tertiary-cancer-center-in-india
#13
Vishwas D Pai, Pavan Sugoor, Prachi S Patil, Vikas Ostwal, Reena Engineer, Supreeta Arya, Ashwin Desouza, Avanish P Saklani
The study aims to compare open intersphincteric resection (OISR) with laparoscopic intersphincteric resection (LISR) in terms of short-term oncological and clinical outcomes. This is a retrospective review of a prospectively maintained database including all the patients of rectal cancer who underwent intersphincteric resection (ISR) at Tata Memorial Centre between 1st July 2013 and 30th November 2015. Short-term oncological parameters evaluated included circumferential resection margin involvement (CRM), distal resection margin involvement, and number of nodes harvested...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29201518/transobturator-four-arms-mesh-in-the-surgical-management-of-stress-urinary-incontinence-with-cystocele
#14
Hammouda Sherif, Tarek Soliman Othman, Amr Eldkhakhany, Hussein Elkady, Adel Elfallah
Objective: This study aims to evaluate safety and efficacy of four arms polypropylene mesh in the long- term follow-up in the management of stress urinary incontinence (SUI) associated with cystocele. Material and methods: This prospective study was conducted on 50 female patients with SUI associated with cystocele. Patients underwent placement of transobturator four-arms mesh implants. Stress incontinence was evaluated using cough stress test with and without prolapse reduction, Stamey's grading of SUI, the validated Arabic version of the International Consultation on Incontinence Questionnaire-Short Form and King Health Questionnaire forms...
December 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29200077/consensus-statement-on-perioperative-use-of-neuromuscular-monitoring
#15
Mohamed Naguib, Sorin J Brull, Aaron F Kopman, Jennifer M Hunter, Béla Fülesdi, Hal R Arkes, Arthur Elstein, Michael M Todd, Ken B Johnson
A panel of clinician scientists with expertise in neuromuscular blockade (NMB) monitoring was convened with a charge to prepare a consensus statement on indications for and proper use of such monitors. The aims of this article are to: (a) provide the rationale and scientific basis for the use of quantitative NMB monitoring; (b) offer a set of recommendations for quantitative NMB monitoring standards; (c) specify educational goals; and (d) propose training recommendations to ensure proper neuromuscular monitoring and management...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29198533/usefulness-of-routine-transtelephonic-monitoring-for-supraventricular-tachycardia-in-infants
#16
Jonathan Yaari, Dorota Gruber, Andrew D Blaufox
OBJECTIVE: We hypothesize that routine daily transtelephonic monitoring (TTM) transmissions can accurately detect supraventricular tachycardia (SVT) in asymptomatic infants and/or assuage parental concerns rather than being used solely to diagnose arrhythmias. STUDY DESIGN: Single center, retrospective chart review of 60 patients with fetal or infant SVT prescribed TTM for at least 30 days, January 2010-September 2016. Patients were excluded if initial SVT was not documented, was perioperative, was atrial flutter/fibrillation, or chaotic atrial tachycardia...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29195854/hypothermia-in-total-joint-arthroplasty-a-wake-up-call
#17
Jordan B Simpson, Vijai S Thomas, Sabir K Ismaily, Pavel I Muradov, Philip C Noble, Stephen J Incavo
BACKGROUND: Total joint patients are particularly vulnerable to perioperative hypothermia (PH) (combined effects of anesthesia, radiation, and convective heat loss from exposed skin surfaces and cool temperatures in the operating room). There are limited studies on PH in these patients. METHODS: In a retrospective review of 204 patients undergoing primary hip and 179 undergoing primary knee replacement surgeries, time and temperature parameters were collected from the electronic health records from preoperative and postoperative recovery room nursing assessments, intraoperative anesthesia records, and floor nursing notes...
November 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29193737/laboratory-testing-in-patients-treated-with-direct-oral-anticoagulants-a-practical-guide-for-clinicians
#18
REVIEW
Jonathan Douxfils, Walter Ageno, Charles-Marc Samama, Sarah Lessire, Hugo Ten Cate, Peter Verhamme, Jean-Michel Dogné, François Mullier
One of the key benefits of the direct oral anticoagulants (DOACs) is that they do not require routine laboratory monitoring. Nevertheless, assessment of DOAC exposure and anticoagulant effects may become useful in various clinical scenarios. The four approved DOACs - apixaban, dabigatran etexilate, edoxaban and rivaroxaban - have different characteristics impacting assay selection and the interpretation of results. This article provides an updated overview on 1) which test to use (and their advantages and limitations), 2) when to assay DOAC levels, 3) how to interpret the results relating to bleeding risk, emergency situations and perioperative management, and 4) what is the impact of DOACs on routine and specialised coagulation assays...
November 29, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29193211/is-tranexamic-acid-exposure-related-to-blood-loss-in-hip-arthroplasty-a-pharmacokinetic-pharmacodynamic-study
#19
Julien Lanoiselée, Paul J Zufferey, Edouard Ollier, Sophie Hodin, Xavier Delavenne
AIMS: Tranexamic acid (TXA) is an antifibrinolytic agent, decreasing blood loss in hip arthroplasty. The present study investigated the relationship between TXA exposure markers, including the time above the in vitro threshold reported for inhibition of fibrinolysis (10 mg l-1 ), and perioperative blood loss. METHODS: Data were obtained from a prospective, double-blind, parallel-arm, randomized superiority study in hip arthroplasty. Patients received a preoperative intravenous bolus of TXA 1 g followed by a continuous infusion of either TXA 1 g or placebo over 8 h...
October 26, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29192952/thromboelastography-for-predicting-bleeding-in-patients-with-aortic-stenosis-treated-with-tavi
#20
Bartosz Rymuza, Karol Zbroński, Piotr Scisło, Kajetan Grodecki, Janusz Kochman, Krzysztof Jerzy Filipiak, Grzegorz Opolski, Zenon Huczek
BACKGROUND AND AIMS: Bleeding complications are frequent and independently impact mortality after TAVI. Thromboelastography (TEG) measures viscoelastic properties of clot formation and is currently best known for perioperative management to reduce blood transfusion in cardiac surgery. We sought to determine whether TEG may be predictive of bleeding in patients treated with TAVI. METHODS AND RESULTS: Overall, 54 consecutive patients with severe aortic stenosis treated with TAVI were prospectively included...
December 1, 2017: Kardiologia Polska
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