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https://www.readbyqxmd.com/read/29134342/an-introduction-and-overview-of-machine-learning-in-neurosurgical-care
#1
REVIEW
Joeky T Senders, Mark M Zaki, Aditya V Karhade, Bliss Chang, William B Gormley, Marike L Broekman, Timothy R Smith, Omar Arnaout
BACKGROUND: Machine learning (ML) is a branch of artificial intelligence that allows computers to learn from large complex datasets without being explicitly programmed. Although ML is already widely manifest in our daily lives in various forms, the considerable potential of ML has yet to find its way into mainstream medical research and day-to-day clinical care. The complex diagnostic and therapeutic modalities used in neurosurgery provide a vast amount of data that is ideally suited for ML models...
November 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29046091/crossing-the-bridge-to-vats-lobectomy
#2
P Tcherveniakov, C Bogdan, N Chaudhuri
Introduction The impact of the introduction of video assisted thoracoscopic surgery (VATS) on the management of lung cancer 20 years ago has been well documented. However, the uptake of VATS lobectomy in surgical practice worldwide has been slower than expected. We believe that this is partly due to a lack of consensus on how this procedure should be integrated into training programmes. We present our initial experience with a newly developed training model, which could help bridge the divide between open and VATS lobectomy...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29042051/extracorporeal-membrane-oxygenation-as-a-bridge-to-lung-transplantation-a-single-center-experience-in-the-present-era
#3
Emily M Todd, Sreeja Biswas Roy, A Samad Hashimi, Rosemarie Serrone, Roshan Panchanathan, Paul Kang, Katherine E Varsch, Barry E Steinbock, Jasmine Huang, Ashraf Omar, Vipul Patel, Rajat Walia, Michael A Smith, Ross M Bremner
OBJECTIVE: Extracorporeal membrane oxygenation has been used as a bridge to lung transplantation in patients with rapid pulmonary function deterioration. The reported success of this modality and perioperative and functional outcomes are varied. METHODS: We retrospectively reviewed all patients who underwent lung transplantation at our institution over 1 year (January 1, 2015, to December 31, 2015). Patients were divided into 2 groups depending on whether they required extracorporeal membrane oxygenation support as a bridge to transplant; preoperative characteristics, lung transplantation outcomes, and survival were compared between groups...
November 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29030709/bleeding-risk-of-submuscular-icd-implantation-with-continued-oral-anticoagulation-versus-heparin-bridging-therapy
#4
Simon Pecha, Ayhan Ayikli, Iris Wilke, Samer Hakmi, Yalin Yildirim, Nils Gosau, Hermann Reichenspurner, Stephan Willems, Muhammet Ali Aydin
Recent studies have shown that subcutaneous or subfascial pacemaker- and ICD implantation with continued oral anticoagulation therapy is associated with lower risk for bleeding complications, when compared to heparin bridging strategies. However, ICD generators are often implanted submuscularly. We therefore compared the bleeding risk with continued phenprocoumon therapy vs. heparin bridging in patients receiving submuscular ICD implantation. Between 01/2013 and 12/2013, 104 patients with need for oral anticoagulation received submuscular ICD or CRT-D implantation in our institution...
October 13, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28954934/effects-and-risks-of-heparin-bridging-and-different-modes-of-interruption-resumption-of-rivaroxaban-on-perioperative-complications-of-catheter-ablation-for-atrial-fibrillation%C3%A3-another-analysis-of-the-jacre-r-registry
#5
Kenzo Hirao, Kazutaka Aonuma, Koichiro Kumagai, Koichi Inoue, Masaomi Kimura, Yasushi Miyauchi, Eiki Tsushima, Ken Okumura
BACKGROUND: The JACRE-R Registry, in which 42 Japanese institutions participated, monitored the efficacy and safety of rivaroxaban in catheter ablation (CA) of atrial fibrillation (AF). In the present analysis, we sought to elucidate the effects and risks of heparin bridging and different patterns of interruption/resumption of rivaroxaban on complications of CA.Methods and Results:We administered rivaroxaban during the perioperative period and recorded the incidence of complications up to 30 days after CA...
September 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28951657/sleeve-gastrectomy-and-left-ventricular-assist-device-for-heart-transplant
#6
Joseph Greene, Tung Tran, Timothy Shope
BACKGROUND AND OBJECTIVES: Heart failure (HF) is a severe obesity-related comorbidity. Many patients with end-stage HF eventually require cardiac transplantation for long-term survival. These patients may be precluded from enrollment in heart transplant programs secondary to morbid obesity. We propose a pathway involving sleeve gastrectomy (SG) for patients with morbid obesity and HF to afford cardiac transplantation eligibility. METHODS: Three patients with HF and morbid obesity underwent implantation of a left ventricular assist device (LVAD) and SG at an academic tertiary care institution in Washington, DC...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28932913/a-prospective-randomized-controlled-trial-evaluating-the-short-term-outcomes-of-transanal-hemorrhoidal-dearterialization-versus-tissue-selecting-technique
#7
A L H Leung, T P P Cheung, K Tung, Y P Tsang, H Cheung, C W Lau, C N Tang
BACKGROUND: Tissue-selecting technique (TST) is a novel stapled hemorrhoidectomy technique which targets the hemorrhoids, leaving uninvolved mucosal bridges intact and avoiding circumferential circular stapling. The aim of this study was to compare the short-term outcomes of TST and transanal hemorrhoidal dearterialization (THD). METHODS: Patients presenting with symptomatic hemorrhoids were recruited. Patients were randomized into two groups: (1) TST and (2) THD...
September 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28931256/the-posterior-transcallosal-approach-to-the-pineal-region-and-posterior-third-ventricle-intervenous-and-paravenous-variants
#8
Prayash G Patel, Aaron A Cohen-Gadol, Philippe Mercier, Frederick A Boop, Paul Klimo
BACKGROUND: There are a number of surgical approaches to the posterior third ventricle and pineal region, each with its associated advantages and disadvantages. OBJECTIVE: To present our experience with the posterior interhemispheric transcallosal approach and to analyze the indications, technique, and outcomes. METHODS: A retrospective study was conducted to identify and analyze all children and young adults who underwent the posterior transcallosal approach from July 2010 to March 2015...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28885501/outcomes-of-abdominal-surgery-in-patients-with-mechanical-ventricular-assist-devices-a-multi-institutional-study
#9
Krystle M Leung, Maria X Kiely, Ashlee Kimbrell, Ammar Asban, Rosemary Kelley, Ronald Bleday, Jennifer S Davids, Nelya Melnitchouk
OBJECTIVE: The aim of this study was to examine the outcomes of elective and emergent abdominal operations performed in end-stage heart failure patients supported with ventricular assist devices (VADs). SUMMARY OF BACKGROUND DATA: With the growing volume of end-stage heart failure patients receiving VADs, an increasing number of these patients require surgery for noncardiac pathology. There is a paucity of studies on the safety of abdominal operations in this population...
September 6, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28874960/impact-of-laparoscopic-liver-resection-on-bleeding-complications-in-patients-receiving-antithrombotics
#10
Takahisa Fujikawa, Hiroshi Kawamoto, Yuichiro Kawamura, Norio Emoto, Yusuke Sakamoto, Akira Tanaka
AIM: To assess the impact of laparoscopic liver resection (LLR) on surgical blood loss (SBL), especially in patients with antithrombotics for thromboembolic risks. METHODS: Consecutive 258 patients receiving liver resection at our institution between 2010 and 2016 were retrospectively reviewed. Preoperative antithrombotic therapy (ATT; antiplatelets and/or anticoagulation) was regularly used in 100 patients (ATT group, 38.8%) whereas not used in 158 (non-ATT group, 61...
August 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28842832/perioperative-management-of-antithrombotic-therapy-in-patients-receiving-cardiovascular-implantable-electronic-devices-a-network-meta-analysis
#11
Hua He, Bing-Bing Ke, Yan Li, Fu-Sheng Han, Xiaodong Li, Yu-Jie Zeng
PURPOSE: Network meta-analysis (NMA) has advantages including being able to simultaneously compare and rank multiple treatments over traditional meta-analysis. We evaluated by a NMA the optimal antithrombotic strategy during the perioperative period of implantation of cardiovascular implantable electronic devices (CIEDs). METHODS: We performed a network meta-analysis of observational studies (cohort and case-control studies). The eligible studies tested the following antithrombotic therapy during the CIED placement: aspirin, clopidogrel, warfarin, novel oral anticoagulants (NOACs), and heparin bridging...
October 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28838826/dental-injury-associated-with-anaesthesia-an-8-year-database-analysis-of-592-claims-from-a-major-french-insurance-company
#12
Antoine Giraudon, Guillaume de Saint Maurice, Matthieu Biais, Dan Benhamou, Karine Nouette-Gaulain
INTRODUCTION: Dental injury is the most common incident associated with anaesthesia. Regarding recent recommendations on informed consent and changes in airway management practices, a large series of claims related to dental injury has not been recently described. The aim of this study was to analyse a recent database in order to describe the characteristics of dental injury in France. METHODS: A database that prospectively collected claims reported to Le Sou Médical-MACSF between January 2003 and December 2010, was analysed...
August 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28833518/post-sternotomy-mediastinitis-in-the-modern-era
#13
Siew S C Goh
BACKGROUND: Post-sternotomy mediastinitis is associated with significant mortality and morbidity. Despite surgical advances in cardiac surgery and improvements in perioperative care, mediastinitis remains a devastating post-operative complication. This study provides a comprehension review of post-sternotomy mediastinitis in the modern era, and discusses the incidence, risk factors, microbiology, prevention, and management of this complication. METHODS: This review was based on a PubMed/MEDLINE literature search up until 9th March 2017 for publications relevant to mediastinitis post-cardiac surgery...
September 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28828987/perioperative-management-of-anticoagulants
#14
Joan M Irizarry-Alvarado, Lynsey A Seim
BACKGROUND: The prevalence of anticoagulant use has increased in the United States. Medical providers have the responsibility to explain to patients the management of anticoagulant regimens before an invasive procedure. The pharmacologic characteristics of these medications-specifically, their half-lives-are important in timing an interruption of anticoagulant therapy. OBJECTIVE: The authors review the current guidelines and recommendations for therapeutic interruption of anticoagulants and the involved pharmacologic factors...
August 21, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28817359/developing-the-storyline-for-an-advance-care-planning-video-for-surgery-patients-patient-centered-outcomes-research-engagement-from-stakeholder-summit-to-state-fair
#15
Rebecca A Aslakson, Anne L R Schuster, Thomas J Lynch, Matthew J Weiss, Lydia Gregg, Judith Miller, Sarina R Isenberg, Norah L Crossnohere, Alison M Conca-Cheng, Angelo E Volandes, Thomas J Smith, John F P Bridges
BACKGROUND: Patient-centered outcomes research (PCOR) methods and social learning theory (SLT) require intensive interaction between researchers and stakeholders. Advance care planning (ACP) is valuable before major surgery, but a systematic review found no extant perioperative ACP tools. Consequently, PCOR methods and SLT can inform the development of an ACP educational video for patients and families preparing for major surgery. OBJECTIVE: The objective is to develop and test acceptability of an ACP video storyline...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28777136/incidence-and-impact-of-on-cardiopulmonary-bypass-vasoplegia-during-heart-transplantation
#16
Lauren K Truby, Koji Takeda, Maryjane Farr, James Beck, Melana Yuzefpolskaya, Paolo C Colombo, Veli Tokpara, Donna Mancini, Yoshifumi Naka, Hiroo Takayama
Despite significant advances in the medical management of heart transplant (HT) recipients, perioperative complications, including vasoplegia, remain a significant contributor to morbidity and mortality. This is a retrospective review of patients who received HT at our institution between 2012 and 2015. Mean systemic vascular resistance (SVR) was calculated during the bypass run. Vasoplegia was defined as a mean SVR <800 dynes s/cm despite a high pressor requirement (>1,500 μg neosynephrine bolused)...
August 2, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28677422/evaluation-of-a-standardized-perioperative-management-protocol-in-the-adult-hematology-anticoagulation-management-service
#17
Diane J Lum, Patricia A Ross, Martin A Bishop, Michelle L Caetano, Michael B Streiff
BACKGROUND: In North America, 250,000 patients on vitamin K antagonists require surgical procedures each year. Temporary interruption of oral anticoagulation and perioperative bridging therapy with unfractionated heparin or low-molecular-weight heparin are recommended by the American College of Chest Physicians 2012 for select patients. OBJECTIVES: The study objectives are to evaluate adherence and nonadherence to the Johns Hopkins clinic guidelines for perioperative management of anticoagulation and identify bleeding or thromboembolic events during perioperative management of anticoagulation...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28664233/endovascular-treatment-of-wide-necked-visceral-artery-aneurysms-using-the-neurovascular-comaneci-neck-bridging-device-a-technical-report
#18
Julian Maingard, Hong Kuan Kok, Emma Phelan, Caitriona Logan, Dinesh Ranatunga, Duncan Mark Brooks, Ronil V Chandra, Michael J Lee, Hamed Asadi
INTRODUCTION: Visceral and renal artery aneurysms (VRAAs) are an uncommon clinical entity but carry a risk of rupture with associated morbidity and mortality. The rupture risk is particularly high when the aneurysms are large, of unfavourable morphology or in the setting of pregnancy and perioperative period. Endovascular approaches are now first line in the treatment of VRAA, but conventional techniques may be ineffective in excluding aneurysms with unfavourable anatomy such as those with wide necks or at arterial bifurcation points...
November 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28653161/the-post-sir-spheres-surgery-study-p4s-retrospective-analysis-of-safety-following-hepatic-resection-or-transplantation-in-patients-previously-treated-with-selective-internal-radiation-therapy-with-yttrium-90-resin-microspheres
#19
Fernando Pardo, Bruno Sangro, Rheun-Chuan Lee, Derek Manas, Rohan Jeyarajah, Vincent Donckier, Geert Maleux, Antonio D Pinna, Lourens Bester, David L Morris, David Iannitti, Pierce K Chow, Richard Stubbs, Paul J Gow, Gianluca Masi, Kevin T Fisher, Wan Y Lau, Konstantinos Kouladouros, Georgios Katsanos, Giorgio Ercolani, Fernando Rotellar, José I Bilbao, Michael Schoen
BACKGROUND: Reports show that selective internal radiation therapy (SIRT) may downsize inoperable liver tumors to resection or transplantation, or enable a bridge-to-transplant. A small-cohort study found that long-term survival in patients undergoing resection following SIRT appears possible but no robust studies on postsurgical safety outcomes exist. The Post-SIR-Spheres Surgery Study was an international, multicenter, retrospective study to assess safety outcomes of liver resection or transplantation following SIRT with yttrium-90 (Y-90) resin microspheres (SIR-Spheres(®); Sirtex)...
September 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28647195/adapting-to-a-total-endovascular-approach-for-complex-aortic-aneurysm-repair-outcomes-after-fenestrated-and-branched-endovascular-aortic-repair
#20
COMPARATIVE STUDY
Jacob Budtz-Lilly, Anders Wanhainen, Jacob Eriksson, Kevin Mani
OBJECTIVE: This study reports the feasibility of adopting a total endovascular approach for the treatment of complex abdominal aortic aneurysms (AAAs) at a European aortic center and compares the short- and midterm results against those from large and multicenter studies. METHODS: All patients treated endovascular aortic repair (EVAR) for juxta/pararenal AAAs or thoracoabdominal aortic aneurysms (TAAAs), both elective and acute, as well as reoperations, from 2010 to 2015 were included...
November 2017: Journal of Vascular Surgery
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