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https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#1
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27863203/safflower-catharmus-tinctorius-l-oil-supplementation-in-overnourished-rats-during-early-neonatal-development-effects-on-heart-and-liver-function-in-the-adult
#2
Laís Ribeiro Costa, Patrícia Cavalcanti Macêdo, Janatar Stella Vasconcelos de Melo, Cristiane Moura Freitas, Aiany Simoes Alves, Humberto de Moura Barbosa, Eduardo Lira, Mariana Pinheiro Fernandes, Manuella Batista-de-Oliveira-Hornsby, Claudia Lagranha
Carthamus tinctorius L. (common name: safflower) is an herb whose extracted oil (safflower oil) has been employed in both alternative and conventional medicine in the treatment of disease. Overnutrition during early postnatal life can increase the lifetime risk of obesity and metabolic syndrome. Here we investigate the effect of safflower oil supplementation given during a critical early developmental stage on the eventual occurrence of metabolic disease in overnourished rats. Groups of overnourished or adequately nourished rats were randomly assigned into 2 additional groups for supplementation with either safflower oil (SF) or vehicle for 7 to 30 days...
December 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/27862613/naso-esophageal-extraluminal-drainage-for-postoperative-anastomotic-leak-after-thoracic-esophagectomy-for-patients-with-esophageal-cancer
#3
Kiyohiko Shuto, Tsuguaki Kono, Yasunori Akutsu, Masaya Uesato, Mikito Mori, Kenichi Matsuo, Chihiro Kosugi, Atsushi Hirano, Kuniya Tanaka, Shinich Okazumi, Keiji Koda, Hisahiro Matsubara
Postoperative anastomotic leaks and subsequent mediastinal abscess are serious complications. The purpose of this study was to assess the efficacy of naso-esophageal extraluminal drainage after thoracic esophagectomy with gastric conduit reconstruction using a posterior mediastinal route. About 50 of 365 patients (13.7%) with esophageal cancer and postoperative anastomotic leak after curative esophagectomy was investigated. Beginning in June 2009, naso-esophageal extraluminal drainage by inserting a naso-esophageal aspiration tube into the abscess cavity when percutaneous abscess drainage was introduced which was ineffective or technically impossible...
November 9, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27805991/treatment-of-spontaneous-esophageal-rupture-with-transnasal-thoracic-drainage-and-temporary-esophageal-stent-and-jejunal-feeding-tube-placement
#4
Gang Wu, Yan Shi Zhao, Yi Fang, Yu Qi, Xiangnan Li, Dechao Jiao, Kewei Ren, Xinwei Han
BACKGROUND: Spontaneous rupture of the esophagus is a rare but life-threatening thoracic emergency, with high rates of clinical misdiagnosis and mortality. This paper summarizes our experience in the treatment of spontaneous esophageal rupture with transnasal thoracic drainage, and temporary esophageal stent and jejunal feeding tube placement. METHODS: We retrospectively assessed the medical records of 19 patients with spontaneous esophageal rupture treated using our intervention protocol...
October 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27784355/-chylothorax-related-with-dasatinib-in-the-treatment-of-chronic-myeloid-leukemia-report-of-3-cases
#5
Lan Yang, Na Lu, Yu Jing, Li Yu
OBJECTIVE: To study the clinical features and prognosis of chylothorax related with dasatinib in treatment of chronic myeloid leukemia(CML). METHODS: The clinical data from 3 cases of CML with chylothorax after the treatment with dasatinib were collected. The clinical characteristics were analyzed and compared in the light of published literatures. RESULTS: They were treated with imatinib 400 mg once daily after diagnosing the illness as CML...
October 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/27778075/risk-factors-for-anastomotic-stricture-post-esophagectomy-with-a-standardized-sutured-anastomosis
#6
Zuhair Ahmed, Jessie A Elliott, Sinead King, Claire L Donohoe, Narayanasamy Ravi, John V Reynolds
BACKGROUND: Benign anastomotic strictures occur frequently after esophagectomy, and impact on postoperative recovery, nutritional status, and quality of life. This large cohort study explored the incidence of stricture after transthoracic (2- and 3-stage) and transhiatal resections with uniform single-layer sutured anastomotic technique, and aimed to identify independent risk factors. METHODS: Patients undergoing esophagectomy with gastric conduit reconstruction between February 2001 and October 2014 were studied prospectively...
October 24, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27727026/best-practice-for-perioperative-management-of-patients-with-cytoreductive-surgery-and-hipec
#7
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27725628/thoracic-duct-chylous-fistula-following-severe-electric-injury-combined-with-sulfuric-acid-burns-a-case-report
#8
Fei Chang, Dasheng Cheng, Mingyuan Qian, Wei Lu, Huatao Li, Hongtai Tang, Zhaofan Xia
BACKGROUND As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. CASE REPORT A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area)...
October 11, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27680069/-application-of-bundles-of-intervention-in-the-treatment-of-esophageal-carcinoma-anastomotic-leak
#9
Wenze Tian, Zhongwu Hu, Jian Ji, Dafu Xu, Zhenbing You, Wei Guo, Keping Xu
OBJECTIVE: To investigate the application of bundles of intervention in the treatment of esophageal carcinoma anastomotic leak. METHODS: From January 2014 to May 2015, 44 cases of esophageal carcinoma anastomotic fistula were treated by bundles of intervention (through the collection of a series of evidence-based treatment and care measures for the treatment of diseases) in Department of Thoracic Surgery, Huai'an First Hospital, Nanjing Medical University (bundles of intervention group), and 68 patients with esophageal carcinoma postoperative anastomotic leak from December 2013 to January 2012 receiving traditional therapy were selected as the control group...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27599460/the-pretreatment-controlling-nutritional-status-conut-score-is-an-independent-prognostic-factor-in-patients-with-resectable-thoracic-esophageal-squamous-cell-carcinoma-results-from-a-retrospective-study
#10
Takahiro Toyokawa, Naoshi Kubo, Tatsuro Tamura, Katsunobu Sakurai, Ryosuke Amano, Hiroaki Tanaka, Kazuya Muguruma, Masakazu Yashiro, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: The purpose of this study was to investigate the impact of the Controlling Nutritional Status (CONUT) score on survival compared with the platelet to lymphocyte ratio (PLR), the neutrophil to lymphocyte ratio (NLR), and the Glasgow Prognostic Score (GPS) in patients with resectable thoracic esophageal squamous cell carcinoma (ESCC). METHODS: One hundred eighty-five consecutive patients who underwent subtotal esophagectomy with curative intent for resectable thoracic ESCC were retrospectively reviewed...
2016: BMC Cancer
https://www.readbyqxmd.com/read/27559257/factors-influencing-compliance-to-radical-treatment-of-middle-thoracic-esophageal-cancer-an-audit-from-a-regional-cancer-centre
#11
Rakesh Kapoor, Anshuma Bansal, Shikhar Kumar, Ravi Teja Miriyala
BACKGROUND: The aim of this study is to identify the factors responsible for interruption of planned treatment in patients of carcinoma mid-thoracic esophagus and also discuss the strategies for improving treatment completion rates. MATERIALS AND METHODS: Patients with nonmetastatic mid-thoracic esophageal cancer who received treatment by multimodality approach using chemotherapy, radiation, and/or surgery were retrospectively analyzed. Factors influencing compliance with planned treatment completion were evaluated, and their significance was determined using multivariate Cox regression analysis...
July 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/27555617/residual-volume-and-total-lung-capacity-to-assess-reversibility-in-obstructive-lung-disease
#12
Conor T McCartney, Melissa N Weis, Gregg L Ruppel, Ravi P Nayak
BACKGROUND: Reversibility of obstructive lung disease is traditionally defined by changes in FEV1 or FVC in response to bronchodilators. These may not fully reflect changes due to a reduction in hyperinflation or air-trapping, which have important clinical implications. To date, only a handful of studies have examined bronchodilators' effect on lung volumes. The authors sought to better characterize the response of residual volume and total lung capacity to bronchodilators. METHODS: Responsiveness of residual volume and total lung capacity to bronchodilators was assessed with a retrospective analysis of pulmonary function tests of 965 subjects with obstructive lung disease as defined by the lower limit of normal based on National Health and Nutritional Examination Survey III prediction equations...
August 23, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27507070/associations-between-body-composition-physical-capabilities-and-pulmonary-function-in-healthy-older-adults
#13
L Schweitzer, C Geisler, M Johannsen, C-C Glüer, M J Müller
BACKGROUND/OBJECTIVES: There are positive associations between pulmonary function (PF) and fat-free mass as well as muscle strength. Contrarily, negative associations were found with indirect measures of visceral adipose tissue (VAT). We aimed to differentiate between associations of body composition and PF by assessing mediating and moderating effects of physical capabilities. SUBJECTS/METHODS: Cross-sectional data were assessed among 40 healthy, free-living elderly (20 males) aged 65...
August 10, 2016: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27465048/geriatric-assessment-factors-are-associated-with-mortality-after-hospitalization-in-older-adults-with-cancer
#14
Sushma Jonna, Leslie Chiang, Jingxia Liu, Maria B Carroll, Kellie Flood, Tanya M Wildes
PURPOSE: Survival in older adults with cancer varies given differences in functional status, comorbidities, and nutrition. Prediction of factors associated with mortality, especially in hospitalized patients, allows physicians to better inform their patients about prognosis during treatment decisions. Our objective was to analyze factors associated with survival in older adults with cancer following hospitalization. METHODS: Through a retrospective cohort study, we reviewed 803 patients who were admitted to Barnes-Jewish Hospital's Oncology Acute Care of Elders (OACE) unit from 2000 to 2008...
November 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27430455/myelopathy
#15
B Oyinkan Marquis, Patrick M Capone
Myelopathy is an inclusive term, referring to pathology leading to a neurologic deficit related to the spinal cord. The clinical diagnosis of myelopathy requires a detailed history and physical examination to define the clinical syndrome. Neuroimaging is indicated in most instances of new-onset myelopathy. It is indicated also when the worsening of a myelopathy is unexplained. Advances in neuroimaging have proved to play a vital role in diagnosis. Appropriate diagnosis and treatment are dependent upon an adequate imaging evaluation to establish the presence of mechanical stability, extrinsic spinal cord compression, or an intramedullary lesion...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27427525/the-evolution-and-current-utility-of-esophageal-stent-placement-for-the-treatment-of-acute-esophageal-perforation
#16
REVIEW
Argenis Herrera, Richard K Freeman
Esophageal stent placement was used primarily for the treatment of malignant strictures until the development of a new generation of biomaterials allowed the production of easily removable, occlusive stents in 2001. Since then, thoracic surgeons have gained experience using esophageal stents for the treatment of acute esophageal perforation. As part of a hybrid treatment strategy, including surgical drainage of infected spaces, enteral nutrition, and aggressive supportive care, esophageal stent placement has produced results that can exceed those of traditional surgical repair...
August 2016: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/27426661/the-discovery-of-lymphatic-system-in-the-seventeenth-century-part-i-the-early-history
#17
Raphael Suy, Sarah Thomis, Inge Fourneau
The early history of lymphatic anatomy from Hippocrates (ca. 460-377 B.C.) to Eustachius (1510-1574). The presence of lymphatic vessels and lymph nodes was reported by ancient anatomists without any accurate knowledge of their true functions. Lymph nodes were described as spongy structures, spread over the whole body for the support of vulnerable body parts. Digestion was explained as being the resorption of clear chyle from digested food by the open endings of chyle vessels. The first insights into the place of lymphatic components within nutrition emanated from the medical school of Alexandria (fourth century B...
June 2, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27406157/low-preoperative-selenium-is-associated-with-post-operative-atrial-fibrillation-in-patients-having-intermediate-risk-coronary-artery-surgery
#18
C McDonald, J Fraser, K Shekar, A Clarke, J Coombes, A Barnett, B Pearse, L Fung
BACKGROUND/OBJECTIVES: Post-operative atrial fibrillation (POAF) is a frequent complication of cardiac surgery. Oxidative stress and reduced antioxidant function have major roles in its development. Selenium is a key to normal antioxidant function, and levels are often low before cardiac surgery. This study investigated whether low preoperative selenium levels were associated with POAF in cardiac surgical patients. SUBJECTS/METHODS: Using the Society of Thoracic Surgeons (STS) Mortality risk score, 50 patients having primary coronary artery bypass grafts (CABG) surgery were divided into two groups: (i) low-risk group (STS ⩽0...
July 13, 2016: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27385770/spinal-infections-among-patients-with-long-term-central-venous-catheters-for-home-parenteral-nutrition-a-descriptive-case-series
#19
Rabia Topan, Tim Ambrose, Mia Small, Elewys Lightman, Jeremy Nightingale, Simon M Gabe
Spinal infections are a rare yet serious metastatic complication of bacteremia among patients with long-term central venous catheters (CVCs) for which clinicians must remain vigilant. We performed a retrospective review of all cases of spinal infection occurring in the context of a CVC for long-term parenteral nutrition (PN) managed in our department between January 2010 and October 2013, a cohort of 310 patients over this time period. Six patients were identified (mean age, 65 years; 5 male). One hundred percent of patients presented with spinal pain (5/6 cervical, 1/6 thoracic)...
July 6, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27355377/circulating-25-hydroxyvitamin-d-and-1-25-dihydroxyvitamin-d-concentrations-and-postoperative-infections-in-cardiac-surgical-patients-the-calcitop-study
#20
Armin Zittermann, Joachim Kuhn, Jana B Ernst, Tobias Becker, Julia Larisch, Jens Dreier, Cornelius Knabbe, Jochen Börgermann, Jan F Gummert
BACKGROUND: Vitamin D has immunomodulatory properties and seems to reduce the risk of infections. Whether low vitamin D concentrations are independent risk factors for nosocomial postoperative infections in surgical patients remains to be studied in detail. METHODS: In 3,340 consecutive cardiac surgical patients, we investigated the association of circulating 25-hydroxyvitamin D (25OHD; indicator of nutritional vitamin D status) and 1,25-dihydroxyvitamin D (1,25[OH]2D; active vitamin D hormone) with nosocomicial infections...
2016: PloS One
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