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https://www.readbyqxmd.com/read/28214967/increased-atrial-%C3%AE-adrenergic-receptors-and-grk-2-gene-expression-can-play-a-fundamental-role-in-heart-failure-after-repair-of-congenital-heart-disease-with-cardiopulmonary-bypass
#1
Marcela Silva Oliveira, Fabio Carmona, Walter V A Vicente, Paulo H Manso, Karina M Mata, Mara Rúbia Celes, Erica C Campos, Simone G Ramos
Surgeries to correct congenital heart diseases are increasing in Brazil and worldwide. However, even with the advances in surgical techniques and perfusion, some cases, especially the more complex ones, can develop heart failure and death. A retrospective study of patients who underwent surgery for correction of congenital heart diseases with cardiopulmonary bypass (CPB) in a university tertiary-care hospital that died, showed infarction in different stages of evolution and scattered microcalcifications in the myocardium, even without coronary obstruction...
February 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28214235/effects-of-postacute-settings-on-readmission-rates-and-reasons-for%C3%A2-readmission-following-total-knee-arthroplasty
#2
Rodney Laine Welsh, James E Graham, Amol M Karmarkar, Natalie E Leland, Jacques G Baillargeon, Dana L Wild, Kenneth J Ottenbacher
OBJECTIVES: Examine the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. DESIGN: Secondary analyses of 100% Medicare (inpatient) claims files. SETTING: Acute hospitals across the United States. PARTICIPANTS: Medicare fee-for-service beneficiaries ≥66 years of age who were discharged from an acute hospital following TKA in 2009-2011 (n = 608,031)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28213879/arthrogryposis-multiplex-congenita-classification-diagnosis-perioperative-care-and-anesthesia
#3
REVIEW
Lulu Ma, Xuerong Yu
Arthrogryposis multiplex congenita (AMC) is a rare disorder characterized by non-progressive, multiple contractures. In addition to affected extremities, patients may also present microstomia, decreased temporomandibular joint mobility. Although the etiology of AMC is unclear, any factor that decreases fetal movement is responsible for AMC. Thus, accurate diagnosis and classification are crucial to the appropriate treatment of AMC. The development of ultrasound technology has enabled prenatal diagnosis. Very early treatment is favorable, and multidisciplinary treatment is necessary to improve the function of AMC patients...
February 17, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28212261/passage-of-gallstones-into-common-bile-duct-during-laparoscopic-cholecystectomy-is-it-surgeon-s-responsibility
#4
Mohammed Bani Hani, Abdel Rahman Al Manasra, Haitham Qandeel
PURPOSE: Gallstones patients without preoperative history of jaundice, deranged liver function tests, or dilated bile ducts (BD) are unlikely to have BD stones. However, some of these patients in our series underwent endoscopic stone(s) removal after laparoscopic cholecystectomy (LC). We aim to find the incidence, possible intraoperative risk factors, and if the Surgeon can be blamed for this event. MATERIALS AND METHODS: We studied LC cases over 12-year period at our university hospital and identified patients who did not have preoperative risk factors for BD stones but developed postoperative jaundice and/or persistent abdominal pain...
February 16, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28212252/health-literacy-in-orthopaedic-trauma-patients
#5
Filip Cosic, Lara Kimmel, Elton Edwards
OBJECTIVE: This study aimed to determine the level of health literacy in a postoperative orthopaedic trauma population and to evaluate the efficacy of a simple predischarge discussion strategy, targeted at improving health literacy. DESIGN: A pre-post intervention study was conducted from April 2014 to January 2015. SETTING: Academic Level 1 trauma center. PARTICIPANTS: One hundred ninety consecutive orthopaedic trauma patients with operatively managed lower limb fractures were recruited...
March 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28212172/cognitive-decline-associated-with-anesthesia-and-surgery-in-the-elderly-does-this-contribute-to-dementia-prevalence
#6
Lisbeth Evered, David A Scott, Brendan Silbert
PURPOSE OF REVIEW: To provide an update on the current state of research investigating the effects of anesthesia and surgery on cognition in the elderly, including consideration of overlap with cognitive disorders in the community. RECENT FINDINGS: The studies reviewed here identify detrimental effects of anesthesia and surgery on cognition in a proportion of elderly individuals. Animal models demonstrate an association between anesthetic agents and Alzheimer's disease pathology...
February 15, 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28211064/selecting-postoperative-adjuvant-systemic-therapy-for-early-stage-breast-cancer-a-critical-assessment-of-commercially-available-gene-expression-assays
#7
REVIEW
David M Hyams, Eric Schuur, Javier Angel Aristizabal, Juan Enrique Bargallo Rocha, Cesar Cabello, Roberto Elizalde, Laura García-Estévez, Henry L Gomez, Artur Katz, Aníbal Nuñez De Pierro
Risk stratification of patients with early stage breast cancer may support adjuvant chemotherapy decision-making. This review details the development and validation of six multi-gene classifiers, each of which claims to provide useful prognostic and possibly predictive information for early stage breast cancer patients. A careful assessment is presented of each test's analytical validity, clinical validity, and clinical utility, as well as the quality of evidence supporting its use.
February 17, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28211020/goal-directed-fluid-restriction-during-brain-surgery-a-prospective-randomized-controlled-trial
#8
Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu, Guo Chen
BACKGROUND: The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain surgery. METHODS: High-risk patients undergoing brain surgery were randomly assigned to a usual care group (control group) or a GDFR group. In the GDFR group, (1) fluid maintenance was restricted to 3 ml/kg/h of a crystalloid solution and (2) colloid boluses were allowed only in case of hypotension associated with a low cardiac index and a high stroke volume variation...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28210655/cost-of-outpatient-arthroscopic-anterior-cruciate-ligament-reconstruction-among-commercially-insured-patients-in-the-united-states-2005-2013
#9
Mackenzie M Herzog, Stephen W Marshall, Jennifer L Lund, Virginia Pate, Jeffrey T Spang
BACKGROUND: Despite the significance of anterior cruciate ligament (ACL) injuries, these conditions have been under-researched from a population-level perspective. It is important to determine the economic effect of these injuries in order to document the public health burden in the United States. PURPOSE: To describe the cost of outpatient arthroscopic ACL reconstruction and health care utilization among commercially insured beneficiaries in the United States. STUDY DESIGN: Economic and decision analysis; Level of evidence, 3...
January 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210451/dental-management-of-patients-taking-novel-oral-anticoagulants-noas-dabigatran
#10
REVIEW
Adrian Curto, Alberto Albaladejo, Alfonso Alvarado
BACKGROUND: A new group of oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban) with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. Patients being treated with oral anticoagulants are at higher risk for bleeding when undergoing dental treatments. MATERIAL AND METHODS: A literature search was conducted through April 2016 for publications in the ISI Web of Knowledge, PubMed and Cochrane Library using the keywords "dabigatran", "rivaroxaban", "apixaban", "edoxaban", "new oral anticoagulants", "novel oral anticoagulants", "bleeding" and "dental treatment"...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28210386/ionic-hydrogel-monotherapy-and-in-combination-with-antiviral-antibiotic-prophylaxis-in-the-post-procedure-management-of-fractional-laser-treated-patients
#11
Francesca Romana Grippaudo
Objective: The pre- and postoperative care for fractionated laser resurfacing is still controversial, especially in regard to the use of antibiotics to prevent bacterial infection and potential consequences. Recently, an ionic hydrogel has shown to be useful in the postoperative treatment of minor burns. The aim of this study is to evaluate the use of this hydrogel after fractional laser treatments targeting photoaging and chronoaging damage to skin. Design: A randomized prospective study. Setting: one plastic surgeon private practice...
November 2016: Journal of Clinical and Aesthetic Dermatology
https://www.readbyqxmd.com/read/28209144/modified-enhanced-recovery-after-surgery-eras-protocols-for-patients-with-obstructive-colorectal-cancer
#12
Dai Shida, Kyoko Tagawa, Kentaro Inada, Keiichi Nasu, Yasuji Seyama, Tsuyoshi Maeshiro, Sachio Miyamoto, Satoru Inoue, Nobutaka Umekita
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now well-known to be useful for elective colorectal surgery, as they result in shorter hospital stays without adversely affecting morbidity. However, the efficacy and safety of ERAS protocols for patients with obstructive colorectal cancer have yet to be clarified. METHODS: We evaluated 122 consecutive resections for obstructive colorectal cancer performed between July 2008 and November 2012 at Tokyo Metropolitan Bokutoh Hospital...
February 16, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28208178/lingual-tonsillectomy-for-treatment-of-pediatric-obstructive-sleep-apnea-a-meta-analysis
#13
Kun-Tai Kang, Peter J Koltai, Chia-Hsuan Lee, Ming-Tzer Lin, Wei-Chung Hsu
Importance: Evidence indicates correlations between lingual tonsil hypertrophy and pediatric obstructive sleep apnea (OSA). However, to our knowledge, a meta-analysis of surgical outcomes for lingual tonsillectomy in children with OSA has not been conducted. Objective: To evaluate the therapeutic outcomes of lingual tonsillectomy for treatment of pediatric OSA. Data Sources: The study protocol was registered on PROSPERO (CRD42015027053). PubMed, MEDLINE, EMBASE, and the Cochrane Reviews databases were searched independently by 2 authors for relevant articles published by September 2016...
February 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28208150/acute-and-subacute-presentations-of-cerebral-edema-following-deep-brain-stimulation-lead-implantation
#14
Albert J Fenoy, Sebastian J Villarreal, Mya C Schiess
BACKGROUND/AIMS: Postoperative cerebral edema around a deep brain stimulation (DBS) electrode is an uncommon reported complication. The goal of this study was to identify instances of postoperative edema based on clinical presentation, and to remark on their management. METHODS: A retrospective chart review was performed on all patients who underwent DBS electrode implantation over a 3-year period. Routine CT imaging on postoperative day (POD) 1 was negative. Patients were identified based on clinical neurological changes, leading to imaging and subsequent diagnosis...
February 17, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28207669/is-intraoperative-local-vancomycin-powder-the-answer-to-surgical-site-infections-in-spine-surgery
#15
Hwee Weng Dennis Hey, Desmond Wei Thiam, Zhi Seng Darren Koh, Joseph Shantakumar Thambiah, Naresh Kumar, Leok-Lim Lau, Ka-Po Gabriel Liu, Hee-Kit Wong
STUDY DESIGN: This is a retrospective cohort comparative study of all patients who underwent instrumented spine surgery at a single institution. OBJECTIVE: To compare the rate of surgical site infection (SSI) between the treatment (vancomycin) and the control group (no vancomycin) in patients undergoing instrumented spine surgery. SUMMARY OF BACKGROUND DATA: SSI after spine surgery is a dreaded complication associated with increased morbidity and mortality...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28207532/synchronous-papillary-thyroid-carcinoma-and-breast-ductal-carcinoma-a-rare-case-report-and-literature-review
#16
Jinjing Zhong, Jianyong Lei, Ke Jiang, Zhihui Li, Rixiang Gong, Jingqiang Zhu
BACKGROUND: The incidences of both thyroid cancer and breast cancer have been rising in recent years; however, it is very rare to find a single person with both of these cancers. Only a few cases of synchronous thyroid and breast cancer have been published, and even fewer cases have been reported in older patients (>60 years). CASE SUMMARY: The current study presents a case of synchronous papillary thyroid carcinoma and breast ductal carcinoma in an elderly patient...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28206936/independent-preoperative-predictors-of-prolonged-length-of-stay-after-laparoscopic-appendectomy-in-patients-over-30-years-of-age-experience-from-a-single-institution
#17
Eric S Wise, Stephen P Gadomski, Annette M Ilg, Camilo Bermudez, Emily W Chan, Michelle L Izmaylov, Samantha J Gridley, Jessica V Kaczmarek, Sir Norman T Melancon, Sarwat Ahmad, Kyle M Hocking, Jose J Diaz, Stephen M Kavic
Prompt discharge after laparoscopic appendectomy (LA) is a marker of quality of care, fiscally desirable and feasible in select patients. Patients over 30 comprise a more heterogeneous cohort known to experience worse outcomes after LA. We aimed to identify easily available preoperative risk factors portending a postoperative length of stay ≥2 days among patients above age 30. In this investigation, 296 included patients from a single institution who underwent LA for acute appendicitis from 2010 to 2014 were retrospectively reviewed for preoperative demographics, laboratory studies, comorbidities, presentation characteristics, radiographic finding, and other rationally selected factors for association with postoperative length of stay ≥2 days...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28205057/comparative-effectiveness-of-adjuvant-chemoradiotherapy-after-gastrectomy-among-older-patients-with-gastric-adenocarcinoma-a-seer-medicare-study
#18
Jennifer M Yeh, Angela C Tramontano, Chin Hur, Deborah Schrag
BACKGROUND: Since the INT-0116 trial reported a survival advantage, postoperative chemoradiotherapy (CRT) has been a care standard for US patients in whom gastric adenocarcinoma has been diagnosed. We sought to estimate the association between treatment and survival among the older US Medicare population. METHODS: This is a retrospective cohort study of Medicare beneficiaries aged 65-79 years with stage IB-III gastric adenocarcinoma diagnosed between 2002 and 2009 in a Surveillance, Epidemiology, and End Results region...
February 15, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28203554/the-13-year-experience-of-performing-pancreaticoduodenectomy-in-a-mid-volume-municipal-hospital
#19
Hongbeom Kim, Jung Kee Chung, Young Joon Ahn, Hae Won Lee, In Mok Jung
PURPOSE: Pancreaticoduodenectomy (PD) is a complex surgery associated with high morbidity, mortality, and cost. Municipal hospitals have their important role in the public health and welfare system. The purpose of this study was to identify the feasibility as well as the cost-effectiveness of performing PD in a mid-volume municipal hospital based on 13 years of experience with PD. METHODS: From March 2003 to November 2015, 183 patients underwent PD at Seoul Metropolitan Government - Seoul National University Boramae Medical Center...
February 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28203539/cost-effectiveness-of-robotic-mitral-valve-surgery
#20
Emmanuel Moss, Michael E Halkos
Significant technological advances have led to an impressive evolution in mitral valve surgery over the last two decades, allowing surgeons to safely perform less invasive operations through the right chest. Most new technology comes with an increased upfront cost that must be measured against postoperative savings and other advantages such as decreased perioperative complications, faster recovery, and earlier return to preoperative level of functioning. The Da Vinci robot is an example of such a technology, combining the significant benefits of minimally invasive surgery with a "gold standard" valve repair...
January 2017: Annals of Cardiothoracic Surgery
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