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https://www.readbyqxmd.com/read/28338491/perioperative-management-of-blood-loss-in-spine-surgery
#1
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Hamid Hassanzadeh
Spine procedures are associated with high rates of blood loss which can result in a greater need for transfusions. Repeated exposure to blood products is associated with risks and adverse reactions such as transfusion-related acute lung injury, fluid shifting, and infections. With the higher number of spine procedures and the increasing open surgery times associated with difficult procedures, excessive blood loss has become more prevalent. Perioperative methods have been established to combat the excessive blood loss and decrease the need for blood products...
March 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28337660/topgear-a-randomized-phase-iii-trial-of-perioperative-ecf-chemotherapy-with-or-without-preoperative-chemoradiation-for-resectable-gastric-cancer-interim-results-from-an-international-intergroup-trial-of-the-agitg-trog-eortc-and-cctg
#2
Trevor Leong, B Mark Smithers, Karin Haustermans, Michael Michael, Val Gebski, Danielle Miller, John Zalcberg, Alex Boussioutas, Michael Findlay, Rachel L O'Connell, Jaclyn Verghis, David Willis, Tomas Kron, Melissa Crain, William K Murray, Florian Lordick, Carol Swallow, Gail Darling, John Simes, Rebecca Wong
BACKGROUND: Postoperative chemoradiation and perioperative chemotherapy using epirubicin/cisplatin/5-fluorouracil (ECF) represent two standards of care for resectable gastric cancer. In the TOPGEAR (Trial Of Preoperative therapy for Gastric and Esophagogastric junction AdenocaRcinoma) trial, we hypothesized that adding preoperative chemoradiation to perioperative ECF will improve survival; however, the safety and feasibility of preoperative chemoradiation have yet to be determined. METHODS: TOPGEAR is an international phase III trial in which patients with adenocarcinoma of the stomach were randomized to perioperative ECF alone or with preoperative chemoradiation...
March 23, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28336105/tolerance-and-efficacy-of-a-polyamine-deficient-diet-for-the-treatment-of-perioperative-pain
#3
Jean-Pierre Estebe, Cécile Degryse, Gilles Rezzadori, Florin Dimache, Georges Daccache, Alain Le Naoures, Anissa Belbachir, Pierre Schoeffler, Anne-Laure Sérandour
BACKGROUND: Polyamines have been identified as pain agonists and interact with N-methyl-D-aspartate receptors. A prospective, randomized, multicenter, and blinded phase II clinical trial was conducted to evaluate a polyamine-deficient diet for the treatment of perioperative pain in patients during spinal surgery. METHODS: All analyses followed the intention-to-treat principle. The trial was designed to evaluate the dose-ranging effect of a low polyamine diet with respect to a total (group 1) or partial (group 2) polyamine diet on perioperative pain (7 d before and 5 d after surgery)...
April 2017: Nutrition
https://www.readbyqxmd.com/read/28333315/transcutaneous-brow-shaping-a-straightforward-and-precise-method-to-lift-and-shape-the-eyebrows
#4
Mario Pelle-Ceravolo, Matteo Angelini
Background: The height of the eyebrow is less crucial aesthetically than is the relationship between the lateral and medial portions of the brow. Although various surgical procedures are effective in raising the brow, the authors maintain that transcutaneous brow shaping (TBS) is the only technique that enables precise shaping of the brow and correction of minor asymmetries. Objectives: The authors described their experiences with direct TBS alone or in conjunction with blepharoplasty and facelift...
March 16, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28332089/surgery-for-total-anomalous-pulmonary-venous-connection-primary-sutureless-repair-vs-conventional-repair
#5
REVIEW
Naoki Yoshimura, Kazuaki Fukahara, Akio Yamashita, Toshio Doi, Katsunori Takeuchi, Shigeyuki Yamashita, Takahiro Homma, Shigeki Yokoyama, Masaya Aoki, Yuki Ikeno
Despite recent advances in surgical technique and perioperative care, the surgical correction of total anomalous pulmonary venous connection (TAPVC) remains a challenge. The major complication and the main cause of reoperation in TAPVC surgery are the occurrence of pulmonary venous obstruction (PVO). In the 1990s, sutureless repair was introduced as a technique to relieve PVO after TAPVC repair. Following the favorable outcomes for postoperative PVO, the indications for sutureless repair as a primary operation have been expanded to include infants who have preoperative PVO or those at risk of developing PVO after the repair of TAPVC...
March 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28331851/predicting-factors-for-allogeneic-blood-transfusion-and-excessive-postoperative-blood-loss-after-single-low-dosage-intra-articular-tranexamic-acid-application-in-total-knee-replacement
#6
Paphon Sa-Ngasoongsong, Siwadol Wongsak, Noratep Kulachote, Pongsthorn Chanplakorn, Patarawan Woratanarat, Viroj Kawinwonggowit
Background. Recently, intra-articular tranexamic acid (IA-TXA) application has become a popular method for perioperative blood loss (PBL) reduction in total knee replacement (TKR). Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT) after IA-TXA. Materials and Methods. A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014). Patient's characteristic and perioperative data were reviewed and collected...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28329232/mid-term-results-of-bilateral-lung-transplant-with-postoperatively-extended-intraoperative-extracorporeal-membrane-oxygenation-for-severe-pulmonary-hypertension%C3%A2
#7
Jawad Salman, Fabio Ius, Wiebke Sommer, Thierry Siemeni, Christian Kuehn, Murat Avsar, Dietmar Boethig, Ulrich Molitoris, Christoph Bara, Jens Gottlieb, Tobias Welte, Axel Haverich, Marius M Hoeper, Gregor Warnecke, Igor Tudorache
OBJECTIVES: In severe pulmonary hypertension, diastolic dysfunction of the left ventricle causes significant morbidity and mortality after lung transplantation, which may be successfully reversed using a protocol based on perioperative veno-arterial extracorporeal membrane oxygenation (ECMO) and early extubation. Here, we present echocardiographic data and mid-term outcomes. METHODS: The records of lung transplanted patients at our institution between May 2010 and January 2016 were retrospectively reviewed...
March 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329064/perioperative-outcomes-of-off-pump-minimally-invasive-coronary-artery-bypass-grafting-with-bilateral-internal-thoracic-arteries-under-direct-vision%C3%A2
#8
Keita Kikuchi, Xufa Chen, Makoto Mori, Atsushi Kurata, Liang Tao
OBJECTIVES: We previously introduced techniques to harvest and use the right internal thoracic artery in minimally invasive coronary artery bypass grafting (CABG) via a single left thoracotomy for revascularization with bilateral internal thoracic arteries (BITA). We report our short-term outcomes of patients who underwent minimally invasive CABG using BITA and a single internal thoracic artery (SITA). METHODS: Consecutive patients who underwent minimally invasive CABG using BITA or SITA at a Japanese medical center between February 2012 and December 2015 were reviewed retrospectively...
January 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28327947/factors-associated-with-pre-and-postoperative-seizures-in-1033-patients-undergoing-supratentorial-meningioma-resection
#9
William C Chen, Stephen T Magill, Dario J Englot, Joe D Baal, Sagar Wagle, Jonathan W Rick, Michael W McDermott
BACKGROUND: Risk factors for pre- and postoperative seizures in supratentorial meningiomas are understudied compared to other brain tumors. OBJECTIVE: To report seizure frequency and identify factors associated with pre- and postoperative seizures in a large single-center population study of patients undergoing resection of supratentorial meningioma. METHODS: Retrospective chart review of 1033 subjects undergoing resection of supratentorial meningioma at the author's institution (1991-2014)...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28323806/improving-pain-management-and-long-term-outcomes-following-high-energy-orthopaedic-trauma-pain-study
#10
Renan C Castillo, Srinivasa N Raja, Katherine P Frey, Heather A Vallier, Paul Tornetta, Todd Jaeblon, Brandon J Goff, Allan Gottschalk, Daniel O Scharfstein, Robert V OʼToole
Poor pain control after orthopaedic trauma is a predictor of physical disability and numerous negative long-term outcomes. Despite increased awareness of the negative consequences of poorly controlled pain, analgesic therapy among hospitalized patients after orthopaedic trauma remains inconsistent and often inadequate. The Pain study is a 3 armed, prospective, double-blind, multicenter randomized trial designed to evaluate the effect of standard pain management versus standard pain management plus perioperative nonsteroidal anti-inflammatory drugs or pregabalin in patients of ages 18-85 with extremity fractures...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#11
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#12
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323335/surgical-guidelines-for-perioperative-management-of-older-adults-what-geriatricians-need-to-know
#13
Jessica L Colburn, Sanjay Mohanty, John R Burton
A multidisciplinary panel of experts representing surgery, anesthesia, and geriatrics recently published guidelines for surgeons on the optimal perioperative management of older adults, including recommendations on postoperative recovery and posthospital transitions of care. Geriatricians have an important role in the care for older adults in the preoperative period as older adults consider surgical options and prepare for surgical procedures, during the perioperative period as inpatient consultants, and in the postoperative period as older adults transition to rehabilitation facilities or to home...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28321533/perioperative-antibiotic-use-in-vagus-nerve-stimulator-implantation-a-clinical-series
#14
Jeffrey S Raskin, Daniel Hansen, Arvind Mohan, I-Wen Pan, Daniel J Curry, Sandi Lam
PURPOSE: Preoperative antibiosis contributes up to one third of total antibiotic use in major hospitals. Choice of antibiotic is not uniformly standardized, and polypharmacy regimens may be used without knowing the effect on rates of surgical site infection, nonsurgical infections, or antibiotic resistance. Careful examination of trends in surgical prophylaxis is warranted. In this study, we aimed to examine our institution's experience with vagus nerve stimulator (VNS) implantation, focusing on association between perioperative antibiotic practices and postoperative infectious outcomes...
March 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28319514/do-not-resuscitate-status-is-associated-with-increased-mortality-but-not-morbidity
#15
Elisa C Walsh, Ethan Y Brovman, Angela M Bader, Richard D Urman
BACKGROUND: Do-not-resuscitate (DNR) orders instruct medical personnel to forego cardiopulmonary resuscitation in the event of cardiopulmonary arrest, but they do not preclude surgical management. Several studies have reported that DNR status is an independent predictor of 30-day mortality; however, the etiology of increased mortality remains unclear. We hypothesized that DNR patients would demonstrate increased postoperative mortality, but not morbidity, relative to non-DNR patients undergoing the same procedures...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319468/the-impact-of-cage-dimensions-positioning-and-side-of-approach-in-extreme-lateral-interbody-fusion
#16
Marjan Alimi, Gernot Lang, Rodrigo Navarro-Ramirez, Moritz Perrech, Connor Berlin, Christoph P Hofstetter, Yu Moriguchi, Eric Elowitz, Roger Härtl
STUDY DESIGN: This is a retrospective single-center study. OBJECTIVE: The aim of the study was to evaluate the impact of cage characteristics and position toward clinical and radiographic outcome measures in patients undergoing extreme lateral interbody fusion (ELIF). SUMMARY OF BACKGROUND DATA: ELIF is utilized for indirect decompression and minimally invasive surgical treatment for various degenerative spinal disorders. However, evidence regarding the influence of cage characteristics in patient outcome is minimal...
March 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28319421/detection-of-subclinical-vitamin-k-deficiency-in-neurosurgery-with-pivka-ii
#17
Sofia Dahlberg, Caroline Ulfsdotter Nilsson, Thomas Kander, Ulf Schött
Vitamin K is known for supporting the carboxylation of hepatic coagulation proteins. Levels of proteins induced by vitamin K absence for factor II (PIVKA-II) reflect hypocarboxylated prothrombin and can be used to detect subclinical vitamin K deficiency. The aim of this study was to determine the prevalence of perioperative subclinical vitamin K deficiency among neurosurgical patients using PIVKA-II and investigate the existence of any correlation to standard coagulation assays. Also, the antitumor effects of vitamin K were reviewed...
March 20, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28317676/effect-of-the-administration-period-of-perioperative-topical-levofloxacin-on-normal-conjunctival-bacterial-flora
#18
Ryohei Nejima, Kimiya Shimizu, Takashi Ono, Yukari Noguchi, Akiko Yagi, Takuya Iwasaki, Nobuyuki Shoji, Kazunori Miyata
PURPOSE: To assess the long-term and short-term effects of post-cataract surgery antibiotic therapy on the drug-resistance profile of normal conjunctival bacterial flora. SETTING: Miyata Eye Hospital, Miyazaki, Japan. DESIGN: Randomized prospective clinical trial. METHODS: Patients aged 20 years or older who had cataract surgery between May and September 2015 were given levofloxacin 1.5% ophthalmic solution for 3 days preoperatively...
January 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#19
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28314974/health-related-quality-of-life-prospectively-evaluated-by-the-8-item-short-form-after-endovascular-repair-versus-open-surgery-for-abdominal-aortic-aneurysms
#20
Takayoshi Kato, Mototsugu Tamaki, Tomohiro Tsunekawa, Yusuke Motoji, Akihiro Hirakawa, Yasuhide Okawa, Shinji Tomita
Open repair for infra-renal abdominal aortic and iliac artery aneurysms (AAAs) is a robust treatment. On the other hand, endovascular aneurysm repair (EVAR) has been widespread because of its less invasiveness. However, patients after EVAR frequently require postoperative radiographic examinations and may feel anxiety for their endoleaks. We prospectively evaluated Health-related Quality of Life of the patients with these two fashions using the 8-item Short Form (SF-8). From 2011 to 2013, 89 consecutive elective cases of AAAs were treated...
March 17, 2017: Heart and Vessels
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