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High Risk Surgery

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https://www.readbyqxmd.com/read/28538384/efficacy-and-safety-of-intravenous-tranexamic-acid-administration-in-patients-undergoing-hip-fracture-surgery-for-hemostasis-a-meta-analysis
#1
Pei Zhang, Jinshan He, Yongchao Fang, Pengtao Chen, Yuan Liang, Jingcheng Wang
BACKGROUND: Patients undergoing hip fracture surgery frequently require blood transfusion. Tranexamic acid (TXA) has been widely used to decrease blood loss and transfusion rates in joint replacement surgery. Therefore, we conducted a meta-analysis to evaluate efficacy and safety of intravenous TXA administration in patients suffering from hip fractures. METHODS: Electronic databases were searched before December 2016 by 2 independent reviewers, including Cochrane Library, EMBASE, PubMed, Web of Science, the Chinese Biomedical Literature database, and the China National Knowledge Infrastructure databases...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538383/stratification-of-risk-groups-according-to-survival-after-recurrence-in-endometrial-cancer-patients
#2
Seung-Hyuk Shim, Dae-Yeon Kim, Hyun Jung Kim, Shin-Wha Lee, Jeong-Yeol Park, Dae-Shik Suh, Jong-Hyeok Kim, Yong-Man Kim, Young-Tak Kim, Joo-Hyun Nam
To identify prognostic factors for overall survival after recurrence (OSr) in endometrioid endometrial cancer (EC) patients and categorize patient subgroups that predict outcomes using these variables.Consecutive patients with recurrent endometrioid EC seen in our institution from 1989 to 2013 were retrospectively reviewed. Cox regression models were used to identify the clinicopathological factors associated with OSr. By summing scores proportionate to the hazard ratio (HR) for each significant variable, we stratified patients into 3 risk groups...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538361/characteristics-of-and-risk-factors-for-severe-neurological-deficit-in-patients-with-pyogenic-vertebral-osteomyelitis-a-case-control-study
#3
Adrien Lemaignen, Idir Ghout, Aurélien Dinh, Guillaume Gras, Bruno Fantin, Virginie Zarrouk, Robert Carlier, Jean-Edouard Loret, Eric Denes, Alix Greder, François-Xavier Lescure, David Boutoille, Pierre Tattevin, Bertrand Issartel, Jean-Philippe Cottier, Louis Bernard
Severe neurological deficit (SND) is a rare but major complication of pyogenic vertebral osteomyelitis (PVO). We aimed to determine the risk factors and the variables associated with clinical improvement for SND during PVO.This case-control study included patients without PVO-associated SND enrolled in a prospective randomized antibiotic duration study, and patients with PVO-associated SND managed in 8 French referral centers. Risk factors for SND were determined by logistic regression.Ninety-seven patients with PVO-associated SND cases, and 297 controls were included...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538081/is-body-mass-index-a-risk-factor-for-revision-procedures-after-minimally-invasive-transforaminal-lumbar-interbody-fusion
#4
Ankur S Narain, Fady Y Hijji, Daniel D Bohl, Kelly H Yom, Krishna T Kudaravalli, Kern Singh
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine if an association exists between body mass index (BMI) and the rate of revision surgery after single-level minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA: MIS TLIF is an effective treatment for lumbar degenerative disease. Previous studies in the orthopedic literature have associated increased BMI with increased postoperative complications and need for revision...
May 19, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28538000/revascularization-for-patients-with-diabetes-mellitus-and-stable-ischemic-heart-disease-an-update
#5
G B John Mancini, Michael Farkouh, Subodh Verma
PURPOSE OF REVIEW: To provide an update on the management of patients with diabetes mellitus and requiring coronary revascularization. RECENT FINDINGS: Evidence continues to show that patients with diabetes mellitus and ischemic heart disease represent a very high-risk group of patients. Choice of stent appears important for minimizing target lesion and target vessel adverse events with everolimus eluting stents having the best performance, particularly in patients being treated with insulin...
May 19, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28535653/-clinical-pathological-characteristics-of-resectable-papillary-thyroid-microcarcinoma
#6
C L Shi, Y Guo, Y C Lyu, Z A B Y S Nanding, W C Gao, T F Shi, H D Qin, S Y Liu
Objective: To investigate the difference of prognostic factors and recurrence rates between papillary thyroid microcarcinoma (PTMC) and lager papillary thyroid carcinoma (PTC) and analyze the clinical pathological characteristics of PTMC suitable for surgery. Methods: A retrospective analysis on the clinicopathological features, expression level of of v-raf murine sarcoma viral oncogene homolog B1 (BRAF) V600E gene mutation and pigment epithelium-derived factor (PEDF), and postoperative follow-up results of the 251 PTC patients who underwent surgical treatment from October 2011 to October 2013, including 169 cases with PTMC and 82 with lager PTC (Tumor diameter>1 cm)...
May 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28534559/-gastric-volvulus-an-infrequent-cause-of-acute-abdominal-pain
#7
D Ruiz-Clavijo García, A Zuñiga Ripa, L Casanova Ortíz, I García de Eulate Martín-Moro, B González de la Higuera Carnicer, J Urman Fernández
Gastric volvulus (GV) is characterized by the abnormal rotation of a portion of the stomach around a horizontal or vertical axis that can cause obstruction, vascular disorder and even strangulation, and may evolve into necrosis or even perforation. It can be classified according to its aetiology into primary or secondary GV, according to its anatomy into axial organ or into axial mesenteric GV, and according to its presentation into chronic or acute GV. Both types of volvulus require treatment; however, in spite of the classic treatment being open surgery, there is no standard treatment, nor is there consensus on the alternative of choice at present...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28534334/-impact-of-neutrophil-to-lymphocyte-ratio-on-the-prognosis-of-patients-with-locally-advanced-colorectal-cancer
#8
Huihong Jiang, Hui Wang, Ajian Li, Erjiang Tang, Ying Chen, Aili Wang, Xiaxing Deng, Moubin Lin
OBJECTIVE: To investigate the impact of neutrophil-to-lymphocyte ratio(NLR) on the prognosis of patients with locally advanced colorectal cancer (LACRC). METHODS: Clinicopathological data of 684 patients with stage II(-III( CRC undergoing radical resection at Shanghai Ruijin Hospital from January 2008 to December 2010 were analyzed retrospectively. NLR was calculated from neutrophil and lymphocyte counts on routine blood tests prior to surgery. The optimal cutoff value of NLR for predicting 5-year overall survival (OS) was determined through receiver operating characteristic (ROC) curve analysis...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28534258/closed-incision-prophylactic-negative-pressure-wound-therapy-in-patients-undergoing-major-complex-abdominal-wall-repair
#9
F E E de Vries, J J Atema, O Lapid, M C Obdeijn, M A Boermeester
PURPOSE: To evaluate if incisional prophylactic negative pressure wound therapy (pNPWT) reduces wound infections and other wound complications in high-risk patients undergoing major complex ventral abdominal wall repair. METHODS: Retrospective before-after comparison nested in a consecutive series of patients undergoing elective major complex abdominal wall repair. Starting January 2014, pNPWT was applied on the closed incisional wound for a minimum of 5 days. To minimize selection bias, we compared two periods of 14 months before and after January 2014...
May 23, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#10
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28534102/circulating-microaggregates-during-cardiac-surgery-precedes-postoperative-stroke
#11
Zühre Uz, Dan M J Milstein, Can Ince, Bastian A J M de Mol
Postoperative stroke and encephalopathy are potentially serious complications associated with coronary artery bypass grafting. In this case report a 78-year-old male patient receiving routine elective cardiac surgery presented with microaggregations in the sublingual microcirculation while on cardiopulmonary bypass that was undetected by routine intraoperative anticoagulation assessment. Microaggregates identified using video microscopy on his sublingual microcirculation during the procedure preceded a stroke postoperatively...
May 22, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28534074/facial-nerve-sparing-surgery-for-large-vestibular-schwannomas
#12
Paolo Ferroli, Lorenzo Bosio, Morgan Broggi
BACKGROUND: Nowadays, there is a general trend in vestibular schwannoma (VS) surgery favoring near-total or subtotal tumor resection (NTR/STR) with facial nerve (FN) function preservation rather than gross total resection (GTR) with high risk of FN damage. METHODS: The surgical technique of FN sparing in large VS includes patient-tailored image-guided craniotomy, continuous intraoperative neurophysiological monitoring (INM), intracapsular wide tumor debulking, and only final extracapsular dissection with FN course identification and brainstem decompression...
May 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28534000/improving-therapeutic-ratios-with-the-oncotype-dx%C3%A2-ductal-carcinoma-in-situ-dcis-score
#13
Nafisha Lalani, Eileen Rakovitch
Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer comprising nearly 25% of breast cancer diagnoses in the mammographic era. Current guidelines recommend breast-conserving surgery followed by adjuvant radiotherapy; however, controversy exists regarding the appropriateness of these recommendations. Some women with DCIS will never recur, which raises the concern of over-treatment. Conversely, a small number of women will develop invasive recurrences, raising concerns of under-treatment. Currently, several clinical and pathologic factors have been identified as prognostic markers for recurrence; however, these variables alone have been unable to identify low-risk and high-risk subgroups...
April 21, 2017: Curēus
https://www.readbyqxmd.com/read/28533874/-cardiac-pseudotumor-revealing-beh%C3%A3-et-s-disease
#14
Fouad Nya, Abdessamad Abdou, Mehdi Bamous, Younes Moutakiallah, Noureddine Atmani, Aniss Seghrouchni, Mahdi Ait Houssa, Abdellatif Boulahya
Intracardiac thrombosis is a rare complication of Behçet's disease (BD), which may manifest as intracardiac tumor. In half of cases, its detection precedes the diagnosis of MB. High mortality rates may be related to post-surgical complications and/or pulmonary arteries involvement. We report the case of a 29-year old young patient, with a previous history of bipolar aphthosis, who underwent surgery after the detection of right atrium and ventricle tumor. Anatomo-pathological examination showed thrombus and MB was diagnosed in the postoperative period...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28533799/definitive-three-dimensional-high-dose-rate-brachytherapy-for-inoperable-endometrial-cancer
#15
Lorena Draghini, Ernesto Maranzano, Michelina Casale, Fabio Trippa, Paola Anselmo, Fabio Arcidiacono, Stefania Fabiani, Marco Italiani, Luigia Chirico, Marco Muti
PURPOSE: To report our experience on high-dose-rate brachytherapy (HDR-BT) in patients with stage I-III endometrial cancer unfit to surgery. MATERIAL AND METHODS: Seventeen patients underwent HDR-BT as definitive treatment. Median age was 79 years (range, 60-95), median Karnofsky performance status 90% (range, 60-100). Histology was endometrial adenocarcinoma in 14 (82%), and non-endometrial in 3 (18%) patients. In 15 (88%) patients, clinical stage was I and in remaining 2 (12%) was III...
April 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28533797/high-dose-rate-interstitial-brachytherapy-for-accelerated-partial-breast-irradiation-trial-results-of-azerbaijan-national-center-of-oncology
#16
Jamil A Aliyev, Isa H Isayev, Kamal S Akbarov, Samir S Qurbanov, Ruslan R Huseynov, Nigar S Aliyeva
PURPOSE: To describe early results of two cohorts of patients with low and intermediate risk of early breast cancer treated with accelerated partial breast irradiation (APBI) using different schedules of multicatheter brachytherapy. MATERIAL AND METHODS: Patients with early stage breast cancer after breast conserving surgery were enrolled for a prospective analysis. The APBI, using multicatheter brachytherapy, was delivered either eight times 4 Gy in five days with a planned total dose of 32 Gy, or seven times 5 Gy in four days with a planned total dose of 35 Gy...
April 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28533485/high-expression-of-fut3-is-linked-to-poor-prognosis-in-clear-cell-renal-cell-carcinoma
#17
Li Meng, Le Xu, Yuanfeng Yang, Lin Zhou, Yuan Chang, Tianming Shi, Cheng Tan, Huimin An, Yu Zhu, Jiejie Xu
BACKGROUND AND PURPOSE: Some of the fucosylation catalyzed by fucosyltransferase-III mediates the epithelial-mesenchymal transition and enhances tumor cell-macrophage signaling, which promotes malignant transforming and immune evasion. The aim of the study was to investigate the association between the expression of fucosyltransferase-III and clinical outcomes of patients with clear-cell renal cell carcinoma after surgery. RESULTS: High fucosyltransferase-III expression was associated with a greater risk of recurrence (p = 0...
May 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28533072/relationship-between-transfusion-of-blood-products-and-the-incidence-of-thrombotic-complications-in-neonates-and-infants-undergoing-cardiac-surgery
#18
David Faraoni, Sirisha Emani, Erin Halpin, Rachel Bernier, Sitaram Emani, James A DiNardo, Juan C Ibla
OBJECTIVES: The authors hypothesized that transfusion of blood products in neonates and infants undergoing high-risk cardiac surgery in the absence of intraoperative coagulation monitoring increases the risk of thrombotic complications. DESIGN: Prospective observational study. SETTING: Neonates and infants undergoing cardiac surgery at a tertiary pediatric center. PARTICIPANTS: Neonates weighing >2.5 kg and infants ≤12 months of age undergoing elective cardiac surgery with cardiopulmonary bypass were included in this prospective observational study...
April 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28533070/maternal-and-paternal-periconceptional-nutrition-as-an-indicator-of-offspring-metabolic-syndrome-risk-in-later-life-through-epigenetic-imprinting-a-systematic-review
#19
REVIEW
Ashley R Dunford, Janice M Sangster
AIMS: This review examined whether maternal and paternal periconceptional nutrition effects an offspring's likelihood of developing chronic metabolic related conditions due to epigenetic imprinting. METHODS: A literature search was conducted in multiple science databases and limited to studies published after 2012, in English language and peer reviewed. The data from selected articles were extracted and a qualitative approach was employed due to heterogeneity of results...
May 10, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28532910/impact-of-elderly-age-on-complications-and-clinical-outcomes-following-anterior-lumbar-interbody-fusion-surgery
#20
Kevin Phan, Vignesh Ramachandran, Tommy Tran, Steven Phan, Prashanth J Rao, Ralph J Mobbs
BACKGROUND: Anterior Lumbar Interbody Fusion (ALIF) is a surgical technique used to treat patients with a variety of lumbar pathologies. Identification of risk factors leading to complication following ALIF surgery may allow surgeons to better judge candidacy and optimize care for high-risk patients. METHODS: A retrospective analysis was conducted on a prospectively collected database of 137 patients who all underwent ALIF surgery by a single primary spine surgeon...
May 19, 2017: World Neurosurgery
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