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Hemoglobin for surgery

Faisal Jehan, Muhammad Khan, Joseph V Sakran, Mohammad Khreiss, Terence O'Keeffe, Albert Chi, Narong Kulvatunyou, Arpana Jain, El Rasheid Zakaria, Bellal Joseph
BACKGROUND: Plasma Hemoglobin A1c (HbA1c) reflects quality of glucose control in diabetic patients. Literature reports that patients undergoing surgery with an elevated HbA1c level are associated with increased postoperative morbidity and mortality. The aim of our study was to evaluate the impact of HbA1c level on outcomes after emergency general surgery (EGS). METHODS: We performed a 3-year analysis of our prospectively maintained EGS database. Patients who had HbA1c levels measured within 3-months before surgery were included...
October 16, 2017: Journal of Trauma and Acute Care Surgery
Lizette F Lopez, Peter D Reaven, Sherman M Harman
Patients with diabetes mellitus are known to have a high risk of postoperative complications, including infections, impaired wound healing, cardiovascular events, venous thromboembolism, and mortality. Because hyperglycemia has been thought to mediate this risk, there is a clinical propensity for improving glycemic control, as assessed by hemoglobin A1c (HbA1c) level, prior to proceeding with elective surgery, particularly joint replacement surgery. However, it is not established whether chronic poor glycemic control, indicated by elevated HbA1c levels, predicts increased risk of postoperative complications...
September 7, 2017: Journal of Diabetes and its Complications
Andras B Fecso, Timothy Samuel, Ahmad Elnahas, Sanjeev Sockalingam, Timothy Jackson, Fayez Quereshy, Allan Okrainec
The purpose of this study was to evaluate the relationship between patient, clinical and laboratory characteristics, and bleeding after bariatric surgery. A retrospective chart review was performed for all patients, who underwent a laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy at our institution between March 2012 and May 2014. In total, 788 patients were included in this study. Seventeen patients had postoperative bleeding. The demographics, comorbidities, and preoperative medications were similar between the groups...
October 11, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Suresh Bhat, Jithin Lal, Fredrick Paul
INTRODUCTION: Percutaneous nephrolithotomy (PCNL) is an effective treatment for renal stones. Due to the significant pain and morbidity after standard PCNL because of nephrostomy tubes, various modifications of PCNL are being performed. We report a randomized trial comparing these modalities. MATERIALS AND METHODS: A total of 75 patients were randomized into three groups of 25 each: standard PCNL with nephrostomy tubes (Group 1), tubeless PCNL with ureteric stent and no nephrostomy (Group 2), and totally tubeless PCNL without ureteric catheter or nephrostomy (Group 3)...
October 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
WenJun Guo, Jie Ding, XiaoJu Jin, GaoJie Li
BACKGROUND: The purpose of this study was to investigate effect of cerebral oxygen saturation (SCTO2) on postoperative nausea and vomiting (PONV) in female patients who underwent laparoscopic surgery. METHODS: This study included 90 female patients who underwent laparoscopic surgery (60 cases of gynecological operations and 30 cases of gallbladder operations). All patients were allocated into 3 groups of 30 patients each: group A (gynecological laparoscopic surgery), group B (gynecological laparoscopic surgery with mannitol treatment) and group C (laparoscopic cholecystectomy surgery)...
October 2017: Medicine (Baltimore)
Catherine Reenaers, Jean-Yves Mary, Maria Nachury, Yoram Bouhnik, David Laharie, Matthieu Allez, Mathurin Fumery, Aurélien Amiot, Guillaume Savoye, Romain Altwegg, Martine Devos, Georgia Malamut, Arnaud Bourreille, Bernard Flourie, Philippe Marteau, Lucine Vuitton, Benoît Coffin, Stéphanie Viennot, Jérôme Lambert, Jean-Frédéric Colombel, Edouard Louis
BACKGROUND & AIMS: Little is known about long-term outcomes of patients with Crohn's disease (CD) after infliximab withdrawal. We aimed to describe the long-term outcomes of patients with CD in clinical remission after infliximab treatment was withdrawn. METHODS: We performed a retrospective analysis of data from the 115 patients included in the infliximab discontinuation in patients with CD in stable remission on combined therapy with anti-metabolites (STORI) study, performed at 20 centers in France and Belgium from March 2006 through December 2009...
October 6, 2017: Clinical Gastroenterology and Hepatology
Yasmin Abu-Ghanem, Dorit E Zilberman, Zohar Dotan, Issac Kaver, Jacob Ramon
BACKGROUND: It has been previously suggested that perioperative blood transfusion (PBT) may induce adverse oncological outcomes following cancer surgery. The aim of the current study is to evaluate the effect of PBT on the prognosis of patients who underwent nephrectomy due to renal cell carcinoma (RCC). METHODS: Study included 1,159 patients who underwent radical nephrectomy or partial nephrectomy (PN) between the years 1987 and 2013. Univariate and multivariate models were used to evaluate the association of PBT with cancer-specific survival (CSS), disease-free survival, and overall survival (OS)...
October 6, 2017: Urologic Oncology
Tiantian Luo, Tingwang Guo, Qian Yang, Shilei Hao, Ju Wang, Zhongjun Cheng, Qing Qu, Ye He, Yuhua Gong, Feiyan Gao, Wenfeng Li, Haijian Xia, Bochu Wang
The role of surgery for most patients with spontaneous intracerebral haemorrhage (ICH) remains controversial due to the continuous occurrence of postoperative iron overload induced by low clot clearance rate. In this study, human hair keratose hydrogel (KG) loading with minocycline hydrochloride (MH) were prepared to reduce iron overload for the improvement of the postoperative functional recovery after ICH aspiration surgery. Hemoglobin-induced iron accumulation in rat primary neuronal culture was delayed by the adsorptive capacity of blank KG, while MH-loaded KG displayed a stronger and more thorough cytoprotective effect than blank KG due to the combined effect of absorptive action to iron and sustained release of the iron chelator...
October 5, 2017: International Journal of Pharmaceutics
Chenzhuo Feng, Bhiken I Naik, Wenjun Xin, Jennie Z Ma, David C Scalzo, Swapna Thammishetti, Robert H Thiele, Zhiyi Zuo, Jacob Raphael
BACKGROUND: Recent studies reported an association between the 2-2 phenotype of haptoglobin (Hp 2-2) and increased cardiorenal morbidity in nonsurgical diabetic patients. Our goal was to determine whether the Hp 2-2 phenotype was associated with acute kidney injury (AKI) after elective cardiac surgery in patients with diabetes mellitus. METHODS AND RESULTS: We prospectively enrolled 99 diabetic patients requiring elective cardiac surgery with cardiopulmonary bypass...
October 5, 2017: Journal of the American Heart Association
Edin Mujagic, Walter R Marti, Michael Coslovsky, Jasmin Zeindler, Sebastian Staubli, Regula Marti, Robert Mechera, Savas D Soysal, Lorenz Gürke, Walter P Weber
BACKGROUND: Routine preoperative blood work is not recommended but selected biochemical markers may predict the risk of surgical site infection (SSI). This study examines the association between preoperative biochemical markers and the risk of SSI. METHODS: This observational cohort study, nested in a randomized controlled trial, was conducted at two tertiary referral centers in Switzerland. RESULTS: 122 (5.8%) of 2093 patients experienced SSI...
September 14, 2017: American Journal of Surgery
Clifford Kent Boese, Leslie Centeno, Ryan W Walters
BACKGROUND: Epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA) are synthetic amino acid derivatives that interfere with fibrinolysis, promoting hemostasis by pharmacological means. Although both drugs have been shown to decrease blood loss with a minimal risk of thromboembolic adverse events following cardiac and vascular surgery, we are aware of only 1 published trial that directly compared the antifibrinolytic effects of EACA with those of TXA after total knee arthroplasty (TKA)...
October 4, 2017: Journal of Bone and Joint Surgery. American Volume
Nattaphorn Hongsawong, Prapimdaw Khamdee, Suchaya Silvilairat, Wattana Chartapisak
BACKGROUND: Cyanotic nephropathy (CN), seen in 30-50% of patients with congenital cyanotic heart disease (CCHD), affects both tubular and glomerular function, resulting in proteinuria and azotemia. Microalbuminuria is an early marker for glomerular damage and an independent predictor of progressive renal disease. METHODS: A cross-sectional study was conducted. A total of 116 patients aged 1 month to 15 years with CCHD at Chiang Mai University Hospital between 2015 and 2016 were assessed and 94 patients were enrolled...
October 2, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Gustavus Lemos Ribeiro Melo, Daniel Souza Lages, João Lopo Madureira Junior, Guilherme de Paula Pellucci, João Wagner Junqueira Pellucci
OBJECTIVES: There is still no consensus as to the best form and dosages of use of tranexamic acid. The aim of this study was to evaluate the use of tranexamic acid in total hip arthroplasty, in order to reduce blood loss and decrease hemoglobin, taking into account different administration protocols. METHODS: 42 patients submitted to total hip arthroplasty were divided into three groups. The study was prospective and randomized. Group 1 received a venous dose of tranexamic acid of 15 mg/kg, 20 min prior to bolus incision...
2017: Revista Brasileira de Ortopedia
Ailin Mazuita Mazlan, Yasmin Ayob, Abd Rahim Hussein, Thiru Kumar Namasiwayam, Wan Mohd Zahiruddin Wan Mohammad
CONTEXT: Coronary artery bypass graft (CABG) operation is associated with high frequency of allogeneic blood transfusion due to the acquired hemostatic challenges in patients undergoing CABG. However, allogeneic blood transfusion carries risks of infection, adverse reaction, and mortality as well as prolonged hospital stay and increased hospital cost. It is important to identify patients who require blood transfusion to mitigate their risk factors and reduce the chance of exposure to allogeneic blood...
July 2017: Asian Journal of Transfusion Science
Shahram Gooran, Mohammad Reza Khajavi, Amir Javid, Sanaz Dehghani, Elnaz Kheiri, Ali Mohammad Fakhr Yaseri, Gholamreza Pourmand
OBJECTIVE: Our objective was to investigate vein blood gas levels in the transplanted kidney during surgery as a predictive factor for delayed graft function after renal transplant. MATERIALS AND METHODS: Sixty patients with renal transplant were enrolled in our study from January 2015 to January 2016. After vessels were declamped posttransplant, blood samples from the transplanted kidney veins were taken and acidosis and oxygenation in these samples were measured...
September 30, 2017: Experimental and Clinical Transplantation
Chen-Yu Chen, Re-Wen Wu, Mei-Chi Hsu, Ching-Jung Hsieh, Man-Chun Chou
PURPOSE: The purpose of this study was to compare the effect of standard wound care with adjunctive hyperbaric oxygen therapy (HBOT) to standard wound care alone on wound healing, markers of inflammation, glycemic control, amputation rate, survival rate of tissue, and health-related quality of life in patients with diabetic foot ulcers (DFUs). DESIGN: Prospective, randomized, open-label, controlled study. SUBJECTS AND SETTING: The sample comprised 38 patients with nonhealing DFUs who were deemed poor candidates for vascular surgery...
September 29, 2017: Journal of Wound, Ostomy, and Continence Nursing
Xin-Yi Liao, Shan-Shan Zuo, Wen-Tong Meng, Jie Zhang, Qin Huang, Da-Ming Gou
BACKGROUND: Intraoperative blood salvage (IBS) recovers most lost blood, and is widely used in the clinic. It is unclear why IBS does not reduce long-term postoperative requirements for red blood cells (RBCs), and 1 possibility is that IBS affects RBC lifespan. METHODS: Prospectively enrolled patients who underwent spine, pelvic, or femur surgery not involving allogeneic RBC transfusion were grouped based on whether they received IBS or not. Volumes of blood lost and of RBCs salvaged during surgery were recorded...
September 2017: Medicine (Baltimore)
Gerardo Sarno, Aristide Ferrara, Vincenzo Cerbone, Enrico Russo, Daniela Vicedomini, Paride De Rosa
A 62-year-old male patient with diabetes underwent deceased-donor kidney transplant at our transplant unit. At reperfusion, a small and clinically not significant subcapsular hematoma was noted. The patient's postoperative course was characterized by delayed graft function since the beginning but was further complicated on postoperative day 6 by evidence (shown at daily Doppler ultrasonography) of a wide increase of the hematoma. The hematoma, which was just visible before, was now leading to graft compression because it covered up to two-thirds of the cortical surface...
September 26, 2017: Experimental and Clinical Transplantation
Ahmet Kale, Bahar Sarıibrahim, Gülfem Başol
BACKGROUND: The aim of this study was to evaluate the feasibility, safety, and early postoperative outcomes of hysterectomies and salpingo-oophorectomies using transvaginal natural orifice transluminal endoscopic surgery (vNOTES). MATERIALS AND METHODS: The women undergoing vNOTES hysterectomies and salpingo-oophorectomies at a tertiary referral medical center between April 2016 and April 2017 were retrospectively analyzed. In all of the vNOTES procedures, a handmade glove port system comprised of a glove-wound retractor NOTES port was used...
September 23, 2017: International Journal of Surgery
Xiao-Shuai Gao, Bang-Hua Liao, Yun-Tian Chen, Shi-Jian Feng, Rang Gao, De-Yi Luo, Jia-Ming Liu, Kun-Jie Wang
PURPOSE: Miniaturized percutaneous nephrolithotomy (MPCNL) including mini-PCNL, ultra-mini-PCNL and micro-PCNL have been developed recently. The aim of this meta-analysis was to compare the safety and efficacy of different tract sizes of MPCNL with retrograde intrarenal surgery (RIRS) in the management of kidney stones. MATERIALS AND METHODS: We searched PubMed, Embase and Web of Science to identify case control trials (CCTs) and randomized controlled trials (RCTs) which evaluated MPCNL versus RIRS before February 2017...
September 26, 2017: Journal of Endourology
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