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https://www.readbyqxmd.com/read/29353319/management-strategies-for-noncardiac-surgery-following-a-coronary-artery-event
#1
REVIEW
Thomas F Whayne, Sibu P Saha
PURPOSE OF REVIEW: Coronary artery event includes acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery. Following such an event, risk of noncardiac surgery is increased. Of major concern is what can make this surgery safer? RECENT FINDINGS: High functional capacity improves cardiovascular (CV) risk; at least 4.0 metabolic equivalents (METs) on stress test are favorable. Risk scores can suggest need for further evaluation...
January 20, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29351595/propensity-matched-comparison-between-minimally-invasive-and-conventional-sternotomy-in-aortic-valve-resuspension
#2
Nadejda Monsefi, Petar Risteski, Aleksandra Miskovic, Andreas Zierer, Anton Moritz
OBJECTIVES: The aim of the study was to compare the results of David procedure through conventional or minimally invasive approach. METHODS: A propensity-matched comparison in patients undergoing a minimally invasive (partial upper sternotomy, n = 103) or complete sternotomy (n = 103) David procedure from 1991 to 2016 was performed. Patients were 57 ± 14 years old on average in both groups. The David technique was modified by generating a neosinus (P < 0...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29349988/-comparison-of-analgesic-effects-between-multimodal-and-patient-controlled-intravenous-analgesia-in-patients-with-rheumatoid-arthritis-in-the-perioperative-period-of-total-knee-arthroplasty
#3
Hua-Li Gao, Lian-Bo Xiao, Wei-Tao Zhai, Yong He, Fei Zhu, Lin Zheng, Xiu-Wei Han
OBJECTIVE: To compare the analgesic effect between multimodal and patient-controlled intravenous analgesia(PCIA) in patients with rheumatoid arthritis(RA) in the perioperative period of knee joint replacement. METHODS: From June 2015 to June 2016, 40 RA patients undergoing total knee arthroplasty were randomly divided into two groups. There were 20 patients in PCIA group, including 3 males and 17 females, with an average age of(59.6±2.3) years old, who received controlled instillation of sufentanil analgesia controlled by an intravenous analgesia pump...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29346684/comparing-cortical-trajectory-transforaminal-lumbar-interbody-fusions-against-pedicle-trajectory-transforaminal-lumbar-interbody-fusions-and-posterolateral-fusions-a-retrospective-cohort-study-of-90-day-outcomes
#4
James G Malcolm, Michael K Moore, Falgun H Choksh, Faiz U Ahmad, Daniel Refai
BACKGROUND: The cortical screw (CS) trajectory for pedicle screw placement is believed to require a smaller incision and less tissue dissection resulting in lower blood loss and faster healing; however, this has not yet been confirmed in clinical studies. OBJECTIVE: To compare CS transforaminal lumbar interbody fusions (TLIF), traditional pedicle screw (TPS) trajectory TLIFs, and posterolateral fusion (PLF) without interbody for differences in operative characteristics and complications...
January 13, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29346608/on-demand-intraoperative-3-dimensional-printing-of-custom-cranioplastic-prostheses
#5
Alexander I Evins, John Dutton, Sayem S Imam, Amal O Dadi, Tao Xu, Du Cheng, Philip E Stieg, Antonio Bernardo
BACKGROUND: Currently, implantation of patient-specific cranial prostheses requires reoperation after a period for design and formulation by a third-party manufacturer. Recently, 3-dimensional (3D) printing via fused deposition modeling has demonstrated increased ease of use, rapid production time, and significantly reduced costs, enabling expanded potential for surgical application. Three-dimensional printing may allow neurosurgeons to remove bone, perform a rapid intraoperative scan of the opening, and 3D print custom cranioplastic prostheses during the remainder of the procedure...
January 13, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29345162/genetic-defect-of-a-combined-17-%C3%AE-hydroxylase-17-20-lyase-deficiency-patient-with-adrenal-crisis
#6
Yunqiang Zhang, Xuyin Zhang, Yiqun Wang, Keqin Hua, Jingxin Ding
Combined 17 α-hydroxylase/17,20-lyase deficiency (17OHD) is a rare autosomal recessive disease that is a type of congenital adrenal hyperplasia, which results in hypertension, hypokalemia, sexual infantilism, primary amenorrhea in females (46,XX), or pseudohermaphroditism in males (46,XY). It is mainly caused by mutation in the CYP17A1 gene, which encodes a key enzyme in the steroidogenic pathway. However, these patients rarely experience adrenal crisis, due to abnormally high corticosterone levels. Here, we report a 17OHD patient who experienced clinical adrenal crisis on day 1 after gonadectomy...
January 18, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29344822/novel-oral-anticoagulants-in-the-preoperative-period-a-meta-analysis
#7
Hua He, Bingbing Ke, Yan Li, Fuheng Han, Xiaodong Li, Yujie Zeng
The purpose of this study is to evaluate the efficacy and safety of novel oral anticoagulant (NOAC) versus warfarin therapy in patients undergoing different operations. We performed a systematic review of MEDLINE, EMBASE, Cochrane Controlled Trials Register, and reports presented at scientific meetings. The efficacy and safety of NOACs during the perioperative period was compared to that using warfarin. Of the 2652 studies initially reviewed, we identified 9 that included 15,880 patients for the meta-analysis...
January 17, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29343076/high-loading-dose-of-atorvastatin-for-the-prevention-of-serum-creatinine-and-cystatin-c-based-contrast-induced-nephropathy-following-percutaneous-coronary-intervention
#8
Naikuan Fu, Min Liang, Shicheng Yang
The aim of this study is to assess the efficacy of high-dose atorvastatin on the prevention of contrast-induced nephropathy (CIN) in patients with acute coronary syndrome (ACS) undergoing percutaneous intervention and observe the incidence of cystatin C (CyC)-based CIN. A total of 496 patients with ACS were randomly assigned to either the control group (247 patients receiving conventional dose atorvastatin 10 mg daily from 1 day before to 3 days after contrast administration) or the high-dose atorvastatin group (249 patients receiving atorvastatin 40 mg daily for the same perioperative period)...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29343024/-hypopituitarism-mode-in-patients-with-craniopharyngioma-in-relation-to-tumor-growth-pattern
#9
S T Qi, J X Peng, J Pan, J Fan, S C Zhang, Y Liu, Y Bao, B H Qiu, X Y Wu
Objective: To investigate the pituitary hormone changes of patients with craniopharyngioma of different growth patterns during perioperative period and follow up time. Methods: Retrospective studies were performed on 212 cases of primary craniopharyngioma patient who received total tumor excision surgery in our hospital from January 2001 to May 2012. The characteristics of pituitary hormone and associated clinical manifestation during preoperative, perioperative and postoperative periods were analyzed according to the QST surgical classification...
January 2, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29340818/changes-in-plasma-albumin-levels-in-early-detection-of-infectious-complications-after-laparoscopic-colorectal-cancer-surgery-with-eras-protocol
#10
Mateusz Wierdak, Magdalena Pisarska, Beata Kuśnierz-Cabala, Jan Witowski, Jadwiga Dworak, Piotr Major, Piotr Małczak, Piotr Ceranowicz, Andrzej Budzyński, Michał Pędziwiatr
BACKGROUND: Combination of laparoscopic approach with ERAS protocol in colorectal surgery allows for an early discharge. However there is a risk that some of the discharged patients are developing, asymptomatic at the time, infectious complications. This may lead to a delay in diagnostics and proper treatment introduction. We aimed to assess the usefulness of preoperative plasma albumin concentration and their changes as indicators of infectious complications in patients undergoing colorectal cancer surgery...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29339545/perioperative-implementation-of-noninvasive-positive-airway-pressure-therapies
#11
REVIEW
David R Hillman, Carla R Jungquist, Dennis Auckley
Noninvasively applied positive airway pressure therapy (PAP) is available in 3 basic modes: continuous positive airway pressure (CPAP), bi-level positive airway pressure (BPAP), and adaptive servo-ventilation. These are in widespread use in home and hospital settings to treat a variety of disorders of ventilation or gas exchange, including obstructive sleep apnea, sleep-related hypoventilation, periodic breathing, acute and chronic hypercapnic respiratory failure, and acute respiratory failure. They are increasingly being used perioperatively to prevent or treat upper airway obstruction, hypoventilation, and periodic breathing, and they have been found to improve postoperative outcomes in the case of obstructive sleep apnea...
January 16, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29339015/ambicor-2-piece-inflatable-penile-prosthesis-who-and-how
#12
George A Abdelsayed, Laurence A Levine
BACKGROUND: Currently the Ambicor is the only 2-piece inflatable penile prosthesis (IPP) available in the United States. By eliminating the separate reservoir, this provides certain advantages for patient and surgeon. Nevertheless, it composes a small percentage of all IPPs implanted in the United States. AIM: To detail the surgical technique for implantation, describe the ideal patient candidates best suited for the Ambicor, and discuss the most common and some rare complications with a review of the available published literature in combination with our clinical experience...
January 12, 2018: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29337771/outcomes-of-closed-versus-open-defects-after-local-excision-of-rectal-neoplasms-a-multi-institutional-matched-analysis
#13
Lawrence Lee, Ashley Althoff, Kimberley Edwards, Matthew R Albert, Sam B Atallah, Iain A Hunter, James Hill, John R T Monson
BACKGROUND: The management of the rectal wall defect after local excision of rectal neoplasms remains controversial, and the existing data are equivocal. OBJECTIVE: This study aimed to determine the effect of open versus closed defects on postoperative outcomes after local excision of rectal neoplasms. DESIGN: Data from 3 institutions were analyzed. Propensity score matching was performed in one-to-one fashion to create a balanced cohort comparing open and closed defects...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29335811/surgical-stress-response-and-promotion-of-metastasis-in-colorectal-cancer-a-complex-and-heterogeneous-process
#14
Corina Behrenbruch, Carolyn Shembrey, Sophie Paquet-Fifield, Christina Mølck, Hyun-Jung Cho, Michael Michael, Benjamin N J Thomson, Alexander G Heriot, Frédéric Hollande
Surgery remains the curative treatment modality for colorectal cancer in all stages, including stage IV with resectable liver metastasis. There is emerging evidence that the stress response caused by surgery as well as other perioperative therapies such as anesthesia and analgesia may promote growth of pre-existing micro-metastasis or potentially initiate tumor dissemination. Therapeutically targeting the perioperative period may therefore reduce the effect that surgical treatments have in promoting metastases, for example by combining β-adrenergic receptor antagonists and cyclooxygenase-2 (COX-2) inhibitors in the perioperative setting...
January 15, 2018: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/29334334/mortality-after-endovascular-treatment-of-infrarenal-abdominal-aortic-aneurysms-the-newer-the-better
#15
Aspasia Tzani, Ilias P Doulamis, Ioannis Katsaros, Eirini Martinou, Dimitrios Schizas, Konstantinos P Economopoulos
Although endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) presents a delicate alternative treatment for abdominal aortic aneurysms (AAA) with lower perioperative mortality, its long-term efficacy remains a matter of concern. The purpose of this study was to evaluate the currently reported mortality evidence after EVAR and to examine the possible effect of aneurysm status and the study period on mortality rates. The PubMed and Cochrane bibliographical databases were thoroughly searched for studies reporting on more than 1 000 patients with non-ruptured or ruptured infrarenal AAA, treated with EVAR from August 1991 to September 2016...
January 15, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29333531/patient-reported-outcome-measures-prom-as-a-preoperative-assessment-tool
#16
Sunghye Kim, Pamela W Duncan, Leanne Groban, Hannah Segal, Rica Moonyeen Abbott, Jeff D Williamson
Aim of review: Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. Methods: Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades...
November 28, 2017: Journal of anesthesia and perioperative medicine
https://www.readbyqxmd.com/read/29332428/the-effectiveness-of-preoperative-preparation-for-improving-perioperative-outcomes-in-children-and-caregivers
#17
Chia-Jung Lin, Hsin-Ping Liu, Pei-Ya Wang, Mei-Hua Yu, Mei-Chun Lu, Ling-Yu Hsieh, Tzu-Chia Lin
Most children experience significant anxiety during the preoperative period. Greater preoperative anxiety may be related to a higher incidence of negative behaviors. This study aimed to develop a family-centered preoperative preparation program and to evaluate the effects of this program on children's preoperative emotional behaviors, postoperative behavior, and posthospital behavior, and on caregiver anxiety. A prospective, randomized controlled study was conducted. The population consisted of children who underwent minor surgery and their caregivers...
January 1, 2018: Behavior Modification
https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#18
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
January 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29332215/heparin-coated-grafts-reduce-mortality-in-pediatric-patients-receiving-systemic-to-pulmonary-shunts
#19
Adeel Ashfaq, Mohammad S Soroya, Amit Iyengar, Myke Federman, Brian L Reemtsen
We aimed to evaluate the outcomes of systemic-to-pulmonary (SP) shunt procedures utilizing heparin-coated (HC) polytetrafluoroethylene (PTFE) vascular grafts compared to uncoated (non-HC) grafts, in order to observe any benefits in pediatric patients. Our institution switched from using non-HC grafts to HC grafts in March 2011. We conducted a retrospective review of consecutive pediatric patients receiving SP shunts from May 2008 to December 2015. Perioperative variables including baseline characteristics, morbidity, mortality, and blood product utilization were evaluated between the HC and non-HC groups...
January 13, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29331007/anaesthetic-management-of-nesidioblastosis-in-two-infants
#20
Muhammad Saad Yousuf, Mohsin Nazir Butt, Fauzia Anis Khan
Nesidioblastosis is the most common cause of non-transient, recurrent and persistent hypoglycaemia in neonates and infants. It is a disorder of diffuse proliferation of beta cells of the pancreas leading to hyperinsulinemia and hypoglycaemia. The main aim is to prevent the severe episodes of hypoglycaemia which can cause damage to the brain and/or mental retardation. In this case report we present two cases of nesidioblastosis and their perioperative anaesthetic course for near-total pancreatectomy. First case was a 7 months old female who had repeated episodes of convulsions since birth...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
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