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https://www.readbyqxmd.com/read/27932888/preoperative-risk-factors-in-total-thyroidectomy-of-substernal-goiter
#1
Aldo Bove, Raffaella Maria Di Renzo, Gauro D'Urbano, Manuela Bellobono, Vincenzo D' Addetta, Alfonso Lapergola, Giuseppe Bongarzoni
The definition of substernal goiter (SG) is based on variable criteria leading to a considerable variation in the reported incidence (from 0.2% to 45%). The peri- and postoperative complications are higher in total thyroidectomy (TT) for SG than that for cervical goiter. The aim of this study was to evaluate the preoperative risk factors associated with postoperative complications. From 2002 to 2014, 142 (8.5%; 98 women and 44 men) of the 1690 patients who underwent TT had a SG. We retrospectively evaluated the following parameters: sex, age, histology, pre- and retrovascular position, recurrence, and extension beyond the carina...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27932196/a-mini-volume-loading-test-mvlt-using-2-5-mlkg-1-boluses-of-crystalloid-for-indication-of-perioperative-changes-in-hydration-status
#2
Audrius Andrijauskas, Christer H Svensen, Narūnas Porvaneckas, Jūratė Šipylaitė, Edgaras Stankevičius, Darius Činčikas, Valentinas Uvarovas, Saulė Švedienė, Igoris Šatkauskas, Saulius Vosylius, Giedrius Kvederas
BACKGROUND AND OBJECTIVE: A mini volume loading test (mVLT) evaluating hemodilution during step-wise crystalloid infusion has established that the arterio-capillary plasma dilution difference is inversely correlated to the body hydration level of subjects. This observational study aimed to test whether this can be replicated in a perioperative setting using a 2.5-mLkg(-1) boluses. MATERIALS AND METHODS: The mVLT was performed before induction of regional anesthesia and 24h later...
November 25, 2016: Medicina
https://www.readbyqxmd.com/read/27931879/the-role-of-immunonutritional-support-in-cancer-treatment-current%C3%A2-evidence
#3
REVIEW
Isabel Prieto, Sara Montemuiño, Javier Luna, Maria Victoria de Torres, Enrique Amaya
The significant role of the immune system in cancer treatment has given rise to an emerging field of study within oncology, and one that is attracting increasing attention from researchers. Immunotherapy has demonstrated that the immune system is crucial in the fight against cancer. This challenge has led researchers to analyze whether the immune influencing capacity of immunonutrition may aid in improving immune status, modulate the acquired immune response, decrease the treatment toxicity and improve patient outcomes...
November 24, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27931648/haemodynamic-coherence-in-perioperative-setting
#4
REVIEW
Andrea Carsetti, Ximena Watson, Maurizio Cecconi
Over the last decade, there has been an increased interest in the use of goal-directed therapy (GDT) in patients undergoing high-risk surgery, and various haemodynamic monitoring tools have been developed to guide perioperative care. Both the complexity of the patient and surgical procedure need to be considered when deciding whether GDT will be beneficial. Ensuring optimum tissue perfusion is paramount in the perioperative period and relies on the coherence between both macrovascular and microvascular circulations...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931320/constant-rate-infusion-of-dexmedetomidine-to-manage-thiopental-anesthesia-during-intracranial-surgery-in-cynomolgus-macaques-macaca-fascicularis
#5
Noemi Romagnoli, Alessandra Buonacucina, Carlotta Lambertini, Domenico Ventrella, Angelo Peli
Macaques (Macaca spp.) are often used as animal models in biomedical research involving a neurosurgical approach. The development of new anesthetic techniques is pivotal for these studies. Studies in human anesthesia for intracranial surgery have shown that dexmedetomidine infusion reduces the incidence of cardiocirculatory complications in the perioperative period, reduces the need for supplemental analgesia, and provides an analgesic effect analogous to that of remifentanil. Data regarding the anesthetic effects of dexmedetomidine infusion in NHP including Macaca spp...
November 2016: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/27928966/hot-topics-in-perioperative-antibiotics-for-cataract-surgery
#6
Patrycja Kuklo, Andrzej Grzybowski, Stephen G Schwartz, Harry W Flynn, Avinash Pathengay
BACKGROUND: Acute-onset postoperative endophthalmitis is an uncommon but potentially serious complication of cataract surgery. Since there are relatively few randomized clinical trials comparing the timing and administration of prophylactic antibiotics, there are wide variations in prevention practices around the world. METHODS: Literature review. RESULTS: Antibiotics may be used before surgery, during surgery, or after surgery in an attempt to decrease the rates of endophthalmitis...
December 7, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27928584/endovascular-management-of-infected-femoral-artery-pseudoaneurysms-in-high-risk-patients-a-case-series
#7
Mario D'Oria, Giada Sgorlon, Cristiano Calvagna, Francesca Zamolo, Stefano Chiarandini, Roberto Adovasio, Filippo Griselli
We report our experience with the urgent treatment of two high-risk patients with infected femoral artery pseudoaneurysms (IFAPs) with the placement of a self-expandable covered stent (SECS). In both cases, there was no perioperative mortality and the aneurysm exclusion was successful without early or late stent thrombosis/stent fracture nor acute or chronic limb ischemia or limb loss. There was no recurrence of local or systemic infection during the follow-up period. Endovascular therapy represents a feasible treatment option for IFAPs in those patients for whom the risk of open surgical repair would be prohibitive, especially under urgent circumstances...
December 7, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27927660/effect-of-prehabilitation-in-gastro-oesophageal-adenocarcinoma-study-protocol-of-a-multicentric-randomised-control-trial-the-prehab-study
#8
Bertrand Le Roy, Bruno Pereira, Corinne Bouteloup, Frédéric Costes, Ruddy Richard, Marie Selvy, Caroline Pétorin, Johan Gagnière, Emmanuel Futier, Karem Slim, Bernard Meunier, Jean-Yves Mabrut, Christophe Mariette, Denis Pezet
INTRODUCTION: Perioperative chemotherapy is the gold standard treatment of the resectable gastro-oesophageal adenocarcinoma. However, 70% of patients cannot receive the complete sequence because of a postoperative complication or a decrease in functional and nutritional reserves. Recently, a new concept appeared in digestive surgery: prehabilitation. This interventional process consists of patient preparation, between surgical consultation and surgery, and is based on 3 components: (1) physical management, (2) nutritional care and (3) psychological care...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27927518/removal-of-infected-posterior-spinal-implants-be-prepared-to-transfuse
#9
Lindsay M Andras, Elizabeth R A Joiner, Kira Skaggs, Liam R Harris, Alexander M Broom, Amy Williams, David L Skaggs
STUDY DESIGN: Single-center retrospective review of spinal deformity patients undergoing removal of infected posterior spinal fusion implants over a 10-year period. OBJECTIVE: To evaluate the intraoperative blood loss and perioperative complications of implant removal in posterior spinal fusions. SUMMARY OF BACKGROUND DATA: To our knowledge, no studies examine blood loss or complications associated with removal of infected spinal implants in spinal deformity...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27925241/vertebral-subluxation-repair-in-a-pet-goat
#10
Sara Nannarone, Enrico Bellezza, Yves P Moens, Paula Larenza Menzies
OBJECTIVES: To describe the perioperative management, including surgery, anesthesia, metabolic derangements, and physiotherapy, in a goat referred for paraparesis secondary to a road traffic accident. STUDY DESIGN: Case report. ANIMALS: 2-year-old mixed breed dwarf 44 kg female pet goat. METHODS: Clinical examination showed symptoms of early compensatory stages of shock, paraparesis with hyperextension of the thoracic limbs, pain on palpation of the thoracolumbar spine, increased patellar reflexes of both pelvic limbs without superficial sensitivity, but preserved deep pain sensation...
December 7, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27922894/antimicrobial-prophylaxis-practice-patterns-in-breast-augmentation-a-national-survey-of-current-practice
#11
Karan Chopra, Arvind U Gowda, Colton H L McNichols, Emile N Brown, Sheri Slezak, Yvonne Rasko
BACKGROUND: Breast augmentation is one of the most commonly performed aesthetic surgery procedures worldwide. Bacterial contamination is of paramount concern due to its role in biofilm formation and capsular contracture. Plastic surgeons have adopted a variety of perioperative interventions in efforts to reduce implant contamination, however definitive evidence supporting these practices is lacking. OBJECTIVE: The goal of this study was to assess current practice patterns aimed at reducing implant-related infections in breast augmentation and comparing them to current evidence-based medicine recommendations...
December 5, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27922026/percutaneous-gastrostomy-device-for-the-treatment-of-class-ii-and-class-iii-obesity-results-of-a-randomized-controlled-trial
#12
Christopher C Thompson, Barham K Abu Dayyeh, Robert Kushner, Shelby Sullivan, Alan B Schorr, Anastassia Amaro, Caroline M Apovian, Terrence Fullum, Amir Zarrinpar, Michael D Jensen, Adam C Stein, Steven Edmundowicz, Michel Kahaleh, Marvin Ryou, J Matthew Bohning, Gregory Ginsberg, Christopher Huang, Daniel D Tran, Joseph P Glaser, John A Martin, David L Jaffe, Francis A Farraye, Samuel B Ho, Nitin Kumar, Donna Harakal, Meredith Young, Catherine E Thomas, Alpana P Shukla, Michele B Ryan, Miki Haas, Heidi Goldsmith, Jennifer McCrea, Louis J Aronne
OBJECTIVES: The AspireAssist System (AspireAssist) is an endoscopic weight loss device that is comprised of an endoscopically placed percutaneous gastrostomy tube and an external device to facilitate drainage of about 30% of the calories consumed in a meal, in conjunction with lifestyle (diet and exercise) counseling. METHODS: In this 52-week clinical trial, 207 participants with a body-mass index (BMI) of 35.0-55.0 kg/m(2) were randomly assigned in a 2:1 ratio to treatment with AspireAssist plus Lifestyle Counseling (n=137; mean BMI was 42...
December 6, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27921016/use-of-dexmedetomidine-and-esmolol-for-hypotension-in-lumbar-spine-surgery
#13
Ovais Nazir, Mushtaq Ahmad Wani, Nadeem Ali, Tarun Sharma, Amit Khatuja, Rajesh Misra, Mehreen Maqsood
BACKGROUND: The importance of decreasing bleeding in spine surgery is not only important to maintain the patient's hemodynamic balance but also allow a better view of the surgical field. OBJECTIVES: The current study aimed to compare dexmedetomidine and Esmolol™ as agents to induce hypotension in lumbar spine surgeries. PATIENTS AND METHODS: A total of 50 patients aged 20 to 65 years belonging to the American society of anaesthesiologist (ASA) class I - II scheduled for decompression and fixation of the lumbar spine were included and divided into two groups namely, Group I, who received Esmolol and group II, who received dexmedetomidine, intravenously...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27920230/troubleshooting-for-bleeding-in-thoracoscopic-anatomic-pulmonary-resection
#14
Hitoshi Igai, Mitsuhiro Kamiyoshihara, Takashi Ibe, Natsuko Kawatani, Fumi Osawa, Ryohei Yoshikawa
INTRODUCTION: The objective of this study was to evaluate intraoperative vessel injury and assess troubleshooting during thoracoscopic anatomic pulmonary resection. METHODS: Between April 2012 and March 2016, 240 patients underwent thoracoscopic anatomic lung resection, 26 of whom were identified as having massive bleeding intraoperatively. We analyzed the injured vessel and the hemostatic procedure employed, then compared the perioperative outcomes in patients with (n = 26) and without (n = 214) vessel injury...
December 5, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27919277/a-study-of-long-term-complications-associated-with-enteral-ostomy-and-their-contributory-factors
#15
Umesh Jayarajah, Asuramuni M P Samarasekara, Dharmabandhu N Samarasekera
BACKGROUND: Complications of ostomy significantly affect the quality of life of ostomates. There is little evidence on the rate of long-term complications in ostomates, especially from the developing countries which include Sri Lanka. This study was aimed to describe the long-term complications of enteral ostomies and their contributory factors. METHODS: A retrospective analysis was carried out on 192 patients who underwent ostomy creation over a period of 5 years...
December 5, 2016: BMC Research Notes
https://www.readbyqxmd.com/read/27916380/contemporary-outcomes-of-open-thoracoabdominal-aneurysm-repair-functional-status-is-the-strongest-predictor-of-perioperative-mortality
#16
Tammam Obeid, Caitlin W Hicks, Kanhua Yin, Isibor Arhuidese, Besma Nejim, Arman Kilic, James H Black, Mahmoud Malas
BACKGROUND: Open repair of thoracoabdominal and descending thoracic aneurysm (TAA) carries significant operative morbidity and mortality. Despite evolving operative techniques patient-level risk factors affecting mortality after open TAA repair, including patient functional status, remain to be fully understood. MATERIALS AND METHODS: We identified all open TAA repair cases in the National Surgical Quality Improvement Program database between 2005 and 2013. Multivariable logistic regression was used to evaluate the effect of patients' age, gender, race, body mass index (BMI), comorbid conditions, functional status, ASA class, smoking, rupture, descending thoracic aneurysm versus Crawford types, dissection, and preoperative: transfusion, creatinine levels, on perioperative (30-d) mortality after open TAA repair...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916222/acute-amiodarone-pulmonary-toxicity-after-surgical-procedures
#17
REVIEW
Jirapat Teerakanok, Pakpoom Tantrachoti, Phumpattra Chariyawong, Kenneth Nugent
Amiodarone can cause toxicity in several organs, including amiodarone-induced pulmonary toxicity which is a subacute or chronic complication. Amiodarone-induced acute respiratory distress syndrome (ARDS) in postoperative patients is a rare acute complication. The PubMed and Google Scholar databases were searched. Seven retrospective and prospective case series and 10 case reports of amiodarone-induced postoperative ARDS were reviewed. All patients received amiodarone chronically or during the perioperative period...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27916073/-perioperative-safety-analysis-of-carotid-endarterectomy-in-diabetic-patients
#18
X N Liu, L Ni, W D Wang, R Zeng, C W Liu
Objective: To compare perioperative outcome of carotid endarterectomy (CEA) between diabetic and non-diabetic patients and discuss the safety of CEA in diabetic patients. Methods: A total of 572 patients with carotid stenosis who underwent CEA from Juanuary 2006 to September 2014 in Peking Union Medical Colloge Hospital were collected and analyzed retrospectively. The patients were distributed into diabetes mellitus (DM) group and non-DM group according to the comorbidities. Their baseline characteristics, intraoperative index and major complications in perioperative period were analyzed and compared...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27916041/-progress-of-perioperative-goal-directed-fluid-therapy-on-prognosis-of-patients
#19
J Zhao, Y H Yu
Fluid therapy is an important part of perioperative period, also one of the most controversial issues. Having reviewed the relevant research in recent years as well as the large-scale meta-analysis, the perioperative goal-directed fluid therapy has been discussed from the aspects of evaluating indicators, new methods and latest progress, and the impact on the prognosis. It manifests that the development of goal-directed fluid therapy makes a better prognosis than traditional fluid therapy, therefore it has also became an important perioperative treatment strategy...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27916031/-experience-of-the-selection-and-maintainence-for-donor-lung-62-cases-attached
#20
G L Peng, X Xu, D X Huang, B Wei, D Xiao, W Wang, Y D Wang, J X He
Objective: To summarize the experience of selection and maintainence for the lungs from donation. Methods: From January 2015 to June 2016, 62 cases had been evaluated by Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University. All the clinic data had been collected to evaluate the donor lungs, including the basic information, physical examination, results of radiology and laboratory, the bronchoscope, etc. All the satisfactory donors had been harvested and transplanted to the receipient and then follow up...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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