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https://www.readbyqxmd.com/read/28930045/antibiotic-use-among-older-adults-on-an-acute-care-general-surgery-service
#1
André S Pollmann, Jon G Bailey, Philip J B Davis, Paul M Johnson
BACKGROUND: Antibiotics play an important role in the treatment of many surgical diseases that affect older adults, and the potential for inappropriate use of these drugs is high. Our objective was to describe antibiotic use among older adults admitted to an acute care surgical service at a tertiary care teaching hospital. METHODS: Detailed data regarding diagnosis, comorbidities, surgery and antibiotic use were retrospectively collected for patients 70 years and older admitted to an acute care surgical service...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929609/benchmarking-against-the-national-emergency-laparotomy-audit-recommendations
#2
Yiu Ming Ho, Julie Cappello, Ramin Kousary, Brian McGowan, Arkadiusz P Wysocki
BACKGROUND: The Royal College of Anaesthetists published the National Emergency Laparotomy Audit (NELA) to describe and compare inpatient care and outcomes of major emergency abdominal surgery in England and Wales in 2015 and 2016. The purpose of this article is to compare emergency abdominal surgical care and mortality in a regional hospital (Logan Hospital, Queensland, Australia) with NELA results. METHODS: Data were extracted from two databases. All deaths from May 2010 to April 2015 were reviewed and patients who had an emergency abdominal operation within 30 days of death were identified...
September 19, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28929279/effectiveness-and-safety-of-combined-cataract-surgery-and-microhook-ab-interno-trabeculotomy-in-japanese-eyes-with-glaucoma-report-of-an-initial-case-series
#3
Masaki Tanito, Yoshifumi Ikeda, Etsuko Fujihara
PURPOSE: To report the early postoperative results and safety profile of ab interno microhook trabeculotomy (μLOT) combined with cataract surgery. PATIENTS AND METHODS: This retrospective observational case series included 68 consecutive glaucomatous eyes of 23 Japanese men and 25 Japanese women [mean (SD) age, 76.0 ± 8.5 years] who underwent μLOT for intraocular pressure (IOP) and visually relevant cataracts. The LOT site/extent, perioperative complications, and complication treatments were collected from the medical and surgical records...
September 19, 2017: Japanese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28928880/in-surgical-colon-cancer-patients-extended-duration-thromboprophylaxis-30-days-with-the-highest-dose-of-tinzaparin-4-500-iu-s-c-q-d-normalizes-the-postoperative-vegf-levels
#4
Michail Mitsis, Panagiotis Koliou, Christina Bali, Evangelia Ntounousi, Vasileios Tatsis, Vasileios Nousias, Georgios D Lianos, Georgios Vartholomatos, Dimitrios Nastos
Background/Purpose: In colon cancer (CC) patients preoperative (pre-op) levels of VEGF-A165 (VEGF) is a strong predictor for disease recurrence. Elevated postoperative (post-op) VEGF levels could have undesirable effects by enhancing tumor growth and metastasis formation. It has been suggested that thromboprophylaxis with a Low Molecular Weight Heparin (LMWH) in surgical cancer patients, further to thromboembolic protection, may exert some anti-neoplastic properties, as well. The aim of our study was to assess the potential impact of the LMWH Tinzaparin (Innohep® - Leo Pharma, Copenhagen, Denmark), given at different doses and for different perioperative (peri-op) periods, upon the post-op variability of serum VEGF levels in surgical CC patients...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#5
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928011/perioperative-therapies-enhancing-the-impact-of-cancer-surgery-with-repurposed-drugs
#6
EDITORIAL
Pan Pantziarka, Gauthier Bouche, Richard Sullivan, André M Ilbawi, Anna J Dare, Lydie Meheus
Surgical resection remains the major modality for modern curative treatment for solid tumours. However, post-surgical recurrence, even following clear-margin resection and adjuvant treatment, remains common in many types of cancer. Reducing recurrence rates, therefore, offers the potential to increase cure rates and increase overall survival. Perioperative therapies, simple interventions during the perioperative period, are designed to address some of the factors which influence post-surgical recurrence. A range of perioperative therapies are introduced and the rationale for further clinical investigation outlined...
September 7, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#7
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28925860/pharmacologic-and-perioperative-considerations-for-antihypertensive-medications
#8
Sher-Lu Pai, Ryan M Chadha, Joan M Irizarry Alvarado, Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: As the prevalence of hypertension continues to increase, physicians routinely encounter patients preoperatively receiving one or more cardiovascular medications to manage hypertension. Thus, the physician's knowledge of perioperative antihypertensive medication management is crucial to ensure patient safety. OBJECTIVE: We discuss the decisions to continue or stop antihypertensive medications to reduce the risk of perioperative complications. METHOD: We conducted a review of the original research studies, review articles, and editorials present on PubMed within the past 60 years...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28923097/impact-of-perioperative-nutritional-status-on-the-outcome-of-abdominal-surgery-in-a-sub-saharan-africa-setting
#9
Christian Gael Mambou Tebou, Mazou N Temgoua, Agnès Esiene, Blondel Oumarou Nana, Jean Jacques Noubiap, Eugène Sobngwi
BACKGROUND: Malnutrition is a clinical condition of multifactorial etiologies and it is associated with several adverse outcomes. In high-income countries, malnutrition has been described as a determinant of delayed wound healing, surgical site infections and mortality in the postoperative period. There is limited information available regarding the outcome of surgery in malnourished patients in sub-Saharan Africa. METHODS: A cross-sectional analytic study was carried out between March and August 2014 in the visceral surgery and the emergency departments of the Yaounde Central Hospital in Cameroon...
September 18, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28922235/perioperative-inflammation-and-its-modulation-by-anesthetics
#10
Jan Rossaint, Alexander Zarbock
Surgery and other invasive procedures, which are routinely performed during general anesthesia, may induce an inflammatory response in the patient. This inflammatory response is an inherent answer of the body to the intervention and can be both beneficial and potentially harmful. The immune system represents a unique evolutionary achievement equipping higher organisms with an effective defense mechanism against exogenous pathogens. However, not only bacteria might evoke an immune response but also other noninfectious stimuli like the surgical trauma or mechanical ventilation may induce an inflammatory response of varying degree...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28922231/use-of-regional-anesthesia-for-outpatient-surgery-within-the-united-states-a-prevalence-study-using-a-nationwide-database
#11
Rodney A Gabriel, Brian M Ilfeld
BACKGROUND: Regional anesthesia is of benefit for outpatient surgery given its demonstrated improvement in analgesia and decrease in complications, resulting in shorter average recovery room times and lower hospital readmission rates. Unfortunately, there are few epidemiological studies outlining the overall utilization of peripheral nerve blocks (PNBs) in this setting. Therefore, the primary objective of this study was to report the overall utilization of several types of PNBs among all candidate cases in the outpatient setting within the United States...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28921676/perioperative-passport-empowering-people-with-diabetes-along-their-surgical-journey
#12
E Page, F Akiboye, S Jackson, C Kerry, R Round, G Rayman
AIM: To determine whether a handheld 'perioperative passport' could improve the experience of perioperative care for people with diabetes and overcome some of the communication issues commonly identified in inpatient extracts. METHODS: Individuals with diabetes undergoing elective surgery requiring at least an overnight stay were identified via a customized information technology system. Those allocated to the passport group were given the perioperative passport before their hospital admission...
September 18, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28921522/extraluminal-biodegradable-splint-to-treat-upper-airway-anterior-malacia-a-preclinical-proof-of-principle
#13
François Gorostidi, Cécile Courbon, Marco Burki, Antoine Reinhard, Kishore Sandu
OBJECTIVE: Upper airway malacia highly complicates the treatment of benign laryngotracheal stenosis, and no ideal option is available to date. We here explore the use of extraluminal biodegradable splints in an animal model of long-segment anterior tracheomalacia (TM). We show the efficacy, as well as the tissue tolerance, of a custom-made biodegradable extraluminal device surgically inserted around the trachea. STUDY DESIGN: Preclinical animal study. METHODS: Anterior TM was induced in rabbits through an anterior neck approach by removing eight consecutive anterior tracheal rings without damaging the underlying mucosa...
September 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28919320/is-selective-echocardiography-in-duodenal-atresia-the-future-standard-of-care
#14
Abid Khan, Sharman Tan Tanny, Elizabeth J Perkins, Rodney W Hunt, John M Hutson, Sebastian K King, Bryn Jones, Warwick J Teague
BACKGROUND: Duodenal atresia (DA) is associated with cardiac defects that may have perioperative care implications. Standard preoperative care includes echocardiography to identify such cardiac defects, but this dogma has been challenged. We aimed to assess selective and selective strategies for preoperative echocardiography in DA patients. METHODS: Single-center retrospective review of neonates with DA over a 16-year period was performed. Data included preoperative cardiovascular and respiratory examination, chest x-ray, and echocardiography...
September 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28919097/j-pouch-vs-side-to-end-anastomosis-after-hand-assisted-laparoscopic-low-anterior-resection-for-rectal-cancer-a-prospective-randomized-trial-on-short-and-long-term-outcomes-including-life-quality-and-functional-results
#15
Nuri Okkabaz, Mustafa Haksal, Ali Emre Atici, Yunus Emre Altuntas, Ersin Gundogan, Fazli Cem Gezen, Mustafa Oncel
PURPOSE: To analyze the outcomes of j-pouch and side-to-end anastomosis in rectal cancer patients treated with laparoscopic hand-assisted low anterior resection. METHODS: Prospective trial on cases randomized to have a colonic j-pouch or a side-to-end anastomosis after low anterior resection. Demographics, characteristics of disease and treatment, perioperative results, and functional outcomes and life quality were compared between the groups. RESULTS: Seventy four patients were randomized...
September 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28917401/pseudophakic-cystoid-macular-edema-and-spectral-domain-optical-coherence-tomography-detectable-central-macular-thickness-changes-with-perioperative-prostaglandin-analogs
#16
Andrew Walkden, Louise F Porter, Jiten Morarji, Simon P Kelly, Evangelos Sioras
PURPOSE: To define the incidence of cystoid macular edema (CME) and spectral-domain optical coherence tomography-detectable (SD-OCT) subclinical changes in central retinal thickness in patients using prostaglandin analog (PGA) eyedrops after phacoemulsification. SETTING: Manchester Royal Eye Hospital, Manchester, United Kingdom. DESIGN: Prospective case series. METHODS: A consecutive analysis of the incidence of postoperative CME after phacoemulsification by a single surgeon was performed in eyes of patients using PGA eyedrops between March 2010 and January 2014...
August 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28916866/laparoscopic-versus-open-parenchymal-preserving-liver-resections-in-the-posterosuperior-segments-a-case-matched-study
#17
Mathieu D'Hondt, Esther Tamby, Isabelle Boscart, Simon Turcotte, Isabelle Parmentier, Hans Pottel, Réal Lapointe, Sander Ovaere, Franky Vansteenkiste, Franck Vandenbroucke-Menu
BACKGROUND: Patients with lesions in the posterosuperior (PS) segments of the liver have been considered poor candidates for laparoscopic liver resection (LLR). This study aims to compare short-term outcomes of LLR and open liver resections (OLR) in the PS segments. METHODS: This multicenter study consisted of all patients who underwent LLR in the PS segments and all patients who underwent OLR in the PS segments between October 2011 and July 2016. Laparoscopic cases were case-matched with those who had an identical open procedure during the same period based on tumor location (same segment) and the Brisbane classification of the resection...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28915203/treatment-of-zenker-s-diverticulum-with-endoscopic-stapled-esophago-divertisculostomy-esd-analysis-of-long-term-outcome
#18
Michele Mazza, Alberto N Bergamini, Paolo Parise, Andrea Cossu, Olga Adamenko, Ugo Elmore, Riccardo Rosati
BACKGROUND: Endoscopic Zenker diverticulum (ZD) treatment has become quite common because of the low complication rates, reduced procedure time, and shorter hospital stay. Many endoscopic treatments are available including the endoscopic stapled esophago-diverticulostomy (ESD). Many data regarding ESD are available on the short-term outcomes, but few on the long-term ones. MATERIALS AND METHODS: From March 1998 to July 2016, 126 patients with ZD were candidate for ESD...
September 14, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28914976/haloperidol-versus-5-ht3-receptor-antagonists-for-postoperative-vomiting-and-qtc-prolongation-a-noninferiority-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#19
REVIEW
Preet Mohinder Singh, Anuradha Borle, Jeetinder Kaur Makkar, Anjan Trikha, David Fish, Ashish Sinha
Haloperidol is an antipsychotic with well-known antiemetic potential. It is underutilized for postoperative nausea vomiting due to reported corrected QT interval (QTc) prolongation. This meta-analysis evaluates its safety and efficacy as an antiemetic in the perioperative period. Trials comparing haloperidol to 5-HT3 -receptor antagonists (5-HT3 -RA) for 24 postoperative vomiting incidences published up to May 2017 were searched in the medical database. Comparisons were made for antiemetic efficiency variables (vomiting incidence, rescue antiemetic need, and patients with complete response) during early (until 6 hours) and late postoperative phases...
September 15, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28913787/mortality-rates-and-risk-factors-for-emergent-open-repair-of-abdominal-aortic-aneurysms-in-the-endovascular-era
#20
Felice Pecoraro, Steffen Gloekler, Caecilia E Mader, Malgorzata Roos, Lyubov Chaykovska, Frank J Veith, Neal S Cayne, Nicola Mangialardi, Thomas Neff, Mario Lachat
The background of this paper is to report the mortality at 30 and 90 days and at mean follow-up after open abdominal aortic aneurysms (AAA) emergent repair and to identify predictive risk factors for 30- and 90-day mortality. Between 1997 and 2002, 104 patients underwent emergent AAA open surgery. Symptomatic and ruptured AAAs were observed, respectively, in 21 and 79% of cases. Mean patient age was 70 (SD 9.2) years. Mean aneurysm maximal diameter was 7.4 (SD 1.6) cm. Primary endpoints were 30- and 90-day mortality...
September 14, 2017: Updates in Surgery
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