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Pre operative assessment

Henry T Peng, Catherine Tenn, Oshin Vartanian, Shawn G Rhind, Jerzy Jarmasz, Homer Tien, Andrew Beckett
Introduction: Tactical Combat Casualty Care (TCCC) training imposes psychophysiological stress on medics. It is unclear whether these stress levels vary with the training modalities selected. It is also unclear how stress levels could have an impact on medical performance and skill uptake. Materials and Methods: We conducted a pilot study to compare the effects of live tissue (LT) with a high-fidelity patient simulator (SIM) on the level of stress elicited, performance, and skill uptake during battlefield trauma training course in an operating room (OR) and in a simulated battlefield scenario (field)...
March 14, 2018: Military Medicine
Minako Shimizu, Shigehiro Doi, Ayumu Nakashima, Takayuki Naito, Takao Masaki
PURPOSE: This study examined the clinical significance of N-terminal pro brain natriuretic peptide level as a cardiac marker in Japanese hemodialysis patients. METHODS: This was a multicenter cross-sectional study involving 1428 Japanese hemodialysis patients. Ultrasonic cardiography data at post-hemodialysis were obtained from 395 patients. We examined whether serum N-terminal pro brain natriuretic peptide levels were associated with cardiac parameters and assessed cut-off values and investigated factors associated with a reduced ratio of N-terminal pro brain natriuretic peptide levels pre- and post-hemodialysis...
March 2018: International Journal of Artificial Organs
Asad Zaman Khan, Aslam Khan, Arshad Naseem
OBJECTIVE: To assess the safety of percutaneous tracheostomy when performed by physician intensivists. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Adult Medical ICU in the Department of Critical Care Medicine, Military Hospital, Rawalpindi, Pakistan, from September 2013 to August 2016. METHODOLOGY: Departmental record for percutaneous tracheostomies, performed by physician intensivifts, was evaluated...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Marcus J Colby, Brian Dawson, Peter Peeling, Jarryd Heasman, Brent Rogalski, Michael K Drew, Jordan Stares
OBJECTIVES: To assess the effect of multiple high risk scenario (HRS) exposures on non-contact injury prediction in elite Australian footballers. DESIGN: Retrospective cohort study. METHODS: Sessional workload data (session-rating of perceived exertion; GPS-derived distance, sprint distance, maximum velocity) from one club (n= 60 players) over 3 seasons were collated; several established HRS were also defined. Accumulated HRS sessional exposures were calculated retrospectively (previous 1-8 weeks)...
March 15, 2018: International Journal of Sports Physiology and Performance
Samuel J Yang, Marc Berndl, D Michael Ando, Mariya Barch, Arunachalam Narayanaswamy, Eric Christiansen, Stephan Hoyer, Chris Roat, Jane Hung, Curtis T Rueden, Asim Shankar, Steven Finkbeiner, Philip Nelson
BACKGROUND: Large image datasets acquired on automated microscopes typically have some fraction of low quality, out-of-focus images, despite the use of hardware autofocus systems. Identification of these images using automated image analysis with high accuracy is important for obtaining a clean, unbiased image dataset. Complicating this task is the fact that image focus quality is only well-defined in foreground regions of images, and as a result, most previous approaches only enable a computation of the relative difference in quality between two or more images, rather than an absolute measure of quality...
March 15, 2018: BMC Bioinformatics
Manuel Cappellari, Gianni Turcato, Stefano Forlivesi, Fabio Bagante, Gianfranco Cervellin, Giuseppe Lippi, Bruno Bonetti, Paolo Bovi, Danilo Toni
Background and purpose The nomogram is an important component of modern medical decision-making, which calculates the probability of an event entirely based on individual characteristics. We aimed to develop and validate a nomogram for individualized prediction of the probability of unfavorable outcome in intravenous thrombolysis-treated stroke patients included in the large multicenter Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register. Methods All patients registered in the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register by 179 Italian centers between May 2001 and March 2016 were originally included...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Wei Wang, Xiao-le He, Xu-Sheng Li
OBJECTIVE: To evaluate the manipulation technique and clinical outcome of Tri-Lock bone preservation stem for acetabular protrusion combined with shorten defect of femoral head and neck. METHODS: From January 2013 to December 2015, 10 patients(12 hips) with acetabular protrusion combined with shorten defect of femoral head and neck were treated with total hip arthroplasty(THA) including 5 males and 5 female with an average age of(51.6±3.0) years old ranging from 42...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Sara A Hayes, James Huang, Jennifer Golia Pernicka, Jane Cunningham, Junting Zheng, Chaya S Moskowitz, Michelle S Ginsberg
BACKGROUND: The aim of this study was to assess pre-operative computed tomography (CT) characteristics of thymic carcinomas and to investigate which features could predict an incomplete surgical resection. A secondary aim was to correlate pre-operative imaging features with Masaoka stage. METHODS: In this study, approved by our Institutional Review Board, two readers retrospectively reviewed pre-operative CTs at our tertiary referral oncology center between 1994 and 2014...
March 10, 2018: Annals of Thoracic Surgery
D A Friedlander, W W Ludwig, J R Jayman, A Akhavan
INTRODUCTION: Endoscopic injection of a bulking agent is a common first-line approach to the treatment of vesicoureteral reflux (VUR). While early outcomes are comparable to open ureteroneocystotomy, 5-25% of children will eventually develop recurrent reflux necessitating repeat injections or open ureteral reimplantation. OBJECTIVE: To determine whether prior endoscopic injection of a bulking agent impacts outcomes of subsequent open ureteral reimplantation. STUDY DESIGN: Using a retrospective cohort design, radiographic and clinical outcomes of open ureteral reimplantation were compared between patients with and without prior endoscopic correction of reflux...
March 1, 2018: Journal of Pediatric Urology
Micheál O'Mahony
Food safety risk assessment in the European Union (EU) recognises consumer illness that arises from marine biotoxins as a risk associated with bivalve mollusc consumption. EU food regulations contain various general food safety obligations, which should contribute significantly to managing this risk. EU food regulations additionally impose various specific obligations on both Food Business Operators and Competent Authorities in order to manage the marine biotoxin food safety risk in the bivalve mollusc food-chain...
March 10, 2018: Toxins
Zhong-Yang Gao, Hui Song, Yu-Huan Li, Peng-Rong Ouyang, Yi-Bin Wang, Xi-Jing He
OBJECTIVE: To study the change trend of cervical range of motion(ROM) after single-level anterior cervical corpectomy and fusion(ACCF) in treating cervical spondylotic myelopathy. METHODS: The clinical data of 23 patients with cervical spondylotic myelopathy was retrospectively analyzed from February 2015 to April 2016. There were 11 males and 12 females, with an average age of (54.6±13.3) years. All the patients were diagnosed as cervical spondylotic myelopathy by interrogation, physical examination and radiology, and were treated by ACCF...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Joshua L Chan, Justin G Miller, Mandy Murphy, Ann Greenberg, Peggy Iraola, Keith A Horvath
BACKGROUND: Prolonged intubation following cardiac surgery is associated with significant morbidity. A fast-track extubation protocol primarily driven by bedside providers was instituted for all postoperative cardiac surgery patients to facilitate safe and expeditious extubation. METHODS: A retrospective review of 1581 cardiac surgery patients over an 8-year period was performed. Prior to 2011, non-protocolized standard perioperative management was utilized (n=807)...
March 9, 2018: Annals of Thoracic Surgery
Bernadette Brown, Jane Young, David P Smith, Andrew B Kneebone, Andrew J Brooks, Sam Egger, Miranda Xhilaga, Amanda Dominello, Dianne L O'Connell, Mary Haines
BACKGROUND: This study assessed whether a theoretically conceptualised tailored intervention centred on multidisciplinary teams (MDTs) increased clinician referral behaviours in line with clinical practice guideline recommendations. METHODS: Nine hospital Sites in New South Wales (NSW), Australia with a urological MDT and involvement in a state-wide urological clinical network participated in this pragmatic stepped wedge, cluster randomised implementation trial...
March 12, 2018: Implementation Science: IS
Ugo de Luca, Giovanni Mangia, Simonetta Tesoro, Ascanio Martino, Maria Sammartino, Alessandro Calisti
The Italian Society of Pediatric Surgery (SICP) together with The Italian Society of Pediatric Anesthesia (SARNePI) through a systematic analysis of the scientific literature, followed by a consensus conference held in Perugia on 2015, have produced some evidence based guidelines on the feasibility of day surgery in relation to different pediatric surgical procedures. The main aspects of the pre-operative assessment, appropriacy of operations and discharge are reported.
March 12, 2018: Italian Journal of Pediatrics
Peter J Lee, Amareshwar Podugu, Dong Wu, Arier C Lee, Tyler Stevens, John A Windsor
BACKGROUND: Controversy remains about the best pre-operative management of jaundice in patients with resectable pancreatic head cancer (RPC) undergoing planned pancreaticoduodenectomy (PD). OBJECTIVE: The aim of this study was to compare rates of post-operative complications in patients undergoing four pre-operative approaches (POA): preoperative biliary drainage with plastic stent (PBD-PS), metal stent (PBD-MS), and percutaneous transhepatic drain (PBD-PT), or no pre-operative biliary drainage (NPBD)...
March 8, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Himabindu Mikkilineni, Patricia B Delzell, Jack Andrish, Jennifer Bullen, Nancy A Obuchowski, Naveen Subhas, Joshua M Polster, Jean P Schils
BACKGROUND: We sought to determine whether there are ultrasound parameters that differ between knees with symptomatic fat pad synovial impingement and asymptomatic knees. METHODS: A prospective study was performed in patients with clinical signs and symptoms of fat pad synovial impingement and asymptomatic controls. Eleven symptomatic knees and 10 asymptomatic controls were evaluated. Ultrasound imaging was performed before and after exercise. Evaluated parameters included largest fat lobule compressibility, subjective assessment of vascularity, largest vessel diameter, and subjective assessment of dynamic fat pad motion during flexion and extension...
March 7, 2018: Knee
Vincent Johan Nijenhuis, Joyce Peper, Veronique M M Vorselaars, Martin J Swaans, Thom De Kroon, Jan A S Van der Heyden, Benno J W M Rensing, Robin Heijmen, Willem-Jan W Bos, Jurrien M Ten Berg
Transcatheter aortic valve implantation (TAVI) is associated with acute kidney injury (AKI), but can also improve the kidney function (IKF). We assessed the effects of kidney function changes in relation to baseline kidney function on 2-year clinical outcomes after TAVI. In total, 639 consecutive patients with aortic stenosis who underwent TAVI were stratified into 3 groups according to the ratio of serum creatinine post- to pre-TAVI: IKF (≤0.80; n = 95 [15%]), stable kidney function (0.80 to 1.5; n = 477 [75%]), and AKI (≥1...
February 12, 2018: American Journal of Cardiology
Maha A Bahammam
OBJECTIVE: This prospective randomized clinical trial was conducted to determine whether the application of a platelet-rich fibrin (PRF) palatal bandage after harvesting free gingival grafts (FGG) would improve healing of donor sites and decrease pain scores and patient discomfort. MATERIALS AND METHODS: Twenty-four patients received FGG to augment keratinized tissue dimensions. The application of a PRF bandage was decided randomly (n = 12 in each group). Patients reported their pain levels for the first 7 days of healing using the visual analog scale (VAS), 101-point numerical rating scale (NRS-101), and 4-point verbal rating scale (VRS-4)...
March 9, 2018: Clinical Oral Investigations
Nampet Jampathong, Malinee Laopaiboon, Siwanon Rattanakanokchai, Porjai Pattanittum
BACKGROUND: Prognostic models have been increasingly developed to predict complete recovery in ischemic stroke. However, questions arise about the performance characteristics of these models. The aim of this study was to systematically review and synthesize performance of existing prognostic models for complete recovery in ischemic stroke. METHODS: We searched journal publications indexed in PUBMED, SCOPUS, CENTRAL, ISI Web of Science and OVID MEDLINE from inception until 4 December, 2017, for studies designed to develop and/or validate prognostic models for predicting complete recovery in ischemic stroke patients...
March 9, 2018: BMC Neurology
Bin Tang, Limin Xiao, Shenhao Xie, Guanlin Huang, Zhigang Wang, Dongwei Zhou, Erming Zeng, Tao Hong
OBJECTIVES: Removal of recurrent or residual symptomatic craniopharyngiomas is more challenging than the primary surgery. The extended endoscopic endonasal (EEE) approach has been proposed an alternative surgical route for removal of various suprasellar tumors including craniopharyngiomas currently. In this study, we summarized the operative experience and described the feasibility and advantages of this technique in recurrent or residual symptomatic craniopharyngiomas. PATIENTS AND METHODS: A retrospective review of 15 patients (9 males and 6 females) whom underwent EEE approach between April 2012 and February 2017, were included in this study...
February 6, 2018: Clinical Neurology and Neurosurgery
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