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Pre operative risk stratification

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https://www.readbyqxmd.com/read/28607592/the-role-of-adjuvant-chemotherapy-for-colorectal-liver-metastasectomy-after-pre-operative-chemotherapy-is-the-treatment-worthwhile
#1
Yun Wang, Zhi-Qiang Wang, Feng-Hua Wang, Yun-Fei Yuan, Bin-Kui Li, Pei-Rong Ding, Gong Chen, Xiao-Jun Wu, Zhen-Hai Lu, Zhi-Zhong Pan, De-Sen Wan, Peng Sun, Shu-Mei Yan, Rui-Hua Xu, Yu-Hong Li
Peri-operative chemotherapy has been proposed to improve the survival of patients with colorectal cancer hepatic metastases (CRCHM). However, the role of the adjuvant chemotherapy post-metastasectomy for CRCHM patients who have undergone pre-operative chemotherapy is still undetermined. We retrospectively analyzed the role of adjuvant chemotherapy post-metastasectomy on relapse-free survival (RFS) and overall survival (OS) in 163 CRCHM patients who received pre-operative chemotherapy using a Kaplan-Meier curve and univariate/multiple Cox model...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28559660/mean-platelet-volume-as-a-predictor-of-heart-failure-related-hospitalizations-in-stable-heart-failure-outpatients-with-sinus-rhythm
#2
Hakki Kaya, Mustafa Kutay Yıldırımlı, Recep Kurt, Osman Beton, Mehmet Birhan Yilmaz
BACKGROUND: In this study, we investigated the relationship between the mean platelet volume (MPV) with mortality and heart failure (HF)-related hospitalization in stable chronic HF outpatients with reduced ejection fraction (HFrEF) and with sinus rhythm (SR). METHODS: This retrospective cohort study included 197 consecutive stable chronic HFrEF outpatients with SR, who were admitted to our cardiology outpatient clinics for examination between January 2014 and January 2015...
May 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28552279/a-retrospective-study-multivariate-logistic-regression-analysis-of-the-outcomes-after-pressure-sores-reconstruction-with-fasciocutaneous-myocutaneous-and-perforator-flaps
#3
Yu-Jen Chiu, Wen-Chieh Liao, Tien-Hsiang Wang, Yu-Chung Shih, Hsu Ma, Chih-Hsun Lin, Szu-Hsien Wu, Cherng-Kang Perng
BACKGROUND: Despite significant advances in medical care and surgical techniques, pressure sore reconstruction is still prone to elevated rates of complication and recurrence. We conducted a retrospective study to investigate not only complication and recurrence rates following pressure sore reconstruction but also preoperative risk stratification. METHODS: This study included 181 ulcers underwent flap operations between January 2002 and December 2013 were included in the study...
April 23, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28543544/the-prognostic-utility-of-the-tumor-burden-score-based-on-preoperative-radiographic-features-of-colorectal-liver-metastases
#4
Kazunari Sasaki, Georgios A Margonis, Nikolaos Andreatos, Xu-Feng Zhang, Stefan Buettner, Jaeyun Wang, Amar Deshwar, Jin He, Christopher L Wolfgang, Matthew Weiss, Timothy M Pawlik
BACKGROUND: Recently, a tumor-burden "metro ticket" score (TBS) based on final pathology was proposed to predict outcome following resection of colorectal liver metastasis (CRLM). We sought to validate the TBS prognostic tool using preoperative radiologic cross-sectional imaging. METHODS: Imaging TBS was defined on a Cartesian plane that incorporated both maximum tumor size (x-axis) and lesion number (y-axis) assessed by pre-operative imaging. The discriminatory power (area under the curve [AUC]) and goodness-of-fit (Harrel's C statistic and Somer's D statistics) of the imaging TBS model was assessed...
May 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28542740/plasma-micrornas-as-biomarkers-of-pancreatic-cancer-risk-in-a-prospective-cohort-study
#5
Eric J Duell, Leila Lujan-Barroso, Núria Sala, Samantha Deitz McElyea, Kim Overvad, Anne Tjonneland, Anja Olsen, Elisabete Weiderpass, Lill-Tove Busund, Line Moi, David Muller, Paolo Vineis, Dagfinn Aune, Giuseppe Matullo, Alessio Naccarati, Salvatore Panico, Giovanna Tagliabue, Rosario Tumino, Domenico Palli, Rudolf Kaaks, Verena A Katzke, Heiner Boeing, H B As Bueno-de-Mesquita, Petra H Peeters, Antonia Trichopoulou, Pagona Lagiou, Anastasia Kotanidou, Ruth C Travis, Nick Wareham, Kay-Tee Khaw, Jose Ramon Quiros, Miguel Rodríguez-Barranco, Miren Dorronsoro, María-Dolores Chirlaque, Eva Ardanaz, Gianluca Severi, Marie-Christine Boutron-Ruault, Vinciane Rebours, Paul Brennan, Marc Gunter, Ghislaine Scelo, Greg Cote, Stuart Sherman, Murray Korc
Noninvasive biomarkers for early pancreatic ductal adenocarcinoma (PDAC) diagnosis and disease risk stratification are greatly needed. We conducted a nested case-control study within the Prospective Investigation into Cancer and Nutrition (EPIC) cohort to evaluate prediagnostic microRNAs (miRs) as biomarkers of subsequent PDAC risk. A panel of eight miRs (miR-10a, -10b, -21-3p, -21-5p, -30c, -106b, -155 and -212) based on previous evidence from our group was evaluated in 225 microscopically confirmed PDAC cases and 225 controls matched on center, sex, fasting status and age/date/time of blood collection...
May 19, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#6
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28511024/cardiopulmonary-exercise-testing-and-surgery
#7
Paul O Older, Denny Zh Levett
The surgical patient population is increasingly elderly and comorbid and poses challenges to perioperative physicians. Accurate pre-operative risk stratification is important to direct perioperative care. Reduced aerobic fitness is associated with increased post-operative morbidity and mortality. Cardiopulmonary exercise testing is an integrated and dynamic test that gives an objective measure of aerobic fitness or functional capacity and identifies the cause of exercise intolerance. Cardiopulmonary exercise testing provides an individualized estimate of patient risk that can be used to predict post-operative morbidity and mortality...
May 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#8
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28494887/preoperative-risk-stratification-of-critically-ill-patients
#9
Curtis C Copeland, Andrew Young, Tristan Grogan, Eilon Gabel, Anahat Dhillon, Vadim Gudzenko
STUDY OBJECTIVE: Risk assessment historically emphasized cardiac morbidity and mortality in elective, outpatient, non-cardiac surgery. However, critically ill patients increasingly present for therapeutic interventions. Our study investigated the relationship of American Society of Anesthesiologists (ASA) class, revised cardiac risk index (RCRI), and sequential organ failure assessment (SOFA) score with survival to discharge in critically ill patients with respiratory failure. DESIGN: Retrospective cohort analysis over a 21-month period...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28491887/risk-factors-for-surgical-site-infection-after-cholecystectomy
#10
David K Warren, Katelin B Nickel, Anna E Wallace, Daniel Mines, Fang Tian, William J Symons, Victoria J Fraser, Margaret A Olsen
BACKGROUND: There are limited data on risk factors for surgical site infection (SSI) after open or laparoscopic cholecystectomy. METHODS: A retrospective cohort of commercially insured persons aged 18-64 years was assembled using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure or Current Procedural Terminology, 4th edition codes for cholecystectomy from December 31, 2004 to December 31, 2010. Complex procedures and patients (eg, cancer, end-stage renal disease) and procedures with pre-existing infection were excluded...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28488754/virtual-endovascular-treatment-of-intracranial-aneurysms-models-and-uncertainty
#11
REVIEW
Ali Sarrami-Foroushani, Toni Lassila, Alejandro F Frangi
Virtual endovascular treatment models (VETMs) have been developed with the view to aid interventional neuroradiologists and neurosurgeons to pre-operatively analyze the comparative efficacy and safety of endovascular treatments for intracranial aneurysms. Based on the current state of VETMs in aneurysm rupture risk stratification and in patient-specific prediction of treatment outcomes, we argue there is a need to go beyond personalized biomechanical flow modeling assuming deterministic parameters and error-free measurements...
May 10, 2017: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
https://www.readbyqxmd.com/read/28458732/does-the-timing-of-pre-operative-medical-evaluation-influence-perioperative-total-hip-arthroplasty-outcomes
#12
Roy H Lan, Atul F Kamath
BACKGROUND: Medical evaluation pre-operatively is an important component of risk stratification and potential risk optimization. However, the effect of timing prior to surgical intervention is not well-understood. We hypothesized that total hip arthroplasty (THA) patients seen in pre-operative evaluation closer to the date of surgery would experience better perioperative outcomes. METHODS: We retrospectively reviewed 167 elective THA patients to study the relationship between the number of days between pre-operative evaluation (range, 0-80 days) and surgical intervention...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28454636/carotid-artery-disease-and-perioperative-stroke-risk-after-surgical-aortic-valve-replacement-a-nationwide-inpatient-sample-analysis
#13
Reshmi Udesh, Amol Mehta, Thomas Gleason, Parthasarathy D Thirumala
To study the role of carotid stenosis (CS) and cerebrovascular disease as independent risk factors for perioperative stroke following surgical aortic valve replacement (SAVR). The National Inpatient Sample (NIS) database was used for our study. All patients who underwent SAVR from 1999 to 2011 were identified using ICD-9 codes. Univariate and multivariate analysis of baseline characteristics, Elixhauser comorbidities and other covariates were examined to identify independent predictors of perioperative strokes following SAVR...
April 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28415003/less-favourable-prognosis-for-low-risk-endometrial-cancer-patients-with-a-discordant-pre-versus-post-operative-risk-stratification
#14
F A Eggink, C H Mom, K Bouwman, D Boll, J H Becker, C L Creutzberg, G C Niemeijer, W J van Driel, A K Reyners, A G van der Zee, G L Bremer, N P Ezendam, R F Kruitwagen, J M Pijnenborg, H Hollema, H W Nijman, M A van der Aa
BACKGROUND: Pre-operative risk stratification based on endometrial sampling determines the extent of surgery for endometrial cancer (EC). We investigated the concordance of pre- and post-operative risk stratifications and the impact of discordance on survival. METHODS: Patients diagnosed with EC within the first 6 months of the years 2005-2014 were selected from the Netherlands Cancer Registry (N = 7875). Pre- and post-operative risk stratifications were determined based on grade and/or histological subtype for 3784 eligible patients...
April 14, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28402740/patients-at-high-risk-for-surgical-site-infection
#15
Krislynn M Mueck, Lillian S Kao
BACKGROUND: Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-operative management to optimize outcomes. METHODS: Review of the pertinent English-language literature. RESULTS: High-risk surgical patients may be identified on the basis of individual risk factors or combinations of factors...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28400169/combined-clinical-parameters-and-multiparametric-magnetic-resonance-imaging-for-advanced-risk-modeling-of-prostate-cancer-patient-tailored-risk-stratification-can-reduce-unnecessary-biopsies
#16
Jan Philipp Radtke, Manuel Wiesenfarth, Claudia Kesch, Martin T Freitag, Celine D Alt, Kamil Celik, Florian Distler, Wilfried Roth, Kathrin Wieczorek, Christian Stock, Stefan Duensing, Matthias C Roethke, Dogu Teber, Heinz-Peter Schlemmer, Markus Hohenfellner, David Bonekamp, Boris A Hadaschik
BACKGROUND: Multiparametric magnetic resonance imaging (mpMRI) is gaining widespread acceptance in prostate cancer (PC) diagnosis and improves significant PC (sPC; Gleason score≥3+4) detection. Decision making based on European Randomised Study of Screening for PC (ERSPC) risk-calculator (RC) parameters may overcome prostate-specific antigen (PSA) limitations. OBJECTIVE: We added pre-biopsy mpMRI to ERSPC-RC parameters and developed risk models (RMs) to predict individual sPC risk for biopsy-naïve men and men after previous biopsy...
April 8, 2017: European Urology
https://www.readbyqxmd.com/read/28365215/mean-arterial-pressure-to-central-venous-pressure-ratio-a-novel-marker-for-right-ventricular-failure-after-left-ventricular-assist-device-placement
#17
Burhan Mohamedali, Rami Doukky, Kelly Karavalos, Elizabeth Avery, Geetha Bhat
BACKGROUND: Early right ventricular failure (RVF) is common after left ventricular assist device (LVAD) implantation and often leads to increased morbidity and mortality. It is difficult to predict early RVF on the basis of clinical and hemodynamic parameters. We investigated the utility of mean arterial pressure (MAP) to central venous pressure (CVP) ratio in predicting early RVF. METHODS AND RESULTS: We analyzed a retrospective cohort of 212 consecutive patients who underwent hemodynamic assessment before destination-therapy LVAD implantation...
March 29, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28318999/the-significance-of-inflow-artery-and-tourniquet-derived-cephalic-vein-diameters-on-predicting-successful-use-and-patency-of-arteriovenous-fistulas-for-haemodialysis
#18
S K Kakkos, N Kaplanis, E C Papachristou, S I Papadoulas, G C Lampropoulos, I A Tsolakis, D S Goumenos
OBJECTIVE: To investigate the significance of inflow artery and cephalic vein diameters on predicting patency of radiocephalic and brachiocephalic arteriovenous fistulas (AVFs). DESIGN: Single centre study with retrospective analysis of prospectively collected data between November 2010 and July 2015. METHODS: A detailed history and physical examination was undertaken, including age, gender, history and duration of haemodialysis, cause of chronic kidney disease, and the presence of comorbidities/risk factors...
March 18, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28279985/restriction-spectrum-imaging-improves-risk-stratification-in-patients-with-glioblastoma
#19
A P Krishnan, R Karunamuni, K M Leyden, T M Seibert, R L Delfanti, J M Kuperman, H Bartsch, P Elbe, A Srikant, A M Dale, S Kesari, D E Piccioni, J A Hattangadi-Gluth, N Farid, C R McDonald, N S White
BACKGROUND AND PURPOSE: ADC as a marker of tumor cellularity has been promising for evaluating the response to therapy in patients with glioblastoma but does not successfully stratify patients according to outcomes, especially in the upfront setting. Here we investigate whether restriction spectrum imaging, an advanced diffusion imaging model, performed after an operation but before radiation therapy, could improve risk stratification in patients with newly diagnosed glioblastoma relative to ADC...
March 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28274715/speckle-tracking-echocardiography-improves-pre-operative-risk-stratification-before-the-total-cavopulmonary-connection
#20
Patsy W Park, Andrew M Atz, Carolyn L Taylor, Shahryar M Chowdhury
INTRODUCTION: Single-ventricle patients with elevated pulmonary vascular resistance (PVR) or end-diastolic pressure (EDP) are excluded from undergoing total cavopulmonary connection (TCPC). However, a subset of patients deemed to be at acceptable risk experience prolonged length of stay (LOS) after TCPC. Routine assessment of ventricular function has been inadequate in identifying these high-risk patients. Speckle-tracking echocardiography (STE) is a novel method for assessment of myocardial deformation that may be useful in single-ventricle patients...
May 2017: Journal of the American Society of Echocardiography
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