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Pre operative risk stratification

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https://www.readbyqxmd.com/read/28415003/less-favourable-prognosis-for-low-risk-endometrial-cancer-patients-with-a-discordant-pre-versus-post-operative-risk-stratification
#1
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
#2
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...
April 12, 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
#3
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
#4
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. METHOD: We analyzed a retrospective cohort of 212 consecutive patients who underwent hemodynamic assessment prior to 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
#5
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 15, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28279985/restriction-spectrum-imaging-improves-risk-stratification-in-patients-with-glioblastoma
#6
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
#7
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...
March 5, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28263226/age-adjusted-alignment-goals-have-the-potential-to-reduce-pjk
#8
Renaud Lafage, Frank Schwab, Steve Glassman, Shay Bess, Bradley Harris, Justin Sheer, Robert Hart, Breton Line, Jensen Henry, Doug Burton, HanJo Kim, Eric Klineberg, Christopher Ames, Virginie Lafage
STUDY DESIGN: Retrospective cohort OBJECTIVE.: To explore proximal junctional kyphosis(PJK) as a function of age-adjusted surgical correction goals. SUMMARY OF BACKGROUND DATA: Recent adult spinal deformity(ASD) studies show that alignment targets are age-specific. Despite recognizing age and malalignment as PJK risk factors, no study has assessed the age-specific effects of alignment on PJK. METHODS: ASD patients with fusions to the pelvis were included and stratified into three groups: young adults(YA<40yo), middle aged(MA: 40-65yo), the elderly(ED>65yo)...
March 3, 2017: Spine
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#9
Maame Yaa A B Maya Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome guidelines directing the clinical practice implementation of ED screening and diagnosis, there is variable screening and diagnostic clinical practice across ED facilities. This practice diversity may be warranted. Understanding the variability may identify opportunities for more consistent practice. METHODS: This is a cross-sectional clinical practice epidemiology study with the emergency department (ED) as the unit of analysis characterizing variability in the acute coronary syndrome (ACS) evaluation across 62 diverse EDs...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28160549/understanding-psa-and-its-derivatives-in-prediction-of-tumor-volume-addressing-health-disparities-in-prostate-cancer-risk-stratification
#10
Felix M Chinea, Kirill Lyapichev, Jonathan I Epstein, Deukwoo Kwon, Paul Taylor Smith, Alan Pollack, Richard J Cote, Oleksandr N Kryvenko
OBJECTIVES: To address health disparities in risk stratification of U.S. Hispanic/Latino men by characterizing influences of prostate weight, body mass index, and race/ethnicity on the correlation of PSA derivatives with Gleason score 6 (Grade Group 1) tumor volume in a diverse cohort. RESULTS: Using published PSA density and PSA mass density cutoff values, men with higher body mass indices and prostate weights were less likely to have a tumor volume <0.5 cm3...
March 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28110616/oncotic-pressure-and-paediatric-cardiopulmonary-bypass-establishing-baseline-data-for-complex-congenital-cardiac-surgery-and-its-relation-to-risk-stratification
#11
Richard Crook, Richard Issitt
OBJECTIVES: Colloid osmotic pressure (COP) is a major determinant of fluid shift in paediatric patients undergoing corrective surgery for congenital heart disease (CHD) using cardiopulmonary bypass (CPB). However, very few baseline data are available for those patients requiring surgery within the first few weeks and months of life. Our aim was to determine if our CHD population exhibited COP similar to that of other extremely ill subsets of patients and, if so, whether this related to risk stratification model scores...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28105153/overexpression-of-microrna-205-predicts-lymph-node-metastasis-and-indicates-an-unfavorable-prognosis-in-endometrial-cancer
#12
Yong-Jing Ma, Chun-Fang Ha, Zhi-Miao Bai, Hai-Ning Li, Ying Xiong, Jie Jiang
As an integral component of the surgical staging system, lymphadenectomy for patients with endometrial cancer (EC) remains controversial, particularly in clinical stage I disease that includes not only low-risk, but also high-risk subgroups. In order to maximize the therapeutic effect of lymph node excision for high-risk patients who can potentially obtain survival benefits from it while minimizing its reverse effects in low-risk patients, pre-operative risk stratification of lymph node metastasis is necessary...
December 2016: Oncology Letters
https://www.readbyqxmd.com/read/28056901/expansion-of-the-milan-criteria-without-any-sacrifice-combination-of-the-hangzhou-criteria-with-the-pre-transplant-platelet-to-lymphocyte-ratio
#13
Weiliang Xia, Qinghong Ke, Hua Guo, Weilin Wang, Min Zhang, Yan Shen, Jian Wu, Xiao Xu, Sheng Yan, Jun Yu, Mangli Zhang, Shusen Zheng
BACKGROUND: The Hangzhou criteria expand the Milan criteria safely and effectively in selecting hepatocellular carcinoma (HCC) candidates for liver transplantation (LT), but some patients exceeding the Milan but fulfilling the Hangzhou criteria still show poor outcomes due to early tumor recurrence. In this study, the platelet-to-lymphocyte ratio (PLR) was employed to differentiate high-risk tumor recurrence recipients, and a new method combining PLR and the Hangzhou criteria was established...
January 5, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28042112/mobile-pump-deep-vein-thrombosis-prophylaxis-just-say-no-to-drugs
#14
J Haynes, R L Barrack, D Nam
AIMS: The purpose of this article was to review the current literature pertaining to the use of mobile compression devices (MCDs) for venous thromboembolism (VTE) following total joint arthroplasty (TJA), and to discuss the results of data from our institution. PATIENTS AND METHODS: Previous studies have illustrated higher rates of post-operative wound complications, re-operation and re-admission with the use of more aggressive anticoagulation regimens, such as warfarin and factor Xa inhibitors...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/27969569/biology-and-treatment-of-renal-tumours-in-childhood
#15
REVIEW
Jesper Brok, Taryn D Treger, Saskia L Gooskens, Marry M van den Heuvel-Eibrink, Kathy Pritchard-Jones
In Europe, almost 1000 children are diagnosed with a malignant renal tumour each year. The vast majority of cases are nephroblastoma, also known as Wilms' tumour (WT). Most children are treated according to Société Internationale d'Oncologie Pédiatrique Renal Tumour Study Group (SIOP-RTSG) protocols with pre-operative chemotherapy, surgery, and post-operative treatment dependent on stage and histology. Overall survival approaches 90%, but a subgroup of WT, with high-risk histology and/or relapsed disease, still have a much poorer prognosis...
October 28, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27955730/rhabdomyosarcoma
#16
REVIEW
Roshni Dasgupta, Jörg Fuchs, David Rodeberg
A malignant tumor of striated muscle origin, rhabdomyosarcoma (RMS) is a childhood tumor that has benefited from nearly 30 years of multimodality therapy, culminating in a >70% overall 5-year survival. Prognosis for RMS is dependent on primary tumor site, age, completeness of resection, presence and number of metastatic sites, histology, and biology of the tumor cells. Multimodality treatment is based on risk stratification according to pre-treatment stage, postoperative group, histology, and site. Unique to RMS is the concept of postoperative clinical grouping that assesses the completeness of disease resection and takes into account lymph node evaluation at both the regional and metastatic basins...
October 2016: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/27942901/laparoscopic-partial-splenectomy-for-unknown-primary-cancer-a-stepwise-approach
#17
Eduardo A Vega, Suguru Yamashita, Chun Yun Shin, Michael Kim, Jason B Fleming, Mathew H Katz, Kanwal P S Raghav, Jean-Nicolas Vauthey, Jeffrey E Lee, Claudius Conrad
BACKGROUND: Laparoscopic partial splenectomy (LPS) for focal splenic lesions is technically demanding and carries risk of hemorrhage. Nevertheless, it can be a valuable option, particularly for children and adults in whom attempt at preservation of splenic immunologic function outweighs risk associated with organ preservation. PATIENT: A 58-year-old man was diagnosed with a focal splenic lesion at the upper splenic pole on surveillance imaging following axillary lymph node metastasis for cancer of unknown primary origin (CUP)...
December 9, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27899969/diagnostic-usefulness-of-the-risk-of-ovarian-malignancy-algorithm-using-the-electrochemiluminescence-immunoassay-for-he4-and-the-chemiluminescence-microparticle-immunoassay-for-ca125
#18
Anita Chudecka-Głaz, Aneta Cymbaluk-Płoska, Katarzyna Luterek-Puszyńska, Janusz Menkiszak
The present study aimed to investigate the usefulness of the Risk of Ovarian Malignancy Algorithm (ROMA) in the preoperative stratification of patients with ovarian tumors using a novel combination of laboratory tests. The study group (n=619) consisted of 354 premenopausal and 265 postmenopausal patients. The levels of carbohydrate antigen 125 (CA125) and human epididymis protein 4 (HE4) were determined, and ROMA calculations were performed for each pre- and postmenopausal patient. HE4 levels were determined using an electrochemiluminescence immunoassay, while CA125 levels were determined by a chemiluminescence microparticle immunoassay...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27863640/assessment-of-adenotonsillar-size-and-caregiver-reported-sleep-symptoms-among-3-6-year-old-children-undergoing-adenotonsillectomy
#19
Onur Balaban, Hina Walia, Dmitry Tumin, Kris R Jatana, Vidya Raman, Joseph D Tobias
INTRODUCTION: Adenotonsillectomy remains the accepted first-line treatment for obstructive sleep apnea syndrome (OSAS) in children. Tonsillar size may be especially relevant in risk stratification as it may impact symptoms of sleep disordered breathing (SDB). This study assesses correlations among subjective tonsillar grading, measured tonsillar size, and degree of adenoid obstruction in patients age 3-6 years with caregiver-reported symptoms. METHODS: Children 3-6 years old undergoing adenotonsillectomy for OSAS were enrolled prospectively...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27842949/the-hat-score-a-simple-risk-stratification-score-for-coagulopathic-bleeding-during-adult-extracorporeal-membrane-oxygenation
#20
Terence Lonergan, Daniel Herr, Zachary Kon, Jay Menaker, Raymond Rector, Kenichi Tanaka, Michael Mazzeffi
OBJECTIVE: The study objective was to create an adult extracorporeal membrane oxygenation (ECMO) coagulopathic bleeding risk score. DESIGN: Secondary analysis was performed on an existing retrospective cohort. Pre-ECMO variables were tested for association with coagulopathic bleeding, and those with the strongest association were included in a multivariable model. Using this model, a risk stratification score was created. The score's utility was validated by comparing bleeding and transfusion rates between score levels...
September 1, 2016: Journal of Cardiothoracic and Vascular Anesthesia
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