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Pre operative risk stratification

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https://www.readbyqxmd.com/read/29108474/molecular-testing-for-oncogenic-gene-alterations-in-pediatric-thyroid-lesions
#1
Sogol Mostoufi-Moab, Emmanuel Labourier, Lisa Sullivan, Virginia A LiVolsi, Yimei Li, Rui Xiao, Sylvie Beaudenon-Huibregtse, Ken Kazahaya, N Scott Adzick, Zubair W Baloch, Andrew J Bauer
BACKGROUND: Thyroid nodules are less common in pediatric patients (≤18 years) than in adults. The Bethesda System for Reporting Thyroid Cytopathology allows for individual risk stratification, but a significant number of nodules are indeterminate. Incorporating gene mutation panels and gene expression classifiers may aid in pre-operative diagnosis. The overall aim of this study was to assess the prevalence of oncogene alterations in a representative pediatric population and across a broad-spectrum of thyroid tumor diagnoses...
November 6, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29101838/a-molecular-intravascular-ultrasound-contrast-agent-allows-detection-of-activated-platelets-on-the-surface-of-symptomatic-human-plaques
#2
Alexander Maier, Patricia Plaza-Heck, Fabian Meixner, Felix Guenther, Beat A Kaufmann, Mara Kramer, Timo Heidt, Andreas Zirlik, Ingo Hilgendorf, Jochen Reinöhl, Peter Stachon, Peter Bronsert, Ralf Birkemeyer, Irene Neudorfer, Karlheinz Peter, Christoph Bode, Constantin von Zur Mühlen
BACKGROUND AND AIMS: Activated platelets are amongst the most attractive imaging targets in atherosclerosis due to their important role in early processes of atherogenesis and thrombus formation. We developed a molecular intravascular ultrasound (IVUS) approach to detect activated platelets ex vivo on the surface of human plaques, using an IVUS system applied in clinical routine. METHODS: Human carotid endarterectomy specimens were obtained directly from the operating room and exposed to artificial arterial flow conditions for incubation with the contrast agent...
October 24, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29095860/red-cell-distribution-width-as-a-novel-marker-for-predicting-high-risk-from-upper-gastro-intestinal-bleeding-patients
#3
Kyeong Ryong Lee, Sang O Park, Sin Young Kim, Dae Young Hong, Jong Won Kim, Kwang Je Baek, Dong Hyuk Shin, Young Hwan Lee
BACKGROUND: In upper gastrointestinal bleeding (UGIB) patients, early risk stratification allows appropriate therapy that may be helpful for reducing morbidity and mortality. OBJECTIVES: to evaluate the efficacy of red-cell distribution width (RDW) for prediction of high-risk in UGIB patients. METHODS: We conducted a clinical retrospective observational study based on data for UGIB patients from 2012 to 2013. The primary outcome was the high-risk UGIB, defined as those who required urgent intervention and/or 30-days mortality...
2017: PloS One
https://www.readbyqxmd.com/read/29034236/prognostic-value-of-the-new-prostate-cancer-international-society-of-urological-pathology-grade-groups
#4
Anne Offermann, Silke Hohensteiner, Christiane Kuempers, Julika Ribbat-Idel, Felix Schneider, Finn Becker, Marie Christine Hupe, Stefan Duensing, Axel S Merseburger, Jutta Kirfel, Markus Reischl, Verena Lubczyk, Rainer Kuefer, Sven Perner
Gleason grading is the best independent predictor for prostate cancer (PCa) progression. Recently, a new PCa grading system has been introduced by the International Society of Urological Pathology (ISUP) and is recommended by the World Health Organization (WHO). Following studies observed more accurate and simplified grade stratification of the new system. Aim of this study was to compare the prognostic value of the new grade groups compared to the former Gleason Grading and to determine whether re-definition of Gleason Pattern 4 might reduce upgrading from prostate biopsy to radical prostatectomy (RP) specimen...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28978106/a-prospective-appraisal-of-preoperative-body-mass-index-in-d2-resected-patients-with-non-metastatic-gastric-carcinoma-and-siewert-type-ii-iii-adenocarcinoma-of-esophagogastric-junction-results-from-a-large-scale-cohort
#5
Lei Huang, Zhi-Jian Wei, Tuan-Jie Li, Yu-Ming Jiang, A-Man Xu
OBJECTIVE: To prospectively investigate associations of presurgical body mass index (BMI) with clinicopathological factors and its prognostic significance in radically D2-resected patients with non-metastasized gastric cancer (GC) and Siewert type II/III adenocarcinoma of esophagogastric junction (AEG). METHODS: A large prospective cohort consisting of radically-resected GC and AEG patients was analyzed. Follow-up was successful in 671 out of 700 patients, who were categorized into underweight (BMI<18...
September 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28969608/positive-surgical-margins-and-biochemical-recurrence-following-minimally-invasive-radical-prostatectomy-an-analysis-of-outcomes-from-a-uk-tertiary-referral-centre
#6
Ashwin Sachdeva, Rajan Veeratterapillay, Antonia Voysey, Katherine Kelly, Mark I Johnson, Jonathan Aning, Naeem A Soomro
BACKGROUND: Positive surgical margins are a strong prognostic marker of disease outcome following radical prostatectomy, though prior evidence is largely from a PSA-screened population. We therefore aim to evaluate the biochemical recurrence in men with positive surgical margins (PSM) after minimally-invasive radical prostatectomy (MIRP) in a UK tertiary centre. METHODS: Retrospective study of men undergoing laparoscopic or robotic-assisted radical prostatectomy between 2002 and 2014...
October 2, 2017: BMC Urology
https://www.readbyqxmd.com/read/28967164/negative-predictive-value-of-dobutamine-stress-echocardiography-for-perioperative-risk-stratification-in-patients-with-cardiac-risk-factors-and-reduced-exercise-capacity-undergoing-non-cardiac-surgery
#7
Gus Go, Kathy T Davies, Cara O'Callaghan, Wendy Senior, Karam Kostner, Narelle Fagermo, Sandhir B Prasad
BACKGROUND: Guidelines recommend functional testing for myocardial ischaemia in the perioperative setting in patients with >1 recognised cardiac risk factors and self-reported reduced exercise capacity. We sought to determine the clinical utility of dobutamine stress echocardiography (DSE) for perioperative risk stratification in patients undergoing major noncardiac surgery. METHODS: Data on 79 consecutive patients undergoing DSE for perioperative risk stratification at a single centre was retrospectively reviewed to determine rates of Major Adverse Cardiac Events (MACE) during the index hospitalisation and 30 days post discharge...
October 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28964612/management-of-the-central-compartment-in-differentiated-thyroid-carcinoma
#8
Ryan P Goepfert, Gary L Clayman
Management of differentiated thyroid carcinoma (DTC) is gradually evolving with considerations of de-escalation of treatment and/or active surveillance in a significant proportion of patients on the basis of an improved understanding of the long-term disease and functional outcomes from both surgical and non-surgical approaches. This is fueled by improved risk stratification using clinicopathologic prognostic factors as determined through high resolution ultrasound and fine needle aspiration cytology. This paper discusses general recommendations for preoperative decision-making in the management of the central compartment in DTC with particular reference to micropapillary thyroid carcinoma and encapsulated follicular variant papillary thyroid carcinoma...
September 13, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28934761/comparison-between-mri-and-pathology-in-the-assessment-of-tumour-regression-grade-in-rectal-cancer
#9
COMPARATIVE STUDY
Francesco Sclafani, Gina Brown, David Cunningham, Andrew Wotherspoon, Larissa Sena Teixeira Mendes, Svetlana Balyasnikova, Jessica Evans, Clare Peckitt, Ruwaida Begum, Diana Tait, Josep Tabernero, Bengt Glimelius, Susana Roselló, Janet Thomas, Jacqui Oates, Ian Chau
BACKGROUND: Limited data exist regarding the correlation between MRI tumour regression grade (mrTRG) and pathological TRG (pTRG) in rectal cancer. METHODS: mrTRG and pTRG were compared in rectal cancer patients from two phase II trials (EXPERT and EXPERT-C). The agreement between radiologist and pathologist was assessed with the weighted κ test while the Kaplan-Meier method was used to estimate survival outcomes. RESULTS: One hundred ninety-one patients were included...
November 7, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28906306/predicting-early-mortality-following-hip-fracture-surgery-the-hip-fracture-estimator-of-mortality-amsterdam-hema
#10
Julian Karres, Noera Kieviet, Jan-Peter Eerenberg, Bart C Vrouenraets
OBJECTIVES: Early mortality following hip fracture surgery is high and pre-operative risk assessment for the individual patient is challenging. A risk model could identify patients in need of more intensive perioperative care, provide insight in the prognosis and allow for risk-adjustment in audits. This study aimed to develop and validate a risk prediction model for 30-day mortality following hip fracture surgery: the Hip fracture Estimator of Mortality Amsterdam (HEMA). METHODS: Data on 1050 consecutive patients undergoing hip fracture surgery between 2004 and 2010 were retrospectively collected and randomly split into a development cohort (746 patients) and validation cohort (304 patients)...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28844347/corrigendum-to-less-favourable-prognosis-for-low-risk-endometrial-cancer-patients-with-a-discordant-pre-versus-post-operative-risk-stratification-eur-j-cancer-78-2017-82-90
#11
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
No abstract text is available yet for this article.
October 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#12
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28781011/pre-operative-proteinuria-in-left-ventricular-assist-devices-and-clinical-outcome
#13
Rahatullah Muslem, Kadir Caliskan, Sakir Akin, Kavita Sharma, Nisha A Gilotra, Jasper J Brugts, Brian Houston, Glenn Whitman, Ryan J Tedford, Dennis A Hesselink, Ad J J C Bogers, Olivier C Manintveld, Stuart D Russell
BACKGROUND: This study evaluated the association of pre-operative proteinuria before continuous flow left ventricular assist device (CF-LVAD) implantation in relation to mortality and the need for renal replacement therapy (RRT) during the first year of follow-up. METHODS: This retrospective, multicenter cohort study evaluated all patients (n = 241) who underwent CF-LVAD implantation in the 2 participating tertiary referral centers. Patients were included if a urine dipstick was performed within 7 days before CF-LVAD implantation...
July 15, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28758236/morphometric-age-and-survival-following-kidney-transplantation
#14
Michael N Terjimanian, Patrick W Underwood, David C Cron, Joshua J Augustine, Kelly A Noon, Devan A Cote, Stewart C Wang, Michael J Englesbe, Kenneth J Woodside
BACKGROUND: As patients with chronic kidney disease become older, there is greater need to identify who will most benefit from kidney transplantation. Analytic morphomics has emerged as an objective risk assessment tool distinct from chronologic age. We hypothesize that morphometric age is a significant predictor of survival following transplantation. METHODS: A retrospective cohort of 158 kidney transplant patients from 2005 to 2014 with 1-year preoperative imaging was identified...
July 31, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28751850/anmco-sic-sici-gise-sicch-executive-summary-of-consensus-document-on-risk-stratification-in-elderly-patients-with-aortic-stenosis-before-surgery-or-transcatheter-aortic-valve-replacement
#15
Giovanni Pulignano, Michele Massimo Gulizia, Samuele Baldasseroni, Francesco Bedogni, Giovanni Cioffi, Ciro Indolfi, Francesco Romeo, Adriano Murrone, Francesco Musumeci, Alessandro Parolari, Leonardo Patanè, Paolo Giuseppe Pino, Annalisa Mongiardo, Carmen Spaccarotella, Roberto Di Bartolomeo, Giuseppe Musumeci
Aortic stenosis is one of the most frequent valvular diseases in developed countries, and its impact on public health resources and assistance is increasing. A substantial proportion of elderly people with severe aortic stenosis is not eligible to surgery because of the advanced age, frailty, and multiple co-morbidities. Transcatheter aortic valve implantation (TAVI) enables the treatment of very elderly patients at high or prohibitive surgical risk considered ineligible for surgery and with an acceptable life expectancy...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28747576/a-prospective-appraisal-of-preoperative-body-mass-index-in-d2-resected-patients-with-non-metastatic-gastric-carcinoma-and-siewert-type-ii-iii-adenocarcinoma-of-esophagogastric-junction-results-from-a-large-scale-cohort
#16
Lei Huang, Zhi-Jian Wei, Tuan-Jie Li, Yu-Ming Jiang, A-Man Xu
OBJECTIVE: To prospectively investigate associations of presurgical body mass index (BMI) with clinicopathological factors and its prognostic significance in radically D2-resected patients with non-metastasized gastric cancer (GC) and Siewert type II/III adenocarcinoma of esophagogastric junction (AEG). METHODS: A large prospective cohort consisting of radically-resected GC and AEG patients was analyzed. Follow-up was successful in 671 out of 700 patients, who were categorized into underweight (BMI<18...
July 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28703300/a-point-based-prediction-model-for-cardiovascular-risk-in-orthotopic-liver-transplantation-the-car-olt-score
#17
Lisa B VanWagner, Hongyan Ning, Maureen Whitsett, Josh Levitsky, Sarah Uttal, John T Wilkins, Michael M Abecassis, Daniela P Ladner, Anton I Skaro, Donald M Lloyd-Jones
Cardiovascular disease (CVD) complications are important causes of morbidity and mortality after orthotopic liver transplantation (OLT). There is currently no preoperative risk-assessment tool that allows physicians to estimate the risk for CVD events following OLT. We sought to develop a point-based prediction model (risk score) for CVD complications after OLT, the Cardiovascular Risk in Orthotopic Liver Transplantation risk score, among a cohort of 1,024 consecutive patients aged 18-75 years who underwent first OLT in a tertiary-care teaching hospital (2002-2011)...
December 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28688658/decreasing-30-day-surgical-mortality-in-a-va-medical-center-utilizing-the-acs-nsqip-surgical-risk-calculator
#18
SreyRam Kuy, Ramon A L Romero
BACKGROUND: The Overton Brooks VA Medical Center Surgical Service had a high mortality. In an effort to reduce surgical mortality, we implemented a series of quality improvement interventions, including utilization of the ACS Surgical Risk Calculator to identify high-risk surgical patients for discussion in a multidisciplinary Pre-Operative Consultation Committee. METHODS: Retrospective study describing the implementation of a risk stratification intervention incorporating the ACS Surgical Risk Calculator Tool and a multidisciplinary Pre-Operative Consultation Committee to target high-risk patients...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28684167/sarcopaenia-in-surgical-populations-a-review
#19
REVIEW
Rachel S M Heard, George Ramsay, Diane R Hildebrand
Sarcopaenia, or decreased muscle mass, has been the subject of a large quantity of recent literature in both medical and surgical disciplines. It has been shown, as outlined below, to be of great prognostic importance, and also may be used in certain circumstances to guide treatment. The greatest volume of research into this topic is in oncological surgical populations, in whom the prevalence of sarcopaenia has been shown to be high. However it is being increasingly studied in other patient groups. Interest in using sarcopaenia as an objective and potentially modifiable marker of frailty is increasing, especially with regards to pre-operative risk stratification and amelioration...
July 3, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28673695/comparison-of-four-scoring-systems-used-to-predict-mortality-in-patients-with-acute-upper-gastrointestinal-bleeding-in-the-emergency-room
#20
Yuedong Tang, Jie Shen, Feng Zhang, Xiaoyong Zhou, Zhongyan Tang, Tingting You
OBJECTIVE: Acute upper gastrointestinal bleeding (UGIB) is a potentially life-threatening condition that requires rapid assessment in the emergency department (ED). We aimed to compare the performance of the AIMS65, Glasgow-Blatchford (Blatchford), preendoscopic Rockall (pre-Rockall), and preendoscopic Baylor bleeding (pre-Baylor) scores in predicting 30-day mortality in patients with acute UGIB in the ED setting. METHODS: Consecutive patients with acute UGIB who were admitted to the ED ward during 2012-2016 were retrospectively recruited...
June 27, 2017: American Journal of Emergency Medicine
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