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Pre operative risk stratification

S Hemmer, H Almansour, W Pepke, M M Innmann, M Akbar
BACKGROUND: In the light of the increasingly aging population and the widespread understanding of the sagittal profile of symptomatic patients with adult spinal deformity (ASD), pervasive utilization of osteotomies on the vertebral column should be expected. These surgeries are accompanied with relatively high complication rates. However, there is no uniform definition or classification in terms of grading the severity or chronological incidence of complications after ASD surgery. OBJECTIVES: The aim of this work is to give an overview of the different classifications described in the literature hitherto and to propose a standardized, clinically utile classification of complications after ASD surgery...
March 15, 2018: Der Orthopäde
Vince W Lands, Ajith Malige, Aldo Carmona, Christopher R Roscher, Robert S Gayner, Jaclyn Rowbotham, William G DeLong
BACKGROUND: When critically analyzing our hospital system's rate of hypotension and acute kidney injury (AKI) after total joint arthroplasty, our incidence rates (14.54%, 6.02%) were much higher than our peers (7.17%, 2.03%) and national rates (2.0%, 3.3%). We present a multi-disciplinary management intervention that aimed to decrease overall complication rates. METHOD: A multi-disciplinary team implemented a protocol at our suburban hospital to limit complication rates after joint replacement surgery...
February 5, 2018: Journal of Arthroplasty
Mauro Dobran, Alessandra Marini, Davide Nasi, Valentina Liverotti, Roberta Benigni, Maurizio Iacoangeli, Massimo Scerrati
OBJECTIVE: Study of mortality rate and clinical outcomes in octogenarians patients operated for intracranial meningiomas. PATIENTS AND METHODS: Clinical, radiological and surgical data of 25 elderly patients aging over 80 years old operated at our Department from 2013 to 2016 for intracranial meningiomas have been recorded and analyzed. One-month mortality and clinical outcome at six-months after surgery were evaluated. Logistic regression was used for detecting the risk factors influencing mortality and neurological functions...
February 17, 2018: Clinical Neurology and Neurosurgery
Daniel José Szor, Andre Roncon Dias, Marina A Pereira, Marcus F K P Ramos, Bruno Zilberstein, Ivan Cecconello, Ulysses Ribeiro
BACKGROUND AND OBJECTIVES: The role of inflammation in cancer development is a well-known phenomenon that may be represented by the neutrophil-lymphocyte ratio (NLR). The present research intends to determine the impact of NLR on the survival outcome of patients with gastric cancer (GC), and to evaluate its use as a stratification factor for the staging groups. METHODS: Data regarding clinical characteristics, surgery, pathology, and follow-up were retrospectively collected from our single-center prospective database...
March 6, 2018: Journal of Surgical Oncology
Zinaida Good, Jolanda Sarno, Astraea Jager, Nikolay Samusik, Nima Aghaeepour, Erin F Simonds, Leah White, Norman J Lacayo, Wendy J Fantl, Grazia Fazio, Giuseppe Gaipa, Andrea Biondi, Robert Tibshirani, Sean C Bendall, Garry P Nolan, Kara L Davis
Insight into the cancer cell populations that are responsible for relapsed disease is needed to improve outcomes. Here we report a single-cell-based study of B cell precursor acute lymphoblastic leukemia at diagnosis that reveals hidden developmentally dependent cell signaling states that are uniquely associated with relapse. By using mass cytometry we simultaneously quantified 35 proteins involved in B cell development in 60 primary diagnostic samples. Each leukemia cell was then matched to its nearest healthy B cell population by a developmental classifier that operated at the single-cell level...
March 5, 2018: Nature Medicine
Nai-Ming Cheng, Yu-Hua Dean Fang, Din-Li Tsan, Li-Yu Lee, Joseph Tung-Chieh Chang, Hung-Ming Wang, Shu-Hang Ng, Chun-Ta Liao, Lan-Yan Yang, Tzu-Chen Yen
OBJECTIVES: Human papillomavirus-negative oropharyngeal squamous cell carcinoma (OPSCC) has unfavorable survival outcomes. Two outcomes have been identified based on smoking history and tumor stage. We investigate the prognostic role of pre-treatment positron emission tomography (PET) in high-risk OPSCC. MATERIALS AND METHODS: We enrolled 147 M0 OPSCC patients with p16-negative staining and a history of heavy smoking (>10 pack-years) or T4 disease. All patients completed primary chemoradiotherapy, and 42% maximum standard uptake values (SUVmax ) were used as the threshold for primary tumor...
March 2018: Oral Oncology
Mattia Portinari, Michele Scagliarini, Giorgia Valpiani, Simona Bianconcini, Dario Andreotti, Rocco Stano, Paolo Carcoforo, Savino Occhionorelli
BACKGROUND: Some authors have proposed different predictive factors of severe acute cholecystitis, but generally, the results of risk analyses are expressed as odds ratios, which makes it difficult to apply in the clinical practice of the acute care surgeon. The severe form of acute cholecystitis should include both gangrenous and phlegmonous cholecystitis, due to their severe clinical course, and cholecystectomy should not be delayed. The aim of this study was to create a nomogram to obtain a graphical tool to compute the probability of having a severe acute cholecystitis...
February 20, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Linda M Pak, Jayasree Chakraborty, Mithat Gonen, William C Chapman, Richard Kg Do, Bas Groot Koerkamp, Kees Verhoef, Ser Yee Lee, Marco Massani, Eric P van der Stok, Amber L Simpson
BACKGROUND: Post-hepatectomy liver insufficiency (PHLI) is a significant cause of morbidity and mortality after liver resection. Quantitative imaging analysis using CT scans measures variations in pixel intensity related to perfusion. A preliminary study demonstrated a correlation between quantitative imaging features of the future liver remnant (FLR) parenchyma from preoperative CT scans and PHLI. The objective of the present study was to explore the potential application of quantitative imaging analysis in PHLI in an expanded, multi-institutional cohort...
February 14, 2018: Journal of the American College of Surgeons
L Licari, G Salamone, Z Parinisi, S Campanella, C Sabatino, G Ciolino, P De Marco, N Falco, S Boventre, G Gulotta
INTRODUCTION: Incisional hernia is one of the main topics in the general surgery since there is not a unanimous consensus concerning to the best surgical methodology to adopt. It seems that prosthetic surgery is the best technique, even if responsible for the development of periprosthetic seroma. The aim of this study is to assess whether the preoperative abnormalities of the bio-humoral parameters may be considered as risk factors for seroma. PATIENTS AND METHODS: From July 2016 to July 2017 at the "Policlinico Paolo Giaccone", Palermo, Department of Emergency Surgery, 56 patients included in this study, underwent laparotomic mesh repair...
November 2017: Il Giornale di Chirurgia
Yankai Meng, Yuchen Zhang, Di Dong, Chunming Li, Xiao Liang, Chongda Zhang, Lijuan Wan, Xinming Zhao, Kai Xu, Chunwu Zhou, Jie Tian, Hongmei Zhang
BACKGROUND: Locally advanced rectal cancer (LARC) patient stratification by clinicoradiologic factors may yield variable results. Therefore, more efficient prognostic biomarkers are needed for improved risk stratification of LARC patients, personalized treatment, and prognostication. PURPOSE/HYPOTHESIS: To compare the ability of a radiomic signature to predict disease-free survival (DFS) with that of a clinicoradiologic risk model in individual patients with LARC...
February 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
Jo-Fen Liu, Robert A Dineen, Shivaram Avula, Tom Chambers, Manali Dutta, Tim Jaspan, Donald C MacArthur, Simon Howarth, Daniele Soria, Philip Quinlan, Srikrishna Harave, Chan Chang Ong, Conor L Mallucci, Ram Kumar, Barry Pizer, David A Walker
BACKGROUND: Despite previous identification of pre-operative clinical and radiological predictors of post-operative paediatric cerebellar mutism syndrome (CMS), a unifying pre-operative risk stratification model for use during surgical consent is currently lacking. The aim of the project is to develop a simple imaging-based pre-operative risk scoring scheme to stratify patients in terms of post-operative CMS risk. METHODS: Pre-operative radiological features were recorded for a retrospectively assembled cohort of 89 posterior fossa tumour patients from two major UK treatment centers (age 2-23yrs; gender 28 M, 61 F; diagnosis: 38 pilocytic astrocytoma, 32 medulloblastoma, 12 ependymoma, 1 high grade glioma, 1 pilomyxoid astrocytoma, 1 atypical teratoid rhabdoid tumour, 1 hemangioma, 1 neurilemmoma, 2 oligodendroglioma)...
February 12, 2018: British Journal of Neurosurgery
J S Karim, J Reynolds, O Salar, E T Davis, S Quraishi, M Ahmed
INTRODUCTION: 80,000 hip fractures are admitted to UK hospitals annually (Royal College of Physicians, 2016). Little is known about 12-month post-operative re-admission, unplanned clinic attendance and mortality. We aimed to determine if there is a role for routine follow-up for certain strata of our hip fracture population treated by Dynamic Hip Screw (DHS) Fixation based on unplanned attendance to clinics and whether it is possible to stratify risk of re-admission, re-operation and mortality within the first 12 months post-operatively...
February 5, 2018: Injury
Greta Gandolfi, Moira Ragazzi, Dario de Biase, Michela Visani, Eleonora Zanetti, Federica Torricelli, Valentina Sancisi, Mila Gugnoni, Gloria Manzotti, Luca Braglia, Silvio Cavuto, Domenico Franco Merlo, Giovanni Tallini, Andrea Frasoldati, Simonetta Piana, Alessia Ciarrocchi
Background: Papillary Thyroid Carcinomas (PTCs) are generally indolent tumors. However, a small but significant percentage of PTCs behaves aggressively, progressing to a diffuse metastatic spreading and leading to patient's death. The lack of reliable markers for predicting the metastatic behavior of these tumors prevents a correct risk based stratification of the disease, thus contributing to the issue of patients' overtreatment. In this study we aimed at identifying genetic features associated with the development of distant metastasis in PTCs...
January 5, 2018: Oncotarget
Regayip Zehir, Ahmet Güner, Mert Ilker Hayiroglu, Tugba Kemaloğlu Oz, Altug Osken, Huseyin Aksu, Sennur Unal Dayi, Gultekin Faik Hobikoğlu
BACKGROUND: Epicardial adipose tissue [EAT] is thought to be associated with extension and severity of coronary artery disease [CAD] and echocardiographic measurement of EAT thickness has been considered to be a possible cardiovascular risk indicator. ESC Task Force recommends further non-invasive testing in patients with an intermediate pre-test probability [PTP] for the diagnosis of CAD. AIM: The purpose of this study was to evaluate the clinical usefulness of performing EAT measurements in patients with a high-intermediate PTP...
February 5, 2018: Kardiologia Polska
Yu Guang Tan, Ernest Eu, Weber Lau Kam On, Hong Hong Huang
Objective: To determine the role of neutrophil-to-lymphocyte ratio (NLR) in prognosticating survival outcomes in patients with advanced/metastatic urothelial bladder cancer. Methods: We retrospectively reviewed 84 patients undergoing radical cystectomy (RC) for UCB from January 2002 to June 2012. NLR was computed (median: 5 days) prior to surgery. No patients received neoadjuvant chemotherapy. NLR was analyzed as a continuous variable and a cut-off point of 2.7 was obtained, with a statistical receiver operating characteristics of 0...
October 2017: Asian Journal of Urology
Jon Brynildsen, Liisa Petäjä, Ville Pettilä, Ståle Nygård, Suvi T Vaara, Rita Linko, Marjatta Okkonen, Tor-Arne Hagve, Leena Soininen, Raili Suojaranta-Ylinen, Magnus Nakrem Lyngbakken, Torbjørn Omland, Helge Røsjø
BACKGROUND: European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) is used for risk stratification before cardiac surgery, but whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hsTnT) may add prognostic information to EuroSCORE II is not known. METHODS: Preoperative (n=640) and postoperative (n=629) blood samples were available from cardiac surgical patients with 961-day follow-up (FINNAKI Heart study; cohort #1)...
January 22, 2018: Clinical Biochemistry
Xiaoling Chen, Jinbiao Wu, Lisa Ying, Dan Su, Yu Chen
Background: Inflammatory response is known to play a vital role in carcinogenesis and cancer progression. The prognostic relevance of monocyte-to-lymphocyte ratio (MLR), as a biomarker of inflammatory response has been demonstrated in patients with hematologic cancers. Objectives: In this study, we assessed the prognostic relevance of MLR in patients with resectable lung carcinoma. Methods: Clinical records of 705 lung cancer patients who underwent radical resection at our hospital between October 2006 and January 2011 were retrospectively reviewed...
January 19, 2018: Laboratory Medicine
Katie Mowers, Toby Rockefeller, David Balzer, Ramzi Nicolas, Shabana Shahanavaz
Catheter-based interventions in the early post-operative period are performed with caution due to concerns for increased procedural risk, particularly across fresh suture lines. The recently published CRISP scoring system provides prospective risk stratification based on pre-procedural criterion. In an effort to refine the assessment of risk in patients undergoing post-operative catheter-based interventions, the predicted risk of an adverse event based on CRISP scores was compared to actual adverse event rates...
January 12, 2018: Pediatric Cardiology
Izak Faiena, Sinae Kim, Nicholas Farber, Young Suk Kwon, Brian Shinder, Neal Patel, Amirali H Salmasi, Thomas Jang, Eric A Singer, Wun-Jae Kim, Isaac Y Kim
Previous studies have reported association of multiple preoperative factors predicting clinically significant prostate cancer with varying results. We assessed the predictive model using a combination of hormone profile, serum biomarkers, and patient characteristics in order to improve the accuracy of risk stratification of patients with prostate cancer. Data on 224 patients from our prostatectomy database were queried. Demographic characteristics, including age, body mass index (BMI), clinical stage, clinical Gleason score (GS) as well as serum biomarkers, such as prostate-specific antigen (PSA), parathyroid hormone (PTH), calcium (Ca), prostate acid phosphatase (PAP), testosterone, and chromogranin A (CgA), were used to build a predictive model of clinically significant prostate cancer using logistic regression methods...
December 12, 2017: Oncotarget
Asma Sultana, Mark Brooke-Smith, Shahid Ullah, Joan Figueras, Myrddin Rees, Jean-Nicolas Vauthey, Claudius Conrad, Thomas J Hugh, O James Garden, Sheung T Fan, Michael Crawford, Masatoshi Makuuchi, Yukihiro Yokoyama, Markus Büchler, Robert Padbury
BACKGROUND: The International Study Group for Liver Surgery (ISGLS) definition of post hepatectomy liver failure (PHLF) was developed to be consistent, widely applicable, and to include severity stratification. This international multicentre collaborative study aimed to prospectively validate the ISGLS definition of PHLF. METHODS: 11 HPB centres from 7 countries developed a standardised reporting form. Prospectively acquired anonymised data on liver resections performed between 01 July 2010 and 30 June 2011 was collected...
December 26, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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