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https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#1
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27904850/the-safety-and-risk-factors-of-major-hepatobiliary-pancreatic-surgery-in-patients-older-than-80-years
#2
Jong Hun Kim, Seog Ki Min, Huisong Lee, Geun Hong, Hyeon Kook Lee
PURPOSE: Recently, the number of elderly patients has increased due to a longer life expectancy. Among these elderly patients, more octogenarians will be diagnosed with major hepatobiliary pancreatic (HBP) diseases. Therefore, we need to evaluate the safety and risk factors of major HBP surgery in patients older than 80 years. METHODS: From January 2000 to April 2015, patients who underwent major HBP surgery were identified. The patients were divided into 2 groups according to their age at the time of surgery: Group O (≥80 years) and group Y (<80 years)...
December 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27871236/the-timing-of-administration-of-intravenous-dexmedetomidine-during-lower-limb-surgery-a-randomized-controlled-trial
#3
Eunsu Kang, Ki Hwa Lee, Sang Yoon Jeon, Kyu Won Lee, Myoung Jin Ko, Hyojoong Kim, Yong Han Kim, Jae-Wook Jung
BACKGROUND: Dexmedetomidine, a selective alpha-2 agonist, has sedative, analgesic, and anxiolytic effects without respiratory depression. Dexmedetomidine can cause a biphasic cardiovascular response, and induce transient hypertension. Hypotension is a common complication of spinal anesthesia. Decreasing anxiety of patients before procedure is important for high quality of procedure. This study aimed to compare the incidence of hypotension and patients' anxiety and comfort levels when dexmedetomidine was intravenously administered before and after spinal anesthesia...
November 21, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27870806/outpatientanterior-cervical-discectomy-and-fusion-is-associated-with-fewer-short-term-complications-inone-and-two-level-cases-a-propensity-adjusted-analysis
#4
Michael C Fu, Jordan A Gruskay, Andre M Samuel, Evan D Sheha, Peter B Derman, Sravisht Iyer, Jonathan N Grauer, Todd J Albert
STUDY DESIGN: Retrospective cohort study of prospectively-collected data from the National Surgical Quality Improvement Program (NSQIP) database. OBJECTIVE: To determine the postoperative morbidity of one-level and two-level outpatient anterior cervical discectomy and fusion (ACDF) relative to inpatient cases, and risk factors for post-discharge complications. SUMMARY OF BACKGROUND DATA: ACDF is increasingly performed as an outpatient procedure, with evidence demonstrating outpatient one-level ACDF to be associated with fewer postoperative complications than inpatients...
November 18, 2016: Spine
https://www.readbyqxmd.com/read/27859010/bevacizumab-combined-with-capecitabine-and-oxaliplatin-in-patients-with-advanced-adenocarcinoma-of-the-small-bowel-or-ampulla-of-vater-a-single-center-open-label-phase-2-study
#5
Pat Gulhati, Kanwal Raghav, Rachna T Shroff, Gauri R Varadhachary, Scott Kopetz, Milind Javle, Wei Qiao, Huamin Wang, Jeffrey Morris, Robert A Wolff, Michael J Overman
BACKGROUND: Capecitabine with oxaliplatin (CAPOX) has previously demonstrated clinical activity in patients with small bowel adenocarcinoma (SBA) and ampullary adenocarcinoma (AAC). Herein, the authors conducted a phase 2 trial to evaluate the benefit of adding bevacizumab to CAPOX. METHODS: In this phase 2, single-arm, single-center, open-label study, patients aged ≥18 years with untreated, advanced SBA or AAC were recruited. Patients received capecitabine at a dose of 750 mg/m(2) orally twice daily on days 1 to 14, oxaliplatin at a dose of 130 mg/m(2) intravenously on day 1, and bevacizumab at a dose of 7...
November 14, 2016: Cancer
https://www.readbyqxmd.com/read/27842499/comparison-of-the-effect-of-continuous-intravenous-infusion-and-two-bolus-injections-of-remifentanil-on-haemodynamic-responses-during-anaesthesia-induction-a-prospective-randomised-single-centre-study
#6
Toyoaki Maruta, Yoshihumi Kodama, Ishie Tanaka, Tetsuro Shirasaka, Isao Tsuneyoshi
BACKGROUND: Remifentanil is an effective drug for protecting against adverse haemodynamic responses to tracheal intubation. We compared the haemodynamic responses during anaesthesia induction between continuous intravenous (IV) infusion and two bolus injections of remifentanil. METHODS: This prospective, randomised, open-label, single-centre study included patients with American Society of Anesthesiologists physical status I-II, scheduled to undergo elective surgery under general anaesthesia...
November 14, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27774750/pulmonary-hypertension-in-childhood-interstitial-lung-disease-a-systematic-review-of-the-literature
#7
Susan Bromley, David Vizcaya
Childhood interstitial lung disease (chILD) comprises a wide heterogeneous group of rare parenchymal lung disorders associated with substantial morbidity and mortality. Pulmonary hypertension is a common comorbidity in adults with interstitial lung disease (ILD) and associated with poor survival. We aimed to systematically review the literature regarding the occurrence of pulmonary hypertension (PH) in chILD, its effect on prognosis and healthcare use, and its treatment in clinical practice. Searches of PubMed and EMBASE databases (up to February 2016), and American Thoracic Society conference abstracts (2009-2015) were conducted using relevant keywords...
October 23, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27754284/me-04-2-aortic-pwv-for-risk-stratification-in-hypertension
#8
Jeong Bae Park
High pressure of the blood in artery is a common condition and it is closely related to cardiovascular (CV) diseases in future. Blood pressure itself is the most important criteria for hypertension prognosis but attempts are being made to detect hypertensive vascular changes early. Healthy arteries are flexible, strong and elastic but if the condition of high blood pressure persists, arteries turn narrow, thick and stiff, become a condition of arteriosclerosis. And so now, pulse wave velocity (PWV) which measures arteriosclerosis became one of the clinically significant method that evaluates CV risks among patients in hypertension (yes, it is also very important for general population), detects biological changes in blood vessels caused by hypertension, and it is known as a guide for hypertension management...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754090/os-20-04-higher-blood-pressure-during-light-exercise-is-associated-with-increased-left-ventricular-mass-in-normotensive-subjects
#9
Min Seok Oh, Jidong Sung, Soojin Cho, Kyung Pyo Hong
OBJECTIVE: Exaggerated blood pressure (BP) response during exercise test reflects future risk of hypertension and has been shown to be related to increased left ventricular mass (LVM) in hypertensive patients. However, it is not known whether there is such a relationship in normotensives. The objective of this study is to investigate whether exercise BP response is related to left ventricular mass in normotensive subjects. DESIGN AND METHOD: Among the normotensive (systolic blood pressure (SBP) < 120 mmHg and diastolic blood pressure (DBP) < 80 mmHg and no history of antihypertensive treatments or clinical cardiovascular diseases) subjects who underwent routine health screening, both exercise test and echocardiography results were available in 7607 men and women...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754018/js-ksh-jsh-chl-01-1-cardio-metabolic-risks-in-hypertension-are-we-different-from-western-societies
#10
Hiroshi Itoh
Many hypertension guidelines have been published mainly from Western countries to standardize the management of hypertension all over the world, however, the significance of hypertension, along with other cardio-metabolic risks, such as obesity, diabetes or dyslipidemia should differ among different races. This paper compares the relevance of hypertension, one of the most important cardio-metabolic risk factors, in Asian and Western societies.1) Low target level of blood pressure control for diabetic hypertensives in JapanIn the Japanese Society of Hypertension Guidelines for the management of Hypertension (JSH2014), the target of blood pressure (BP) control in hypertensive patients with diabetes was set as < 130/80 mmHg...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754000/db-02-2-strict-control-of-hypertension-in-the-frail-elderly-is-it-beneficial-con
#11
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753810/ssa-04-1-similarities-and-differences-in-latin-american-guidelines-from-others
#12
Agustin Ramirez
The presentation will focus on the different guidelines we have actually in hands (JNCHT 8, ESH / ESC, ISH) and compare them to the last Latin-American Society of Hypertension Guidelines to be published in this year.In this way, we will focus our attention in the socio-economic problem of the different countries in LA and the differences we have included in our Guidelines due to the actual needs in LA.Additionally we will specially mention the special populations from LA like andineans, people living over 500m from sea level, and the different black populations that are different from those described in North America...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27746537/clinical-evaluation-of-the-effect-of-intravenous-dexmedetomidine-on-the-hemodynamic-response-to-laryngoscopy-and-endotracheal-intubation-in-patients-undergoing-thyroid-surgeries
#13
H D Rashmi, H K Komala
BACKGROUND: The procedures in anesthesia such as laryngoscopy and endotracheal intubation are the most important skills to be mastered by an anesthesiologist. However, they produce marked cardiovascular responses such as hypertension and tachycardia. Various drugs have been used to suppress this response. One of those is a novel centrally acting α2 agonist - dexmedetomidine. It has numerous uses in anesthesia as it is having sedative, analgesic, hypnotic, and opioid sparing effects. It is also known to suppress the hemodynamic response to laryngoscopy and intubation...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27721954/comprehensive-echocardiographic-assessment-of-the-right-ventricle-in-murine-models
#14
Andrew Kohut, Nishi Patel, Harpreet Singh
BACKGROUND: Non-invasive high-resolution echocardiography to evaluate cardiovascular function of small animals is increasingly being used due to availability of genetically engineered murine models. Even though guidelines and standard values for humans were revised by the American Society of Echocardiography, evaluations on murine models are not performed according to any standard protocols. These limitations are preventing translation of preclinical evaluations to clinical meaningful conclusions...
September 2016: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27689707/executive-summary-of-the-american-heart-association-and-american-thoracic-society-joint-guidelines-for-pediatric-pulmonary-hypertension
#15
Steven H Abman, D Dunbar Ivy, Stephen L Archer, Kevin Wilson
Although pulmonary hypertension (PH) contributes significantly to poor outcomes in diverse pediatric diseases, approaches toward the care of children with PH have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a committee of experienced clinicians was formed to systematically identify, synthesize, and appraise relevant evidence and then to formulate evidence-based recommendations regarding the diagnosis and management of pediatric PH...
October 1, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27687420/surgical-apgar-score-is-associated-with-myocardial-injury-after-noncardiac-surgery
#16
L McLean House, Khensani N Marolen, Paul J St Jacques, Matthew D McEvoy, Jesse M Ehrenfeld
STUDY OBJECTIVE: To assess the impact of intraoperative hemodynamics in the development of perioperative myocardial infarction (MI) and myocardial ischemia after noncardiac surgery. DESIGN: Single-center retrospective cohort study of surgical patients from 2007 to 2012. SETTING: Postanesthesia care unit, intensive care unit, and medical-surgical ward at an academic tertiary medical center. PATIENTS: A total of 46,799 adult noncardiac, nonthoracic surgery patients, for which 2290 peak cardiac troponin (cTn) levels were available...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687401/pulse-oximetry-derived-pleth-variability-index-can-predict-dexmedetomidine-induced-changes-in-blood-pressure-in-spontaneously-breathing-patients
#17
Makoto Sato, Takayuki Kunisawa, Atsushi Kurosawa, Tomoki Sasakawa
STUDY OBJECTIVE: Hypertension or hypotension in patients receiving continuous infusions of dexmedetomidine (DEX) is often due to changes in vascular resistance caused by α2 receptor stimulation. We investigated whether baseline perfusion index (PI) and pleth variability index (PVI), derived from pulse oximetry readings, could predict DEX-induced changes in the hemodynamic status in spontaneously breathing patients. DESIGN: Observational study. SETTING: Operating room...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27647302/correction-to-treatment-of-hypertension-in-patients-with-coronary-artery-disease-a-scientific-statement-from-the-american-heart-association-american-college-of-cardiology-and-american-society-of-hypertension
#18
https://www.readbyqxmd.com/read/27643326/ssa-04-1-similarities-and-differences-in-latin-american-guidelines-from-others
#19
Agustin Ramirez
The presentation will focus on the different guidelines we have actually in hands (JNCHT 8, ESH / ESC, ISH) and compare them to the last Latin-American Society of Hypertension Guidelines to be published in this year.In this way, we will focus our attention in the socio-economic problem of the different countries in LA and the differences we have included in our Guidelines due to the actual needs in LA.Additionally we will specially mention the special populations from LA like andineans, people living over 500m from sea level, and the different black populations that are different from those described in North America...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643282/me-04-2-aortic-pwv-for-risk-stratification-in-hypertension
#20
Jeong Bae Park
High pressure of the blood in artery is a common condition and it is closely related to cardiovascular (CV) diseases in future. Blood pressure itself is the most important criteria for hypertension prognosis but attempts are being made to detect hypertensive vascular changes early. Healthy arteries are flexible, strong and elastic but if the condition of high blood pressure persists, arteries turn narrow, thick and stiff, become a condition of arteriosclerosis. And so now, pulse wave velocity (PWV) which measures arteriosclerosis became one of the clinically significant method that evaluates CV risks among patients in hypertension (yes, it is also very important for general population), detects biological changes in blood vessels caused by hypertension, and it is known as a guide for hypertension management...
September 2016: Journal of Hypertension
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