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https://www.readbyqxmd.com/read/29349356/qt-interval-prolongation-due-to-medication-found-in-the-preoperative-evaluation
#1
Mika Seto, Sayo Koga, Ryosuke Kita, Toshihiro Kikuta
QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29339230/balanced-crystalloids-vs-0-9-saline-for-adult-patients-undergoing-non-renal-surgery-a-meta-analysis
#2
REVIEW
Lili Huang, Xiaoshuang Zhou, Hai Yu
BACKGROUND: Fluid maintenance and resuscitation is an important strategy during major surgeries. There has been a debate on the choice of crystalloids over the past decades. 0.9% saline (normal saline) is more likely to cause hyperchloremic acidosis when compared to balanced crystalloids with low chloride content. Meta-analyses comparing these two kinds of crystalloids have been performed in renal transplantations. We aim to compare the safety of balanced crystalloids to normal saline among adult patients undergoing non-renal surgery...
January 12, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29336226/identifying-metrics-before-and-after-readmission-following-head-and-neck-surgery-and-factors-affecting-readmission-rate
#3
Sidharth V Puram, Neil Bhattacharyya
Objectives Determine nationally representative readmission rates after head and neck cancer (HNCA) surgery and factors associated with readmission. Study Design Cross-sectional analysis of admissions database. Methods The 2013 Nationwide Readmissions Database was analyzed for HNCA surgery admissions and subsequent readmission within 30 days. The readmission rate, length of stay (LOS), disposition, mortality rate, and total charges were determined. Diagnoses and procedures upon readmission were quantified. Factors that were associated with readmission were determined...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29331086/current-management-of-small-bowel-obstruction-in-the-uk-results-from-the-national-audit-of-small-bowel-obstruction-clinical-practice-survey
#4
Matthew J Lee, Adele E Sayers, Timothy R Wilson, Austin G Acheson, Iain D Anderson, Nicola S Fearnhead
AIM: Small bowel obstruction (SBO) is associated with high rates of morbidity and mortality. The National Audit of Small Bowel Obstruction (NASBO) is a collaboration between trainees and specialty associations to improve the care of patients with SBO through national clinical audit. The aim of this study was to define current Consultant practice preferences in the management of small bowel obstruction in the UK. METHOD: A survey was designed to assess practice preferences of consultant surgeons...
January 13, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29296063/atrial-fibrillation-after-cardiac-surgery-prevention-and-management-the-australasian-experience
#5
REVIEW
Mohammed Alawami, Andrew Chatfield, Rajaie Ghashi, Laurence Walker
Background: Atrial fibrillation (AF) after cardiac surgery is a major health problem that is associated with a significant financial burden. This paper aims to highlight this problem and review the current guidelines in the prevention and management of AF after cardiac surgery, providing our experience in the Australasian centers. Methods: We conducted a literature review using mainly PubMed to compare the current practice with the available evidence. EMBASE and Cochrane library were also searched...
January 2018: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/29279076/symptomatic-hyponatremia-after-bowel-preparation-report-of-two-cases-and-literature-review
#6
Juliana Moura Costa, João Bruno Soares
INTRODUCTION: Bowel preparation for colonoscopy and/or colorectal surgery can cause electrolyte imbalances. The risk of electrolyte imbalances seems to be related to the type of bowel cleansing solution, age of patients and comorbidities. CASE REPORT: We report two cases of symptomatic hyponatremia (focal neurological signs and coma) after bowel preparation with sodium picosulfate/magnesium citrate for colonoscopy. In both cases, symptoms related to hyponatremia rapidly disappeared after sodium level correction with intravenous administration of hypertonic saline (3% NaCl)...
November 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29276586/postoperative-enterocutaneous-fistula-principles-in-non-operative-approach
#7
E A Sule, M A Nzegwu, J C Okolo, R U Onyemekheia
Introduction: Postoperative enterocutaneous fistulae could constitute a challenge when they occur following an abdominal surgery. Astute application of correct principles in its management is essential for good outcomes. Methods: A retrospective review of records of patients with enterocutaneous fistulas managed non-operatively was done. Clinical assessment, anatomic and physiologic classification of fistula, fluid resuscitation, electrolyte correction, parenteral/enteral nutrition, antibiotic use and fistula effluent monitoring, formed the basis of management...
December 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29258720/safety-of-intraperitoneal-mitomycin-c-versus-intraperitoneal-oxaliplatin-in-patients-with-peritoneal-carcinomatosis-of-colorectal-cancer-undergoing-cytoreductive-surgery-and-hipec
#8
W J van Eden, N F M Kok, K Woensdregt, A D R Huitema, H Boot, A G J Aalbers
BACKGROUND: Colorectal peritoneal carcinomatosis (PC) is commonly treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is an ongoing international debate about which intraperitoneal chemotherapeutic agent is preferred, Mitomycin C (MMC) or oxaliplatin. We questioned whether the type of chemotherapeutic agent influenced postoperative complication rates or short-term survival. METHODS: In this retrospective cohort study patients with colorectal PC who underwent CRS-HIPEC between January 2010 and December 2016 were included...
November 15, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29245340/successful-salvage-for-the-intractable-massive-chylous-leakage-in-a-cirrhotic-patient-a-case-report-and-literature-review
#9
Chun-Lin Su, Geng-He Chang, Ku-Hao Fang, Chang-Cheng Chang
RATIONALE: Iatrogenic chylous leakage (CL) is a rare but potentially life-threatening complication after neck surgery. In cirrhotic patient, the massive CL is even more intractable and extremely dangerous due to portal hypertension. PATIENTS CONCERNS: A 54-year-old liver cirrhotic patient had milky fluid leakage from left neck drainage tube after neck dissection surgery and hypopharyngeal cancer ablation. Electrolyte imbalance and shock status were reported when conservative managements and exploratory surgical repair failed to terminate the leakage...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29232194/persistent-ventricular-bigeminy-during-anesthesia-in-pediatric-patients-a-case-report-of-an-11-year-old-child
#10
Sheetal Dalal, Vikas Chaudhari
An 11-year-old male child with fractures in both bones in his left forearm presented for open reduction and internal fixation. The pre-anesthetic check-up and investigations did not reveal any pre-existing underlying cardio-respiratory disease. The patient had an uneventful peri-operative period during the operation and was comfortable without any anxiety or restlessness. After an uneventful induction and intubation as per routine protocol, the patient received 600 mg of amoxicillin+clavunate intravenously as an antibiotic...
December 12, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29203991/postoperative-delirium-in-indian-patients-following-major-abdominal-surgery-for-cancer-risk-factors-and-associations
#11
Vibhawari Dhakharia, Subir Sinha, Jaydip Bhaumik
Postoperative delirium (POD) is not uncommon following major abdominal surgery with its incidence ranging between five and 51%. As cancer affects disproportionately, the population older than 65 years and as delirium is more common in the elderly, surgical oncology patients are at a higher risk of developing POD. The present study was undertaken to explore the impact and associations of POD in Indian patients undergoing oncological major abdominal surgery. A retrospective review of the electronic medical records in a tertiary cancer care institution of all postoperative patients who had undergone major gastrointestinal gynaecological and urological abdominal surgery for cancer and required psycho-oncology referral was performed...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29197194/the-role-of-self-expandable-metallic-stents-as-bridge-to-surgery-for-the-treatment-of-acute-malignant-colorectal-obstruction-our-experience
#12
Gianpasquale Gallo, Giuseppe Sammarco, Alessandro Paolo Chiriatti, Ferdinando Calabria, Rosario Sacco
INTRODUCTION: Despite the widespread use of screening programs, the colorectal cancer occurs in 7-29% of cases with a bowel obstruction, needing an immediate decompression treatment by emergency surgery; unfortunately, the emergency surgery is characterized by high morbidity and mortality rates. The endoscopic placement of self-expandable metallic stents can be a useful alternative, allowing to decompress the acute obstruction in a short time, in order to correct dehydration, electrolytic imbalance and to improve the overall clinical conditions prior to adequately plan the intervention of elective surgery...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29185147/predicting-pituitary-stalk-position-by-in-vivo-visualization-of-the-hypothalamo-hypophyseal-tract-in-craniopharyngioma-using-diffusion-tensor-imaging-tractography
#13
Fuyu Wang, Jinli Jiang, Jiashu Zhang, Qun Wang
The pituitary stalk (PS) is crucial to endocrine function and water-electrolyte equilibrium. Preservation of the PS during craniopharyngioma (CP) surgery is critical; however, in a pathological state, it is difficult to identify. The hypothalamo-hypophyseal tract (HHT) connects the hypothalamus and the posterior pituitary gland and projects through the PS. Thus, visualization of the HHT can help locate the PS. Preoperative visualization of the neural fasciculus has been widely achieved using diffusion tensor imaging (DTI) tractography...
November 28, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29170998/introducing-topmast-the-first-double-blind-randomized-clinical-trial-specifically-dedicated-to-perioperative-maintenance-fluid-therapy-in-adults
#14
Steven Hendrickx, Karen Van Vlimmeren, Ingrid Baar, Walter Verbrugghe, Karolien Dams, Sophie Van Cromphaut, Ella Roelant, Bart Embrecht, Anouk Wittock, Pieter Mertens, Jeroen M Hendriks, Patrick Lauwers, Paul E Van Schil, Amaryllis H Van Craenenbroeck, Tim Van den Wyngaert, Philippe Jorens, Niels Van Regenmortel
BACKGROUND: Although prescribed to every patient undergoing surgery, maintenance fluid therapy is a poorly researched part of perioperative fluid therapy. The tonicity of the chosen solutions, on the other hand, could be an important cause of morbidity, with hyponatremia being a potential side effect of hypotonic solutions, where isotonic solution could lead to fluid overload. METHODS: The TOPMAST-trial is an ongoing prospective single-center double-blind randomized trial comparing an isotonic and a hypotonic maintenance fluid strategy during and after surgery in patients undergoing different types of major thoracic surgery...
November 24, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29156484/-perioperative-intravenous-fluid-therapy-in-children
#15
Robert Sümpelmann
The objective of this consensus-based S1 Guideline for perioperative fluid therapy in children is to maintain or re-establish the child's homeostasis. Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. For the intraoperative background infusion a physiologically composed balanced isotonic electrolyte solution (BS) with 1 - 2.5% glucose is recommended to maintain normal glucose concentrations and to avoid hyponatremia, hyperchloremia, and lipolysis...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29154517/a-proposal-for-a-tailored-approach-to-diverting-ostomy-for-colorectal-anastomosis
#16
Lisa Manzenreiter, Georg Spaun, Michael Weitzendorfer, Rosalia Luketina, Stavros A Antoniou, Helwig Wundsam, Oliver O Koch, Klaus Emmanuel
BACKGROUND: The use of a protective stoma represents an important issue in colorectal surgery. Although evidence suggests that loop ileostomy may be superior, the optimal method for temporary decompression of colorectal anastomosis still remains controversial. Aim of this study was to make an evidence-based proposal for a tailored approach to the use of diverting colostomy or ileostomy. METHODS: A retrospective analysis of all patients subjected to creation and closure of a diverting loop colostomy or loop ileostomy between May 2007 and November 2014 in our institution was performed...
November 20, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/29137593/central-pontine-myelinolysis-after-living-donor-liver-transplant-a-report-of-2-cases
#17
Ya-Lan Hsu, Chia-En Hsieh, Kuo-Hua Lin, Chen-Te Chou, Ping-Yi Lin, Su-Han Wang, Yao-Li Chen
Here, we present 2 patients who developed central pontine myelinolysis after living-donor liver transplant. Both patients had abnormal sodium level before living-donor liver transplant. Patient 1 presented with severe hyponatremia on admission. After administration of 3% saline, her sodium level during the first 24 hours was kept at 100 mEq/L and then increased to 116 mEq/L during the next 24 hours. The level increased 5.8 mEq/L during the 4- to 5-hour transplant procedure. Patient 2 was admitted to the hospital with an unprovoked seizure...
November 15, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29128103/the-benefits-of-a-low-dose-complex-carbohydrate-citrulline-electrolyte-solution-for-preoperative-carbohydrate-loading-focus-on-glycemic-variability
#18
Barrett A Kielhorn, Anthony J Senagore, Theodor Asgeirsson
BACKGROUND: Perioperative insulin resistance is associated with significant hyperglycemia-related morbidity in patients undergoing major surgery. We sought to assess the effect of preoperative loading with a low-dose maltodextrin/citrulline solution compared to a commercially available sports drink on glycemic levels in an established colorectal enhanced recovery program. METHODS: Retrospective analysis was undertaken of elective non-diabetic colectomies and enterectomies from January 2016-March 2017...
November 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29108375/association-between-postoperative-hyponatremia-and-renal-prognosis-in-major-urologic-surgery
#19
Sehoon Park, Jung Nam An, Jung Pyo Lee, Yun Kyu Oh, Dong Ki Kim, Kwon Wook Joo, Yon Su Kim, Chun Soo Lim
Recent evidence for the clinical significance of postoperative hyponatremia after urologic surgeries remains scarce. We examined the incidence, risk factors, and outcomes of electrolyte imbalance in urologic surgery. Patients with newly developed hyponatremia, defined as a sodium level lower than 135 mEq/L within 7 days after surgery, were included in our study group. The primary outcome was progression to end-stage renal disease (ESRD). Secondary outcome was composition of progression to ESRD and creatinine doubling/eGFR halving from baseline...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29106785/n-terminal-pro-b-type-natriuretic-peptide-in-three-different-mechanisms-of-dysnatremia-onset-after-a-child-s-craniopharyngioma-surgery
#20
(no author information available yet)
Craniopharyngioma, due to its sellar location, can be perioperatively complicated by different types of dysnatremia. We present a rare postoperative onset of a combination of three different mechanisms of dysnatremia with N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) and renal function parameters in a boy with a good outcome after craniopharyngioma surgery: 1/ Central diabetes insipidus (CDI) onset immediately after the operation, hypernatremia with peak serum sodium (SNa) 158 mmol/l) caused by free water polyuria (electrolyte-free water clearance, EWC 0...
October 6, 2017: Neuro Endocrinology Letters
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