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https://www.readbyqxmd.com/read/28203252/management-of-chyle-leak-after-head-and-neck-surgery-review-of-current-treatment-strategies
#1
REVIEW
Sean W Delaney, Haoran Shi, Alireza Shokrani, Uttam K Sinha
Chyle leak formation is an uncommon but serious sequela of head and neck surgery when the thoracic duct is inadvertently injured, particularly with the resection of malignancy low in the neck. The thoracic duct is the primary structure that returns lymph and chyle from the entire left and right lower half of the body. Chyle extravasation can result in delayed wound healing, dehydration, malnutrition, electrolyte disturbances, and immunosuppression. Prompt identification and treatment of a chyle leak are essential for optimal surgical outcome...
2017: International Journal of Otolaryngology
https://www.readbyqxmd.com/read/28197054/hyperchloremic-metabolic-acidosis-following-total-gut-irrigation-with-normal-saline-in-pediatric-patients-a-rare-occurrence
#2
Indu Bala, Deepak Dwivedi, Divya Jain, Jai Kumar Mahajan
Use of 0.9% sodium chloride for total gut irrigation (TGI) through nasogastric route is an effective method of bowel preparation in children undergoing colorectal surgeries. TGI with normal saline (NS) can result in nausea, vomiting, abdominal distension, and mild electrolyte imbalance; however, hyperchloremic metabolic acidosis has not been documented. We report two cases of hyperchloremic metabolic acidosis in children posted for colorectal surgery following TGI with NS who were successfully managed.
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28190713/transient-atrial-fibrillation-after-open-abdominal-aortic-revascularization-surgery-is-associated-with-increased-length-of-stay-mortality-and-readmission-rates
#3
Barbara A Blanco, Anai N Kothari, Pegge M Halandras, Robert H Blackwell, Dawn M Graunke, Paul C Kuo, Jae S Cho
BACKGROUND: It is well established that transient postoperative atrial fibrillation (TPAF) is associated with adverse postoperative outcomes after major cardiac and noncardiac operations. The purpose of this study was to elucidate the incidence, impact, and risk factors associated with the development of TPAF in patients undergoing revascularization surgery for occlusive diseases of the abdominal aorta and its branches (AAB). METHODS: By use of the Healthcare Cost and Utilization Project State Inpatient Database from Florida and California, patients who underwent open revascularization of AAB between 2006 and 2011 were identified...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#4
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28177854/risk-factors-for-30-day-hospital-re-admission-with-an-infectious-complication-after-lower-extremity-vascular-procedures
#5
Joseph C Melvin, Jamie B Smith, Robin L Kruse, Todd R Vogel
BACKGROUND: Lowering the 30-d re-admission rate after vascular surgery offers the potential to improve healthcare quality. This study evaluated re-admission associated with infections after open and endovascular lower extremity (LE) procedures for peripheral artery disease (PAD). METHODS: Patients admitted for elective LE procedures for PAD were selected from the Cerner Health Facts(®) database. Chi-square analysis evaluated the characteristics of the index admission associated with infection at 30-d re-admission...
February 8, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28174411/-primary-lung-cancer-associated-with-dilated-phase-of-hypertrophic-cardiomyopathy-report-of-a-case
#6
Takehiro Sakai, Takao Tsushima, Daisuke Kimura, Ryo Hatanaka, Masahiro Sawada, Yutaka Sato
A 66-year-old man diagnosed as dilated phase of hypertrophic cardiomyopathy (D-HCM) was pointed out an abnormal shadow on routine chest radiography. The patient had past medical history of hypertension, congestive heart failure and chronic obstructive pulmonary disease. The computed tomography showed a 3.8 cm-sized tumor in the left lower lobe of the lung, and histopathological examination revealed squamous cell carcinoma (cT2aN0-1M0, cStage I B-II A). Cardiosonography showed diffuse hypokinesis from basal to mid area, and ejection fraction was 36...
February 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28146293/effect-of-fluid-media-on-the-mechanical-properties-of-continuous-pattern-ending-surgeon-s-square-and-aberdeen-knots-in-vitro
#7
Matthew Coleridge, Alexandra M Gillen, Ramsis Farag, R Reid Hanson, Amelia S Munsterman
OBJECTIVE: To investigate the knot holding capacity (KHC) of pattern-ending square, surgeon's and Aberdeen knots each tied in 4 throw combinations using large gauge suture after exposure to media commonly found in equine abdominal surgery. STUDY DESIGN: In vitro mechanical study. SAMPLE POPULATION: Knotted suture strands (n = 10/group). METHODS: Strands of 2 polydioxanone or 3 polyglactin 910 were exposed to 1 of 4 media for 15 minutes...
February 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28138765/low-dose-carperitide-%C3%AE-human-a-type-natriuretic-peptide-alleviates-hemoglobin-concentration-decrease-during-prolonged-oral-surgery-a-randomized-controlled-study
#8
Masanori Tsukamoto, Sayuri Koyama, Kanako Esaki, Takashi Hitosugi, Takeshi Yokoyama
PURPOSE: Surgical injury stimulates the renin-angiotensin-aldosterone system (RAAS) and causes antidiuresis, leading to postoperative oliguria. Carperitide (α-human A-type natriuretic peptide) is a cardiac peptide hormone secreted from the atrium. This peptide hormone enhances diuresis by suppressing the RAAS. In our experience, carperitide alleviates decreased hemoglobin (Hb) concentration during elective surgery. In the current study, we investigated the relationship between low-dose carperitide (0...
January 30, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28137649/lesions-of-the-paraventricular-thalamic-nucleus-attenuates-prepulse-inhibition-of-the-acoustic-startle-reflex
#9
Pınar Öz, F Duygu Kaya Yertutanol, Tayfun Gözler, Ayşe Özçetin, I Tayfun Uzbay
The paraventricular thalamic nucleus (PVT) is a midline nucleus with strong connections to cortical and subcortical brain regions such as the prefrontal cortex, amygdala, nucleus accumbens and hippocampus and receives strong projections from brain stem nuclei. Prepulse inhibition (PPI) is mediated and modulated by complex cortical and subcortical networks that are yet to be fully identified in detail. Here, we suggest that the PVT may be an important brain region for the modulation of PPI. In our study, the paraventricular thalamic nuclei of rats were electrolytically lesioned...
January 27, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28133158/-clinical-experience-with-nutrition-and-anticoagulation-therapy-for-a-patient-with-a-30-cm-residual-jejunum
#10
Arisa Muratsu, Shingo Noura, Tae Matsumura, Masaki Hirota, Yuta Yoshida, Takashi Shuto, Akinobu Yasuyama, Chikato Koga, Masahiro Murakami, Chizu Kameda, Ryohei Kawabata, Junzou Shimizu, Junichi Hasegawa
Patients with short bowel syndrome experience malabsorption and digestive disorders. They are unable to maintain adequate nutrition by the oral or enteral route alone, and their requirements for liquids, electrolytes, nutrients, microelements, vitamins, etc., are not completely met. Managing the nutritional needs of these patients is important. Another concern is these patients' inability to absorb medication, because the small intestine that is shortened in short bowel syndrome is the principal site of drug absorption...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28118414/copeptin-predicts-mortality-in-critically-ill-patients
#11
Konstantin A Krychtiuk, Maria C Honeder, Max Lenz, Gerald Maurer, Johann Wojta, Gottfried Heinz, Kurt Huber, Walter S Speidl
BACKGROUND: Critically ill patients admitted to a medical intensive care unit exhibit a high mortality rate irrespective of the cause of admission. Besides its role in fluid and electrolyte balance, vasopressin has been described as a stress hormone. Copeptin, the C-terminal portion of provasopressin mirrors vasopressin levels and has been described as a reliable biomarker for the individual's stress level and was associated with outcome in various disease entities. The aim of this study was to analyze whether circulating levels of copeptin at ICU admission are associated with 30-day mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28088017/co-delivery-of-ibuprofen-and-gentamicin-from-nanoporous-anodic-titanium-dioxide-layers
#12
Anna Pawlik, Magdalena Jarosz, Karolina Syrek, Grzegorz D Sulka
Although single-drug therapy may prove insufficient in treating bacterial infections or inflammation after orthopaedic surgeries, complex therapy (using both an antibiotic and an anti-inflammatory drug) is thought to address the problem. Among drug delivery systems (DDSs) with prolonged drug release profiles, nanoporous anodic titanium dioxide (ATO) layers on Ti foil are very promising. In the discussed research, ATO samples were synthesized via a three-step anodization process in an ethylene glycol-based electrolyte with fluoride ions...
January 8, 2017: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/28079789/the-impact-of-irrigating-fluid-absorption-on-blood-coagulation-in-patients-undergoing-transurethral-resection-of-the-prostate-a-prospective-observational-study-using-rotational-thromboelastometry
#13
Hyun-Jung Shin, Hyo-Seok Na, Young-Tae Jeon, Hee-Pyoung Park, Sun-Woo Nam, Jung-Won Hwang
Although endoscopic transurethral resection of the prostate (TURP) is a well-established procedure as a treatment for benign prostatic hyperplasia, its complications remain a concern. Among these, coagulopathy may be caused by the absorption of irrigating fluid. This study aimed to evaluate such phenomenon using a rotational thromboelastometry (ROTEM).A total of 20 patients undergoing TURP participated in this study. A mixture of 2.7% sorbitol-0.54% mannitol solution and 1% ethanol was used as an irrigating fluid, and fluid absorption was measured via the ethanol concentration in expired breath...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28073139/-influence-of-comorbidities-on-revision-rate-within-the-first-year-after-primary-total-hip-arthroplasty
#14
Roman Nesslage, Kerstin Radtke, Lisa Hohloch, Thilo Flörkemeier, Henning Windhagen, Gabriela von Lewinski
: Background Total hip arthroplasty (THA) is very frequently performed. Despite low complication rates, revisions play an important clinical and economical role. The aim of this study was to identify comorbid diseases of patients undergoing primary THA and their potential influence on the survival of hip replacements. Patients/Material and Methods A total of 867 patients were included in this retrospective study. All revisions were reviewed that took place at our hospital within one year of primary implantation of THA...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28028530/acid-base-and-hemodynamic-status-of-patients-with-intraoperative-hemorrhage-using-two-solution-types-crystalloid-ringer-lactate-and-1-3-sodium-bicarbonate-in-half-normal-saline-solution
#15
Sayed Jalal Hashemi, Sayed Morteza Heidari, Ahmad Yaraghi, Reza Seirafi
BACKGROUND: Intraoperative hemorrhage is one of the problems during surgery and, if it happens in a high volume without an immediate action to control, it can be fatal. Nowadays, various injectable solutions are used. The aim of this study was to compare the acid-base and hemodynamic status of the patient using two solutions, Ringer lactate and 1.3% sodium bicarbonate, in half saline solution. MATERIALS AND METHODS: This clinical trial was performed at the Al-Zahra Hospital in 2013 on 66 patients who were randomly selected and put in two studied groups at the onset of hemorrhage...
2016: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28005739/minimally-invasive-strip-craniectomy-simplifies-anesthesia-practice-in-patients-with-isolated-sagittal-synostosis
#16
Daan P F van Nunen, Bart M Stubenitsky, Peter A Woerdeman, Kuo Sen Han, Corstiaan C Breugem, Aebele B Mink van der Molen, Jurgen C de Graaff
BACKGROUND: Traditional open corrective surgery for isolated sagittal synostosis entails significant blood loss, transfusion rates, morbidity, and a lengthy hospitalization. Minimally invasive strip craniectomy (MISC) was introduced to avoid the disadvantages of open techniques. OBJECTIVES: The aim of the study was, first, to compare the anesthesia practice in MISC and open extended strip craniectomy (OESC), and, second, to evaluate the incidence of perioperative complications in both surgical procedures...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27998859/-effect-of-magnesium-sulphate-infusion-on-emergence-agitation-in-patients-undergoing-esophageal-carcinoma-with-general-anesthesia-a-randomized-double-blind-controlled-trial
#17
Min Xie, Xiang-Kui Li, Jie Chen
OBJECTIVE: To evaluate the safety and effectiveness of magnesium sulphate for reducing the incidence of the emergence agitation in patients undergoing surgery for esophageal carcinoma with general anesthesia. METHODS: This randomized, double-blind, controlled clinical trial was conducted in patients undergoing elective radical resection of esophageal carcinoma in Sichuan Provincial People's Hospital between October, 2015 and March, 2016. The patients underwent surgeries under general intravenous anesthesia, and after anesthesia induction, the patients were infused with magnesium sulphate at the rate of 0...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27967227/sodium-and-water-imbalance-after-sellar-suprasellar-and-parasellar-surgery
#18
Zareen Kiran, Aisha Sheikh, Sehrish Nizar Ali Momin, Isra Majeed, Safia Awan, Owais Rashid, Najmul Islam
OBJECTIVES: To report the frequency of sodium and water disturbances (SWD) in patients undergoing sellar, suprasellar and parasellar surgery (SSPS). METHODS: We conducted a cross-sectional retrospective study on 115 patients in the Aga Khan University Hospital after ethical approval. Patients were 16 years old or older undergoing pituitary or sellar surgeries. We collected data on basic sociodemographic characteristics and clinical indication for surgery. We noted laboratory values for serum electrolytes, plasma and urine osmolality, urine sodium and 24-hour fluid balance from immediate postoperative day till discharge and follow up...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27921058/celiac-crisis-associated-with-herpes-simplex-virus-esophagitis
#19
Alan Chen, Christopher M Linz, Julie L Tsay, Ming Jin, Samer S El-Dika
Celiac crisis is a rare presentation of celiac disease that is characterized by life-threatening electrolyte abnormalities, vitamin and mineral deficiencies, and diarrhea. Triggers for celiac crisis include major surgeries, pancreatitis, and infections of cytomegalovirus, and salmonella. A 24-year-old woman presented with celiac crisis associated with severe herpes simplex virus (HSV) esophagitis. This case demonstrates that nutritional deficiencies seen in celiac disease can result in a relative immunodeficiency, which may lead to other infectious complications...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27904001/reninoma-masked-by-the-use-of-an-angiotensin-receptor-blocker
#20
Min Jung Kim, Joo Hui Kim, Il Young Kim, Dong Won Lee, Soo Bong Lee
Reninoma is a tumor that secretes excessive renin and is a rare cause of secondary hypertension. We report a case of reninoma with delayed diagnosis in a 33-year-old woman taking an angiotensin receptor blocker. During angiotensin receptor blocker medication, she had exhibited no electrolyte abnormality. The angiotensin receptor blocker was stopped for pregnancy planning purposes, and subsequent hypokalemia was observed. Abdominal computed tomography showed an enhanced round mass in the right kidney. Right partial nephrectomy was performed and the renal mass was removed...
November 2016: Iranian Journal of Kidney Diseases
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