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https://www.readbyqxmd.com/read/28448323/hyperkalemia-after-laparoscopic-nephrectomy-in-patients-with-renal-insufficiency-a-case-report
#1
Frank J Penna, Hiep T Nguyen, Constance S Houck
Laparoscopic surgery is an evolving surgical modality in children, which has been applied to increasingly more complex surgeries and patients, including patients with renal insufficiency. These patients are particularly susceptible to the challenges that laparoscopy imposes on their altered physiology, leading to marked electrolyte disturbances, including metabolic acidosis and hyperkalemia. Hyperkalemia has the potential for marked impairment of cardiac conduction. We report 2 cases where significant, potentially lethal hyperkalemia developed during laparoscopic nephrectomy in adolescents with renal insufficiency...
April 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28445869/silicone-oil-related-visual-loss
#2
Hamouda Hamdy Ghoraba, Adel Galal Zaky, Mohamed Amin Heikal, Emad Eldin Mohamed Elgemai, Haithem Mamoun Abd Al Fatah
BACKGROUND: Silicone oil (SO) is used as an intravitreal tamponade agent in vitreoretinal surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy or with large, multiple retinal tears. Usually, SO is left in the eye for at least 3 months. Although its use can lead to well-known complications, intraocular SO is generally well tolerated. Some studies have reported unexpected central vision loss after SO use or removal. OBJECTIVE: To investigate and analyze the reason for visual loss after the use or removal of intraocular SO in patients who underwent vitrectomy surgeries for RRD...
April 27, 2017: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/28439845/a-systematic-review-of-the-clinical-presentation-diagnosis-and-treatment-of-small-bowel-obstruction
#3
REVIEW
Srinivas R Rami Reddy, Mitchell S Cappell
PURPOSE OF REVIEW: This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy. RECENT FINDINGS: SBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn's disease (5%), and other (15%). Bowel dilatation occurs proximal to obstruction primarily from swallowed air and secondarily from intraluminal fluid accumulation. Dilatation increases mural tension, decreases mucosal perfusion, causes bacterial proliferation, and decreases mural tensile strength that increases bowel perforation risks...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28424936/preoperative-chemoradiotherapy-versus-perioperative-chemotherapy-for-patients-with-resectable-esophageal-or-gastroesophageal-junction-adenocarcinoma
#4
M C J Anderegg, P C van der Sluis, J P Ruurda, S S Gisbertz, M C C M Hulshof, M van Vulpen, N Haj Mohammed, H W M van Laarhoven, M J Wiezer, M Los, M I van Berge Henegouwen, R van Hillegersberg
BACKGROUND: This study compares neoadjuvant chemoradiotherapy (nCRT) with perioperative chemotherapy (pCT) for patients with resectable esophageal or gastroesophageal junction (GEJ) adenocarcinoma in terms of toxicity, postoperative complications, pathologic response, and survival. METHODS: This study retrospectively analyzed and compared 313 patients with resectable esophageal or GEJ adenocarcinoma treated with either nCRT (carboplatin/paclitaxel 41.4 Gy, n = 176) or pCT (epirubicin, cisplatin and capecitabine, n = 137)...
April 19, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#5
Richard Issitt, Tim James, Bronagh Walsh, David Voegeli
BACKGROUND: Acute kidney injury (AKI) following cardiopulmonary bypass affects 5% of patients, representing significant postoperative morbidity and mortality. Animal models have shown an increased uptake of lipid microemboli (LME) into the renal vasculature, potentially indicating ischaemic causation. This study tested a new lipid filtration system (RemoweLL) against a conventional system with no lipid-depleting capacity to determine the efficacy of the filtration system and its effects on renal function...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#6
J F Crismale, K A Meliambro, S DeMaria, D B Bronster, S Florman, T D Schiano
The osmotic demyelination syndrome (ODS) is a serious neurologic condition that occurs in the setting of rapid correction of hyponatremia. It presents with protean manifestations, from encephalopathy to the "locked-in" syndrome. ODS can complicate liver transplantation (LT), and its incidence may increase with the inclusion of serum sodium as a factor in the Model for End-Stage Liver Disease score. A comprehensive understanding of risk factors for the development of ODS in the setting of LT, along with recommendations to mitigate the risk of ODS, are necessary...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28421731/intraoperative-dexmedetomidine-sedation-reduces-the-postoperative-agitated-behaviour-in-elderly-patients-undergoing-orthopaedic-surgery-compared-to-the-propofol-sedation-a-retrospective-analysis-of-855-patients
#7
Hyun-Jung Shin, Bon-Wook Koo, Seung-Uk Bang, Jin-Hee Kim, Jung-Won Hwang, Sang-Hwan DO, Hyo-Seok Na
BACKGROUND: Postoperative agitation or confusion is one of the symptoms of hyperactive delirium in elderly patients. We retrospectively evaluated the incidence of postoperative abnormal psychomotor behaviour in elderly surgical patients according to the use of different intraoperative sedative agents: dexmedetomidine vs. propofol. METHODS: The medical records of 855 elderly patients, who underwent orthopaedic surgery with regional anaesthesia between July 2012 and September 2015, were divided into two groups-the dexmedetomidine group (n=263) and the propofol group (n=592)-and evaluated...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28413524/perioperative-complications-in-endovascular-neurosurgery-anesthesiologist-s-perspective
#8
Megha U Sharma, Pragati Ganjoo, Daljit Singh, Monica S Tandon, Jyotsna Agarwal, Durga P Sharma, Anita Jagetia
BACKGROUND: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. METHODS: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28385032/the-transparency-of-irrigation-fluids-used-in-endoscopic-surgery
#9
Ilan Gielchinsky, Dov Pode, Mordechai Duvdevani, Vladimir Yutkin, Yehezkel Landau, Guy Hidas, Ofer N Gofrit
PURPOSE: Transurethral surgery has been traditionally done using the non-electrolyte, isotonic 1.5% glycine solution as irrigation fluid. The emergence of modern technologies, which can be applied with electrolyte solutions, such as bipolar resection and LASER evaporation, as well as the worry of transurethral resection syndrome have driven urologists away from glycine towards the use of normal saline. Differences in the transparencies of these fluids have not been studied. MATERIALS AND METHODS: The ability to resolve two bars at 1 mm apart using a 30 cystoscope lens immersed in different solutions was studied...
April 6, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28372687/pharmacokinetics-and-pharmacodynamics-of-cisatracurium-in-patients-undergoing-surgery-with-two-hemodilution-methods
#10
Jianrong Guo, Xiaohong Yuan, Xiaofang Zhou, Xiaoju Jin
OBJECTIVE: To investigate the pharmacokinetics and pharmacodynamics of cisatracurium in patients undergoing surgery under acute normovolemic hemodilution (ANH) and acute hypervolemic hemodilution (AHH). METHODS: Ninety patients with orthopedic surgery were divided into ANH, AHH and control groups, which received hemodilution by hydroxyethyl starch 130/0.4 transfusion, Voluven transfusion and regular transfusion and infusion during surgery, respectively. Each group was divided into 3 sub-groups, administrated with cisatracurium at dosage of 0...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28343443/lacosamide-induced-recurrent-ventricular-tachycardia-in-the-acute-care-setting
#11
Theodore J Berei, Matthew P Lillyblad, Adrian K Almquist
Lacosamide is a new-generation antiepileptic drug (AED) most commonly used adjunctively in the setting of partial-onset seizures refractory to traditional therapy. We describe the first case report, to our knowledge, of a patient who developed recurrent, sustained ventricular tachycardia with multiple administrations of lacosamide in an acute setting. A 70-year-old woman with a history significant for valvular heart disease was admitted to the inpatient cardiology service for worsening heart failure. On hospital day 7, she received a bioprosthetic aortic valve...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28340835/can-patients-who-develop-cerebral-death-in-fulminant-liver-failure-despite-liver-transplantation-be-previously-forseen
#12
K B Sarici, S Karakas, E Otan, V Ince, C Koc, S Koc, H Bayraktar, C Aydin, C Kayaalp, S Gungor, Y Kablan, S Yilmaz
BACKGROUND: The outcome of medical treatment is worse in fulminant liver failure (FLF) developing on acute or chronic ground. Recently, liver transplantations with the use of living and cadaveric donors have been performed in these diseases and good results obtained. In this study, we aimed to present the factors affecting the recovery of cerebral functions after liver transplantation in hepatic encephalopathy (HE) developing in FLF, to identify irreversible patient groups and to prevent unnecessary liver transplantation...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28338158/-diagnosis-and-treatment-of-duodenal-injury-and-fistula
#13
Kunmei Gong, Shikui Guo, Kunhua Wang
Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#14
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28302660/rhabdomyolysis-induced-compartment-syndrome-secondary-to-atorvastatin-and-strenuous-exercise
#15
Louise Dunphy, Rossel Morhij, Sarah Tucker
A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28301430/etiopathogenesis-of-nephrolithiasis-in-ulcerative-colitis-patients-with-the-ileal-pouch-anal-anastomosis
#16
Zubin Arora, Saurabh Mukewar, Rocio Lopez, Debra Camino, Bo Shen, Phillip Hall
BACKGROUND: Our previous study showed that nephrolithiasis is a common complication in ulcerative colitis patients after ileal pouch anal anastomosis (IPAA). However, the pathogenesis of nephrolithiasis in IPAA patients has not been studied. The aim of this study was to compare urine and serum metabolic compositions in IPAA patients with nephrolithiasis and controls with IPAA and no nephrolithiasis. METHODS: Using cross-sectional study design, serum and 24-hour urine metabolic compositions were compared between IPAA patients with nephrolithiasis (the study group) and those without (the control group)...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28282006/a-nationwide-analysis-of-kidney-autotransplantation
#17
Zhobin Moghadamyeghaneh, Mark H Hanna, Reza Fazlalizadeh, Yoshitsugu Obi, Clarence E Foster, Michael J Stamos, Hirohito Ichii
There are limited data regarding outcomes of patients underwent kidney autotransplantation. This study aims to investigate outcomes of such patients. The nationwide inpatient sample database was used to identify patients underwent kidney autotransplantation during 2002 to 2012. Multivariate analyses using logistic regression were performed to investigate morbidity predictors. A total of 817 patients underwent kidney autotransplantation from 2002 to 2012. The most common indication of surgery was renal artery pathology (22...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28259602/perioperative-strokes-and-early-outcomes-in-mitral-valve-surgery-a-nationwide-analysis
#18
Reshmi Udesh, Amol Mehta, Thomas G Gleason, Lawrence Wechsler, Parthasarathy D Thirumala
OBJECTIVE: To demonstrate the role of perioperative stroke as an independent risk factor for in-hospital morbidity and mortality after mitral valve surgery and review the trends in the early outcomes of mitral valve surgery over the past decade. DESIGN: Using data from the National Inpatient Sample database for analysis, all patients who underwent isolated mitral valve procedures were identified using International Classification of Diseases-Ninth Revision codes...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28259184/can-we-rely-on-out-of-hospital-blood-samples-a-prospective-interventional-study-on-the-pre-analytical-stability-of-blood-samples-under-prehospital-emergency-medicine-conditions
#19
Johannes Prottengeier, Nicola Jess, Frank Harig, Christine Gall, Joachim Schmidt, Torsten Birkholz
BACKGROUND: Prehospital intravenous access provides the opportunity to sample blood from an emergency patient at the earliest possible moment in the course of acute illness and in a state prior to therapeutic interventions. Our study investigates the pre-analytical stability of biomarkers in prehospital emergency medicine and will answer the question whether an approach of blood sampling out in the field will deliver valid laboratory results. METHODS: We prepared pairs of blood samples from healthy volunteers and volunteering patients post cardio-thoracic surgery...
March 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28255797/acetate-buffered-crystalloid-infusate-versus-infusion-of-0-9-saline-and-hemodynamic-stability-in-patients-undergoing-renal-transplantation-prospective-randomized-controlled-trial
#20
Carmen Pfortmueller, Georg-Christian Funk, Eva Potura, Christian Reiterer, Florian Luf, Barbara Kabon, Wilfred Druml, Edith Fleischmann, Gregor Lindner
BACKGROUND: Infusion therapy is one of the most frequently prescribed medications in hospitalized patients. Currently used crystalloid solutes have a variable composition and may therefore influence acid-base status, intracellular and extracellular water content and plasma electrolyte compositions and have a major impact on organ function and outcome. The aim of our study was to investigate whether use of acetate-based balanced crystalloids leads to better hemodynamic stability compared to 0...
March 2, 2017: Wiener Klinische Wochenschrift
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