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https://www.readbyqxmd.com/read/29787349/head-and-neck-cancer-patients-rates-reasons-and-risk-factors-for-30-day-unplanned-readmission
#1
Michael K Ghiam, Alexander Langerman, Zoukaa Sargi, Sarah Rohde
Objective To analyze rates, risk factors, and complications for 30-day readmission among head and neck cancer (HNC) patients. Methods Retrospective review of administrative records from Vizient (Irving, Texas) Clinical Data Base/Resource Manager on HNC patients who underwent a head and neck surgical procedure from January 2013 through September 2015 at 176 academic and community medical centers. Results Of the 18,121 patients included in the study, 2502 patients were readmitted within 30 days (13.8%). Mean time to readmission was 11 ± 8...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29771807/administration-of-an-oral-hydration-solution-prevents-electrolyte-and-fluid-disturbances-and-reduces-readmissions-in-patients-with-a-diverting-ileostomy-after-colorectal-surgery-a-prospective-randomized-controlled-trial
#2
Athanasios Migdanis, Georgios Koukoulis, Ioannis Mamaloudis, Ioannis Baloyiannis, Ioannis Migdanis, Maria Kanaki, Eleni Malissiova, Georgios Tzovaras
BACKGROUND: Patients with a newly formed ileostomy often develop electrolyte abnormalities and dehydration. OBJECTIVE: The study assessed the prophylactic effect of an isotonic hydration solution on dehydration and electrolyte abnormalities in patients with a newly formed ileostomy. DESIGN: This was a prospective, randomized, controlled trial (NCT02036346). SETTINGS: The study was conducted at a single surgical unit of a public university hospital...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29730103/value-of-routine-preoperative-tests-for-coagulation-before-elective-cranial-surgery-results-of-an-institutional-audit-and-a-nationwide-survey-of-neurosurgical-centers-in-pakistan
#3
Naveed Zaman Akhunzada, Muhammad Bilal Tariq, Saad Akhtar Khan, Sidra Sattar, Wajeeha Tariq, Muhammad Shahzad Shamim, Samie Asghar Dogar
Routine preoperative blood testing has become a dogma. The general practice is to order preoperative work up as a knee jerk response rather than individualize it for each patient. The fact that the bleeding brain tends to swell, which coupled with limited options for proximal control, packing and overall hemostasis, leads to an over emphasis on preoperative coagulation profile. MATERIAL AND METHODS: This is a retrospective review of the medical records of patients admitted at Aga Khan University Hospital from January 2010 to December 2015 for an elective craniotomy...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29714433/peritoneal-dialysis-in-neonates-six-years-of-single-center-experience
#4
Ferda Özlü, Hacer Yapıcıoğlu Yıldızdaş, Gül Şeker, Hüseyin Şimşek, Aysun Karabay Bayazıt, Mehmet Satar
Background/aim: Peritoneal dialysis (PD) is generally considered the practical dialysis modality for neonates in the treatment of acute kidney injury (AKI) and metabolic disturbances. The aim of this study was to evaluate the indications, complications, and outcomes of PD between January 2011 and December 2016. Materials and methods: This study included all 56 neonates that underwent PD over six years in our neonatal intensive care unit (NICU). A retrospective chart review was performed for all patients in our institution...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29710234/association-of-postoperative-readmissions-with-surgical-quality-using-a-delphi-consensus-process-to-identify-relevant-diagnosis-codes
#5
Hillary J Mull, Laura A Graham, Melanie S Morris, Amy K Rosen, Joshua S Richman, Jeffery Whittle, Edith Burns, Todd H Wagner, Laurel A Copeland, Tyler Wahl, Caroline Jones, Robert H Hollis, Kamal M F Itani, Mary T Hawn
Importance: Postoperative readmission data are used to measure hospital performance, yet the extent to which these readmissions reflect surgical quality is unknown. Objective: To establish expert consensus on whether reasons for postoperative readmission are associated with the quality of surgery in the index admission. Design, Setting, and Participants: In a modified Delphi process, a panel of 14 experts in medical and surgical readmissions comprising physicians and nonphysicians from Veterans Affairs (VA) and private-sector institutions reviewed 30-day postoperative readmissions from fiscal years 2008 through 2014 associated with inpatient surgical procedures performed at a VA medical center between October 1, 2007, and September 30, 2014...
April 18, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29697599/significantly-elevated-c-reactive-protein-levels-after-epicardial-clipping-of-the-left-atrial-appendage
#6
Niels J Verberkmoes, Ferdi Akca, Ann-Sofie Vandevenne, Luuk Jacobs, Mohamed A Soliman Hamad, Albert H M van Straten
OBJECTIVE: Besides mechanical and anatomical changes of the left atrium, epicardial closure of the left atrial appendage has also possible homeostatic effects. The aim of this study was to assess whether epicardial clipping of the left atrial appendage has different biochemical effects compared with complete removal of the left atrial appendage. METHODS: Eighty-two patients were included and underwent a totally thoracoscopic AF ablation procedure. As part of the procedure, the left atrial appendage was excluded with an epicardial clip (n = 57) or the left atrial appendage was fully amputated with an endoscopic vascular stapler (n = 25)...
April 24, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29695021/pre-clinical-model-to-study-recurrent-venous-thrombosis-in-the-inferior-vena-cava
#7
Elizabeth A Andraska, Catherine E Luke, Megan A Elfline, Samuel P Henke, Siddharth S Madapoosi, Allan K Metz, Megan E Hoinville, Thomas W Wakefield, Peter K Henke, Jose A Diaz
BACKGROUND:  Patients undergoing deep vein thrombosis (VT) have over 30% recurrence, directly increasing their risk of post-thrombotic syndrome. Current murine models of inferior vena cava (IVC) VT model host one thrombosis event. OBJECTIVE:  We aimed to develop a murine model to study IVC recurrent VT in mice. MATERIALS AND METHODS:  An initial VT was induced using the electrolytic IVC model (EIM) with constant blood flow. This approach takes advantage of the restored vein lumen 21 days after a single VT event in the EIM demonstrated by ultrasound...
April 25, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29685726/perianesthesia-measurement-during-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-procedure-a-case-report-and-review-of-the-literature
#8
Dan Li, Richard Henker, Fei Zhang
PURPOSE: This purpose of this case study and review was to understand perianesthesia care of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy surgery (CRS+HIPEC). DESIGN: Case study. METHODS: The perianesthesiaa medical record of a patient under CRS+HIPEC was analyzed to study the characteristics of perianestheia care for CRS+HIPEC. The literature of perianestheisa care for CRS+HIPEC was reviewed. FINDINGS: The challenges that perianesthesia care for CRS+HIPEC include-but are not limited to-electrolyte abnormalities, hemodynamic instabilities, and temperature fluctuation...
April 20, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29684990/acid-base-alterations-during-major-abdominal-surgery-6-hydroxyethyl-starch-infusion-versus-5-albumin
#9
Hyun Jeong Kwak, Oh Kyung Lim, Jae Myung Baik, Youn Yi Jo
Background: To compare the effects of intraoperative infusions of balanced electrolyte solution (BES)-based hydroxyethyl starch (HES) and saline-based albumin on metabolic acidosis and acid/base changes during major abdominal surgery conducted using Stewart's approach. Methods: Forty patients, aged 20-65 years, undergoing major abdominal surgery, were randomly assigned to the HES group (n = 20; received 500 ml of BES-based 6% HES 130/0.4) or the albumin group (n = 20; received 500 ml of normal saline-based 5% albumin)...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29653271/risk-factors-additional-length-of-stay-and-cost-associated-with-postoperative-ileus-following-anterior-lumbar-interbody-fusion-in-the-elderly
#10
Jason A Horowitz, Amit Jain, Varun Puvanesarajah, Rabia Qureshi, Hamid Hassanzadeh
OBJECTIVE: Identify the independent risk factors, additional length of stay, and additional cost associated with postoperative ileus following anterior lumbar interbody fusion in the elderly. METHODS: The PearlDiver Patient Records Database (Young & Ellison, LLC, Colorado Springs, CO) was queried for all Medicare patients 65 years of age and older undergoing 1 or 2 level primary elective anterior lumbar interbody fusion from 2005-2014. Independent risk factors, additional length of stay, and additional cost associated with postoperative ileus were evaluated with multivariate analysis...
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29643727/outcome-of-mainz-ii-pouch-urinary-diversion-after-radical-cystectomy-in-patients-with-muscle-invasive-bladder-cancer-our-experience
#11
Stephen Odunayo Ikuerowo, Olufemi O Ojewuyi, Muftau Jimoh Bioku, Abimbola Ayodeji Abolarinwa, Olufunmilade Akinfolarin Omisanjo
Introduction: Mainz II pouch urinary diversion in patients with muscle-invasive bladder cancer is one of the options of continent urinary diversion following radical cystectomy (RC). We aim to report our experience and the outcome of our patients who had this procedure. Patients and Methods: Patients who had RC and Mainz II pouch urinary diversion for muscle-invasive bladder cancer in our institution from 2007 to 2016 were evaluated. Variables analyzed included age, gender, stage of the disease, pathological grade and tumor types, complications, and survival status...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29628565/postoperative-cognitive-dysfunction-in-indian-patients-undergoing-total-knee-replacement-under-spinal-anesthesia
#12
Praful Kilaru, A Ramachandra Reddy, Maryada Venketeshwar Reddy, Brijesh Kidiyoor, Vinay Mathew Joseph, Annapareddy Venkata Gurava Reddy
Introduction: Total knee replacement is a common surgical procedure in the elderly. The number of surgeries has increased owing to the increasing life expectancy of the population and better functional outcomes postsurgery. Postoperative cognitive dysfunction (POCD) is an identified entity postsurgery in elderly but most of the studies have been on patients undergoing cardiac and other nonorthopaedic surgeries. The studies have shown variable incidence due to selection bias. We studied the incidence and probable predictive factors of POCD in elderly Indian population undergoing total knee replacement under spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29596212/perioperative-nutritional-optimization-in-spine-surgery
#13
Rabia Qureshi, Mohammad Rasool, Varun Puvanesarajah, Hamid Hassanzadeh
Nutritional optimization in patients undergoing spine surgery is important as improved surgical outcomes and decreased rates of complications have been noted in optimized patients. With the increasingly high numbers of elderly patient and patients with metabolic comorbidities undergoing spine procedures, perioperative nutritional status should be enhanced for the best possible surgical outcomes. Methods of optimization include preoperative screening with Nutritional Risk Score or other scoring systems, looking for changes in body mass index, detecting sarcopenia, and screening for metabolic abnormalities...
April 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29595672/a-case-report-of-a-man-on-peritoneal-dialysis-having-intractable-hyponatremia
#14
Xu-Jie Zhou, Ying Yang, Tao Su, Jie Dong
RATIONALE: Hyponatremia is one of the most common electrolyte disorders in patients on peritoneal dialysis (PD). It can be associated with severe consequences, higher morbidity and mortality. Therefore, hyponatremia should be assessed and monitored more carefully in these patients. PATIENT CONCERNS: A 55-year-old male PD patient progressively developed intractable hyponatremia was admitted to our hospital. DIAGNOSES: The observation that no significant salt was lost in kidney and PD drainage prompted us to seek the underlying reasons for malnutrition and chronic inflammation...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29588985/ketogenic-parenteral-nutrition-in-17-pediatric-patients-with-epilepsy
#15
Anastasia Dressler, Nadja Haiden, Petra Trimmel-Schwahofer, Franz Benninger, Sharon Samueli, Gudrun Gröppel, Sina Spatzierer, Angelika Mühlebner, Klaus Abraham, Martha Feucht
Objective: Ketogenic parenteral nutrition (kPN) is indicated when enteral intake is temporarily limited or impossible, but evidence-based prescriptions are lacking. Objective was to evaluate the efficacy and safety of kPN in children with epileptic encephalopathies using a new computer-based algorithm for accurate component calculating. Methods: Children with epilepsy receiving kPN were included. A computer-based algorithm was established on the basis of guidelines of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN): fat intake not exceeding 4 g/kg/day, age-adequate supply of protein, electrolytes, vitamins, and trace elements, but reduced carbohydrates...
March 2018: Epilepsia Open
https://www.readbyqxmd.com/read/29552136/drug-distribution-and-clinical-safety-in-treating-cystic-craniopharyngiomas-using-intracavitary-radiotherapy-with-phosphorus-32-colloid
#16
Hongbo Chang, Jianning Zhang, Weidong Cao, Yaming Wang, Hulin Zhao, Rui Liu, Shengli Guo
The present study evaluated drug distribution and clinical safety in treating patients with cystic craniopharyngioma (CP) with intracavitary radiotherapy using phosphorus-32 (32 P) colloid. In total, 40 patients who were recently diagnosed with primary or recurrent cystic CP were enrolled into the study. Patients underwent stereotactic intracavitary therapy and were administered 32 P colloid and iopamidol-300 (1:1 dilution). Head computed tomography (CT) scans were performed 2 h after surgery in order to assess drug distribution and leakage...
April 2018: Oncology Letters
https://www.readbyqxmd.com/read/29524704/endoscopic-endonasal-surgery-treatment-strategies-for-invasive-pituitary-adenoma-analysis-of-four-approaches
#17
Yang Ji-Hu, Huang Guo-Dong, Ji Tao, Wang Hai-Dong, Liu Yu-Fei, Guo Jian, Li Zhen, Li Wei-Ping
OBJECTIVE: To explore the surgical methods and clinical effect of endoscopic endonasal approaches for the treatment of invasive pituitary adenomas(IPA). METHODS: A retrospective analysis of the clinical data of 74 patients(75 procedures) with invasive pituitary adenomas treated by different endoscopic endonasal approaches at the Department of Neurosurgery, the First Affiliated Hospital of Shenzhen University from May 2014 to August 2017. The data include clinical manifestation, imaging features, surgical methods and complications, resection rate, cure rate, prognosis and complications in different Knosp classifications and Hardy stages...
March 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29492131/chronic-subdural-hematoma-associated-with-fahr-syndrome-a-clinical-association-or-just-a-simple-coincidence
#18
Oktay Gurcan, Ahmet Gurhan Gurcay, Atilla Kazanci, Tuncer Goker, Oguzhan Eylen, Omer Faruk Turkoglu
The Fahr syndrome (FS) is a rare degenerative neurological disorder (its prevalence is <0.5%). FS is distinguished by the presence of abnormal bilateral intracranial calcifications with a predilection for the basal ganglia, also presented by movement disorders such as parkinsonism, paresis, and speech disorders. Chronic subdural hematoma (CSH), which is typically the result of mild head trauma, is a regularly encountered condition in elderly. A 63-year-old man has referred to our clinic from another hospital with a history of mild head trauma approximately a month ago...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29489656/the-impact-of-early-enteral-nutrition-on-pediatric-patients-undergoing-gastrointestinal-anastomosis-a-propensity-score-matching-analysis
#19
Qingjuan Shang, Qiankun Geng, Xuebing Zhang, Hongfang Xu, Chunbao Guo
This study was conducted to assess the clinical advantages of early enteral nutrition (EEN) in pediatric patients who underwent surgery with gastrointestinal (GI) anastomosis.EEN has been associated with clinical benefits in various aspect of surgical intervention, including GI function recovery and postoperative complications reduction. Evaluable data documenting clinical advantages with EEN for pediatric patients after surgery with GI anastomosis are limited.We retrospectively reviewed the medical records of 575 pediatric patients undergoing surgical intervention with GI anastomosis...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29452285/risk-factors-for-perioperative-morbidity-in-spine-surgeries-of-different-complexities-a-multivariate-analysis-of-1-009-consecutive-patients
#20
Mazda Farshad, David E Bauer, Cyrill Wechsler, Christian Gerber, Alexander Aichmair
BACKGROUND CONTEXT: There is a broad spectrum of complications during or after surgical procedures, with differing incidences reported in the published literature. Heterogeneity can be explained by the lack of an established evidence-based classification system for documentation and classification of complications in a standardized manner. PURPOSE: The objective of this study was to identify predictive risk factors for perioperative and early postoperative morbidities in spine surgeries of different complexities in a large cohort of consecutive patients...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
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