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https://www.readbyqxmd.com/read/29238824/effect-of-perioperative-gabapentin-on-postoperative-pain-resolution-and-opioid-cessation-in-a-mixed-surgical-cohort-a-randomized-clinical-trial
#1
Jennifer Hah, Sean C Mackey, Peter Schmidt, Rebecca McCue, Keith Humphreys, Jodie Trafton, Bradley Efron, Debra Clay, Yasamin Sharifzadeh, Gabriela Ruchelli, Stuart Goodman, James Huddleston, William J Maloney, Frederick M Dirbas, Joseph Shrager, John Costouros, Catherine Curtin, Ian Carroll
Importance: Guidelines recommend using gabapentin to decrease postoperative pain and opioid use, but significant variation exists in clinical practice. Objective: To determine the effect of perioperative gabapentin on remote postoperative time to pain resolution and opioid cessation. Design, Setting, and Participants: A randomized, double-blind, placebo-controlled trial of perioperative gabapentin was conducted at a single-center, tertiary referral teaching hospital...
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29229610/follow-up-imaging-after-nephrectomy-for-cancer-in-canada-urologists-compliance-with-guidelines-an-observational-study
#2
Alice Dragomir, Armen Aprikian, Anil Kapoor, Antonio Finelli, Frédéric Pouliot, Ricardo Rendon, Peter C Black, Ronald Moore, Rodney H Breau, Jun Kawakami, Darrell Drachenberg, Jean-Baptiste Lattouf, Simon Tanguay
BACKGROUND: Surgical tumour removal remains the preferred treatment for most patients with renal cell carcinoma, and many medical associations have proposed guidelines for the optimal surveillance of patients following surgery. This study evaluated the adherence of Canadian urologists to the follow-up guidelines proposed by the Canadian Urological Association (CUA) in 2009. METHODS: The study cohort was identified from the Canadian Kidney Cancer Information System, a prospectively populated database from 15 academic institutions in 6 Canadian provinces: British Colombia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia...
December 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29228411/management-of-breast-cancer-in-adjuvant-chemotherapy-settings-in-the-kanagawa-breast-oncology-group
#3
Mayako Terao, Naoki Niikura, Yasuhiro Suzuki, Norihiko Sengoku, Hitoshi Arioka, Takashi Ishikawa, Koichiro Tsugawa, Yutaka Tokuda
OBJECTIVE: Many different options for adjuvant chemotherapy are recommended in guidelines for the treatment of breast cancer. Therapeutic strategies vary among physicians. The major goals for this project were to gain a better understanding of how biomarkers are integrated into practice and how physicians select adjuvant chemotherapy. METHODS: We assembled a questionnaire with 23 example scenarios of breast cancer cases, including 6 items relevant to postoperative adjuvant therapy...
December 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/29227454/immediate-and-long-term-hearing-outcomes-with-the-middle-cranial-fossa-approach-for-vestibular-schwannoma-resection
#4
Sameer Ahmed, H Alexander Arts, Hussam El-Kashlan, Gregory J Basura, B Gregory Thompson, Steven A Telian
OBJECTIVE: To analyze the immediate postoperative and long-term hearing outcome data in patients who have undergone hearing preservation attempts with the middle cranial fossa (MCF) approach for the resection of sporadic vestibular schwannoma. STUDY DESIGN: Retrospective review of a surgical patient cohort. SETTING: Tertiary academic referral center. PATIENTS: Adult patients with unilateral sporadic vestibular schwannoma...
January 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29226971/intravenous-dexamethasone-for-prophylaxis-of-postoperative-nausea-and-vomiting-after-administration-of-long-acting-neuraxial-opioids-a-systematic-review-and-meta-analysis
#5
REVIEW
S Grape, I Usmanova, K R Kirkham, E Albrecht
Long-acting neuraxial opioids provide excellent analgesia after surgery, but are associated with higher rates of postoperative nausea and vomiting. Dexamethasone effectively prevents postoperative nausea and vomiting after general anaesthesia, but its value in patients receiving long-acting neuraxial opioids is undetermined. Therefore, the objective of this meta-analysis was to assess the prophylactic anti-emetic efficacy of intravenous (i.v.) dexamethasone in this population. The study methodology followed the PRISMA statement guidelines...
December 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29221303/the-society-for-translational-medicine-clinical-practice-guidelines-for-the-postoperative-management-of-chest-tube-for-patients-undergoing-lobectomy
#6
REVIEW
Shugeng Gao, Zhongheng Zhang, Javier Aragón, Alessandro Brunelli, Stephen Cassivi, Ying Chai, Chang Chen, Chun Chen, Gang Chen, Haiquan Chen, Jin-Shing Chen, David Tom Cooke, John B Downs, Pierre-Emmanuel Falcoz, Wentao Fang, Pier Luigi Filosso, Xiangning Fu, Seth D Force, Martínez I Garutti, Diego Gonzalez-Rivas, Dominique Gossot, Henrik Jessen Hansen, Jianxing He, Jie He, Bo Laksáfoss Holbek, Jian Hu, Yunchao Huang, Mohsen Ibrahim, Andrea Imperatori, Mahmoud Ismail, Gening Jiang, Hongjing Jiang, Zhongmin Jiang, Hyun Koo Kim, Danqing Li, Gaofeng Li, Hui Li, Qiang Li, Xiaofei Li, Yin Li, Zhijun Li, Eric Lim, Chia-Chuan Liu, Deruo Liu, Lunxu Liu, Yongyi Liu, Kevin W Lobdell, Haitao Ma, Weimin Mao, Yousheng Mao, Juwei Mou, Calvin Sze Hang Ng, Nuria M Novoa, René H Petersen, Hiroyuki Oizumi, Kostas Papagiannopoulos, Cecilia Pompili, Guibin Qiao, Majed Refai, Gaetano Rocco, Erico Ruffini, Michele Salati, Agathe Seguin-Givelet, Alan Dart Loon Sihoe, Lijie Tan, Qunyou Tan, Tang Tong, Kosmas Tsakiridis, Federico Venuta, Giulia Veronesi, Nestor Villamizar, Haidong Wang, Qun Wang, Ruwen Wang, Shumin Wang, Gavin M Wright, Deyao Xie, Qi Xue, Tao Xue, Lin Xu, Shidong Xu, Songtao Xu, Tiansheng Yan, Fenglei Yu, Zhentao Yu, Chunfang Zhang, Lanjun Zhang, Tao Zhang, Xun Zhang, Xiaojing Zhao, Xuewei Zhao, Xiuyi Zhi, Qinghua Zhou
The Society for Translational Medicine and The Chinese Society for Thoracic and Cardiovascular Surgery conducted a systematic review of the literature in an attempt to improve our understanding in the postoperative management of chest tubes of patients undergoing pulmonary lobectomy. Recommendations were produced and classified based on an internationally accepted GRADE system. The following recommendations were extracted in the present review: (I) chest tubes can be removed safely with daily pleural fluid of up to 450 mL (non-chylous and non-sanguinous), which may reduce chest tube duration and hospital length of stay (2B); (II) in rare instances, e...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29219857/a-literature-review-of-percutaneous-endoscopic-gastrostomy-dealing-with-complications
#7
Hatice Pars, Hicran Çavuşoğlu
Sufficient energy and essential nutrients are vital for normal growth and development in childhood. Ideally, nutrition should be provided orally. However, if the gastrointestinal system is functional, enteral tube feeding can be used when nutritional requirements cannot be provided orally, thus providing nutritional benefits and enabling positive disease management in pediatric patients. Postoperative care in children allows monitoring of the position and functionality of the tube; performing nutrition intolerance, growth, hydration, and nutritional assessments; and performing metabolic and complication follow-ups...
December 6, 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/29215480/optimal-surveillance-protocols-after-curative-resection-in-patients-with-stage-iv-colorectal-cancer-a-multicenter-retrospective-study
#8
Tomokazu Kishiki, Brittany Lapin, Hiroyoshi Matsuoka, Takeshi Watanabe, Kohei Takayasu, Koichiro Kojima, Kenichi Sugihara, Tadahiko Masaki
BACKGROUND: After patients with stage IV colorectal cancer undergo curative surgical resection, there is a large risk for recurrence. To establish optimal surveillance guidelines, an understanding of the temporal risk factors for recurrence is necessary. OBJECTIVE: The primary aim of our study was to determine predictors for early (within 1 year), middle (1-2 years), and late (2 years or later) recurrence following curative resection in patients with stage IV colorectal cancer...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29215370/opioid-use-after-discharge-in-postoperative-patients-a-systematic-review
#9
Adina E Feinberg, Tyler R Chesney, Sanjho Srikandarajah, Sergio A Acuna, Robin S McLeod
BACKGROUND: Over the past 2 decades, there has been an increase in opioid use and subsequently, opioid deaths. The amount of opioid prescribed to surgical patients has also increased. The aim of this systematic review was to determine postdischarge opioid consumption in surgical patients compared with the amount of opioid prescribed. Secondary outcomes included adequacy of pain control and disposal methods for unused opioids. OBJECTIVE: The objective of this study is to characterize postdischarge opioid consumption and prescription patterns in surgical patients...
December 5, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29212492/using-patient-data-to-optimize-an-expert-based-guideline-on-convalescence-recommendations-after-gynecological-surgery-a-prospective-cohort-study
#10
Esther V A Bouwsma, Johannes R Anema, A Vonk Noordegraaf, Henrica C W de Vet, Judith A F Huirne
BACKGROUND: Convalescence advice is often based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves. The aim of this study was to analyse recovery in terms of resumption of various daily activities including work, following different laparoscopic and abdominal surgery in order to optimize an expert-based guideline on convalescence recommendations. METHODS: This is a prospective cohort study conducted in nine general and one university hospital in the Netherlands...
December 6, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29206790/aspirin-for-prophylaxis-against-venous-thromboembolism-after-orthopaedic-oncologic-surgery
#11
Gregory M Mendez, Yash M Patel, Daniel A Ricketti, John P Gaughan, Richard D Lackman, Tae Won B Kim
BACKGROUND: Patients who undergo orthopaedic oncologic surgical procedures are at increased risk of developing a venous thromboembolism (VTE). Guidelines from surgical societies are shifting to include aspirin as a postoperative VTE prophylactic agent. The purpose of this study was to review our experience using aspirin as postoperative VTE prophylaxis for orthopaedic oncologic surgical procedures. METHODS: This study was a retrospective review of patients diagnosed with a primary malignant soft-tissue or bone tumor or metastatic carcinoma...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29206731/enteral-feeding-practices-in-infants-with-congenital-heart-disease-across-european-picus-a-european-society-of-pediatric-and-neonatal-intensive-care-survey
#12
Lyvonne N Tume, Reinis Balmaks, Eduardo da Cruz, Lynne Latten, Sascha Verbruggen, Frédéric V Valla
OBJECTIVES: To describe enteral feeding practices in pre and postoperative infants with congenital heart disease in European PICUs. DESIGN: Cross-sectional electronic survey. SETTING: European PICUs that admit infants with congenital heart disease pre- and postoperatively. PARTICIPANTS: One senior PICU physician or designated person per unit. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fifty-nine PICUs from 18 European countries responded to the survey...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29203506/effectiveness-of-preoperative-medical-consultations-by-internal-medicine-physicians-a-systematic-review
#13
Clarabelle T Pham, Catherine L Gibb, Robert A Fitridge, Jonathan D Karnon
OBJECTIVE: Clinics have been established to provide preoperative medical consultations, and enable the anaesthetist and surgeon to deliver the best surgical outcome for patients. However, there is uncertainty regarding the effect of such clinics on surgical, in-hospital and long-term outcomes. A systematic review of the literature was conducted to determine the effectiveness of preoperative medical consultations by internal medicine physicians for patients listed for elective surgery...
December 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29203433/management-of-soft-tissue-tumors-of-the-musculoskeletal-system
#14
REVIEW
A Rochwerger, J C Mattei
A palpable mass in the musculoskeletal system is a common reason for consultation. The main issue is that a malignant tumor must not be missed. Inappropriate initial treatment can have direct consequences on the risk of local recurrence, the patient's future function and life expectancy. A mass more than 5cm in diameter, a subfascial location and a recent increase in size are signs that should lead the physician to question whether the lesion is truly benign and to carry out diagnostic examinations. MRI is the gold standard imaging exam...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29203354/unicompartmental-knee-arthroplasty-vs-high-tibial-osteotomy-for-knee-osteoarthritis-a-systematic-review-and-meta-analysis
#15
ZhenWu Cao, XiuJun Mai, Jun Wang, EnHui Feng, YongMing Huang
BACKGROUND: Prior studies have compared unicompartmental knee arthroplasty (UKA) with high tibial osteotomy (HTO) suggesting that both procedures had good clinical outcomes. However, which treatment is more beneficial for unicompartmental knee osteoarthritis is still a controversy. The purpose of our study is to obtain postoperative outcomes of revision rate, complications, function results, range of motion (ROM), and pain between the 2 procedures. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and study protocol was published online at PROSPERO under registration number CRD42016049316...
December 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29198638/guideline-for-discharge-opioid-prescriptions-after-inpatient-general-surgical-procedures
#16
Maureen V Hill, Ryland S Stucke, Sarah E Billmeier, Julia L Kelly, Richard J Barth
BACKGROUND: There is a paucity of data to inform appropriate opioid prescribing for patients who are discharged after a hospital admission for a surgical procedure. STUDY DESIGN: We studied 333 inpatients discharged to home after bariatric, benign foregut, liver, pancreas, ventral hernia, and colon surgery. Chronic opioid users or patients who had complications were excluded. Home opioid usage was quantified in 90% of the remaining patients by questionnaires and phone surveys...
November 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29198001/imaging-findings-of-recurrent-pancreatic-cancer-following-resection
#17
S Javadi, N Karbasian, P Bhosale, S de Castro Faria, O Le, M H Katz, E J Koay, E P Tamm
Pancreatic cancer is a challenging malignancy to treat, largely due to aggressive regional involvement, early systemic dissemination, high recurrence rate, and subsequent low patient survival. Generally, 15-20% of newly diagnosed pancreatic cancers are candidates for possible curative resection. Eighty percent of these patients, however, will experience locoregional or distant recurrence in first 2 years. Although there is no strong evidence-based guideline for optimal surveillance after pancreatic cancer resection, careful comparison of surveillance follow-up multi-detector CT (MDCT) studies with a postoperative baseline MDCT examination aids detection of early recurrent pancreatic cancer...
December 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29197165/the-treatment-of-postoperative-endophthalmitis-should-we-still-follow-the-endophthalmitis-vitrectomy-study-more-than-two-decades-after-its-publication
#18
Andrzej Grzybowski, Magdalena Turczynowska, Ferenc Kuhn
Conducted in the early 1990s Endophthalmitis Vitrectomy Study (EVS) have helped in establishing reasonable guidelines for the management of infectious postoperative endophthalmitis. However at present, more than 20 years after its publication, tremendous progress has been introduced in vitrectomy technology, which now permits the vitreoretinal surgeon to perform surgery more safely, and with better outcomes. Moerover, performing a complete vitreous removal, along with the moving up of the surgical intervention to as early as possible allows the prevention of complications that would limit the functional improvement postoperatively...
December 2, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/29195738/a-perioperative-care-map-improves-outcomes-in-patients-with-morbid-obesity-undergoing-major-surgery
#19
Benjamin D Boodaie, Anthony H Bui, David L Feldman, Michael Brodman, Peter Shamamian, Ronald Kaleya, Meg Rosenblatt, Donna Somerville, Patricia Kischak, I Michael Leitman
BACKGROUND: The surgical management of patients with morbid obesity (BMI ≥ 40) is notable for a relatively high risk of complications. To address this problem, a perioperative care map was developed using precautions and best practices commonly employed in bariatric surgery. It requires additional medical assessments, sleep apnea surveillance, more stringent guidelines for anesthetic management, and readily available bariatric operating room equipment, among other items. This care map was implemented in 2013 at four major urban teaching hospitals for use in patients undergoing all types of non-ambulatory surgery with a BMI greater than 40 kg/m2...
November 28, 2017: Surgery
https://www.readbyqxmd.com/read/29193376/evaluation-of-left-ventricular-reverse-remodeling-in-patients-with-severe-aortic-regurgitation-undergoing-aortic-valve-replacement-comparison-between-diameters-and-volumes
#20
Géraldine Ong, Bjorn Redfors, Aaron Crowley, Husam Abdel-Qadir, Alana Harrington, Yangbo Liu, Myriam Lafrenière-Roula, Howard Leong-Poi, Mark D Peterson, Kim A Connelly
BACKGROUND: In patients with severe aortic regurgitation (AR), the left ventricular ejection fraction (LVEF) and left ventricle (LV) size are crucial for determining clinical prognosis and timing of valve intervention. In clinical practice, LV internal diameters obtained at end-diastole are used to assess the degree of LV dilatation. Whether quantification of LV volumes would provide more robust information as compared to LV linear dimensions is unknown. METHODS: We retrospectively analyzed preoperative and postoperative transthoracic echocardiograms of patients who underwent aortic valve replacement (AVR) for severe AR...
November 28, 2017: Echocardiography
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