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https://www.readbyqxmd.com/read/28719540/clinical-predictors-of-the-risk-of-early-colectomy-in-ulcerative-colitis-a-population-based-study
#1
Ahmed Al-Darmaki, James Hubbard, Cynthia H Seow, Yvette Leung, Kerri Novak, Abdel Aziz Shaheen, Remo Panaccione, Gilaad G Kaplan
BACKGROUND: A subset of patients with ulcerative colitis (UC) will require colectomy within a few years of diagnosis. Thus, our aim was to determine the clinical predictors of early colectomy among patients with UC who are hospitalized with an acute flare. METHODS: Using population-based surveillance (1996-2009), all adults (≥18 years) hospitalized for UC within 3 years of diagnosis (n = 489) were identified. The primary outcome was a colectomy within 3 years of diagnosis...
August 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28719091/multimodal-analgesia-as-an-alternative-to-the-risks-of-opioid-monotherapy-in-surgical-pain-management
#2
John J Savarese, Norman G Tabler
Clinicians have long been aware of the danger of overreliance on opioids to manage acute pain, such as the pain accompanying surgery. The risk of adverse drug events is higher with opioids than with any other common class of drugs. Overreliance on opioids increases length of stay and hospital costs, while decreasing patient satisfaction. Opioids can lead to problems that continue well after discharge, including chronic pain, abuse and addiction, and even death. Increasingly, prescribed opioids have proved to lead to heroin addiction...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28719039/differences-in-clinical-characteristics-and-prognosis-of-sudden-low-and-high-frequency-hearing-loss
#3
Oak-Sung Choo, Suk Min Yang, Hun Yi Park, Jong Bin Lee, Jeong Hun Jang, Seong Jun Choi, Yun-Hoon Choung
OBJECTIVES/HYPOTHESIS: We compared the clinical characteristics between acute low- and high-frequency hearing loss (LF and HF, respectively) patients, and the efficacy of three different treatment protocols (systemic steroids, intratympanic steroid injection, and combination therapy). STUDY DESIGN: Prospective, randomized controlled study. METHODS: A total of 111 patients diagnosed with LF or HF were treated on an outpatient basis. Each group was randomly divided into three equal subgroups based on therapy: oral steroid, intratympanic dexamethasone injection (IT), and combination therapy...
August 2017: Laryngoscope
https://www.readbyqxmd.com/read/28718317/hand-surgeons-and-orthopedic-trauma-surgeons-call-coverage-of-acute-upper-extremity-injuries-where-should-the-line-be-drawn
#4
Matthew B Cantlon, Andrew J Miller, Asif M Ilyas
BACKGROUND: There is a lack of consensus as to which subspecialty service should cover acute upper extremity injuries in the emergency department (ED). The purpose of the present study is to understand how upper extremity injuries are currently triaged to specialists and to assess the current opinion among hand and orthopedic trauma specialists as to how these injuries should be best triaged based on injury location and severity. METHODS: The American Association for Hand Surgery (AAHS) membership and Orthopaedic Trauma Association (OTA) membership were surveyed using a 28-item online questionnaire...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28717856/intraoperative-radiotherapy-for-extremity-soft-tissue-sarcomas-can-long-term-local-control-be-achieved
#5
Esther Carbó-Laso, Pablo Sanz-Ruiz, José Antonio Calvo-Haro, Miguel Cuervo-Dehesa, Rubén Pérez-Mañanes, Lydia Mediavilla-Santos, Coral Sánchez-Pérez, Ana Álvarez-González, Javier Vaquero-Martín
BACKGROUND: Intraoperative electron-beam radiation therapy (IOERT) during limb-sparing surgery has the advantage of delivering a single high boost dose to sarcoma residues and surgical bed area near to radiosensitive structures with limited toxicity. Retrospective studies have suggested that IOERT may improve local control compared to standard radiotherapy and we aimed to demonstrate this theory. Therefore, we performed an observational prospective study to determine (1) if it is possible to achieve high local control by adding IOERT to external-beam radiation therapy (EBRT) in extremity soft-tissue sarcomas (STS), (2) if it is possible to improve long-term survival rates, and (3) if toxicity could be reduced with IOERT MATERIALS AND METHODS: From 1995-2003, 39 patients with extremity STS were treated with IOERT and postoperative radiotherapy...
July 17, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28717853/radiation-related-heart-disease-after-breast-cancer-radiation-therapy-in-korean-women
#6
Jee Suk Chang, Byung Kyun Ko, Jeoung Won Bae, Jong-Han Yu, Min Ho Park, Yongsik Jung, Ye Won Jeon, Kyung Hwan Kim, Jaeyong Shin, Chang-Ok Suh, Yong Bae Kim
PURPOSE: To study the late cardiac toxicity of breast radiation therapy (RT) in Asian women. METHODS: Female breast cancer patients in Korea who underwent breast conservation surgery followed by RT from 1990-2012 were identified from two large registries at institution and population levels. Cumulative incidences of acute coronary events (ACE) or cardiac mortality were estimated in relation to the laterality of breast cancer using a competing risks analysis. RESULTS: In an analysis of 2577 women from a single institution, 3...
July 17, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28717840/nonoperative-management-of-perforated-acute-diverticulitis-with-extraluminal-air-results-and-risk-factors-of-failure
#7
Alberto Titos-García, Jose M Aranda-Narváez, Laura Romacho-López, Antonio J González-Sánchez, Isaac Cabrera-Serna, Julio Santoyo-Santoyo
AIM: The aim of this study was to analyze the results of nonoperative management of patients with perforated acute diverticulitis with extraluminal air and to identify risk factors that may lead to failure and necessity of surgery. METHODS: Methods included observational retrospective cohort study of patients between 2010 and 2015 with diagnosis of diverticulitis with extraluminal air and with nonoperative management initial. Patient demographics, clinical, and analytical data were collected, as were data related with computed tomography...
July 17, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28717815/hip-fractures-in-older-patients-trajectories-of-disability-after-surgery
#8
J J Aarden, M van der Esch, R H H Engelbert, M van der Schaaf, S E de Rooij, B M Buurman
BACKGROUND: Hip fracture in older patients often lead to permanent disabilities and can result in mortality. OBJECTIVE: To identify distinct disability trajectories from admission to one-year post-discharge in acutely hospitalized older patients after hip fracture. DESIGN: Prospective cohort study, with assessments at admission, three-months and one-year post-discharge. SETTING AND PARTICIPANTS: Patients ≥ 65 years admitted to a 1024-bed tertiary teaching hospital in the Netherlands...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28717624/ipsilateral-hamstring-tendon-graft-reconstruction-for-chronic-patellar-tendon-ruptures-surgical-technique
#9
Nicola Maffulli, Angelo Del Buono, Francesco Oliva
BACKGROUND: Patellar tendon chronic ruptures are more debated to manage that acute injuries as the patella tends to retract proximally (after 2 weeks), and surrounding soft tissues may make the repair more complicate. PURPOSE: We propose a novel technique in which the patellar tendon is reconstructed using ipsilateral hamstring tendons. This surgical procedure implies to drill a single tunnel through the patella and another through the tibia to reduce the risk of bony breakage...
January 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28717614/activity-level-recovery-after-acute-achilles-tendon-rupture-surgically-repaired-a-series-of-29-patients-with-a-mean-follow-up-of-46-months
#10
Richard Zayni, Raphaël Coursier, Moudasser Zakaria, Jean-François Desrousseaux, Denis Cordonnier, Gilles Polveche
BACKGROUND: Achilles tendon rupture is a common injury but its optimal management is still controversial. When decided, surgical repair can be performed by open or percutaneous techniques. Till now, there is no agreement on the ideal type of surgical management. PURPOSE: To compare the outcomes of the percutaneous and open surgical treatment for acute Achilles tendon rupture and to assess the postoperative activity level recovery. METHODS: Between 2008 and 2013, 29 patients were surgically treated for acute Achilles tendon rupture in our institution...
January 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28717611/conservative-minimally-invasive-and-open-surgical-repair-for-management-of-acute-ruptures-of-the-achilles-tendon-a-clinical-and-functional-retrospective-study
#11
Gayle Maffulli, Angelo Del Buono, Paula Richards, Francesco Oliva, Nicola Maffulli
BACKGROUND: At present, it is unclear which is the best management for Achilles tendon rupture. PURPOSE: We assess the clinical, functional and imaging outcomes of active patients undergoing 3 different types of management for acute subcutaneous rupture of the Achilles tendon, including conservative cast immobilization, traditional open surgery and percutaneous repair. METHODS: 26 active patients were managed for a rupture of the Achilles Tendon from January 2007 to March 2008...
January 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28717556/thorax-computed-tomography-findings-in-patients-with-erectile-dysfunction
#12
Mustafa Resorlu, Muhammet Arslan, Ozan Karatag, Gurhan Adam
OBJECTIVE: Diabetes mellitus, smoking, dyslipidemia, and obesity play an important role in the etiology of erectile dysfunction, particularly in cases with vascular insufficiency. These risk factors also target the lungs due to their systemic effects. MATERIALS AND METHODS: Patients with penile vascular insufficiency determined at Doppler ultrasonography and undergoing thoracic computerized tomography for various reasons were included in this study. A history of acute thoracic trauma, pneumonic consolidation, or pelvic surgery and trauma were regarded as exclusion criteria...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28717377/appropriate-blood-component-therapy-can-reduce-postcardiac-surgery-acute-kidney-injury-through-packed-cell-transfusion-reduction
#13
Kianoush Saberi, Mehrdad Salehi, Mehrzad Rahmanian, Ali Reza Bakhshandeh, Gholam Reza Massoumi
BACKGROUND: Acute kidney injury (AKI) can happen due to different factors such as anemia. Packed cell (PC) transfusion is an important cause of AKI occurrence. The aim of the study is to investigate whether appropriate blood component (BC) therapy can reduce blood transfusion and it would result in AKI decreasing. MATERIALS AND METHODS: We conducted a cohort study of 1388 patients who underwent cardiac surgery in one university hospital. A serum creatinine higher than 2 mg/dl, renal disease history, renal replacement therapy (chronic dialysis) were our exclusion criteria...
2017: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/28716864/alpha1-antitrypsin-binds-hemin-and-prevents-oxidative-activation-of-human-neutrophils-putative-pathophysiological-significance
#14
Sabina Janciauskiene, Srinu Tumpara, Malgorzata Wiese, Sabine Wrenger, Vijith Vijayan, Faikah Gueler, Rongjun Chen, Kukuh Madyaningrana, Ravi Mahadeva, Tobias Welte, Stephan Immenschuh, Joanna Chorostowska-Wynimko
Heme is a ubiquitous compound of human tissues, and it is involved in cellular physiology and metabolism. Once released from the cell, free heme oxidizes to the ferric state (hemin). High levels of hemin can cause oxidative stress and inflammation if not neutralized immediately by specialized scavenger proteins. Human alpha1-antitrypsin (A1AT), an acute-phase glycoprotein and important inhibitor of neutrophil proteases, is also a hemin-binding protein. A short-term exposure of freshly isolated human blood neutrophils to 4 µM hemin results in cell spreading, surface expression of filament protein, vimentin, free radical production, expression of heme oxygenase-1 (HO-1), release of IL-8, and enhanced neutrophil adhesion to human endothelial cells...
July 17, 2017: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/28716832/mechanical-circulatory-support-devices-for-acute-right-ventricular-failure
#15
REVIEW
Navin K Kapur, Michele L Esposito, Yousef Bader, Kevin J Morine, Michael S Kiernan, Duc Thinh Pham, Daniel Burkhoff
Right ventricular (RV) failure remains a major cause of global morbidity and mortality for patients with advanced heart failure, pulmonary hypertension, or acute myocardial infarction and after major cardiac surgery. Over the past 2 decades, percutaneously delivered acute mechanical circulatory support pumps specifically designed to support RV failure have been introduced into clinical practice. RV acute mechanical circulatory support now represents an important step in the management of RV failure and provides an opportunity to rapidly stabilize patients with cardiogenic shock involving the RV...
July 18, 2017: Circulation
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#16
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28716643/reduced-risk-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-after-bariatric-surgery-a-self-controlled-case-series-study
#17
Tadahiro Goto, Yusuke Tsugawa, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
BACKGROUND: Obesity is common among individuals with chronic obstructive pulmonary disease (COPD) and associated with increased COPD morbidities. However, little is known about the impact of weight reduction on COPD-related outcomes in obese patients. METHODS: Using the population-based emergency department (ED) and inpatient sample in three U.S. states (California, Florida, and Nebraska), we performed a self-controlled case series study of 481 obese adults (aged 40-65 years) with COPD who underwent bariatric surgery...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28716368/surgeons-and-surgical-trainees-acute-stress-in-real-operations-or-simulation-a-systematic-review
#18
REVIEW
Konstantinos Georgiou, Andreas Larentzakis, Athanasios G Papavassiliou
BACKGROUND AND PURPOSE: Acute stress in surgery is ubiquitous and has an immediate impact on surgical performance and patient safety. Surgeons react with several coping strategies; however, they recognise the necessity of formal stress management training. Thus, stress assessment is a direct need. Surgical simulation is a validated standardised training milieu designed to replicate real-life situations. It replicates stress, prevents biases, and provides objective metrics. The complexity of stress mechanisms makes stress measurement difficult to quantify and interpret...
July 14, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28716062/the-effects-of-acute-and-elective-cardiac-surgery-on-the-anxiety-traits-of-patients-with-marfan-syndrome
#19
Kálmán Benke, Bence Ágg, Miklós Pólos, Alex Ali Sayour, Tamás Radovits, Elektra Bartha, Péter Nagy, Balázs Rákóczi, Ákos Koller, Viola Szokolai, Julianna Hedberg, Béla Merkely, Zsolt B Nagy, Zoltán Szabolcs
BACKGROUND: Marfan syndrome is a genetic disease, presenting with dysfunction of connective tissues leading to lesions in the cardiovascular and skeletal muscle system. Within these symptoms, the most typical is weakness of the connective tissue in the aorta, manifesting as aortic dilatation (aneurysm). This could, in turn, become annuloaortic ectasia, or life-threatening dissection. As a result, life-saving and preventative cardiac surgical interventions are frequent among Marfan syndrome patients...
July 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28715070/evaluation-of-the-relationship-between-renal-resistive-index-and-extensivity-and-complexity-of-coronary-artery-disease-in-patients-with-acute-coronary-syndrome
#20
Alaa Quisi, Ibrahim Halil Kurt, Durmuş Yıldıray Şahin, Onur Kaypaklı, Gökhan Söker, Ömer Kaya, Samir Allahverdiyev, Ömer Genç, Gökhan Alıcı, Mevlüt Koç
BACKGROUND: Despite the advances in cardiovascular medicine, acute coronary syndrome (ACS) is still a major cause of morbidity and mortality worldwide. Synergy between PCI ™ with TAXUS and Cardiac Surgery (SYNTAX) score is used to determine the extensivity and complexity of coronary artery disease (CAD). Renal resistive index (RRI), a renal Doppler ultrasound parameter, is used to detect renal hemodynamics. Although some risk factors for CAD, including hypertension and diabetes mellitus were demonstrated to have an association with RRI, direct relationship between the presence...
July 17, 2017: Kardiologia Polska
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