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https://www.readbyqxmd.com/read/28437372/heart-rate-modification-of-cardiac-output-following-cardiac-surgery-the-importance-of-cardiac-time-intervals
#1
Guido Tavazzi, Andy Kontogeorgis, Fabio Guarracino, Niels Bergsland, Ana Martinez-Naharro, John Pepper, Susanna Price
OBJECTIVES: Inadequate cardiac output is associated with a poor outcome following cardiac surgery and is generally modified by the use of positive inotropic agents, volume resuscitation, and pacing. Echocardiography-guided pacemaker optimization is used in the outpatient setting, using different variables including total isovolumic time and the Tei index. We sought to determine the acute impact of heart rate on cardiac electromechanics, cardiac output, and stroke volume in the perioperative setting...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437329/metastatic-spinal-cord-compression-and-steroid-treatment-a-systematic-review
#2
Abhishek Kumar, Michael H Weber, Ziya Gokaslan, Jean-Paul Wolinsky, Meic Schmidt, Laurence Rhines, Michael G Fehlings, Ilya Laufer, Daniel M Sciubba, Michelle J Clarke, Narayan Sundaresan, Jorrit-Jan Verlaan, Arjun Sahgal, Dean Chou, Charles G Fisher
STUDY DESIGN: Systematic review. OBJECTIVES: We conducted a systematic review of the literature to answer the following questions regarding the use of steroid therapy in metastatic spinal cord compression (MSCC): 1. In cases of MSCC, what is the effect of steroid administration before definitive radiotherapy or surgery on ambulatory status, bowel and bladder function and survival? 2. What steroid dosing regimens are associated with the best outcomes concerning neurological symptoms and complication prevention in cases of MSCC? SUMMARY OF BACKGROUND DATA: Currently, there is significant variation in the initial bolus dose, daily maintenance dose and duration of treatment when steroids are used as a bridge to definitive therapy for MSCC...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437260/early-postoperative-neuropathic-pain-assessed-by-the-dn4-score-predicts-an-increased-risk-of-persistent-postsurgical-neuropathic-pain
#3
Helene Beloeil, Barthelemy Sion, Chloe Rousseau, Pierre Albaladejo, Mathieu Raux, Frederic Aubrun, Valeria Martinez
BACKGROUND: Acute neuropathic pain can occur in the postoperative period but any link with persistent post-surgical neuropathic pain remains unclear. OBJECTIVES: The objectives of this study were to prospectively describe the incidence of acute post-surgical neuropathic pain in a large population using the DN4 (clinician administered) questionnaire and to confirm the hypothetical link between acute and persistent neuropathic pain at 2 months after surgery in a large population using the DN2 (self administered) questionnaire...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28437129/acute-ankle-sprain-in-a-mouse-model-changes-in-knee-joint-space
#4
Tricia Hubbard-Turner, Erik A Wikstrom, Sophie Guderian, Michael J Turner
CONTEXT:   Ankle sprains remain the most common orthopaedic injury. Conducting long-term studies in humans is difficult and costly, so the long-term consequences of an ankle sprain are not entirely known. OBJECTIVE:   To measure knee-joint space after a single surgically induced ankle sprain in mice. DESIGN:   Randomized controlled trial. SETTING:   University research laboratory. PATIENTS OR OTHER PARTICIPANTS:   Thirty male mice (CBA/2J) were randomly placed into 1 of 3 surgical groups: the transected calcaneofibular ligament (CFL) group, the transected anterior talofibular ligament/CFL group, and a sham treatment group...
April 24, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28436815/moyamoya-in-a-patient-with-fires-a-first-case-report
#5
Taylor Kaufman, Andrew White
Febrile infection-related epilepsy syndrome (FIRES) is a form of epileptic encephalopathy with severe refractory epilepsy that presents in previously healthy, school-aged children after significant febrile illness with concomitant rise in body temperature. Suspected causes include genetic or acquired channelopathies, as well as mitochondrial disturbances. In FIRES, the EEG shows diffuse slowing, generalized, and/or multifocal discharges. Seizures are present and resistant to treatment. Moyamoya angiopathy (MMA) is characterized by progressive stenosis of cerebral arteries and subsequent development of a network of collateral circulation that is prone to rupture...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/28435273/an-innovative-nonpharmacological-intervention-combined-with-intravenous-patient-controlled-analgesia-increased-patient-global-improvement-in-pain-and-satisfaction-after-major-surgery
#6
Chia-Chun Chuang, Chien-Ching Lee, Li-Kai Wang, Bor-Shyh Lin, Wen-Ju Wu, Chung-Han Ho, Jen-Yin Chen
PURPOSE: This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit) into standard operating procedure (SOP) in acute pain service (APS) improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA). PATIENTS AND METHODS: This was a nonrandomized before-after study. Adult patients (aged between 20 and 80 years) who received IV-PCA after major surgery were included...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28435216/pain-perception-description-after-advanced-surface-ablation
#7
Eva M Sobas, Sebastián Videla, Amanda Vázquez, Itziar Fernández, Miguel J Maldonado, José-Carlos Pastor
PURPOSE: The objective of this study was to characterize the evolution of ocular pain after advanced surface ablation (ASA) to improve strategies in postoperative pain management. METHODS: This was a multicenter, prospective, descriptive, cohort study. The inclusion criteria were healthy individuals ≥18 years old receiving bilateral alcohol-assisted surface ablation with epithelial removal. Pain intensity was evaluated with the visual analog scale (VAS) and the numeric pain rating scale before and after surgery...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/28435149/regional-anesthesia-did-not-delay-diagnosis-of-compartment-syndrome-a-case-report-of-anterior-compartment-syndrome-in-the-thigh-not-masked-by-an-adductor-canal-catheter
#8
Arissa Torrie, Jyoti Sharma, Mark Mason, Hillenn Cruz Eng
BACKGROUND Acute compartment syndrome (ACS) of the thigh after elective primary total knee arthroplasty is rare. If not recognized and treated promptly, devastating consequences may result. Certain regional anesthesia techniques are thought to mask the symptoms of acute compartment syndrome, but there are no cases reported of adductor canal catheters masking the symptoms of thigh compartment syndrome. We report a case where symptoms and diagnosis of acute anterior thigh compartment syndrome were not masked by a functioning adductor canal catheter...
April 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28434457/system-changes-to-implement-the-joint-commission-tobacco-treatment-tob-performance-measures-for-improving-the-treatment-of-tobacco-use-among-hospitalized-patients
#9
Donna Shelley, Keith S Goldfeld, Hannah Park, Ana Mola, Ryan Sullivan, Jonathan Austrian
BACKGROUND: In 2012 The Joint Commission implemented new Tobacco Treatment (TOB) performance measures for hospitals. A study evaluated the impact of a hospital-based electronic health record (EHR) intervention on adherence to the revised TOB measures. METHODS: The study was conducted in two acute care hospitals in New York City. Data abstracted from the EHR were analyzed retrospectively from 4,871 smokers discharged between December 2012 and March 2015 to evaluate the impact of two interventions: an order set to prompt clinicians to prescribe pharmacotherapy and a nurse-delivered counseling module that automatically populated the nursing care plan for all smokers...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28433042/-alarmins-and-surgical-injury
#10
J Máca, M Peteja
Surgical intervention is an inseparable part of the management of serious surgical disease. However, surgery also presents a potential risk related to the so-called surgical injury causing immune response. When dysregulated the immune activation is able to cause local complications (i.e. wound dehiscence, impaired healing). Systemic decompartmentization of the immunologic disturbance can negatively influence long-term outcomes (i.e. hospital length of stay, mortality). Due to aseptic conditions in the operating room, such an immune activation is almost always of sterile nature...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28432174/postintervention-acute-opsoclonus-myoclonus-syndrome
#11
Annelise Aquilina, Nicola Dingli, Josanne Aquilina
Opsoclonus myoclonus syndrome (OMS) is a rare, neurological condition affecting 1 in 10 000 000 people annually. Opsoclonus, defined as involuntary rapid, multivectorial oscillations of the eyes, together with ataxia and myoclonus are usually present. OMS may be paraneoplastic: often associated with occult neuroblastoma in childhood and with breast carcinoma or small cell lung carcinoma in adults. Other aetiologies include viral or toxic agents. The pathogenesis is thought to be immune mediated. A 37-year-old woman with previous inflammatory cranial mononeuropathies was admitted for elective dilatation and curettage (D&C)...
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28432158/risk-score-for-cardiac-surgery-in-active-left-sided-infective-endocarditis
#12
Carmen Olmos, Isidre Vilacosta, Gilbert Habib, Luis Maroto, Cristina Fernández, Javier López, Cristina Sarriá, Erwan Salaun, Salvatore Di Stefano, Manuel Carnero, Sandrine Hubert, Carlos Ferrera, Gabriela Tirado, Afonso Freitas-Ferraz, Carmen Sáez, Javier Cobiella, Juan Bustamante-Munguira, Cristina Sánchez-Enrique, Pablo Elpidio García-Granja, Cecile Lavoute, Benjamin Obadia, David Vivas, Ángela Gutiérrez, José Alberto San Román
OBJECTIVE: To develop and validate a calculator to predict the risk of in-hospital mortality in patients with active infective endocarditis (IE) undergoing cardiac surgery. METHODS: Thousand two hundred and ninety-nine consecutive patients with IE were prospectively recruited (1996-2014) and retrospectively analysed. Left-sided patients who underwent cardiac surgery (n=671) form our study population and were randomised into development (n=424) and validation (n=247) samples...
April 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#13
Jinbao Qin, Zhen Zhao, Ruihua Wang, Kaichuang Ye, Weimin Li, Xiaobing Liu, Guang Liu, Chaoyi Cui, Huihua Shi, Zhiyou Peng, Fukang Yuan, Xinrui Yang, Min Lu, Xintian Huang, Mier Jiang, Xin Wang, Minyi Yin, Xinwu Lu
BACKGROUND: Reconstruction of the aortic major branches during thoracic endovascular aortic repair is complicated because of the complex anatomic configuration and variation of the aortic arch. In situ laser fenestration has shown great potential for the revascularization of aortic branches. This study aims to evaluate the feasibility, effectiveness, and safety of in situ laser fenestration on the three branches of the aortic arch during thoracic endovascular aortic repair. METHODS AND RESULTS: Before clinical application, the polytetrafluoroethylene and Dacron grafts were fenestrated by an 810-nm laser system ex vivo, which did not damage the bare metal portion of the endografts and created a clean fenestration while maintaining the integrity of the endografts...
April 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28431451/-experience-with-the-hind-foot-relaxation-boot
#14
Hans Zwipp, Michael Borrmann, Eberhard Walter
The goal of this paper is to report our experience with hindfoot fractures using our specially developed boot, with a follow-up of 557 cases. This boot works like the well-known Allgöwer-Röck ortheses (ARO), but is a hybrid between a boot and an orthesis. It allows full weightbearing without using crutches and completely protects an acutely operated hind foot fracture, hind foot arthrodesis or a hind foot fracture which is suitable for conservative treatment. In its first generation, this boot was custom made and used in 408 cases, from March 1999 to February 2011...
April 21, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28431424/sleep-disordered-breathing-postoperative-delirium-and-cognitive-impairment
#15
Enoch W K Lam, Frances Chung, Jean Wong
Sleep-disordered breathing (SDB) is highly prevalent in the general population and has been associated with cognitive impairment in older individuals. Delirium is an acute decline in cognitive function and attention that often occurs after surgery, especially in older individuals. Several recent studies suggest an association between SDB and postoperative delirium. The aim of this systematic review is to examine the current literature on SDB, postoperative delirium, and cognitive impairment and to discuss the pathophysiology and perioperative considerations...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431197/serum-c-reactive-protein-procalcitonin-and-lactate-dehydrogenase-for-the-diagnosis-of-pancreatic-necrosis
#16
REVIEW
Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with pancreatic necrosis differs from that of people with oedematous pancreatitis. It is important to know the diagnostic accuracy of serum C-reactive protein (CRP), serum procalcitonin, and serum lactate dehydrogenase (LDH) as a triage test for the detection of pancreatic necrosis in people with acute pancreatitis, so that an informed decision can be made as to whether the person with pancreatic necrosis needs further investigations such as computed tomography (CT) scan or magnetic resonance imaging (MRI) scan and treatment for pancreatic necrosis started...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28430754/biomarkers-for-early-acute-kidney-injury-diagnosis-and-severity-prediction-a-pilot-multicenter-canadian-study-of-children-admitted-to-the-icu
#17
Jennifer Palermo, Allison B Dart, Alanna De Mello, Prasad Devarajan, Ronald Gottesman, Gonzalo Garcia Guerra, Greg Hansen, Ari R Joffe, Cherry Mammen, Nick Majesic, Catherine Morgan, Peter Skippen, Michael Pizzi, Ana Palijan, Michael Zappitelli
OBJECTIVE: Acute kidney injury occurs early in PICU admission and increases risks for poor outcomes. We evaluated the feasibility of a multicenter acute kidney injury biomarker urine collection protocol and measured diagnostic characteristics of urine neutrophil gelatinase-associated lipocalin, interleukin-18, and liver fatty acid binding protein to predict acute kidney injury and prolonged acute kidney injury. DESIGN: Prospective observational pilot cohort study...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28430722/the-use-of-liposomal-bupivacaine-administered-with-standard-bupivacaine-in-ankle-fractures-requiring-open-reduction-internal-fixation-a-single-blinded-randomized-controlled-trial
#18
Roy Davidovitch, Abraham Goch, Adam Driesman, Sanjit Konda, Christian Pean, Kenneth Egol
OBJECTIVES: To determine the efficacy of liposomal bupivacaine compared to placebo for post-operative pain control in patients undergoing operative fixation of ankle fractures. DESIGN: Prospective single blinded randomized control trial SETTING:: Academic Medical CenterPatients/Participants: After IRB approval, seventy-six patients who sustained an acute ankle fracture (OTA 44A-C) requiring operative fixation met inclusion criteria. INTERVENTION: Patients were randomly assigned to one of two groups, control (local intra-operative sterile saline injection under general anesthesia) or interventional (local intra-operative liposomal bupivacaine and bupivacaine injection under general anesthesia)...
April 6, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28429952/rare-cases-imitating-acute-appendicitis-three-case-reports-and-a-review-of-literature
#19
L Kunovsky, Z Kala, L Mitas, V Can, J Dolina, E Nemcová, L Klvacova, T Gajdosova, I Penka
Acute appendicitis with its characteristic clinical course is one of the most common diagnoses that require urgent surgery. The following three case reports present patients with symptoms typical of acute appendicitis which was, however, not confirmed intraoperatively. Preoperative CT or MRI were not requested because symptoms clearly indicated acute appendicitis. The first case describes a male patient with right-sided diverticulitis, the second case report involves a pregnant woman in 33rd week of gestation with right adnexal torsion due to a dermoid cyst, and in the last report, a case of spontaneous perforation of appendiceal mucinous neoplasm is presented...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28429927/endovascular-correction-in-acute-bleeding-after-femoropopliteal-bypass-a-single-centre-experience
#20
Giulia Mazzitelli, Mariagnese Mele, Francesco Setacci, Giuseppe Galzerano, Gianmarco DE Donato, Domenico Benevento, Massimiliano W Guerrieri, Carlo Setacci
INTRODUCTION: The endovascular correction (EC) has emerged in recent years as a possible alternative to surgical revision (SR) in case of bleeding complications after peripheral bypass (PB) . The purpose of this study is to evaluate the efficacy and safety of EC compared to SR in case of bleeding complications of PB. METHODS: From January 2004 to December 2014, we have submitted 32 patients to surgery for acute bleeding in previous PB (25 venous bypass, in situ or reversed, 6 PTFE bypass and 1 composite bypass)...
April 21, 2017: Minerva Cardioangiologica
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