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Preoperative anemia

Zi-Jian Li, Min-Wei Zhao, Lin Zeng
Background: Total knee arthroplasty (TKA) is the most frequently performed procedure in treating advanced knee osteoarthritis. Excessive perioperative blood loss can sometimes lead to postoperative anemia. Tranexamic acid (TXA) is a potent fibrinolysis inhibitor which has been extensively used at the surgical incision and closure to lower overall blood loss in adult reconstruction surgery. Our previous study suggested that about two-thirds of the total blood loss (TBL) came from hidden blood loss (HBL) on postoperative days 1 and 2...
March 20, 2018: Chinese Medical Journal
David F Pinal-García, Carlos M Nuño-Guzmán, Audrey Gómez-Abarca, Jorge L Corona, Ismael Espejo
Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography...
January 2018: Case Reports in Gastroenterology
Mark Nelson, Jeffrey Green, Bruce Spiess, Vigneshwar Kasirajan, Patricia Nicolato, Hangcheng Liu, Ryan S Meshkin
BACKGROUND: Cardiac surgery is associated with a significant decrease in hematocrit. It is unclear whether that occurs from hemodilution, loss of red cells, or both. Hematocrit is a major determinant of transfusion decisions although transfusion is associated with increased morbidity and mortality. Physicians must determine whether this anemia is the result of hemodilution or red blood cell loss as the former would be treated with packed red blood cell transfusions and the latter by diuresis...
March 3, 2018: Annals of Thoracic Surgery
Megan Cray, Allyson C Berent, Chick W Weisse, Demetrius Bagley
CASE DESCRIPTION 4 cats were examined because of ureteral obstruction. CLINICAL FINDINGS Clinical and clinicopathologic abnormalities were nonspecific and included anorexia, lethargy, weight loss, anemia, leukocytosis, neutrophilia, lymphopenia, and azotemia. A diagnosis of pyonephrosis was made in all cats. The presence of bacteriuria was confirmed by means of urinalysis in 2 cats, bacterial culture of a urine sample obtained by means of preoperative cystocentesis in 2 cats, and bacterial culture of samples obtained from the renal pelvis intraoperatively in 3 cats...
March 15, 2018: Journal of the American Veterinary Medical Association
Ji-Hyun Kim, You-Jin Bae, Kyong-Hwa Jun, Hyung-Min Chin
BACKGROUND: This study explored the cumulative incidence of anemia after gastrectomy in patients with early-stage gastric cancer and evaluated the relationship between postgastrectomy anemia and nutritional factors during long-term follow-up. METHODS: The medical records of patients with stage I gastric cancer who underwent curative gastrectomy between January 2006 and December 2013 were reviewed retrospectively. Hematologic parameters like hemoglobin, iron, ferritin, and vitamin B12 level were obtained prior to and after surgery with other nutritional parameters such as total protein, albumin, total cholesterol, triglyceride, calcium, and phosphate...
February 20, 2018: International Journal of Surgery
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Joshua S Everhart, John H Sojka, Joel L Mayerson, Andrew H Glassman, Thomas J Scharschmidt
BACKGROUND: Perioperative allogeneic red blood-cell transfusion is a suspected risk factor for surgical site infection (SSI) after total joint arthroplasty (TJA), but the interrelationships among SSI risk, transfusion dose, preoperative anemia, and the presence of coagulopathies have not been well described. METHODS: Data on SSI within 1 year after surgery as well as on transfusion with blood products within 30 days after surgery were obtained for 6,788 patients who had undergone primary or revision total hip or knee arthroplasty from 2000 to 2011 in a single hospital system...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
M Farshad, D E Bauer, C Wechsler, C Gerber, A 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: To identify predictive risk factors for peri- and early post-operative 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
Serdar Aydın, Hale Göksever Çelik, Mustafa Maraşlı, Rabia Zehra Bakar
OBJECTIVE: Uterine leiomyomas are the most common pelvic tumor in women. The calculated prevalence of prolapsed pedunculated leiomyoma was 2.5% in patients who underwent surgery. Although vaginal removal is safe and effective, hysterectomy demand is questionable. We aimed to analyze the association between patient characteristics, clinical features of prolapsed pedunculated submucosal leiomyoma and the probability of successful vaginal myomectomy. MATERIALS AND METHODS: This study was conducted in 35 women who presented with prolapsed pedunculated uterine leiomyoma...
February 1, 2018: Journal of the Turkish German Gynecological Association
Patawut Bovonratwet, Daniel D Bohl, Glenn S Russo, Nathaniel T Ondeck, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: Patients with geriatric hip fractures may be at increased risk for postoperative Clostridium difficile colitis, which can cause severe morbidity and can influence hospital quality metrics. However, to our knowledge, no large database study has calculated the incidence of, factors associated with, and effect of C. difficile colitis on geriatric patients undergoing hip fracture surgery. QUESTIONS/PURPOSES: To use a large national database with in-hospital and postdischarge data (National Surgical Quality Improvement Program [NSQIP®]) to (1) determine the incidence and timing of C...
March 2018: Clinical Orthopaedics and related Research
Qiang Lu, Hao Peng, Guan-Jin Zhou, Dong Yin
Total knee arthroplasty (TKA) often causes a significant amount of blood loss with an accompanying decline in hemoglobin and may increase the frequency of allogeneic blood transfusion rates. Unfortunately, allogeneic blood transfusions have associated risks including postoperative confusion, infection, cardiac arrhythmia, fluid overload, increased length of hospital stay, and increased mortality. Other than reducing the need for blood transfusions, reducing perioperative blood loss in TKA may also minimize intra-articular hemorrhage, limb swelling, and postoperative pain, and increase the range of motion during the early postoperative period...
February 9, 2018: Orthopaedic Surgery
Samer Al Masri, Yaser Shaib, Mostapha Edelbi, Hani Tamim, Faek Jamali, Nicholas Batley, Walid Faraj, Ali Hallal
BACKGROUND: Laparoscopic cholecystectomy (LC) is the standard surgical treatment for benign gallbladder disease. Nevertheless, conversion to open cholecystectomy (OC) is needed in some cases. The aim of this study is to calculate our institutional conversion rate and to identify the variables that are implicated in increasing the risk of conversion (LC-OC). MATERIALS AND METHODS: We carried out a retrospective study of all cases of LC performed at the American University of Beirut Medical Center between 2000 and 2015...
February 7, 2018: World Journal of Surgery
Takuya Hamakawa, Kazuhiro Nishikawa, Motohiro Hirao, Kei Yamamoto, Ayako Fujiwara, Sakae Maeda, Mamoru Uemura, Masakazu Miyake, Naoki Hama, Atsushi Miyamoto, Michihiko Miyazaki, Takeshi Kato, Koji Takami, Shoji Nakamori, Mitsugu Sekimoto
Here we report a case of a hemorrhagic gastric cancer patient with severe coronary artery disease, in whom the cancer was successfully resected with the support of intra-aortic balloon pumping(IABP). An 80-year-old man was referred to our hospital for further examination of his anemia and tumor around the pancreatic head. He was diagnosed with type 3 gastric cancer with multiple bulky lymph node metastases invadingto the pancreas(cT4b[LN-Panc], N3a, M1[LYM No.16a2int], cStage IV ). Tarry stools continued and blood transfusion was repeatedly required...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Chikara Ebisui, Rie Hamano, Takayuki Minoji, Tomohiro Kitahara, Tetsu Yanagisawa, Shu Okamura, Nariaki Fukuchi, Kohei Murata, Hideoki Yokouchi, Masakatsu Kinuta, Kazuhito Ohishi
A 67-year-old man was admitted to our hospital because of anemia and weight loss, and diagnosed with a type 3 tumor in the upper gastric body. Pathological examination suggested moderately differentiated adenocarcinoma with immunohistochemically negative staining for HER2. Abdominal CT revealed thickening of the gastric wall and multiple liver metastases. The clinical findings suggested Stage IV disease(T4aN0M1). Chemotherapy was administered with a combination of S-1 plus CDDP(SP). However, the level of CEA(ng/mL)increased from 49...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Jonathan Green, Christopher R Schlieve, Ann K Friedrich, Kevin Baratta, David H Ma, May Min, Krunal Patel, David Stein, David R Cave, Demetrius E Litwin, Mitchell A Cahan
BACKGROUND: Small bowel lesions (SBL) are rare, representing diagnostic and management challenges. The purpose of this cross-sectional study was to evaluate diagnostic modalities used and management practices of patients with SBL at an advanced endoscopic referral center. METHODS: We analyzed patients undergoing surgical management for SBL from 2005 to 2015 at a single tertiary care center. Patients were stratified into gastrointestinal bleed/anemia (GIBA) or obstruction/pain (OP)...
January 25, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Riki Asakura, Kentaro Kawasaki, Taisuke Okawa, Hiroki Sakamoto, Takahisa Akashi, Yu Asakura, Yoshiyuki Owada, Seiji Haze, Tetsuya Ienaga, Yoshihiro Ikura, Yasuhiro Iwai
A man in his 60s was admitted to our hospital with anemia. An endoscopic examination revealed advanced gastric cancer. CT revealed peri-gastric and para-aortic lymphadenopathy, and a nodular shadow(20mm)in the lower lobe of the right lung. PET-CT revealed abnormal uptake in the para-aortic lymph node and stomach wall and the nodular shadow in the right lung. A bronchoscopy revealed pulmonary adenocarcinoma. From the above, he was diagnosed with gastric cancer(cT4a, cN2, cM1, cStage IV )and lung cancer(cT2a, cN0, cM0, cStage I B)...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Jamal Shillingford, Joseph Laratta, Nathan Hardy, Comron Saifi, Joseph Lombardi, Andrew J Pugely, Ronald A Lehman, K Daniel Riew
Background: To compare the differences in the thirty-day postoperative outcomes between cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF). Methods: Patients undergoing primary single-level ACDF and CDA from 2010-2014 were identified by unique Current Procedural Terminology (CPT) codes within the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) database. Primary outcomes included surgical and medical complications, length of hospital stay (LOS), unplanned readmission, return to operating room, and mortality all occurring within 30 days of the initial procedure...
December 2017: Journal of Spine Surgery (Hong Kong)
Mitsuhide Naruse, Fumitoshi Satoh, Akiyo Tanabe, Takahiro Okamoto, Atsuhiro Ichihara, Mika Tsuiki, Takuyuki Katabami, Masatoshi Nomura, Tomoaki Tanaka, Tadashi Matsuda, Tsuneo Imai, Masanobu Yamada, Tomohiro Harada, Nobuyuki Kawata, Kazuhiro Takekoshi
To assess the efficacy, safety, and pharmacokinetics of metyrosine (an inhibitor of catecholamine synthesis) in patients with pheochromocytoma/paraganglioma (PPGL), we conducted a prospective, multi-center, open-label study at 11 sites in Japan. We recruited PPGL patients aged ≥12 years requiring preoperative or chronic treatment, receiving α-blocker treatment, having baseline urinary metanephrine (uMN) or normetanephrine (uNMN) levels ≥3 times the upper limit of normal values, and having symptoms associated with excess catecholamine...
January 20, 2018: Endocrine Journal
Juha P Väyrynen, Anne Tuomisto, Sara A Väyrynen, Kai Klintrup, Toni Karhu, Jyrki Mäkelä, Karl-Heinz Herzig, Tuomo J Karttunen, Markus J Mäkinen
Anemia is common in colorectal cancer (CRC) but its relationships with tumor characteristics, systemic inflammation, and survival have not been well characterized. In this study, blood hemoglobin levels and erythrocyte mean corpuscular volume (MCV) levels were measured in two independent cohorts of 148 CRC patients and 208 CRC patients, and their correlation with patient and tumor characteristics, systemic inflammatory markers (modified Glasgow Prognostic Score: mGPS; serum levels of thirteen cytokines, C-reactive protein, albumin), and survival were analyzed...
January 18, 2018: Scientific Reports
Xuechao Liu, Haibo Qiu, Yuying Huang, Dazhi Xu, Wei Li, Yuanfang Li, Yingbo Chen, Zhiwei Zhou, Xiaowei Sun
We sought to evaluate whether preoperative anemia was an important determinant of survival in gastric cancer (GC). A single institution cohort of 2163 GC patients who underwent curative resection were retrospectively analyzed. Anemia was defined as a preoperative hemoglobin level <120 g/L in males and <110 g/L in females. Overall survival (OS) was analyzed using the Kaplan-Meier method, and a multivariate Cox proportional hazards model was performed to identify the independent prognostic factor. Anemic patients had a poorer OS compared with nonanemic patients after resection for tumor-nodes-metastasis (TNM) stage III tumors (5-year OS rate: 32...
January 17, 2018: Cancer Medicine
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