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Preoperative medical evaluation

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https://read.qxmd.com/read/30761615/intra-operative-blood-transfusion-predicts-post-operative-delirium-among-older-patients-undergoing-elective-orthopedic-surgery-a-prospective-cohort-study
#1
Ming-Yueh Chou, Yu-Chun Wang, Li-Ning Peng, Chih-Kuang Liang, Che-Sheng Chu, Mei-Chen Liao, Yu-Te Lin, Chien-Jen Hsu, Liang-Kung Chen
OBJECTIVES: To evaluate the roles of preoperative anemia and intra-operative blood transfusion in the development of post-operative delirium among older patients undergoing elective orthopedic surgery. METHODS: This prospective cohort study recruited subjects aged 60 years and over who were admitted for elective orthopedic surgery in a tertiary medical center during April 2011 to December 2013. Demographic data (age, gender, BMI, educational level), surgery-related factors (ASA class, type of anesthesia and surgery, intra-operative blood transfusion), results of geriatric assessment (hearing/visual impairment, cognition, depressive mood, comorbidity, malnutrition, polypharmacy, ADL, and IADL), laboratory data, length of hospital stay and the development of post-operative delirium were collected for analysis...
February 13, 2019: International Journal of Geriatric Psychiatry
https://read.qxmd.com/read/30758472/enhanced-recovery-eras-after-liver-surgery-comparative-study-in-a-brazilian-terciary-center
#2
Uirá Fernandes Teixeira, Marcos Bertozzi Goldoni, Fábio Luiz Waechter, José Artur Sampaio, Florentino Fernandes Mendes, Paulo Roberto Ott Fontes
BACKGROUND: After the publication of the first recommendations of ERAS Society regarding colonic surgery, the proposal of surgical stress reduction, maintenance of physiological functions and optimized recovery was expanded to other surgical specialties, with minimal variations. AIM: To analyze the implementation of ERAS protocols for liver surgery in a tertiary center. METHODS: Fifty patients that underwent elective hepatic surgery were retrospectively evaluated, using medical records data, from June 2014 to August 2016...
February 7, 2019: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://read.qxmd.com/read/30753560/the-influence-of-preoperative-medications-on-postoperative-complications-in-patients-after-intestinal-surgery-for-crohn-s-disease
#3
Chang Sik Yu, Sung Woo Jung, Jong Lyul Lee, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk Kyun Ynag, Byung Duk Ye, Sang Hyung Park, Minkyu Han, Jin Cheon Kim
Background: Many patients with Crohn's disease (CD) are treated with medications, including steroids, immunomodulators, and anti-tumor necrosis factor alpha (anti-TNF-α) agents, at the time of surgery. This study evaluated the effects of these medications on postoperative complications in CD patients. Methods: This retrospective study analyzed patients who underwent bowel resection for CD between January 2006 and December 2015. Postoperative complications were defined as a Clavien-Dindo classification of grade 2A or higher within the first 30 days after surgery...
February 8, 2019: Inflammatory Bowel Diseases
https://read.qxmd.com/read/30747546/how-to-predict-intraocular-pressure-reduction-after-cataract-surgery-a-prospective-study
#4
Claudio I Perez, Sunee Chansangpetch, Anwell Nguyen, Max Feinstein, Marta Mora, Mai Badr, Marisse Masis, Travis Porco, Shan C Lin
Purpose/Aim: To evaluate the best formula to predict intraocular pressure (IOP) reduction after cataract surgery. MATERIALS AND METHODS: Prospective longitudinal study. We included consecutive patients with or without glaucoma, either with open or narrow angles but without peripheral anterior synechiae, who underwent phacoemulsification. Clinical factors and anterior segment parameters measured with optical biometry and optical coherence tomography were evaluated as preoperative predictors for IOP reduction at 6 months postoperatively...
February 12, 2019: Current Eye Research
https://read.qxmd.com/read/30744510/long-term-hemodynamic-effects-after-carotid-artery-revascularization
#5
Sungho Lim, Michael J Javorski, Sean P Nassoiy, Yaeji Park, Pegge M Halandras, Carlos F Bechara, Bernadette Aulivola, Paul R Crisostomo
OBJECTIVE: The baroreceptor at the carotid body plays an important role in hemodynamic autoregulation. Manipulation of the baroreceptor during carotid endarterectomy (CEA) or radial force from carotid artery angioplasty and/or stenting (CAS) may cause both intraoperative and postoperative hemodynamic instability. The purpose of this study is to evaluate the long-term effects of CEA and CAS on blood pressure (BP), heart rate (HR), and subsequent changes on antihypertensive medications...
February 11, 2019: Vascular and Endovascular Surgery
https://read.qxmd.com/read/30742301/how-does-early-decompressive-craniectomy-influence-the-intracranial-volume-relationship-in-traumatic-brain-injury-tbi-patients
#6
Piotr Jasielski, Zbigniew Czernicki, Piotr Dąbrowski, Waldemar Koszewski, Rafał Rojkowski
BACKGROUND: Decompressive craniectomy (DC) is a common neurosurgical procedure involving the removal of part of the skull vault combined with subsequent duroplasty. The goal of DC is to produce extra space for the swollen brain and/or to reduce intracranial pressure. In the present study, DC was performed in order to create space for the swollen brain. AIM OF THE STUDY: to compare the volume alteration of selected intracranial fluid spaces before and after DC, to evaluate the volume of post-decompressive brain displacement (PDBD) and the largest dimension of oval craniectomy (LDOC), and to assess the early clinical effects of DC...
February 11, 2019: Neurologia i Neurochirurgia Polska
https://read.qxmd.com/read/30741073/role-of-neutrophil-to-lymphocyte-ratio-as-a-prognostic-indicator-for-hemodialysis-arteriovenous-fistula-failure
#7
Yuthapong Wongmahisorn
OBJECTIVE: To evaluate the role of preoperative peripheral blood neutrophil-to-lymphocyte ratio in predicting early arteriovenous fistula failure. The impact of postoperative neutrophil-to-lymphocyte ratio on arteriovenous fistula failure was also investigated. METHODS: Medical records from 470 patients who underwent first-time arteriovenous fistula creation were studied. Demographic, clinical, and laboratory data were obtained. Receiver operating characteristic curves were constructed to determine the optimal cutoff values of preoperative and postoperative neutrophil-to-lymphocyte ratios for predicting early arteriovenous fistula failure...
February 10, 2019: Journal of Vascular Access
https://read.qxmd.com/read/30738397/peroneal-nerve-decompression-institutional-review-and-meta-analysis-to-identify-prognostic-associations-with-favorable-and-unfavorable-surgical-outcomes
#8
Christopher Wilson, Alan P Yaacoub, Adewale Bakare, Na Bo, Abdul Aasar, Nicholas M Barbaro
OBJECTIVEA common cause of peroneal neuropathy is compression near the fibular head. Studies demonstrate excellent outcomes after decompression but include few cases (range 15-60 patients). Consequently, attempts to define predictors of good outcomes are limited. Here, the authors combine their institutional outcomes with those in the literature to identify predictors of good outcomes after peroneal nerve decompression.METHODSThe authors searched their institutional electronic medical records to identify all peroneal nerve decompressions performed in the period between December 1, 2012, and September 30, 2016, and created an IRB-approved database...
February 8, 2019: Journal of Neurosurgery. Spine
https://read.qxmd.com/read/30737151/is-age-a-real-or-perceived-discriminator-for-bariatric-surgery-a-long-term-analysis-of-bariatric-surgery-in-the-elderly
#9
Jai Prasad, Ellen Vogels, James T Dove, Craig Wood, Anthony T Petrick, David M Parker
BACKGROUND: Bariatric surgery is the most effective treatment of obesity. There are few studies evaluating long-term outcomes in elderly patients. OBJECTIVES: Our study was designed to evaluate the safety and long-term outcomes of bariatric surgery in the elderly compared with a contemporary medically managed cohort. SETTING: University hospital. METHODS: Three hundred thirty-seven patients age ≥60 who underwent a sleeve gastrectomy or Roux-en-Y gastric bypass between January 2007 and April 2017 were identified (ElderSurg) and compared with a matched cohort of medically managed elderly patients with obesity (ElderNonSurg)...
December 22, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://read.qxmd.com/read/30736077/-trabeculectomy-with-collagen-matrix-implant-as-bevacizumab-depot-clinical-results-on-efficacy-and-safety
#10
Claudia Lommatzsch, Carsten Heinz, Kai Rothaus, Jörg M Koch
BACKGROUND: Trabeculectomy for the surgical reduction of internal eye pressure is an established procedure, but the principle limitations are in postoperative wound healing. Various antimetabolites are regularly used to avoid postoperative subconjunctival scarring. The present study investigates whether the combination of an Ologen implant with bevacizumab can modify the rates of success and/or complications during trabeculectomy. METHODS: Three different groups of patients were evaluated in which trabeculectomy was performed with mitomycin C, either alone (group 1) or in combination with an Ologen implant (group 2) or with an Ologen implant with bevacizumab (group 3)...
February 8, 2019: Klinische Monatsblätter Für Augenheilkunde
https://read.qxmd.com/read/30735874/antiplatelet-medication-and-operative-subdural-hematomas-a-retrospective-cohort-study-evaluating-reoperation-rates
#11
Paul M Foreman, James Mooney, Adeel Ilyas, Bonita Agee, Sheela Vivekanandan, Reginald P Fong, Mamerhi O Okor, Kristen O Riley, Christoph J Griessenauer
BACKGROUND: Antiplatelet therapy is common and complicates the operative management of subdural hematomas (SDH). The risk of reoperation inferred by antiplatelet medication and the ability of platelet transfusion to reduce hemorrhagic complications in patients presenting with antiplatelet associated SDHs is poorly defined. METHODS: We performed a retrospective review of consecutive patients treated with craniotomy or craniectomy for evacuation of an acute or mixed density SDH between 2012-2017 at two academic institutions...
February 5, 2019: World Neurosurgery
https://read.qxmd.com/read/30733255/improved-detection-of-subtle-mesial-temporal-sclerosis-validation-of-a-commercially-available-software-for-automated-segmentation-of-hippocampal-volume
#12
J M Mettenburg, B F Branstetter, C A Wiley, P Lee, R M Richardson
BACKGROUND AND PURPOSE: Identification of mesial temporal sclerosis is critical in the evaluation of individuals with temporal lobe epilepsy. Our aim was to assess the performance of FDA-approved software measures of hippocampal volume to identify mesial temporal sclerosis in patients with medically refractory temporal lobe epilepsy compared with the initial clinical interpretation of a neuroradiologist. MATERIALS AND METHODS: Preoperative MRIs of 75 consecutive patients who underwent a temporal resection for temporal lobe epilepsy from 2011 to 2016 were retrospectively reviewed, and 71 were analyzed using Neuroreader, a commercially available automated segmentation and volumetric analysis package...
February 7, 2019: AJNR. American Journal of Neuroradiology
https://read.qxmd.com/read/30732174/clinical-characteristics-and-surgical-outcome-of-prolactinoma-in-patients-under-14-years-old
#13
Yi Zhao, Di Jin, Wei Lian, Bing Xing, Ming Feng, Xiaohai Liu, Renzhi Wang
Prolactinoma is one of the most common pituitary tumors, but relatively uncommon in patients under 14 years old. Surgery is the second-line treatment for prolactinoma when patients show resistance or intolerance to medical therapy. There are only a few published series of children who underwent surgery treatment. This study is performed to investigate the clinical manifestation and surgical outcome of pituitary prolactinoma in patients under 14 years old who are resistant or intolerant to medical therapy of dopamine agonist...
February 2019: Medicine (Baltimore)
https://read.qxmd.com/read/30724615/current-state-of-the-art-and-emerging-pharmacotherapy-for-uterine-leiomyosarcomas
#14
Matteo Tantari, Fabio Barra, Stefano Di Domenico, Domenico Ferraioli, Valerio Gaetano Vellone, Franco De Cian, Simone Ferrero
Uterine leiomyosarcomas (ULMS) account for 1% of all uterine malignancies and for 30% of all uterine sarcomas. The preoperative diagnosis of ULMS is challenging for the physicians, as the symptoms of these tumors are often vague and nonspecific. Moreover, as ULMS have an aggressive biologic behavior, affected women frequently have very poor prognosis. Areas covered: The aim of this review is to describe the current pharmacotherapy for ULMS, including the ongoing clinical trials. Expert opinion: Surgery is the standard treatment for patients with early-stage ULMS...
February 6, 2019: Expert Opinion on Pharmacotherapy
https://read.qxmd.com/read/30722115/is-advanced-age-a-hesitation-for-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-in-colorectal-cancer
#15
Naciye Cigdem Arslan, Tayfun Bisgin, Canan Altay, Tugba Yavuzsen, Aziz Karaoglu, Aras Emre Canda, Sulen Sarioglu, Selman Sokmen
PURPOSE: The purpose of this study was to assess the feasibility and safety of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in elderly patients with peritoneal carcinomatosis of colorectal cancer. METHODS: Patients who underwent curative complete CRS and HIPEC for peritoneal carcinomatosis of colorectal cancer with minimum follow-up of 24 months were included in the analysis. Charlson comorbidity index and ECOG performance status were used to evaluate preoperative condition...
December 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://read.qxmd.com/read/30720575/bleb-morphology-after-mitomycin-c-augmented-trabeculectomy-comparison-between-clinical-evaluation-and-anterior-segment-optical-coherence-tomography
#16
Soeren Waibel, Eberhard Spoerl, Olga Furashova, Lutz E Pillunat, Karin R Pillunat
PURPOSE: To study the longitudinal correlation between the clinical morphological appearance of filtering blebs with anterior segment optical coherence tomography (AS-OCT) in the early postoperative period. METHODS: Thirty eyes of 30 glaucoma patients scheduled for first-time trabeculectomy with mitomycin C 0.02% were consecutively enrolled. The filtering blebs were evaluated clinically according to a grading system and with AS-OCT at day 1 and weeks 1, 2, 3, 4 and 12 following surgery...
February 1, 2019: Journal of Glaucoma
https://read.qxmd.com/read/30717638/diagnostic-accuracy-of-midline-pediatric-neck-masses
#17
Hilary Pitner, Charles Elmaraghy, Beth Fischer, Amanda Onwuka, Andrew Rabe, Patrick Walz
OBJECTIVE: To assess clinical evaluation, ultrasound, and previously published predictive score at preoperatively diagnosing midline neck masses and demographic or clinical associations that aid in differentiation of thyroglossal duct and dermoid cysts. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care children's hospital. SUBJECTS: Patients <18 years undergoing primary midline neck mass surgery with histopathologic diagnosis of thyroglossal duct or dermoid cyst who had preoperative ultrasound performed were included...
February 5, 2019: Otolaryngology—Head and Neck Surgery
https://read.qxmd.com/read/30717041/treatment-of-only-the-fractional-curve-for-radiculopathy-in-adult-scoliosis-comparison-to-lower-thoracic-and-upper-thoracic-fusions
#18
Dominic Amara, Praveen V Mummaneni, Christopher P Ames, Bobby Tay, Vedat Deviren, Shane Burch, Sigurd H Berven, Dean Chou
OBJECTIVEMany options exist for the surgical management of adult spinal deformity. Radiculopathy and lumbosacral pain from the fractional curve (FC), typically from L4 to S1, is frequently a reason for scoliosis patients to pursue surgical intervention. The purpose of this study was to evaluate the outcomes of limited fusion of the FC only versus treatment of the entire deformity with long fusions.METHODSAll adult scoliosis patients treated at the authors' institution in the period from 2006 to 2016 were retrospectively analyzed...
February 1, 2019: Journal of Neurosurgery. Spine
https://read.qxmd.com/read/30714341/risk-factors-for-postoperative-urinary-retention-among-women-who-underwent-laparoscopic-cholecystectomy
#19
Jae Hwi Choi, Sol Yoon, Sin Woo Lee, Seong Uk Jeh, Jeong Seok Hwa, Jae Seog Hyun, Ky Hyun Chung, Deok Ha Seo, Chunwoo Lee, Sung Chul Kam, See Min Choi
OBJECTIVES: The aim of this study was to investigate the risk factors for postoperative urinary retention (POUR) among female patients by evaluating its occurrence in women who underwent laparoscopic cholecystectomy in Gyeongsang National University Hospital. METHODS: The medical records of female patients who had undergone laparoscopic cholecystectomy for gallbladder stones between March 2014 and February 2018 were reviewed. Information was collected regarding patient age, body mass index (BMI), creatinine, absolute neutrophil count, duration of the operation and anesthesia, the amount of fluid infused, American Society of Anesthesiologists (ASA) classification, and medical comorbidities, such as hypertension, diabetes, and lung, liver, heart, renal, and neurologic disease...
February 3, 2019: Lower Urinary Tract Symptoms
https://read.qxmd.com/read/30711185/a-retrospective-comparison-of-outcome-in-patients-who-received-both-nonsurgical-root-canal-treatment-and-single-tooth-implants
#20
Seyed Aliakbar Vahdati, Mahmoud Torabinejad, Robert Handysides, Jamie Lozada
INTRODUCTION: Currently, no study has compared the outcome of nonsurgical root canal treatment (NSRCT) and single-tooth implants (STIs) provided to the same patient. The purpose of this study was to determine if the survival outcome of the 2 treatment modalities is different. METHODS: The medical/dental records of 3671 patients with at least 1 STI and 1 NSRCT were reviewed. One hundred seventy patients with at least a 5-year follow-up were included. The survival outcome of NSRCT and STI and related factors were evaluated...
February 2019: Journal of Endodontics
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