Chaolin Huang, Lixue Huang, Yeming Wang, Xia Li, Lili Ren, Xiaoying Gu, Liang Kang, Li Guo, Min Liu, Xing Zhou, Jianfeng Luo, Zhenghui Huang, Shengjin Tu, Yue Zhao, Li Chen, Decui Xu, Yanping Li, Caihong Li, Lu Peng, Yong Li, Wuxiang Xie, Dan Cui, Lianhan Shang, Guohui Fan, Jiuyang Xu, Geng Wang, Ying Wang, Jingchuan Zhong, Chen Wang, Jianwei Wang, Dingyu Zhang, Bin Cao
BACKGROUND: The long-term health consequences of COVID-19 remain largely unclear. The aim of this study was to describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity. METHODS: We did an ambidirectional cohort study of patients with confirmed COVID-19 who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7, 2020, and May 29, 2020...
January 8, 2021: Lancet
Francis Sutherland, Chad G Ball, Jennifer Schendel, Elijah Dixon
We sought to determine if lateral-inferior traction on the Hartmann pouch could produce bile duct kinking and subsequent misinterpretation of the space on the left side of the bile duct as the hepatobiliary triangle. Once traction was applied, we measured the angle between the cystic duct and inferior gallbladder wall hepatobiliary triangle) in 76 cases, and the angle between the common bile duct and common hepatic duct (porta hepatis "triangle") in 41 cases. The mean angles were significantly different (hepatobiliary triangle mean 68...
January 7, 2021: Canadian Journal of Surgery. Journal Canadien de Chirurgie
C Ann Vitous, Mary E Byrnes, Ana De Roo, Sara M Jafri, Pasithorn A Suwanabol
OBJECTIVE: This qualitative study explored the impact of postoperative complications on surgeons and their well-being. BACKGROUND: Complications are an inherent component of surgical practice. Although there have been extensive efforts to reduce postoperative complications, the impact of complications on surgeons have not been well-studied. Surgeons are often left to process their own emotional responses to these complications, the effects of which are not well characterized...
January 11, 2021: Annals of Surgery
Moises Auron, Marina Y Duran Castillo, Omar Felipe Duenas Garcia
Nonobstetric surgery during pregnancy should be avoided if possible, but when surgery is required, an obstetrician should be part of the perioperative team. In general, preoperative assessment is similar regardless of whether a woman is pregnant, but cardiovascular, pulmonary, hematologic, and renal changes of pregnancy can increase surgical risk and must be taken into account. Special management considerations include pregnancy-associated laboratory changes, timing of surgery, anesthesia choice, intubation precautions, patient positioning, preoperative blood typing, intraoperative fetal monitoring, and venous thromboembolism prophylaxis...
December 31, 2020: Cleveland Clinic Journal of Medicine
Lawrence O Gostin, Daniel A Salmon, Heidi J Larson
No abstract text is available yet for this article.
December 29, 2020: JAMA
Alicia A C Waite, David O Hamilton, Roberto Pizzi, Walter Ageno, Ingeborg D Welters
COVID-19 was first described in late 2019 and has since developed into a pandemic affecting more than 21 million people worldwide. Of particular relevance for acute care is the occurrence of COVID-19-associated coagulopathy (CAC), which is characterised by hypercoagulability, immunothrombosis and venous thromboembolism, and contributes to hypoxia in a significant proportion of patients. This review describes diagnosis and treatment of CAC in the emergency department and in intensive care. We summarise the pathological mechanisms and common complications of CAC such as pulmonary thrombosis and venous thromboembolic events and discuss current strategies for thromboprophylaxis and therapeutic anti-coagulation in the acute care setting...
December 2020: Thrombosis and Haemostasis
Manoj Sivan, Sharon Taylor
No abstract text is available yet for this article.
December 23, 2020: BMJ: British Medical Journal
Erica L Mitchell
No abstract text is available yet for this article.
January 2021: Journal of Vascular Surgery
Valerie Smith, Declan Devane, Alistair Nichol, David Roche
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the strain of coronavirus that causes coronavirus disease 2019 (COVID-19) can cause serious illness in some people resulting in admission to intensive care units (ICU) and frequently, ventilatory support for acute respiratory failure. Evaluating ICU care, and what is effective in improving outcomes for these patients is critical. Care bundles, a small set of evidence-based interventions, delivered together consistently, may improve patient outcomes...
December 21, 2020: Cochrane Database of Systematic Reviews
Richard M Pino, Jaskaran Singh
No abstract text is available yet for this article.
December 17, 2020: Anesthesiology
Simon R Mucha, Siddharth Dugar, Keith McCrae, Douglas Joseph, John Bartholomew, Gretchen L Sacha, Michael Militello
Severe COVID-19 illness is associated with intense inflammation, leading to high rates of thrombotic complications that increase morbidity and mortality. Markedly elevated levels of D-dimer with normal fibrinogen levels are the hallmark laboratory findings of severe COVID-19-associated coagulopathy. Prophylaxis against venous thromboembolism is paramount for all hospitalized patients with COVID-19, with more aggressive prophylaxis and screening recommended for critically ill patients with D-dimer levels above 3...
December 15, 2020: Cleveland Clinic Journal of Medicine
Anne F Peery, Aasma Shaukat, Lisa L Strate
Colonic diverticulitis is a painful gastrointestinal disease that recurs unpredictably and can lead to chronic gastrointestinal symptoms. Gastroenterologists commonly care for these patients. The purpose of this clinical practice update is to provide practical and evidence-based advice for diverticulitis management. We reviewed systematic reviews, meta-analyses, randomized controlled trials, and observational studies to develop 14 best practices. In brief, computed tomography is often necessary to make a diagnosis...
December 3, 2020: Gastroenterology
David C Fajgenbaum, Carl H June
New England Journal of Medicine, Volume 383, Issue 23, Page 2255-2273, December 2020.
December 3, 2020: New England Journal of Medicine
David A Katzka, Peter J Kahrilas
Gastroesophageal reflux disease (GERD) is a multifaceted disorder encompassing a family of syndromes attributable to, or exacerbated by, gastroesophageal reflux that impart morbidity, mainly through troublesome symptoms. Major GERD phenotypes are non-erosive reflux disease, GERD hypersensitivity, low or high grade esophagitis, Barrett's esophagus, reflux chest pain, laryngopharyngeal reflux, and regurgitation dominant reflux. GERD is common throughout the world, and its epidemiology is linked to the Western lifestyle, obesity, and the demise of Helicobacter pylori...
November 23, 2020: BMJ: British Medical Journal
Jo Ellen Wilson, Matthew F Mart, Colm Cunningham, Yahya Shehabi, Timothy D Girard, Alasdair M J MacLullich, Arjen J C Slooter, E Wesley Ely
Delirium, a syndrome characterized by an acute change in attention, awareness and cognition, is caused by a medical condition that cannot be better explained by a pre-existing neurocognitive disorder. Multiple predisposing factors (for example, pre-existing cognitive impairment) and precipitating factors (for example, urinary tract infection) for delirium have been described, with most patients having both types. Because multiple factors are implicated in the aetiology of delirium, there are likely several neurobiological processes that contribute to delirium pathogenesis, including neuroinflammation, brain vascular dysfunction, altered brain metabolism, neurotransmitter imbalance and impaired neuronal network connectivity...
November 12, 2020: Nature Reviews. Disease Primers
Alexandre Santos, Panu Mentula, Tarja Pinta, Shamel Ismail, Tero Rautio, Risto Juusela, Aleksi Lähdesmäki, Tom Scheinin, Ville Sallinen
Importance: Diverticulitis has a tendency to recur and affect quality of life. Objective: To assess whether sigmoid resection is superior to conservative treatment in improving quality of life of patients with recurrent, complicated, or persistent painful diverticulitis. Design, Setting, and Participants: This open-label randomized clinical trial assessed for eligibility 128 patients with recurrent, complicated, or persistent painful diverticulitis in 6 Finnish hospitals from September 29, 2014, to October 10, 2018...
November 18, 2020: JAMA Surgery
Michael A Matthay, Yaseen M Arabi, Emily R Siegel, Lorraine B Ware, Lieuwe D J Bos, Pratik Sinha, Jeremy R Beitler, Katherine D Wick, Martha A Q Curley, Jean-Michel Constantin, Joseph E Levitt, Carolyn S Calfee
Although the acute respiratory distress syndrome (ARDS) is well defined by the development of acute hypoxemia, bilateral infiltrates and non-cardiogenic pulmonary edema, ARDS is heterogeneous in terms of clinical risk factors, physiology of lung injury, microbiology, and biology, potentially explaining why pharmacologic therapies have been mostly unsuccessful in treating ARDS. Identifying phenotypes of ARDS and integrating this information into patient selection for clinical trials may increase the chance for efficacy with new treatments...
November 18, 2020: Intensive Care Medicine
Martin B Brodsky, Lee M Akst, Erin Jedlanek, Vinciya Pandian, Brendan Blackford, Carrie Price, Gai Cole, Pedro A Mendez-Tellez, Alexander T Hillel, Simon R Best, Matthew J Levy
Laryngeal injury from intubation can substantially impact airway, voice, and swallowing, thus necessitating multidisciplinary interventions. The goals of this systematic review were (1) to review the types of laryngeal injuries and their patient-reported symptoms and clinical signs resulting from endotracheal intubation in patients intubated for surgeries and (2) to better understand the overall the frequency at which these injuries occur. We conducted a search of 4 online bibliographic databases (ie, PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature [CINAHL], and The Cochrane Library) and ProQuest and Open Access Thesis Dissertations (OPTD) from database inception to September 2019 without restrictions for language...
November 11, 2020: Anesthesia and Analgesia
Biff F Palmer, Juan Jesus Carrero, Deborah J Clegg, Gates B Colbert, Michael Emmett, Steven Fishbane, Debra J Hain, Edgar Lerma, Macaulay Onuigbo, Anjay Rastogi, Simon D Roger, Bruce S Spinowitz, Matthew R Weir
Hyperkalemia is an electrolyte abnormality with potentially life-threatening consequences. Despite various guidelines, no universally accepted consensus exists on best practices for hyperkalemia monitoring, with variations in precise potassium (K+ ) concentration thresholds or for the management of acute or chronic hyperkalemia. Based on the available evidence, this review identifies several critical issues and unmet needs with regard to the management of hyperkalemia. Real-world studies are needed for a better understanding of the prevalence of hyperkalemia outside the clinical trial setting...
November 4, 2020: Mayo Clinic Proceedings
Wilson Luiz da Costa, Hop S Tran Cao, Kyle H Sheetz, Xiangjun Gu, Edward C Norton, Nader N Massarweh
BACKGROUND: Neoadjuvant therapy (NAT) is increasingly being used in the management of patients with resectable pancreatic ductal adenocarcinoma (PDAC); however, there is a lack of evidence regarding the benefit among these patients. OBJECTIVE: The aim of this study was to evaluate overall survival (OS) in PDAC patients with resectable disease treated with NAT or upfront resection through instrumental variable (IV) analysis. DESIGN: A national cohort study of resectable PDAC patients in the National Cancer Data Base (2007-2015) treated with either upfront surgery or resection after NAT...
November 10, 2020: Annals of Surgical Oncology
2020-11-15 16:53:04
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