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[PMID]:28453639
[Au] Autor:Abe T; Takada N; Kikuchi H; Matsumoto R; Osawa T; Murai S; Miyajima N; Maruyama S; Shinohara N
[Ad] Endereço:For reprints and all correspondence: Takashige Abe, Department of Urology, Hokkaido University Graduate School of Medicine, North-15, West-7, North Ward, Sapporo 060-8638, Japan. E-mail: takataka@rf6.so-net.ne.jp
[Ti] Título:Perioperative morbidity and mortality of octogenarians treated by radical cystectomy-a multi-institutional retrospective study in Japan.
[So] Source:Jpn J Clin Oncol;47(8):755-761, 2017 08 01.
[Is] ISSN:1465-3621
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: To determine the characteristics of 90-day morbidity and mortality after radical cystectomy in Japanese octogenarians. Methods: A retrospective multi-institutional study. We reviewed the records of 834 patients treated by open radical cystectomy between 1997 and 2010. All complications within 90 days after surgery were sorted into the 11 categories proposed by the Memorial Sloan-Kettering Cancer Center and graded according to the modified Clavien-Dindo system. We compared the characteristics of complications between ≥80-year (n = 86) and <80-year (n = 748) groups. Multivariate regression models were used to determine the predictors of complications. Results: American Society of Anesthesiologists score III-IV was more frequent (14% vs. 6%, respectively, P < 0.0001), and ureterocutaneostomy was more frequently performed (30% vs. 21%, respectively, P = 0.0148) in the ≥80-year group compared with <80-year group. There were no significant differences in the rates of any complication, major (Grade 3-5) complication, or 90-day mortality between the two groups (≥80-year group: 70%, 21%, 3.5%, respectively, <80-year group: 68%, 22%, 2%, respectively). The ≥80-year group had fewer genitourinary complications (7% vs. 16%, respectively, P = 0.0131). Multivariate regression analyses revealed that bowel-using urinary diversion (P = 0.0031) and the operative time (P = 0.0269) were significant predictors of any grade of complications, and a male sex (P = 0.0167), annual cystectomy volume (P = 0.0284) and prior cardiovascular comorbidity (P = 0.0034) were significant predictors of major complications. Conclusions: In our experience, radical cystectomy in Japanese octogenarians caused similar perioperative comorbidities. Old age as a single criterion should not be used to abandon radical cystectomy; careful preoperative assessment is mandatory.
[Mh] Termos MeSH primário: Cistectomia/efeitos adversos
Período Perioperatório/mortalidade
Neoplasias da Bexiga Urinária/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Comorbidade
Cistectomia/métodos
Feminino
Seres Humanos
Japão
Masculino
Meia-Idade
Morbidade
Estudos Retrospectivos
Resultado do Tratamento
Neoplasias da Bexiga Urinária/mortalidade
Neoplasias da Bexiga Urinária/patologia
Derivação Urinária/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/jjco/hyx062


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[PMID]:29254318
[Au] Autor:Vicenti G; Pesce V; Bizzoca D; Nappi V; Palmiotto F; Carrozzo M; Moretti B
[Ad] Endereço:School of Medicine, University of Bari Aldo Moro, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, Bari, Italy.
[Ti] Título:Perioperative plasmatic presepsin levels in patients undergoing total hip or knee replacement: a preliminary study.
[So] Source:J Biol Regul Homeost Agents;31(4):1081-1086, 2017 Oct-Dec.
[Is] ISSN:0393-974X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Presepsin (sCD14-ST) is an emerging biomarker in the diagnosis of sepsis. In the field of orthopaedics, it could be useful in the diagnosis and management of periprosthetic joint infections (PJI). The aim of this study is to define the normal perioperative plasmatic levels of presepsin in patients undergoing primary cementless total hip replacement (THR) or primary cemented total knee replacement (TKR). For this purpose, 50 patients (19 male, 31 female, mean age= 64.04±8.88) were recruited. The patients were divided into two groups: Group A patients underwent cementless THR, whereas Group B patients underwent cemented TKR. On recruitment, anthropometric data, smocking status, osteoarthritis stage according to Kellgren and Lawrence, Harris Hip Score (HHS) for Group A patients and Knee Society Score (KSS) for Group B patients, drugs assumption and comorbidities were recorded. All the patients underwent serial blood tests, including complete blood count, presepsin (PS), C-reactive protein (CRP) and procalcitonin (PCT) 24 hours before arthroplasty (T0) and at 24 (T1), 48 (T2), 72 (T3) and 96 (T4) hours postoperatively. Body temperature (θ) was recorded every six hours in the time lapse T0-T4. Presepsin plasmatic concentration was comparable at baseline in both groups. After surgery, however, a significant increase of presepsin was observed in Group A, whereas in Group B no significant changes of presepsin were recorded. A comparable trend of this biomarker was found in the two groups, i.e. presepsin increased from T0 to T3, when it reached its maximum value, and its decrease started at T4. Finally, presepsin resulted more accurate than CRP in the evaluation of perioperative inflammatory response in patients undergoing THR or TKR. These data will be helpful in defining a reference interval for presepsin in patients with prosthetic joint implants, and a cut-off of this biomarker for the diagnosis of PJI.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Artroplastia do Joelho
Receptores de Lipopolissacarídeos/sangue
Osteoartrite do Quadril/sangue
Osteoartrite do Joelho/sangue
Fragmentos de Peptídeos/sangue
Sepse/sangue
[Mh] Termos MeSH secundário: Idoso
Biomarcadores/sangue
Proteína C-Reativa/metabolismo
Calcitonina/sangue
Feminino
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/complicações
Osteoartrite do Quadril/diagnóstico
Osteoartrite do Quadril/cirurgia
Osteoartrite do Joelho/complicações
Osteoartrite do Joelho/diagnóstico
Osteoartrite do Joelho/cirurgia
Período Perioperatório
Dados Preliminares
Sepse/complicações
Sepse/diagnóstico
Sepse/cirurgia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Lipopolysaccharide Receptors); 0 (Peptide Fragments); 0 (presepsin protein, human); 9007-12-9 (Calcitonin); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


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[PMID]:29381920
[Au] Autor:Lin TY; Yang CY; Liu SC
[Ad] Endereço:Department of Orthopedics, Mackay Memorial Hospital Medical Center, New Taipei City, Taiwan, R.O.C.
[Ti] Título:Corrective osteotomy with retrograde Fassier-Duval nail in an osteogenesis imperfecta patient with bilateral genu valgum: A case report.
[So] Source:Medicine (Baltimore);96(47):e8459, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The treatment of osteogenesis imperfecta (OI) requires a multidisciplinary approach to maximize function and reduce fracture incidence. The aim of this case report was to discuss an alternative surgical approach to stabilize a corrective osteotomy using the Fassier Duval (FD) system in an OI patient. PATIENT CONCERNS: A 20-year-old OI woman presented with left thigh pain, gait disturbance, and bilateral genu valgus deformities. DIAGNOSES: Physical examination and standing radiographs revealed bilateral genu valgum with previous fixation implants in the femoral and the left tibia. INTERVENTIONS: Staged surgery was performed. A previous Ender pin was removed from the left femur, and a FD nail was inserted in a retrograde fashion. An intercondylar fracture was encountered while inserting the female rod in the distal left femur. After removal of a previous Rush pin from the right femur, several complications were also encountered during FD nailing of the right femur. The tip threads of the FD male nail could not achieve adequate anchorage in the region of the greater trochanter. To prevent male nail dropping, a horizontal stop Kirschner pin was inserted close to the distal end of the female nail. OUTCOME: Despite perioperative problems such as rod dropping and occurrence of an intercondylar fracture of the left distal femur, bilateral retrograde nailing using the FD system was successful. An accurate entry portal is important when performing retrograde rodding. In addition, reaming the portal to a larger diameter in order to accommodate the large head of the female nail can prevent intraoperative intercondylar split, especially when combined with an osteotomy at the distal femur. LESSONS: Selection of the proper surgical technique is dependent on both the surgeon's experience and the condition of the patient. Although not an optimal device, a FD nail can be used as an IM nail for corrective osteotomy at the distal femur in an adult OI patient with a small femoral IM canal.
[Mh] Termos MeSH primário: Genu Valgum/complicações
Osteogênese Imperfeita/complicações
Osteogênese Imperfeita/cirurgia
Osteotomia/métodos
[Mh] Termos MeSH secundário: Pinos Ortopédicos
Feminino
Fraturas do Fêmur/complicações
Fraturas do Fêmur/cirurgia
Seres Humanos
Período Perioperatório
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008459


  4 / 2108 MEDLINE  
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[PMID]:29211220
[Au] Autor:Campos IC; Tanganelli V; Maues HP; Coelho MCM; Martins FA; Munhoz G; Egito JGT; Souza HCC; Giannini CMC; Farsky PS
[Ad] Endereço:Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
[Ti] Título:Blood Transfusion and Increased Perioperative Risk in Coronary Artery Bypass Grafts.
[So] Source:Braz J Cardiovasc Surg;32(5):394-400, 2017 Sep-Oct.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To correlate blood transfusions and clinical outcomes during hospitalization in coronary artery bypass grafting surgery (CABG). METHODS: Transfusion, clinical and hematological data were collected for 1,378 patients undergoing isolated or combined CABG between January 2011 and December 2012. The effect of blood transfusions was evaluated through multivariate analysis to predict three co-primary outcomes: composite ischemic events, composite infectious complications and hospital mortality. Because higher risk patients receive more transfusions, the hospital mortality outcome was also tested on a stratum of low-risk patients to isolate the effect of preoperative risk on the results. RESULTS: The transfusion rate was 63.9%. The use of blood products was associated with a higher incidence of the three coprimary outcomes: composite infectious complications (OR 2.67, 95% CI 1.70 to 4.19; P<0.001), composite ischemic events (OR 2.42, 95% CI 1.70 to 3.46; P<0.001) and hospital mortality (OR 3.07, 95% CI 1.53 to 6.13; P<0.001). When only patients with logistic EuroSCORE ≤ 2% were evaluated, i.e., low-risk individuals, the mortality rate and the incidence of ischemic events and infectious complications composites remained higher among the transfused patients [6% vs. 0.4% (P<0.001), 11.7% vs. 24,3% (P<0.001) and 6.5% vs. 12.7% (P=0.002), respectively]. CONCLUSION: The use of blood components in patients undergoing CABG was associated with ischemic events, infectious complications and hospital mortality, even in low-risk patients.
[Mh] Termos MeSH primário: Transfusão de Sangue/estatística & dados numéricos
Ponte de Artéria Coronária/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Transfusão de Sangue/mortalidade
Ponte de Artéria Coronária/métodos
Ponte de Artéria Coronária/mortalidade
Feminino
Mortalidade Hospitalar
Seres Humanos
Infecção/etiologia
Masculino
Meia-Idade
Isquemia Miocárdica/etiologia
Período Perioperatório
Complicações Pós-Operatórias
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29411032
[Au] Autor:Ng PY; Ng AK; Subramaniam B; Burns SM; Herisson F; Timm FP; Med C; Rudolph MI; Med C; Scheffenbichler F; Med C; Friedrich S; Med C; Houle TT; Bhatt DL; Eikermann M
[Ad] Endereço:Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Association of Preoperatively Diagnosed Patent Foramen Ovale With Perioperative Ischemic Stroke.
[So] Source:JAMA;319(5):452-462, 2018 02 06.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Perioperative stroke is a major complication for patients undergoing surgery. Patent foramen ovale (PFO) represents a possible anatomical link between venous thrombosis and stroke. Objective: To determine whether a preoperatively diagnosed PFO is associated with increased risk of perioperative ischemic stroke. Design, Setting, and Participants: Retrospective cohort study from Massachusetts General Hospital and 2 affiliated community hospitals between January 1, 2007, and December 31, 2015. Participants were 182 393 consecutive adults undergoing noncardiac surgery with general anesthesia. Exposures: Preoperatively diagnosed PFO. Main Outcomes and Measures: Perioperative ischemic stroke occurring within 30 days of surgery; stroke subtype by Oxfordshire Community Stroke Project classification and stroke severity by National Institute of Health Stroke Scale (NIHSS). Results: Among the 150 198 patient cases analyzed (median [SD] age, 55 [16] years), 1540 (1.0%) had a diagnosis of PFO before surgery. A total of 850 (0.6%) ischemic strokes occurred within 30 days of surgery (49 [3.2%] among patients with PFO and 801 [0.5%] among patients without PFO). In adjusted analyses, patients with PFO had an increased risk of ischemic stroke compared with patients without PFO (odds ratio, 2.66 [95% CI, 1.96-3.63]; P < .001). The estimated risks of stroke were 5.9 for every 1000 patients with PFO and 2.2 for every 1000 patients without PFO (adjusted absolute risk difference, 0.4% [95% CI, 0.2%-0.6%). Patients with PFO also had an increased risk of large vessel territory stroke (relative risk ratio, 3.14 [95% CI, 2.21-4.48]; P < .001) and a more severe stroke-related neurologic deficit measured by NIHSS (median, 4 [interquartile range {IQR}, 2-10] vs median, 3 [IQR, 1-6] for those without PFO; P = .02). Conclusions and Relevance: Among adult patients undergoing noncardiac surgery at 3 hospitals, having a preoperatively diagnosed PFO was significantly associated with increased risk of perioperative ischemic stroke within 30 days after surgery. Further research is needed to confirm these findings and to determine whether interventions would decrease this risk.
[Mh] Termos MeSH primário: Forame Oval Patente/complicações
Acidente Vascular Cerebral/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Área Sob a Curva
Isquemia Encefálica/etiologia
Comorbidade
Ecocardiografia
Feminino
Forame Oval Patente/diagnóstico por imagem
Seres Humanos
Incidência
Modelos Logísticos
Masculino
Meia-Idade
Período Perioperatório
Período Pré-Operatório
Estudos Retrospectivos
Fatores de Risco
Acidente Vascular Cerebral/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.21899


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[PMID]:29381942
[Au] Autor:Wang TF; Wu YT; Tseng CF; Chou C
[Ad] Endereço:School of Nursing, National Yang Ming University.
[Ti] Título:Associations between dental anxiety and postoperative pain following extraction of horizontally impacted wisdom teeth: A prospective observational study.
[So] Source:Medicine (Baltimore);96(47):e8665, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of the study is to identify associations between dental anxiety and postoperative pain in patients undergoing extraction of horizontally impacted wisdom teeth.A total of 119 volunteers provided demographic data, and completed questionnaires, the State-Trait Anxiety Inventory (STAI), Chinese Index of Dental Anxiety and Fear (C-IDAF)-4C, and the Numeric Rating Scale (NRS) for pain.Mean SAI, TAI, and C-IDAF-4C scores were 42.5 ±â€Š8.7, 46.4 ±â€Š10.9, and 16.9 ±â€Š7.2, respectively. Mean postoperative pain level score was 3.0 ±â€Š1.8 (range: 0.3-8.4). SAI scores increased as preoperative pain levels increased (ß = 1.30, 95% confidence interval [CI]: 0.62-1.98, P < .001); females had higher SAI scores than males (5.34; 95% CI: 1.74-8.95, P = .004). Multivariable analysis revealed that females, bad exodontic experience, and higher predicted pain levels were associated with higher IDAF-4C scores. SAI scores (γ = 0.611, P < .001) and TAI scores (γ = 0.305, P < .001) increased as C-IDAF-4C scores increased. Higher C-IDAF-4C scores and longer operative time were significantly associated with higher levels of postoperative pain.Specific factors are associated with anxiety and stress, and postoperative pain in patients undergoing wisdom teeth extraction. Addressing these factors preoperatively may reduce stress and anxiety, and lead to more favorable treatment outcomes.
[Mh] Termos MeSH primário: Ansiedade ao Tratamento Odontológico
Dor Pós-Operatória
Extração Dentária
Dente Impactado/cirurgia
[Mh] Termos MeSH secundário: Adulto
Ansiedade ao Tratamento Odontológico/diagnóstico
Ansiedade ao Tratamento Odontológico/fisiopatologia
Feminino
Seres Humanos
Masculino
Avaliação de Processos e Resultados (Cuidados de Saúde)
Medição da Dor/métodos
Dor Pós-Operatória/diagnóstico
Dor Pós-Operatória/psicologia
Período Perioperatório/psicologia
Estatística como Assunto
Taiwan/epidemiologia
Escala de Ansiedade Frente a Teste
Extração Dentária/efeitos adversos
Extração Dentária/psicologia
Dente Impactado/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008665


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[PMID]:29235761
[Au] Autor:Sydor RI; Khranovska NM; Skachkova OV; Skivka LM
[Ti] Título:The effect of perioperative analgesic drugs omnopon and dexketoprofen on the functional activity of immune cells in murine model of tumor surgery.
[So] Source:Ukr Biochem J;88(4):40-7, 2016 Jul-Aug.
[Is] ISSN:2409-4943
[Cp] País de publicação:Ukraine
[La] Idioma:eng
[Ab] Resumo:We aimed to investigate the effect of perioperative analgesia with nonselective cyclooxygenase-2 inhibitor dexketoprofen and opioid drug omnopon on the functional activity of immune cells in tumor excision murine model. Lewis lung carcinoma cells were transplanted into hind paw of C57/black mice. On the 23th day tumor was removed. Analgesic drugs were injected 30 min before and once a day for 3 days after the surgery. Biological material was obtained a day before, 1 day and 3 days after the tumor removal. IFN-γ, IL-4, IL-10 and TGF-ß mRNA levels in splenic cells were assessed by quantitative real-time RT-PCR. Cytotoxic activity of splenocytes was estimated by flow cytometry. We found that in splenocytes of mice received opioid analgesia IL-10 mRNA level was increased 2.3 times on day one after the surgery compared to preoperative level (P < 0.05), while in dexketoprofen group this parameter did not change. IFN-γ gene expression level on day 3 after tumor removal was 40% higher in splenocytes of dexketoprofen treated mice as compared with omnopon treated animals (P < 0.05). Cytotoxic activity of splenocytes on day 3 postsurgery was (62.2 ± 2.4)% in dexketoprofen against (50.2 ± 3.3)% in omnopon group. In conclusion, perioperative analgesia with cyclooxygenase inhibitor dexketoprofen in contrast to opioid analgesia with omnopon preserves higher functional activity of murine immune cells in the experimental model of tumor surgery.
[Mh] Termos MeSH primário: Analgésicos/farmacologia
Carcinoma Pulmonar de Lewis/imunologia
Citotoxicidade Imunológica/efeitos dos fármacos
Cetoprofeno/farmacologia
Linfócitos/efeitos dos fármacos
Ópio/farmacologia
Dor Processual/prevenção & controle
[Mh] Termos MeSH secundário: Animais
Carcinoma Pulmonar de Lewis/genética
Carcinoma Pulmonar de Lewis/patologia
Carcinoma Pulmonar de Lewis/cirurgia
Expressão Gênica
Membro Posterior
Interferon gama/genética
Interferon gama/imunologia
Interleucina-10/genética
Interleucina-10/imunologia
Interleucina-4/genética
Interleucina-4/imunologia
Cetoprofeno/análogos & derivados
Linfócitos/citologia
Linfócitos/imunologia
Camundongos
Camundongos Endogâmicos C57BL
Transplante de Neoplasias
Dor Processual/imunologia
Dor Processual/fisiopatologia
Período Perioperatório
RNA Mensageiro/genética
RNA Mensageiro/imunologia
Baço/citologia
Baço/efeitos dos fármacos
Baço/imunologia
Fator de Crescimento Transformador beta/genética
Fator de Crescimento Transformador beta/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics); 0 (IL10 protein, mouse); 0 (RNA, Messenger); 0 (Transforming Growth Factor beta); 130068-27-8 (Interleukin-10); 207137-56-2 (Interleukin-4); 8008-60-4 (Opium); 82115-62-6 (Interferon-gamma); 90Y4QC304K (Ketoprofen)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.15407/ubj88.04.040


  8 / 2108 MEDLINE  
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[PMID]:29245285
[Au] Autor:Park HM; Park SJ; Shim JR; Lee EC; Lee SD; Han SS; Kim SH
[Ad] Endereço:Center for Liver Cancer, National Cancer Center, Gyeonggi-do, South Korea.
[Ti] Título:Perioperative transfusion in pancreatoduodenectomy: The double-edged sword of pancreatic surgeons.
[So] Source:Medicine (Baltimore);96(49):e9019, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We designed the study to clarify the prognostic significance of perioperative (preoperative, intraoperative, and postoperative) red blood cell (RBC) transfusion following pancreaticoduodenectomy (PD) for periampullary cancers.This study retrospectively analyzed 244 periampullary cancer patients (pancreatic cancer, 124 patients; bile duct cancer, 63 patients; and ampullary cancer, 57 patients) treated by PD from June 2001 to June 2010 at the National Cancer Center, Korea (NCC2017-0106).A total of 112 (46%) of 244 patients had received transfusion (preoperative, 5%; intraoperative, 17%; and postoperative, 37%). The 5-year survival rate of patients without perioperative transfusion was 36%, whereas that of patients with a transfusion was 25% (P = .04). Perioperative transfusion and intraoperative transfusion were found to be independent poor prognostic factors [relative risk (RR): 1.52 and 1.95, respectively]. The independent factors associated with perioperative transfusion were being female, operation time >420 minutes, portal vein (PV) resection, and preoperative serum hemoglobin (Hb) < 12 mg/dL. As the amount of perioperative transfusion increased, overall survival (OS) decreased.Perioperative transfusion, especially intraoperative transfusion was an independent prognostic factor for survival after PD. Therefore, for patients with periampullary cancer, intraoperative bleeding and operation time should be minimized and preoperative anemia corrected.
[Mh] Termos MeSH primário: Transfusão de Eritrócitos/estatística & dados numéricos
Pancreaticoduodenectomia/métodos
Período Perioperatório/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Ampola Hepatopancreática
Feminino
Hemoglobinas/análise
Seres Humanos
Masculino
Meia-Idade
Duração da Cirurgia
Pancreaticoduodenectomia/mortalidade
Estudos Retrospectivos
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Hemoglobins)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009019


  9 / 2108 MEDLINE  
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[PMID]:29208832
[Au] Autor:Yadav S; Sahay P; Maharana PK; Titiyal JS; Vajpayee RB; Sharma N
[Ad] Endereço:Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
[Ti] Título:Comparison of visual performance and after cataract formation between two monofocal aspheric intraocular lenses following phacoemulsification for senile cataract: A randomized controlled study.
[So] Source:Indian J Ophthalmol;65(12):1445-1449, 2017 Dec.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Monofocal aspheric intraocular lenses (IOLs) provide better visual outcome compared to other available IOLs following cataract surgery. However, the imported IOLs are expensive and are not affordable by all subset of patients in low- to middle-income countries like India. The aim of this study is to compare the safety and efficacy of a relatively low cost indigenous IOL (Acriol EC) with an imported aspheric IOL (AcrySof IQ). METHODS: A randomized controlled trial was conducted at a tertiary care centre. Two hundred and five eyes of 137 patients >45 years of age with uncomplicated age-related cataract were recruited. All cases underwent standard phacoemulsification and randomly assigned to one of the IOL implantations (Group I: AcrySof IOL; Group II: Acriol EC IOL). Primary outcome measure was best-corrected visual acuity (BCVA). Secondary outcomes included visual function (VF) score, spherical equivalent, contrast sensitivity, optical aberrations, and posterior capsular opacification. Independent t-test to compare two means; Mann-Whitney test; Pearson's Chi-square test, and McNemar's test were used for analyzing the nonparametric data such as incidence of posterior capsule opacification. RESULTS: There was no significant difference in the mean postoperative BCVA at 1, 3, 6, and 12 months in either group (P > 0.05). The contrast sensitivity, wavefront aberrations, VF score, and posterior capsular opacification were comparable between the groups except for higher-order aberrations and spherical aberration, which were higher in Group II. CONCLUSIONS: Acriol EC IOL provides visual outcomes comparable to other commonly used aspheric IOLs with comparable safety and efficacy at an affordable cost.
[Mh] Termos MeSH primário: Catarata/diagnóstico
Sensibilidades de Contraste/fisiologia
Lentes Intraoculares
Facoemulsificação/métodos
Acuidade Visual/fisiologia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Período Perioperatório
Estudos Prospectivos
Desenho de Prótese
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_757_17


  10 / 2108 MEDLINE  
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[PMID]:29182140
[Au] Autor:Alshammari D; Alhefzi A; Bund L; Schneider L; Gicquel P
[Ti] Título:Popliteal artery dissection presented 12 hours after admission for a Salter III fracture of proximal tibia.
[So] Source:Acta Orthop Belg;82(4):918-922, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:A 16-year-old boy sustained a salter III fracture of the upper tibia following a motorcycle accident. Except for well localized knee pain, the patient did not have any other symptom. Repeated clinical examination did not reveal any absent peripheral pulse. Given the state of the fracture, anatomical reduction and screw fixation was planned in the operating room.  Twelve hours after admission the patient was taken to the operating room. During the period preceding surgery he continued to have normal vascular clinical examinations. Further clinical assessment was performed in the operating room and remained to be normal. However after induction and upon extension of the lower limb, peripheral pulses in the affected side were abruptly lost. Urgent vascular exploration of the area showed a popliteal artery dissection necessitating a bypass graft to restore blood flow.  We present a review of the literature alongside a case report showing how popliteal artery pathology in a similar context can present late and be for a period of time clinically undetectable.
[Mh] Termos MeSH primário: Aneurisma Dissecante/cirurgia
Parafusos Ósseos
Fixação Interna de Fraturas
Traumatismos do Joelho/cirurgia
Período Perioperatório
Artéria Poplítea/cirurgia
Fraturas da Tíbia/cirurgia
Procedimentos Cirúrgicos Vasculares
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Adolescente
Aneurisma Dissecante/complicações
Seres Humanos
Traumatismos do Joelho/complicações
Lacerações/complicações
Lacerações/cirurgia
Masculino
Motocicletas
Artéria Poplítea/lesões
Veia Poplítea/lesões
Veia Poplítea/cirurgia
Fraturas da Tíbia/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE



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