1,426,631 results match your criteria complications patients

Characteristics, presentation and outcomes of music festival patrons with stimulant drug-induced serotonin toxicity.

Emerg Med Australas 2021 Apr 15. Epub 2021 Apr 15.

Clinical Services, St John Ambulance Australia, Melbourne, Victoria, Australia.

Objective: A large number of stimulant drug-associated deaths at music festivals in Australia were reported during the southern hemisphere summer of 2018-2019. This led to the prehospital deployment of healthcare professional-led critical care response teams. We aimed to describe the characteristics, clinical presentation, management and outcomes of music festival patrons with stimulant drug-induced serotonin toxicity managed using this model during the study period. Read More

View Article and Full-Text PDF

Vulnerability to Postoperative Complications in Obstructive Sleep Apnea: Importance of Phenotypes.

Anesth Analg 2021 May;132(5):1328-1337

From the Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing surgical procedures. Patients with OSA are at heightened risk of postoperative complications. Current treatments for OSA focus on alleviating upper airway collapse due to impaired upper airway anatomy. Read More

View Article and Full-Text PDF

Perioperative Continuous Positive Airway Pressure Therapy: A Review With the Emphasis on Randomized Controlled Trials and Obstructive Sleep Apnea.

Anesth Analg 2021 May;132(5):1306-1313

Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.

The perioperative use of continuous positive airway pressure (CPAP) therapy has increased substantially in recent years, particularly in relationship to the treatment of patients with known or suspected obstructive sleep apnea (OSA). OSA is common in the surgical population and is reported as an independent risk factor for postoperative complications, intensive care unit admission, and increased length of hospital stay. A large proportion of OSA patients are undiagnosed at the time of surgery and can therefore not be optimized preoperatively. Read More

View Article and Full-Text PDF

Perioperative Management of the Patient With Obstructive Sleep Apnea: A Narrative Review.

Anesth Analg 2021 May;132(5):1231-1243

From the Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria.

The prevalence of obstructive sleep apnea (OSA) has reached 1 billion people worldwide, implying significant risk for the perioperative setting as patients are vulnerable to cardiopulmonary complications, critical care requirement, and unexpected death. This review summarizes main aspects and considerations for the perioperative management of OSA, a condition of public health concern. Critical determinants of perioperative risk include OSA-related changes in upper airway anatomy with augmented collapsibility, diminished capability of upper airway dilator muscles to respond to airway obstruction, disparities in hypoxemia and hypercarbia arousal thresholds, and instability of ventilatory control. Read More

View Article and Full-Text PDF

Outcomes of Sleep Apnea Surgery in Outpatient and Inpatient Settings.

Anesth Analg 2021 May;132(5):1215-1222

From the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Upper airway surgery is an alternative treatment for patients with severe obstructive sleep apnea (OSA). However, there is controversy regarding selection criteria for outpatient versus inpatient settings for these surgical procedures. The aim of this retrospective study was to compare postoperative outcomes of patients undergoing airway surgery in outpatient and inpatient settings based on length of stay at the facility. Read More

View Article and Full-Text PDF

Prestenting Versus Nonprestenting on the Outcomes of Flexible Ureteroscopy for Large Upper Urinary Stones: A Systematic Review and Meta-Analysis.

Urol Int 2021 Apr 15:1-8. Epub 2021 Apr 15.

Department of Urology, Second Hospital of Hebei Medical University, Shijiazhuang, China.

Introduction: The purpose of this article is to evaluate the efficacy and safety of prestenting (PS) versus non-PS (NPS) of flexible ureteroscopy (fURS) to treat large upper urinary stones.

Methods: We conducted a systematic literature research of PubMed, Ovid, Scopus (up to August 2019), and citation lists to identify eligible studies. All studies comparing PS versus NPS of fURS were included. Read More

View Article and Full-Text PDF

Endotoxin Adsorbent Therapy in Severe COVID-19 Pneumonia.

Blood Purif 2021 Apr 15:1-8. Epub 2021 Apr 15.

Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Introduction: Uncontrolled systemic inflammation may occur in severe coronavirus disease 19 (COVID-19). We have previously shown that endotoxemia, presumably from the gut, may complicate COVID-19. However, the role of endotoxin adsorbent (EA) therapy to mitigate organ dysfunction in COVID-19 has not been explored. Read More

View Article and Full-Text PDF

Postoperative extremity compartment syndrome in a cancer center: Incidence and risk factors.

Surg Oncol 2021 Apr 3;38:101563. Epub 2021 Apr 3.

Department of Surgery, Orthopaedic Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.

Objective: Postoperative compartment syndrome is a reported complication with known patient- and treatment-specific risk factors. Cancer patients carry unique risk factors associated with their underlying disease and long, complex procedures. While elevated serum lactate in traumatic and intensive care settings portends higher risk, no laboratory parameter has demonstrated utility in postoperative risk stratification. Read More

View Article and Full-Text PDF

Postoperative morbidity following pancreatic cancer surgery is significantly associated with worse overall patient survival; systematic review and meta-analysis.

Surg Oncol 2021 Apr 6;38:101573. Epub 2021 Apr 6.

Department of Visceral, Thoracic- and Vascular Surgery, Philipps-University Marburg, Germany.

Backround: The influence of postoperative morbidity on survival after potentially curative resection for pancreatic ductal adenocarcinoma (PDAC) remains unclear.

Methods: Medline, Web of Science and Cochrane Library were searched for studies reporting survival in patients with and without complications, defined according to the Clavien-Dindo classification, after primary, potentially curative resection for pancreatic cancer followed by adjuvant treatment. Meta-analysis was performed using a random-effects model. Read More

View Article and Full-Text PDF

Prevention and treatment of postoperative pain in pediatric patients undergone craniotomy: Systematic review of clinical evidence.

Clin Neurol Neurosurg 2021 Apr 1;205:106627. Epub 2021 Apr 1.

Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University of Rome, Italy.

Background: Prevention and treatment of postoperative pain after craniotomy in pediatric patients is an open and challenging clinical problem due to limited epidemiological data and significant concerns on safety of the most common analgesics in neurosurgical patients. We reviewed the literature to evaluate the possible available strategies in pain management in pediatric patients.

Methods: The systematic review was performed in accordance with PRISMA statement recommendations. Read More

View Article and Full-Text PDF

Trauma Center Outcomes After Transition From Level 2 to Level 1: A National Trauma Data Bank Analysis.

J Surg Res 2021 Apr 12;264:499-509. Epub 2021 Apr 12.

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Johns Hopkins School of Medicine, Baltimore, Maryland.

Background: Previous US-based studies have shown that a trauma center designation of level 1 is associated with improved patient outcomes. However, most studies are cross-sectional, focus on volume-related issues and are direct comparisons between levels. This study investigates the change in patient characteristics when individual trauma centers transition from level 2 to level 1 and whether the patients have similar outcomes during the initial period of the transition. Read More

View Article and Full-Text PDF

Outcomes Following Cholecystectomy on a Service Designed to Maximize Chief Resident Entrustment.

J Surg Res 2021 Apr 12;264:474-480. Epub 2021 Apr 12.

Department of Surgery, Wake Forest Baptist Health, Wake Forest University School of Medicine, Winston-Salem, NC. Electronic address:

Background: The chief resident service provides surgical trainees in their final year of training the opportunity to maximize responsibility, continuity, and decision-making. Although supervised, chief residents operate according to personal preferences instead of adapting to their attendings' preferences. We hypothesized that outcomes following cholecystectomy are equivalent between the chief resident service and standard academic services. Read More

View Article and Full-Text PDF

Efficacy and safety of apixaban for primary prevention in gastrointestinal cancers: A post-hoc analysis of the AVERT trial.

Thromb Res 2021 Mar 21;202:151-154. Epub 2021 Mar 21.

Department of Medicine, Ottawa Hospital Research Institute at the University of Ottawa, Ontario, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. Electronic address:

Background: Recent trials have demonstrated that thromboprophylaxis using direct oral anticoagulants is effective but associated with a higher rate of major bleeding in intermediate-to-high risk (Khorana score ≥ 2) patients with cancer initiating systemic chemotherapy. Patients with gastrointestinal cancer may be at higher risk of major bleeding complications. We sought to assess the efficacy and safety of using thromboprophylaxis with apixaban in this patient population. Read More

View Article and Full-Text PDF

Cost and clinical outcomes of postoperative intensive care unit versus general floor management in head and neck free flap reconstructive surgery patients.

Am J Otolaryngol 2021 Apr 12;42(5):103029. Epub 2021 Apr 12.

Department of Otolaryngology- Head and Neck Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. Electronic address:

Purpose: To compare clinical, surgical, and cost outcomes in patients undergoing head and neck free-flap reconstructive surgery in the setting of postoperative intensive care unit (ICU) against general floor management.

Methods: Retrospective analysis of head and neck free-flap reconstructive surgery patients at a single tertiary academic medical center. Clinical data was obtained from medical records. Read More

View Article and Full-Text PDF

Comparison of Trendelenburg angle in vaginal, laparoscopic, and robotic uterovaginal apical prolapse repairs.

J Minim Invasive Gynecol 2021 Apr 12. Epub 2021 Apr 12.

Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address:

Study Objective: To compare the Trendelenburg angle used in laparoscopic uterovaginal apical prolapse repairs to the angle used in vaginal and robotic uterovaginal apical prolapse repairs.

Design: Prospective, multi-center cohort study from May 2015-December 2016 SETTING: Two academic teaching hospitals PATIENTS: Sixty patients who underwent vaginal high uterosacral ligament suspension, laparoscopic sacrocolpopexy or robotic sacrocolpopexy among 6 surgeons board-certified in Female Pelvic Medicine and Reconstructive Surgery.

Interventions: Measurement of Trendelenburg angle and time spent in Trendelenburg during surgery. Read More

View Article and Full-Text PDF

Evaluation of Global Alignment and Proportion Score in an Independent Database.

Spine J 2021 Apr 12. Epub 2021 Apr 12.

Department of Orthopedic Surgery, Barnes-Jewish Institute of Health, Washington University, St Louis, Missouri, USA.

Background Context: Sagittal spinopelvic alignment has been associated with patient-reported outcome measures and mechanical complication rates. Recently, it was claimed that linear numerical values of pelvic tilt and lumbar lordosis measurements may be misleading for patients that have different magnitudes of pelvic incidence. The use of "relative" measurements embedded in a weighted scoring of Global Alignment and Proportion (GAP) was proposed. Read More

View Article and Full-Text PDF

Immune responses against oxidized LDL as possible targets for prevention of atherosclerosis in systemic lupus erythematosus.

Vascul Pharmacol 2021 Apr 12:106863. Epub 2021 Apr 12.

Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden.

Patients suffering from systemic lupus erythematosus (SLE) are at increased risk of developing cardiovascular disease (CVD) and traditional therapies including statins provide insufficient protection. Impaired removal of apoptotic material is a common pathogenic mechanism in both SLE and atherosclerosis and is considered to be a key factor in the development of autoimmunity. Since oxidized LDL and apoptotic material bind to the same receptors, we aimed to investigate if targeting the oxidized LDL autoimmunity can affect atherosclerosis in SLE. Read More

View Article and Full-Text PDF

Image-Guided Percutaneous Pancreatic Duct Drainage: A 10-Year Observational Study.

J Vasc Interv Radiol 2021 Apr 12. Epub 2021 Apr 12.

Professor of Surgery and Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, DuCane Road, London W12 0HS, UK.

Purpose: To study the safety, efficacy, and long-term outcomes of percutaneous pancreatic duct drainage (PPDD) for treating pancreatic duct (PD) obstruction.

Materials And Methods: This prospective observational cohort study included 73 patients with PD obstruction between December 2010 and June 2020. Patients underwent PPDD under ultrasound and fluoroscopy guidance, computed tomography (CT) and fluoroscopy guidance, or CT guidance only. Read More

View Article and Full-Text PDF

Clinical evidence for an accessible modification to the Scott resection-recession procedure, using a matching duction technique.

J AAPOS 2021 Apr 12. Epub 2021 Apr 12.

Purpose: To evaluate the resection-recession procedure on a single muscle for the management of incomitant strabismus using an alternative calculation.

Methods: The medical records of adult patients undergoing combined adjustable resection-recession surgery on a single rectus muscle at one institution from 2008 to 2019 were reviewed retrospectively. Each patient had a full orthoptic evaluation before and at least 10 weeks after surgery. Read More

View Article and Full-Text PDF

fvVaginal drug delivery approaches for localized management of cervical cancer.

Adv Drug Deliv Rev 2021 Apr 12. Epub 2021 Apr 12.

State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, P. R. China. Electronic address:

Cervical cancer or cervical intraepithelial neoplasia (CIN) remain a major public health problem among women globally. Traditional methods such as surgery are often associated with possible complications which may impact future pregnancies and childbirth especially for young female patients. Vagina with a high contact surface is a suitable route for the local and systemic delivery of drugs but its abundant mucus in continuous exchange presents a barrier for the popularization of conventional vaginal formulations including suppositories, gel, patch, creams and so on. Read More

View Article and Full-Text PDF

Cellular Protein Markers, Therapeutics, and Drug Delivery Strategies in the Treatment of Diabetes-Associated Liver Fibrosis.

Adv Drug Deliv Rev 2021 Apr 12. Epub 2021 Apr 12.

Division of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO 64108. Electronic address:

Liver fibrosis is the excessive accumulation of extracellular matrix due to chronic injuries, such as viral infection, alcohol abuse, high-fat diet, and toxins. Liver fibrosis is reversible before it progresses to cirrhosis and hepatocellular carcinoma. Type 2 diabetes significantly increases the risk of developing various complications including liver diseases. Read More

View Article and Full-Text PDF

Large-Scale Screening of Lipase Acid Deficiency in at Risk Population.

Clin Chim Acta 2021 Apr 12. Epub 2021 Apr 12.

Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, Department of Metabolic Biochemistry, 76000 Rouen, France. Electronic address:

Background: Lysosomal acid lipase deficiency (LALD, OMIM#278000) is a rare lysosomal disorder with an autosomal recessive inheritance. The main clinical manifestations are related to a progressive accumulation of cholesteryl esters, triglycerides or both within the lysosome in different organs such as the liver, spleen, and cardiovascular system. A wide range of clinical severity is associated with LALD including a severe very rare antenatal/neonatal/infantile phenotype named Wolman disease and a late-onset form named cholesteryl ester storage disease (CESD). Read More

View Article and Full-Text PDF

Impact of Antibiotic Resistance Genes in Gut Microbiome of Patients with Cirrhosis.

Gastroenterology 2021 Apr 12. Epub 2021 Apr 12.

Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Central Virginia Veterans Healthcare System, Richmond, Virginia, USA. Electronic address:

Background And Aims: Cirrhosis is associated with changes in intestinal microbiota that can lead to hepatic encephalopathy (HE) and infections, especially with antibiotic-resistant organisms. However, the impact of gut microbial antibiotic resistance gene (ARG) burden on clinical outcomes is unclear.

Aims: Determine the impact of ARGs in cirrhosis-related gut metagenome on outcomes and disease progression, study the effect of rifaximin on ARG burden, and compare ARGs in cirrhosis with chronic kidney disease (CKD) and diabetes. Read More

View Article and Full-Text PDF

Safety of Tranexamic Acid in Hip and Knee Arthroplasty in High-risk Patients.

Anesthesiology 2021 Apr 15. Epub 2021 Apr 15.

Background: With increasing use of tranexamic acid in total hip and knee arthroplasties, safety concerns remain. Using national claims data, this study examined tranexamic acid use in patients with preexisting comorbidities. The hypothesis was that tranexamic acid use is not associated with increased complication risk in hip and knee arthroplasty patients with comorbidities. Read More

View Article and Full-Text PDF

Surgical outcomes after primary Baerveldt glaucoma implant surgery with vitrectomy for neovascular glaucoma.

PLoS One 2021 15;16(4):e0249898. Epub 2021 Apr 15.

Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata, Japan.

This study aimed to evaluate the 3-year long-term outcomes of primary Baerveldt glaucoma implant (BGI) surgery for neovascular glaucoma (NVG). We retrospectively evaluated 27 consecutive patients with NVG between November 2013 and November 2017. All the patients were treated with panretinal photocoagulation and pars plana vitrectomy before BGI surgery without anti-vascular endothelial growth factor treatment. Read More

View Article and Full-Text PDF

The Impact of the COVID-19 Pandemic on an Israeli Acute Care Surgery Unit: Fewer Patients, More Disease.

Am Surg 2021 Apr 15:31348211011132. Epub 2021 Apr 15.

Department of General Surgery, 26738Tel-Aviv Sourasky Medical Center, Ichilov Hospital, Tel. Aviv, Israel.

Background: The COVID-19 pandemic has transformed and affected every aspect of health care. Like any catastrophic event, the stress on hospitals to maintain a certain level of function is immense. Acute surgical pathologies cannot be prevented or curtailed; therefore, it is important to understand patterns and outcomes during catastrophes in order to optimize care and organize the health care system. Read More

View Article and Full-Text PDF

Consensus for Treatment of Metastatic Castration-Sensitive Prostate Cancer: Report From the First Global Prostate Cancer Consensus Conference for Developing Countries (PCCCDC).

JCO Glob Oncol 2021 Apr;7:550-558

Oncology Institute of Southern Switzerland (IOSI), Bellinzona and Università della Svizzera Italiana, Lugano, Switzerland.

Purpose: International guideline recommendations may not always be extrapolated to developing countries where access to resources is limited. In metastatic castration-sensitive prostate cancer (mCSPC), there have been successful drug and imaging advancements that were addressed in the Prostate Cancer Consensus Conference for Developing Countries for best-practice and limited-resource scenarios.

Methods: A total of 24 out of 300 questions addressed staging, treatment, and follow-up for patients with mCSPC both in best-practice settings and resource-limited settings. Read More

View Article and Full-Text PDF

Removal and repositioning of urinary tract implants by use of an endovascular snare system in dogs and cats (2013-2019).

J Am Vet Med Assoc 2021 May;258(9):983-990

Objective: To report the fluoroscopic removal or repositioning of urinary tract implants in dogs and cats by use of an endovascular snare system (ESS) and to report procedural usefulness and complications in dogs and cats.

Animals: 3 cats and 14 dogs.

Procedures: A medical records review was performed to identify dogs and cats that underwent removal or repositioning of urinary tract foreign bodies or implants by use of an ESS with fluoroscopic guidance at a veterinary teaching hospital from 2013 to 2019. Read More

View Article and Full-Text PDF

Inflammatory markers response to crocin supplementation in patients with type 2 diabetes mellitus: A randomized controlled trial.

Phytother Res 2021 Apr 15. Epub 2021 Apr 15.

Department of Internal Medicine, Imam-Hossein General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Inflammation and oxidative stress is a risk factor for the development of long-term consequences in patients with type 2 diabetes mellitus (T2DM). This study was designed to investigate the effects of crocin consumption on oxidative stress and inflammatory markers in patients with T2DM. In this clinical trial with a parallel-group design, 50 patients with T2DM were randomly assigned to either the crocin or the placebo group. Read More

View Article and Full-Text PDF

Microbiota restoration for recurrent Clostridioides difficile: Getting one step closer every day!

S Khanna

J Intern Med 2021 Apr 15. Epub 2021 Apr 15.

From the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Clostridioides difficile infection (CDI) is an urgent health threat being the most common healthcare-associated infection, and its management is a clinical conundrum. Over 450 000 infections are seen in the United States with similar incidence seen in the rest of the developed world. The majority of infections seen are mild-moderate with fulminant disease and mortality being rare complications seen in the elderly and in those with comorbidities. Read More

View Article and Full-Text PDF