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Lumbar Spine Surgery and What We Lost in the Era of the Coronavirus Pandemic: A Survey of the Lumbar Spine Research Society.

Clin Spine Surg 2021 Sep 21. Epub 2021 Sep 21.

Department of Neurosurgery Stephens Family Clinical Research Institute, Carle Foundation Hospital, Urbana, IL Hackensack Meridian School of Medicine, Nutley Mountainside Medical Center, Montclair NJ Rothman Orthopaedic Institute, Philadelphia, PA Department of Electrical and Computer Engineering, The Grainger College of Engineering, Urbana, IL Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA.

Study Design: This was a survey of the surgeon members of the Lumbar Spine Research Society (LSRS).

Objective: The purpose of this study was to assess trends in surgical practice and patient management involving elective and emergency surgery in the early months of the coronavirus pandemic.

Summary Of Background Data: The novel coronavirus has radically disrupted medical care in the first half of 2020. Read More

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September 2021

Association of Medicaid expansion under the Affordable Care Act with access to elective spine surgical care.

J Neurosurg Spine 2021 Sep 24:1-9. Epub 2021 Sep 24.

1Department of Neurological Surgery.

Objective: The Affordable Care Act expanded Medicaid eligibility in many states, improving access to some forms of elective healthcare in the United States. Whether this effort increased access to elective spine surgical care is unknown. This study's objective was to evaluate the impact of Medicaid expansion under the Affordable Care Act on the volume and payer mix of elective spine surgery in the United States. Read More

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September 2021

Time to return to work after elective lumbar spine surgery.

J Neurosurg Spine 2021 Sep 24:1-9. Epub 2021 Sep 24.

1Combined Neurosurgical and Orthopedic Spine Service, Department of Orthopedic Surgery, University of British Columbia, Vancouver, British Columbia.

Objective: Time to return to work (RTW) after elective lumbar spine surgery is variable and dependent on many factors including patient, work-related, and surgical factors. The primary objective of this study was to describe the time and rate of RTW after elective lumbar spine surgery. Secondary objectives were to determine predictors of early RTW (< 90 days) and no RTW in this population. Read More

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September 2021

Surgeon Volume and Established Hospital Perioperative Mortality Rate Together Predict Superior Outcomes After Open AAA Repair.

J Vasc Surg 2021 Sep 21. Epub 2021 Sep 21.

Division of Vascular Surgery, University of Rochester Medical Center, Rochester, New York. Electronic address:

Background: In 2018, the SVS published hospital volume guidelines for elective open abdominal aortic aneurysm (AAA) repair, recommending elective open surgical repair for AAA be performed at centers with an annual volume of at least 10 open aortic operations of any type and a documented perioperative mortality of 5% or less. Recent work suggests a yearly surgeon volume of ≥7 open aortic cases for improved outcomes. The objective of this study is to assess the importance of hospital volume and surgeon volume at these cut points in predicting 1-year mortality after OSR for AAA. Read More

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September 2021

Morbidity and Mortality Associated with Open Repair of Visceral Aneurysms.

J Vasc Surg 2021 Sep 21. Epub 2021 Sep 21.

Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.

Background: The Society for Vascular Surgery (SVS) recently published clinical practice guidelines on the management of visceral aneurysms. However, studies investigating perioperative outcomes of open repair of visceral aneurysms have been limited to single-center experiences with variable results that span multiple decades. This study sought to detail the morbidity and mortality associated with open repair of visceral aneurysms using a national database in the contemporary era. Read More

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September 2021

Obstructive sleep apnea in surgical patients and its relationship with difficult intubation: two years of experience from a single center.

Braz J Anesthesiol 2021 Sep 21. Epub 2021 Sep 21.

Demiroglu Bilim University Florence Nightingale Hospital School of Nursing, Istanbul, Turkey.

Background And Objectives: In this study, we aimed to determine the risk of obstructive sleep apnea (OSA) in patients undergoing elective surgery and its relationship with difficult intubation (DI).

Methods: This prospective, descriptive cross-sectional study was conducted between December 2018 and February 2020 in the anesthesiology and reanimation service of a training and research hospital. The study included patients who were ASA I-II, 18 years of age and older who underwent elective surgery under general anesthesia. Read More

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September 2021

Endoscopic ear surgery during COVID-19 pandemic.

Med J Malaysia 2021 Aug;76(Suppl 4):42-44

Hospital Sultan Ismail, Department of Otorhinolaryngology - Head and Neck Surgery, Jalan Mutiara Emas Utama, Taman Mount Austin Johor Bahru, Johor, Malaysia.

Similar to other surgical fraternities, endoscopic ear surgery (EES) faced great challenges during the COVID-19 pandemic. Many elective operations involving EES needed to be postponed, resulting in accumulated cases. Throughout one year during COVID-19, Hospital Sultan Ismail, Johor, Malaysia continued to perform various EES procedures. Read More

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Fiber-optic-assisted endotracheal intubation complicated by iatrogenic right main bronchus obstruction.

Ann Afr Med 2021 Jul-Sep;20(3):232-234

Department of Anaesthesiology and Critical Care, All Indian Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.

Several aids have been designed for helping anesthetist in managing the difficult airway. Oral carcinomas often distort the airway anatomy and present as difficult airway usually with restricted mouth opening. In these scenarios, elective nasotracheal intubation with fiberoptic is done to secure the airway as well as to provide the full surgical field to the surgeon. Read More

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September 2021

Impact of COVID-19 pandemic on bariatric surgery in India: An obesity and metabolic surgery society of India survey of 1307 patients.

J Minim Access Surg 2021 Oct-Dec;17(4):542-547

Wockhardt Hospital, Mumbai, Maharashtra, India.

Background: Although safe practice guidelines were issued by the Obesity and Metabolic Surgery Society of India (OSSI) in the end of May 2020, surgeons have been in a dilemma about risk of subjecting patients to hospitalisation and bariatric surgery. This survey was conducted with the objective to evaluate the risk of coronavirus disease-19 (COVID-19) infection in peri- and post-operative period after bariatric and metabolic surgery (BMS).

Methods: A survey with OSSI members was conducted from 20 July 2020 to 31 August 2020 in accordance with EQUATOR guidelines. Read More

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September 2021

Skin and mucous membranes colonisation with or MRSA as a risk factor for surgical site infections in elective Caesarean Section.

J Obstet Gynaecol 2021 Sep 24:1-6. Epub 2021 Sep 24.

Clinical Nursing, Department School of Nursing, The University of Jordan, Amman, Jordan.

The purpose of this study was to determine if skin and mucous membrane colonisation with () and methicillin-resistant (MRSA) increases the incidence of surgical site infection (SSI) post-elective Caesarean Sections. A prospective study was conducted at a major centre in Jordan, involving 127 patients who underwent elective Caesarean Section surgeries during 2019. Participants were screened for skin and mucous membranes colonisation for preoperatively and were followed for 90 days for any signs of SSI. Read More

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September 2021

Safety of elective abdominal and vascular surgery during the COVID-19 pandemic: a retrospective single-center study.

Eur J Med Res 2021 Sep 23;26(1):112. Epub 2021 Sep 23.

Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany.

Background: Patients with coronavirus disease 2019 (COVID-19) who undergo surgery have impaired postoperative outcomes and increased mortality. Consequently, elective and semi-urgent operations on the increasing number of patients severely affected by COVID-19 have been indefinitely postponed.in many countries with unclear implications on disease progression and overall survival. Read More

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September 2021

Survival and Durability After Endovascular Aneurysm Repair Reflect Era-Related Surgical Judgement.

J Vasc Surg 2021 Sep 20. Epub 2021 Sep 20.

Endovascular and Cardiovascular Surgery, St Bartholomew's Hospital, London, UK; Associate Professor, Department of Surgery and Interventional Sciences, University College London. Electronic address:

Objectives: Abdominal aortic aneurysm (AAA) management guidelines from the National Institute for Clinical Excellence (NICE UK) in 2020, based heavily upon randomized controlled trials in an early era of infrarenal endovascular aneurysm repair (EVAR), suggested that the long-term outcomes post EVAR jeopardize its use in elective AAA repair. We hypothesized that in a rapidly-evolving surgical field, the era of aneurysm repair may have a significant influence on long-term patient outcomes.

Methods: Using a single centre retrospective cohort design, we identified two EVAR cohorts, the "early" cohort n=166, undergoing EVAR from 2008-2010, and a contemporary "late" cohort, n= 129, from 2015-2017. Read More

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September 2021

Comparison of Contemporary and Historical Outcomes of Elective and Ruptured Open Abdominal Aortic Aneurysm Repair.

J Vasc Surg 2021 Sep 21. Epub 2021 Sep 21.

The George Washington University Department of Surgery, Washington, District of Columbia.

Introduction: Recently, open AAA repair (OSR) has become less common and is often reserved for more complex aortic anatomy. Despite improvement in patient management, reduced surgical volume raises concern for potentially worsened outcomes in the contemporary era (2014-2019) compared to an earlier era where open repair was more widely practiced (2005-2010). This study compares the 30-day outcomes of open AAA repair between these two eras. Read More

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September 2021

A simpler screening tool for sarcopenia in surgical patients.

PLoS One 2021 23;16(9):e0257672. Epub 2021 Sep 23.

Integrated Perioperative Geriatric Excellent Research Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Sarcopenia is defined as decreased skeletal muscle mass and muscle functions (strength and physical performance). Muscle mass is measured by specific methods, such as bioelectrical impedance analysis and dual-energy X-ray absorptiometry. However, the devices used for these methods are costly and are usually not portable. Read More

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September 2021

Individualised, targeted step count intervention following gastrointestinal cancer surgery: The Fit-4-Home randomised clinical trial.

ANZ J Surg 2021 Sep 22. Epub 2021 Sep 22.

Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.

Background: To determine the effectiveness of an individualised, daily targeted step count intervention and usual care compared with usual care alone on improving surgical and patient reported outcomes.

Methods: The Fit-4-Home trial was a pragmatic, randomised controlled trial conducted from April 2019 to February 2021. Patients undergoing elective surgery for liver, stomach or pancreatic cancer in two Australian hospitals were recruited. Read More

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September 2021

Asymptomatic Pre-Operative COVID-19 Screening for Essential and Elective Surgeries: Early Results of Universal Screening at a Midwestern Academic Medical Center.

Iowa Orthop J 2021;41(1):33-38

Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.

Background: During the novel Coronavirus 2019 (COVID-19) worldwide pandemic, viral testing has largely focused on patients presenting with fever and respiratory symptoms. Although Centers for Disease Control has reported 1,551,095 cases in the United States as of May 21, 2020, asymptomatic infection rates remain unknown within the U.S. Read More

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January 2021

Harvard Medical School Department of Global Health and Social Medicine COVID-19 seminar series: COVID and surgical, anesthetic and obstetric care.

BMC Proc 2021 Sep 23;15(Suppl 8):20. Epub 2021 Sep 23.

Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.

On May 21, 2020, the Harvard Program in Global Surgery and Social Change (PGSSC) hosted a webinar as part of the Harvard Medical School Department of Global Health and Social Medicine's COVID-19 webinar series. The goal of PGSSC's virtual webinar was to share the experiences of surgical, anesthesia, and obstetric (SAO) providers on the frontlines of the COVID pandemic, from both high-income countries (HICs), such as the United States and the United Kingdom, as well as low- and middle-income countries (LMICs). Providers shared not only their experiences delivering SAO care during this global pandemic, but also solutions and innovations they and their colleagues developed to address these new challenges. Read More

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September 2021

Impact of chronic medications in the perioperative period -mechanisms of action and adverse drug effects (part i).

Postgrad Med 2021 Sep 23. Epub 2021 Sep 23.

Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

This review article will discuss the pharmacology of the most common used chronic medications in patients undergoing elective surgical procedures. The mechanism of action and adverse side effects of cardiovascular medications (e.g. Read More

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September 2021

Impact of chronic medications in the perioperative period -anesthetic implications (part ii).

Postgrad Med 2021 Sep 23. Epub 2021 Sep 23.

Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

This review article will discuss the pharmacodynamic effects of the most commonly used chronic medications by patients undergoing elective surgical procedures, namely cardiovascular drugs (e.g., beta blockers, alpha-2 agonist, calcium channel blockers, ACE inhibitors, diuretics, etc. Read More

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September 2021

Clinical Outcome in Patients with Nosocomial COVID-19 Infection After Thoracic Surgery.

Adv Exp Med Biol 2021 Sep 23. Epub 2021 Sep 23.

Department of Thoracic Surgery, Klinik am Park Lünen, Lünen, Germany.

In the present study, we retrospectively evaluated outcomes in 8 patients (mean age 67 ± 7, range 55-77 years; male/female 7/1) who acquired nosocomial COVID-19 infection postoperatively out of the 39 adults who underwent elective thoracic surgery in November 2020. All patients were tested negative for COVID-19 on admission. The mortality rate in the eight patients was 25%. Read More

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September 2021

The use of tissue oxygen measurements compared to indocyanine green imaging for the assessment of intraoperative tissue viability of human bowel.

Surg Endosc 2021 Sep 22. Epub 2021 Sep 22.

Department of Surgery, Northwell Health, New Hyde Park, USA.

Background: Adequate tissue oxygenation and perfusion remain fundamental to safe bowel resection surgery. Near infrared (NIR) imaging using indocyanine green has proven itself superior to clinical evaluation alone in assessing bowel perfusion, but requires expensive equipment not readily available in many centers.

Methods: We studied the IntraOx device (Vioptix Inc, Newark, CA USA), a handheld, tissue oxygen saturation assessment tool, to assess whether tissue bed oxygen saturation (StO2) is comparable to NIR assessment of bowel viability. Read More

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September 2021

Surgeon volume and the risk of deep surgical site infection following open reduction and internal fixation of closed tibial plateau fracture.

Int Orthop 2021 Sep 22. Epub 2021 Sep 22.

Department of Orthopaedic Surgery, the 3Rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China.

Background: Emerging evidences supported that the surgeon case volume significantly affected post-operative complications or outcomes following a range of elective or non-elective orthopaedic surgery; no data has been available for surgically treated tibial plateau fractures. We aimed to investigate the relationship between surgeon volume and the risk of deep surgical site infection (DSSI) following open reduction and internal fixation (ORIF) of closed tibial plateau fracture.

Methods: This was a further analysis of the prospectively collected data. Read More

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September 2021

A continuous PREMs and PROMs Observatory for elective hip and knee arthroplasty: study protocol.

BMJ Open 2021 Sep 21;11(9):e049826. Epub 2021 Sep 21.

Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy.

Introduction: Scholars, healthcare practitioners and policymakers have increasingly focused their attention on patient-centredness. Patient-reported metrics support patient-driven improvement actions in healthcare systems. Despite the great interest, patient-reported outcome measures (PROMs) are still not extensively collected in many countries and not integrated with the collection of patient-reported experience measures (PREMs). Read More

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September 2021

Financial and educational impact of the COVID-19 pandemic in an academic hospital-based tertiary cytopathology practice.

J Am Soc Cytopathol 2021 Sep 2. Epub 2021 Sep 2.

Department of Pathology, State University of New York, Upstate Medical University, Syracuse, New York. Electronic address:

Background: The ongoing COVID-19 pandemic has led to a dramatic shift in volumes and practice patterns for hospitals around the globe. We analyzed its effect on the cytopathology subspecialty practice and resident education at our institution.

Design: Specimen volumes were analyzed for the cytology practice for 2019 and 2020. Read More

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September 2021

Meloxicam administration in the management of postoperative pain and inflammation associated with caesarean section in beef heifers: Evaluation of reproductive parameters.

Theriogenology 2021 Sep 11;175:148-154. Epub 2021 Sep 11.

Laboratoire National de Contrôle des Reproducteurs, 13 rue Jouet, 94700, Maisons-Alfort, France.

Post-operative pain and inflammation are normal physiological reactions to caesarean section. Their management in cattle have rarely been investigated. This surgical procedure negatively affects reproductive function with, for example, a reduction in fertility resulting in an increase in calving interval. Read More

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September 2021

Association between perioperative intravenous lidocaine and subjective quality of recovery: A meta-analysis of randomized controlled trials.

J Clin Anesth 2021 Sep 20;75:110521. Epub 2021 Sep 20.

Department of Emergency Medicine, E-Da Hospital, Kaohsiung city, Taiwan; College of Medicine, I-Shou University, Kaohsiun cityg, Taiwan. Electronic address:

Study Objective: To evaluate the impact of perioperative intravenous lidocaine on the quality of recovery (QoR) following surgery.

Design: Meta-analysis of randomized controlled trials (RCTs).

Setting: Postoperative care. Read More

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September 2021

Center Volume Impacts Readmissions and Mortality Following Congenital Cardiac Surgery.

J Pediatr 2021 Sep 18. Epub 2021 Sep 18.

Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine at UCLA; Division of Cardiac Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA. Electronic address:

Objective: To characterize the relationship between surgical volume and postoperative outcomes in congenital heart surgery, we used a national cohort to assess costs, readmissions and complications in children undergoing cardiac operations.

Study Design: The Nationwide Readmissions Database was used to identify pediatric patients (≤18 years) undergoing congenital cardiac surgery from 2010-2017. Hospitals were categorized based on deciles and tertiles of annual caseload with high-volume categorized as the highest tertile of volume. Read More

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September 2021

A comparison of surgical site infections in children after stoma reversal between purse-string and linear closure.

Pediatr Surg Int 2021 Sep 21. Epub 2021 Sep 21.

Department of Surgery, Khon Kaen University, Khon Kaen, 40002, Thailand.

Background: To reduce the surgical site infections (SSI), the purse-string closure technique has been widely performed and has also been recommended in adult stoma reversal. However, for children, some debate still exists. This study aims to compare the SSI rates in children between the purse-string and the linear for the skin closure of stoma reversal. Read More

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September 2021

The role of immature platelet count and immature platelet fraction in determining the need for transfusion in patients undergoing CABG.

Cardiovasc J Afr 2021 Sep 20;32:1-5. Epub 2021 Sep 20.

Okmeydani Training and Research Hospital, Istanbul, Turkey.

Background: Platelet dysfunction has been shown to play a role in postoperative bleeding, however it is not clear whether immature platelets (IP) can induce appropriate homeostasis to prevent excessive bleeding in patients undergoing coronary artery bypass grafting (CABG). The aim of this study was to evaluate the postoperative change in IP count (IPC), IP fraction (IPF) and mean platelet volume (MPV), and to examine their relationship with postoperative bleeding and blood transfusion.

Methods: One hundred and forty-nine consecutive patients undergoing elective CABG were included in this prospective study. Read More

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September 2021

Primary Repair of Upper Extremity Peripheral Nerve Injuries: An NSQIP Analysis From 2010 to 2016.

Hand (N Y) 2021 Sep 21:15589447211044768. Epub 2021 Sep 21.

Medical University of South Carolina, Charleston, USA.

Background: To identify the rate of 30-day complications after primary repair of upper extremity peripheral nerve injuries, associated diagnoses, and postoperative complication rate.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was reviewed from 2010 to 2016. Current Procedural Terminology codes consistent with primary nerve repair of the upper extremity were identified and included in the analysis. Read More

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September 2021