OBJECTIVE:: Although osteopenia is common in HIV infected patients, there is by now limited data on the evolution of bone mineral density in this population. We aimed to evaluate the course of osteopenia over a two-year period in HIV-1-infected men, and to identify risk factors for abnormal bone mineral density ...

OBJECTIVE:: Determination of biomarker and neuropathogenesis of postoperative cognitive change (POCC) or postoperative cognitive dysfunction. BACKGROUND:: POCC is one of the most common postoperative complications in elderly patients. Whether preoperative cerebrospinal fluid (CSF) β-amyloid protein (Aβ) to tau ratio, an Alzheimer disease biomarker, is a biomarker for risk of POCC ...

BACKGROUND:: Intraoperative high inspired oxygen fraction (FIO2) is thought to reduce the incidence of surgical site infection (SSI) and postoperative nausea and vomiting, and to promote postoperative atelectasis. METHODS:: The authors searched for randomized trials (till September 2012) comparing intraoperative high with normal FIO2 in adults undergoing surgery with general ...

BACKGROUND: Urinary tract infections (UTIs) are common after kidney transplantation, with limited data to guide antibiotic prophylaxis. METHODS: Retrospective single-center study comparing sulfamethoxazole-trimethoprim 800/160 mg (SMZ/TMP) daily for 30 days followed by Monday, Wednesday, Friday for an additional 5 months (Group 1) versus SMZ/TMP Monday, Wednesday, Friday for 6 months ...

OBJECTIVES: The objective of this study was to compare the early outcomes of off-pump and on-pump surgeries in high-risk patient groups. METHODS: The outcomes of 83 914 high-risk patients undergoing off-pump or on-pump isolated coronary bypass surgery identified from the Nationwide Inpatient Sample from 2005 to 2010 were compared using ...

BACKGROUND: The incidence of symptomatic venous thromboembolism (VTE) after knee arthroscopy is uncertain. In this study, we estimate the incidence of symptomatic VTE after knee arthroscopy. OBJECTIVES: To estimate the incidence of symptomatic VTE after arthroscopic knee surgery. Methods: In a population-based historical cohort study, all Olmsted County, MN residents ...

OBJECTIVES: To investigate whether preoperative risk for delirium moderates the effect of postoperative pain and opioids on the development of postoperative delirium. DESIGN: Prospective cohort study. SETTING: University medical center. PARTICIPANTS: Patients 65 years of age or older scheduled for major noncardiac surgery. MEASUREMENTS: A structured interview was conducted preoperatively ...

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is performed to provide nutrition to patients with swallowing difficulties. A multicenter study was conducted to evaluate the predictors of complications and mortality after PEG placement. METHODS: This study retrospectively analyzed patients who underwent initial PEG placement between January 2004 and December 2011 at seven ...

PURPOSE: To investigate whether tracheostomy increases the risk of sternal wound infection (SWI) post cardiac surgery. METHODS: All patients undergoing cardiac surgery via median sternotomy from September 1997 to October 2010 were included in this retrospective observational study. Primary exposure was tracheostomy performed during admission to the cardiac surgical intensive ...

OBJECTIVES:Gastrointestinal (GI) bleeding may impose a serious threat in patients undergoing total hip or knee replacement (THR/TKR). The objectives of this study are to evaluate the timing of GI bleeding following THR/TKR and to determine the effect modification by proton pump inhibitor (PPI) use.METHODS:In a nationwide Danish cohort study, we ...

OBJECTIVE: The incidence of anal human papillomavirus (HPV) infection and of HPV-related disease in men who have sex with men continues to rise. Screening procedures can be uncomfortable and may lead to decreased patient compliance. We endeavored to determine the tolerability of screening procedures for anal HPV disease. MATERIALS AND ...

BACKGROUND: Prevalence of bacteremia caused by non-fermentative gram-negative bacteria (NFGNB) has been increasing over the past decade. Although many studies have already investigated epidemiology of NFGNB bacteremia, most focused only on common NFGNB including Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB). Knowledge of uncommon NFGNB bacteremia is very limited. Our ...

Purpose: Catheter-related bloodstream infection is a frequent complication for patients who use catheter as dialysis access. This study was performed to identify the risk factors for failed catheter salvage. 
Methods: We enrolled patients who received non-tunneled catheters as initial vascular access during a two-year period. Catheter salvage was attempted in ...

OBJECTIVE: The incidence of hospital-acquired Clostridium difficile infection (CDI) has increased rapidly over the past decade; patients undergoing major surgery, including coronary artery bypass grafting (CABG), are at particular risk. Intravenous vancomycin exposure has been identified as an independent risk factor for CDI, but this is controversial. It is not ...

PURPOSE: To investigate the association between pathological myopia (PM) and immunological/inflammatory markers and to identify the possible risk factors for the formation of myopic choroidal neovascularization (mCNV). METHODS: One hundred fourteen unrelated subjects were recruited: 63 PM patients (PM group) with spherical equivalent of at least -8.00 diopters (range, -8.00 ...

BACKGROUND: Packed RBC transfusion has been postulated to increase morbidity and mortality after cardiac/general surgical operations, but its effects after lower extremity bypass (LEB) have not been studied extensively. STUDY DESIGN: Using the Vascular Study Group of New England's database (2003-2010), we examined 1,880 consecutive infrainguinal LEB performed for critical ...

BACKGROUND: Conducting total thyroidectomy (TT) or subtotal thyroidectomy (ST) in patients with Graves' disease remains controversial. We performed a meta-analysis based on the published randomized controlled trials to evaluate the complications of TT versus ST. METHODS: We searched multiple electronic databases for prospective, randomized, controlled trials related to safety and ...

AimsTranscatheter aortic valve implantation (TAVI) is an established treatment alternative to surgical aortic valve replacement in high-risk and inoperable patients and outcomes among patients with estimated low or intermediate risk remain to be determined. The aim of this study was to assess clinical outcomes among patients with estimated low or ...

OBJECTIVES: The aortic augmentation index (AIx), a marker of arterial stiffness, and peripheral arterial disease (PAD) are associated with an increased cardiovascular risk. In claudicants, the effect of balloon angioplasty (percutaneous transluminal angioplasty, PTA) on AIx has not been determined so far. METHODS: Measurements of the ankle-brachial pressure index (ABI) ...

To the Editor: In their report on the Aspirin to Prevent Recurrent Venous Thromboembolism (ASPIRE) trial, Brighton et al. (Nov. 22 issue)(1) describe a nonsignificant decrease in the rate of recurrent venous thromboembolism and a significant reduction in the rate of major vascular events in patients receiving low-dose aspirin, as ...

To the Editor: In their report on the Aspirin to Prevent Recurrent Venous Thromboembolism (ASPIRE) trial, Brighton et al. (Nov. 22 issue)(1) describe a nonsignificant decrease in the rate of recurrent venous thromboembolism and a significant reduction in the rate of major vascular events in patients receiving low-dose aspirin, as ...

To the Editor: In their report on the Aspirin to Prevent Recurrent Venous Thromboembolism (ASPIRE) trial, Brighton et al. (Nov. 22 issue)(1) describe a nonsignificant decrease in the rate of recurrent venous thromboembolism and a significant reduction in the rate of major vascular events in patients receiving low-dose aspirin, as ...

BACKGROUND: Myeloperoxidase (MPO) has been associated with the development of atrial fibrillation (AF), but its impact on the recurrence of AF after catheter ablation has not been explored. This study investigated the effect of plasma MPO on recurrence after catheter ablation of paroxysmal AF. METHODS AND RESULTS: Two hundred eighty-eight ...

We conducted a retrospective analysis of acute cystitis (AC) patients to evaluate the risk factors of recurrent cystitis (RC) patients following AC. The clinical records of 254 subjects with a confirmed diagnosis of AC and 90 healthy subjects who visited the Health Promotion Center between 2008 and 2012 were reviewed. ...

BACKGROUND: There is currently no consensus in the literature on which embolic agent induces the greatest degree of liver hypertrophy after portal vein embolization (PVE). Only experimental results in a pig model have demonstrated an advantage of n-butyl-cyanoacrylate (NBCA) over 3 other embolic materials (hydrophilic gel, small and large polyvinyl ...

CONTEXT: Coma is a state of profound unresponsiveness that can occur as a serious perioperative complication. The study of risk factors for, and sequelae of, postoperative coma has been limited due to the rarity of the event. OBJECTIVE: To determine the incidence, risk factors and impact of postoperative coma in ...

Abstract Objective. To compare patients younger and older than 50 years with diverticulitis with regard to complications, disease recurrence and to the need for surgery. Material and methods. A literature review and meta-analysis was conducted according to the PRISMA guidelines. MEDLINE, Embase and the Cochrane databases were searched for longitudinal ...

BACKGROUND: Although 7% to 38% of revision total knee arthroplasties (RTKAs) are attributable to prosthetic knee infections, controversy exists regarding the best surgical approach while reducing the risk of extensor mechanism complications and the reinfection rate. QUESTIONS/PURPOSES: We compared The Knee Society Score(©) (KSS), incidences of complications, maximum knee flexion, ...

BACKGROUND:: In 2004, the Mozambican Ministry of Health began a national scale-up of antiretroviral therapy (ART) using a vertical model of HIV clinics co-located within large, urban hospitals. In 2006, the ministry expanded access by integrating ART into primary health care clinics. METHODS:: We conducted a retrospective cohort study including ...

Physical activity and sedentary behaviour are key moderators of cardiovascular disease risk and metabolic control. Despite the importance of a physically active lifestyle, little is known about the effects of stroke on physical activity. We assessed physical activity and sedentary behaviour at three time points following stroke compared to a ...

Imported fire ant (IFA) subcutaneous immunotherapy (SCIT) is safe and effective. For optimal protection, SCIT is given monthly for 3 to 5 years. Successful outcomes require patient adherence. To evaluate SCIT adherence in IFA allergic patients in an endemic area. Patients with systemic reactions to an IFA sting, with detectable ...

Dialysis vascular access complications are considered as significant causes of morbidity in chronic hemodialysis patients. The aim of the present study was a comparison of axillary loop and straight grafts patency and its complications in hemodialysis access. In this cohort study conducted at Shahid Beheshti Medical University, 77 patients who ...

OBJECTIVES: Pancreaticoduodenectomy (PD) is associated with high morbidity, in part as a result of infectious complications increased by preoperative bile contamination. The aim of the present study was to assess the effect on the incidence of infectious complications of short-term antimicrobial therapy (AMT) in high-risk patients. METHODS: Patients with a ...

Most of the evidence regarding complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA) is based on studies of patients with osteoarthritis (OA), with little being known about outcomes in patients with rheumatoid arthritis (RA). The objective of the present study was to review the current evidence regarding ...

Aspirin, by virtue of inhibition of platelet hemostatic function, is withheld before many invasive procedures because of the bleeding risk. American Society of Gastrointestinal Endoscopy guidelines acknowledge the paucity of "high quality data" to make recommendations regarding the use of aspirin (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs) before endoscopic procedures. ...

The EuroSCORE, worldwide used as a model for prediction of mortality after cardiac surgery, has recently been renewed. Since October 2011, the EuroSCORE II calculator is available at the EuroSCORE website and recommended for clinical use. The intention of this paper is to compare the use of the initial EuroSCORE ...

Diabetes mellitus (DM) and hypertension may be associated with complications following fractionated radiotherapy. To date no studies have determined the risk of radiation toxicity in patients with DM or hypertension who have undergone Gamma Knife surgery (GKS) for brain arteriovenous malformations (AVMs). The goal of the present study was to ...

Inflammation related hematological parameters vary greatly depending on patients. It is not well known how much increase of which parameter warrants suspicion of postoperative infection. This study proposes to identify the normal range and the predictive factors for postoperative infection by conducting a time series analysis of the hematological parameters ...

The UGT1A1*28 variant has been associated with hyperbilirubinemia and atazanavir discontinuation. Protocol A5202 randomly assigned human immunodeficiency virus type 1 (HIV-1)-infected patients to receive atazanavir/ritonavir (atazanavir/r) or efavirenz, with tenofovir/emtricitabine or abacavir/lamivudine. A total of 646 atazanavir/r recipients were evaluable for UGT1A1. Homozygosity for *28/*28 was present in 8% of ...

Risk of abnormal bleeding in surgery patients prescribed serotonin reuptake inhibitors (SRIs) is unclear. Considering the quantity of literature on abnormal gastrointestinal (GI) bleeding with SRIs, relatively little exists on SRI bleeding risks in surgical procedures. We investigated whether SRIs increase the risk of surgical bleeding in patients undergoing knee ...

BACKGROUND: Patients with methicillin-resistant Staphylococcus aureus (MRSA) infections caused by isolates with a high but 'susceptible' minimum inhibitory concentration (MIC) to vancomycin may suffer poor outcomes. The aim of this study was to determine the association of high compared to low vancomycin MICs and clinical outcomes (treatment failure and mortality) ...

Background Prophylactic local application of collagen-gentamicin sponges for prevention of sternal wound infections (SWI) after cardiac surgery has been used routinely in risk patients for several years at our center. However, a recent US study failed to show a significant reduction in SWI with the prophylaxis. Therefore, a systematic reevaluation of ...

BACKGROUND: To analyze the trifecta outcome (continence, potency, and cancer control) in 300 cases of robotic-assisted laparoscopic radical prostatectomy (RARP). METHODS: A prospective assessment of outcomes in 300 consecutive patients that underwent a RARP performed by a single surgeon. Patients were grouped according to D'Amico risk criteria: Group I consisted ...

BACKGROUND: The CHA(2)DS(2)-VASc (congestive heart failure, hypertension, age ≥ 75 years (doubled), type 2 diabetes, previous stroke, transient ischemic attack, or thromboembolism (doubled), vascular disease, age 65-75 years, and sex category) score was published as a predictive scoring model for stroke in atrial fibrillation patients. As multiple vascular risk factors are ...

BACKGROUND:: Coronary heart disease (CHD) risk factor reduction is required to maximize the benefits to be gained from coronary artery bypass grafting. Risk factor reduction after surgery, however, is often incomplete and adherence rates are poor. The health behaviors of the cardiac partner can be supportive or can act to ...

Rationale. Most vascular catheter-related infections (CRIs) occur extraluminally in ICU patients. Chlorhexidine-impregnated and strongly adherent dressings may decrease catheter colonization and CRI rates. Methods. In a 2:1:1 assessor-blinded randomized trial in patients with vascular catheters inserted for an expected duration of 48 hours or more in 12 French ICUs, we ...

Abstract After gastrectomy, a longer period of intravenous alimentation is required than for other digestive surgeries, portending a higher risk of catheter-related bloodstream infection (CRBSI). From assessment of CRBSI occurring between 2004 and 2007 (preintervention group), the duration of intravenous infusion between 2008 and 2010 (postintervention group) was changed to ...

INTRODUCTION: Postoperative infection is the most common postsurgical oral complication but no double-blind, randomized, placebo-controlled trial has been made yet to assess amoxicillin prophylaxis for oral surgery. The aim of this pilot study was to assess the effectiveness of prophylactic amoxicillin 3g per os versus placebo in the prevention of ...

Delayed sternal closure (DSC) is employed after conventional cardiac surgery without a significantly increased risk of late mediastinitis or sternal wound infection. There are no data specifically examining its late effects on patients undergoing implantation with a ventricular assist device (VAD). Between October 1996 and October 2010, 364 patients underwent ...

Background: Current guidelines recommend bridging anticoagulation in patients undergoing cardiac rhythm device surgery with a "moderate to high risk" of thromboembolism. Patients at "low risk" are advised to stop oral anticoagulation without bridging to the procedure. This study examines real world adherence to accepted guidelines and the clinical sequelae of ...