International journal of surgery
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Increasing numbers of older people are undergoing emergency and elective arterial vascular procedures. Many older patients are frail which is a recognised predictor of adverse postoperative outcomes in other surgical specialties. This study in older patients undergoing arterial vascular surgery examined; the prevalence of preoperative frailty; the clinical feasibility of preoperatively measuring frailty and functional status; the association between these characteristics and adverse postoperative outcome. ⋯ Patients aged over 60 years admitted for arterial vascular surgery were frail, had impaired functional status and were cognitively impaired. This combination of preoperative characteristics was predictive of longer hospital length of stay and associated with adverse postoperative outcome.
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Postoperative nausea and vomiting (PONV) still represents one of the most distressing side effects of anaesthesia and surgery. Clinical risk scores e.g. Apfel score is today commonly used to identify patients at risk. We found in a previous study different platelet counts in patients with and without PONV. The aim of the present explorative study was to assess whether females experiencing PONV after breast surgery had any difference in preoperative platelet count and/or volume assessed by platelet testing. ⋯ One third of patients' experienced PONV, increased incidence associated to Apfel score but platelet numbers and simple platelet test provided no additional information around risk for PONV.
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Management of traumatic popliteal vascular injuries in a level I trauma center: A 6-year experience.
Popliteal vascular trauma remains a challenging entity, and carries the greatest risk of limb loss among the lower extremity vascular injuries. Operative management of traumatic popliteal vascular injuries continues to evolve. We aim at describing our experience with such complex injuries, with associated patterns of injury, diagnostic and therapeutic challenges, and outcomes. ⋯ Blunt popliteal vascular injuries are associated with increased morbidity compared to penetrating trauma. Early restoration of blood perfusion, frequent use of interposition grafts with autogenous saphenous vein, and liberal use of fasciotomies play important role to achieve acceptable outcomes.
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The number of citations that a paper has received reflects the impact of the article within a particular medical area. Citation analysis concerning the most cited articles have been widely reported in orthopedic surgery and its subspecialties. However, which articles are cited most frequently in orthopedic elbow surgery is unknown. This study aimed to identify and analyze the characteristics of the 50 most cited articles in elbow surgery. ⋯ Identification of the most cited papers in elbow surgery shows an insight into the historical development of elbow surgery and provides the foundation for further investigations.
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Interventional radiology (IR) provides a range of adjunctive techniques to assist with hemorrhage control after trauma that can be employed pre- or post-operatively. The role of IR in lower-middle income countries (LMICs) remains unexplored. This study describes the use of adjunctive angioembolization (AE) in severely injured patients following its recent implementation at an urban trauma center in a LMIC. ⋯ With the availability of multi-detector computed tomography and a dedicated interventional radiology suite, implementation of AE for the care of trauma patients in LMIC settings is possible.