Evolution of quality of life, anxiety, and depression over time in patients with an abdominal aortic aneurysm approaching the surgical threshold.

Background: Contrary to the impact of screening, the effect of long-term surveillance on the quality of life of patients with an abdominal aortic aneurysm is not well known. Therefore, the aim of this study was to describe patient-reported outcomes of patients with an abdominal aortic aneurysm approaching the surgical threshold.

Methods: This multicentre, observational cohort study included patients with an abdominal aortic aneurysm with a maximum aneurysm diameter of greater than or equal to 40 mm.

Targeted plasma multi-omics propose glutathione, glycine and serine as biomarkers for abdominal aortic aneurysm growth on serial CT scanning.

Background And Aims: Abdominal aortic aneurysm (AAA) patients undergo uniform imaging surveillance until reaching the surgical threshold. In spite of the ongoing exploration of AAA pathophysiology, biomarkers for personalized surveillance are lacking. This study aims to identify potential circulating biomarkers for AAA growth on serial CT scans.

Perioperative transfusion study (PETS): Does a liberal transfusion protocol improve outcome in high-risk cardiovascular patients undergoing non-cardiac surgery? A randomised controlled pilot study.

Background: Small studies have shown that patients with advanced coronary artery disease might benefit from a more liberal blood transfusion strategy. The goal of this pilot study was to test the feasibility of a blood transfusion intervention in a group of vascular surgery patients who have elevated cardiac troponins in rest.

Methods: We conducted a single-centre, randomised controlled pilot study.

[Eating disorders in the light of addiction].

Eating disorders (ED) are complex and damaging to health. They cause suffering similar to that of addictions. Although they share some similarities, eating disorders remain distinct from addictions.

Targeted proteomics and metabolomics for biomarker discovery in abdominal aortic aneurysm and post-EVAR sac volume.

Background And Aims: Abdominal aortic aneurysm (AAA) patients undergo uniform surveillance programs both leading up to, and following surgery. Circulating biomarkers could play a pivotal role in individualizing surveillance. We applied a multi-omics approach to identify relevant biomarkers and gain pathophysiological insights.

Postoperative myocardial injury phenotypes and self-reported disability in patients undergoing noncardiac surgery: a multicentre observational study.

Background: Postoperative myocardial injury (PMI) comprises a spectrum of mechanisms resulting in troponin release. The impact of different PMI phenotypes on postoperative disability remains unknown.

Methods: This was a multicentre prospective cohort study including patients aged ≥50 yr undergoing elective major noncardiac surgery.

How We Would Treat Our Own Thoracoabdominal Aortic Aneurysm.

This manuscript is intended to provide a comprehensive review of the current state of knowledge on endovascular repair of thoracoabdominal aortic aneurysms (TAAAs). The management of these complex aneurysms requires an interdisciplinary and patient-specific approach in high-volume centers. An index case is used to discuss the diagnosis and treatment of a patient undergoing fenestrated-branched endovascular aneurysm repair for a TAAA.

Prediction, prognosis, and professionalism in perioperative medicine.

Guidelines provide a framework to take better care of our patients. They are published by different professional groups and are based on all the research done for us by hardworking colleagues. Compiling a guideline is an enormous amount of work and is generally done with the utmost care.

Tracing 25 years of 'initiativitis' in central government attempts to join up local public services in England.

Over the last 25 years, central government has attempted to join up local public services in England on at least 55 occasions, illustrating the 'initiativitis' inflicted upon local governments by the large volume and variety of coordination programmes. By analysing and mapping some of the characteristics of these initiatives, we have uncovered insights into the ways central government has sought to achieve local coordination. We observe a clear preference for the use of funding and fiscal powers as a lever, a competitive allocation process, and a constrained discretion model of governance, with some distinct patterns over time.

Circulating biomarkers of cardiovascular disease are related to aneurysm volume in abdominal aortic aneurysm.

Background: Surveillance programs in abdominal aortic aneurysms (AAA) are mainly based on imaging and leave room for improvement to timely identify patients at risk for AAA growth. Many biomarkers are dysregulated in patients with AAA, which fuels interest in biomarkers as indicators of disease progression. We examined associations of 92 cardiovascular disease (CVD)-related circulating biomarkers with AAA and sac volume.

Intraoperative hypotension in noncardiac surgery patients with chronic beta-blocker therapy: A matched cohort analysis.

Study Objective: To explore the incidence of intraoperative hypotension in patients with chronic beta-blocker therapy, expressed as time spent, area and time-weighted average under predefined mean arterial pressure thresholds.

Design: Retrospective analysis of a prospective observational cohort registry.

Setting: Patients ≥60 years undergoing intermediate- to high-risk noncardiac surgery with routine postoperative troponin measurements on the first three days after surgery.

'If you don't take a temperature, you can't find a fever': relevance to continuous arterial pressure monitoring.

Intraoperative hypotension is common and is associated with adverse postoperative outcomes. A substantial fraction of all perioperative hypotension occurs shortly after induction of anaesthesia and before the procedure begins. Arterial pressure monitoring is usually intermittent in this period, with a risk of missing significant hypotensive events.

Immediate postoperative high-sensitivity troponin T concentrations and long-term patient-reported health-related quality of life: A prospective cohort study.

Background: Myocardial injury after noncardiac surgery is associated with mortality and major adverse postoperative cardiovascular events. The effect of postoperative troponin concentrations on patient-reported health-related quality of life (HRQoL) is unknown.

Objective: The study examined the association between immediate postoperative troponin concentrations and self-reported HRQoL 1 year after surgery.

Postoperative Hypotension after Noncardiac Surgery and the Association with Myocardial Injury.

Background: Intraoperative hypotension has been associated with postoperative morbidity and early mortality. Postoperative hypotension, however, has been less studied. This study examines postoperative hypotension, hypothesizing that both the degree of hypotension severity and longer durations would be associated with myocardial injury.

Nutrition Approach for Inpatients With Anorexia Nervosa: Impact of a Clinical Refeeding Guideline.

Objective: This study assesses the impact of a clinical refeeding guideline on weight restoration, length of stay, rate of refeeding complications, and rehospitalizations.

Method: This retrospective study included patient records of 107 participants aged 13-55 years with a diagnosis of AN, admitted for at least 7 days for renutrition before and after introduction of the refeeding guideline. Weight evolution graphs were rated by 2 clinical experts independently.

Preoperative coronary angiography in vascular surgery patients with asymptomatic elevated high-sensitivity troponin T: a case series.

This case series presents 10 patients undergoing vascular surgery with asymptomatic elevated high-sensitivity troponin T concentrations, measured at outpatient clinic before surgery. Patients were included in the RAVE (Rotterdam Antiplatelet therapy in Vascular patiEnts) pilot study. All included patients underwent coronary angiography before surgery to identify significant obstructive coronary artery disease.

[Fatigue in the adolescent athlète].

Adolescent athletes frequently complain of fatigue. Acute fatigue after intense training is physiological and necessary in order to develop capacity and increase performance. However, healthcare practitioners must question persistant fatigue, which causes are multiple, sometimes clear, though mostly multifactorial.

Type D Personality and Health-Related Quality of Life in Vascular Surgery Patients.

Background: This study evaluated the association of type D personality and health-related quality of life (HRQoL) and assessed the stability of type D personality in vascular surgery patients during the year after surgery.

Method: In a prospective cohort study between 2008 and 2014, 294 patients were assessed with validated questionnaires preoperatively and at 1, 6, and 12 months after surgery. Associations between type D personality, depression, and HRQoL were analyzed by generalized estimating equation models.

Factors associated with weight gain in anorexia nervosa inpatients.

Objective: Nutrition restoration in inpatients with anorexia nervosa (AN) is a core element in treatment, enabling recovery of cognitive functions essential for psychological care. This study aims to identify factors associated with inpatient weight gain.

Methods: Medical records from 107 inpatients aged 13-55 years with AN, hospitalized for more than 7 days at a specialized unit, were examined in a retrospective study.

Postoperative troponin release is associated with major adverse cardiovascular events in the first year after noncardiac surgery.

Introduction: Troponin elevations after intermediate-to-high risk noncardiac surgery are common and can predict mortality. However, the prognostic value for early and late major adverse cardiovascular events (MACE) is less well investigated. The authors evaluated the relationship between postoperative troponin release and MACE in the first year after noncardiac surgery.

What we can learn from Big Data about factors influencing perioperative outcome.

Purpose Of Review: This narrative review will discuss what value Big Data has to offer anesthesiology and aims to highlight recently published articles of large databases exploring factors influencing perioperative outcome. Additionally, the future perspectives of Big Data and its major pitfalls will be discussed.

Recent Findings: The potential of Big Data has given an incentive to create nationwide and anesthesia-initiated registries like the MPOG and NACOR.

[Adolescents suffering from anorexia nervosa: an evidence-based approach of the parent's role in 2018].

A new paradigm in the management of adolescents with eating disorders promotes different treatment orientations aiming at increasing therapeutic effectiveness as well as offering a more integrated and coherent care for families. Particular attention is given to the process of refeeding to avoid the severe somatic sequelae of eating disorder and the risk of a chronic course for a disorder which is well known for its « addictive » power and influence. The parents and the need for a strong alliance with the healthcare team stand at the centre of this new paradigm.

Prognostic value of postoperative high-sensitivity troponin T in patients with different stages of kidney disease undergoing noncardiac surgery.

Background: Emerging evidence suggests that postoperative troponin release is a strong and independent predictor of short-term mortality. However, evaluating elevated troponins in patients with chronic kidney disease (CKD) is still controversial and is often disregarded. This study examines morbidity along with short- and long-term mortality risk associated with elevated high-sensitivity troponin T (hsTnT) in patients with different stages CKD undergoing noncardiac surgery.

Association between postoperative mean arterial blood pressure and myocardial injury after noncardiac surgery.

Background: Myocardial injury after noncardiac surgery is common, although the exact pathophysiology is unknown. It is plausible that hypotension after surgery is relevant for the development of myocardial injury. The authors evaluated whether low mean arterial pressures (MAPs) after surgery are related to an increased incidence in postoperative cardiac-troponin elevation.