Bleeding Independently associated with Mortality after noncardiac Surgery (BIMS): an international prospective cohort study establishing diagnostic criteria and prognostic importance.

Background: We aimed to establish diagnostic criteria for bleeding independently associated with mortality after noncardiac surgery (BIMS) defined as bleeding during or within 30 days after noncardiac surgery that is independently associated with mortality within 30 days of surgery, and to estimate the proportion of 30-day postoperative mortality potentially attributable to BIMS.

Methods: This was a prospective cohort study of participants ≥45 yr old having inpatient noncardiac surgery at 12 academic hospitals in eight countries between 2007 and 2011. Cox proportional hazards models evaluated the adjusted relationship between candidate diagnostic criteria for BIMS and all-cause mortality within 30 days of surgery.

[Endoscopy-Assisted Treatment of Metaphyseal Osteomyelitis Focus in the Distal Tibia after Osteosynthesis of Comminuted Pilon Fracture].

The submitted case study concerns a 36-year-old patient with a ladder fall injury, who suffered a comminuted right pilon fracture type C3 according to the AO classification. The primary treatment consisted in fixing the fracture with an ankle spanning external fixation and subsequent internal osteosynthesis after the recovery of soft tissues. At four weeks, an infection with fistula developed on the anterior face of the distal tibia.

Age Does Not Affect Metoprolol's Effect on Perioperative Outcomes (From the POISE Database).

Background: Perioperative β-blockade reduces the incidence of myocardial infarction but increases that of death, stroke, and hypotension. The elderly may experience few benefits but more harms associated with β-blockade due to a normal effect of aging, that of a reduced resting heart rate. The tested hypothesis was that the effect of perioperative β-blockade is more significant with increasing age.

[Severe Lower Extremity Infections Treated with Hip Disarticulation - Case Series].

Hip disarticulation is a major ablative procedure with serious risks as well as consequences for the patient, performed rarely for a lower extremity infection. According to literature, the mortality rate in these procedures reaches up to 60%. Unfavourable prognostic factors are emergency surgeries without adequate preparation of the patient and surgeries indicated for an ischemic terrain infection.