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Effects of head direction during prone position on postoperative delirium in elderly patients undergoing thoracolumbar spine surgery: a study protocol for a randomised controlled trial.
BMJ Open
December 2024
The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China
Introduction: Prone positioning with head rotation can influence cerebral haemodynamics, potentially affecting cerebral perfusion and oxygenation. Elderly patients with impaired brain perfusion and oxygenation are at an increased risk of developing postoperative delirium (POD). Despite this, few studies have explored whether head orientation during prone positioning contributes to POD in older adults, an aspect often overlooked by clinicians.
View Article and Find Full Text PDFAcute perioperative alterations in metabolism: A pilot study using mass spectrometry-based metabolomics.
Surgery
December 2024
Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC; Department of Medicine (Endocrinology), Duke University School of Medicine, Durham, NC.
Objective: To characterize early physiologic stresses imposed by surgery by applying metabolomic analyses to deeply phenotype pre- and postoperative plasma and urine of patients undergoing elective surgical procedures.
Background: Patients experience perioperative stress through depletion of metabolic fuels. Bowel stasis or injury might allow more microbiome-derived uremic toxins to enter the blood, while the liver and kidney are simultaneously clearing analgesic and anesthetic drugs.
Guiding Sole Intraoperative Radiotherapy in Breast Cancer According to ASTRO Guidelines: Mitigating Adverse Outcomes in a Taiwan Single-Center.
Cancer Med
January 2025
Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
Background: Intraoperative radiotherapy (IORT) is considered a de-escalating adjuvant treatment for breast cancer low-risk patients. However, the broader criteria applied by the Taiwan IORT Study Cooperative Group led to an increased rate of locoregional recurrence (LRR) among patients receiving only IORT. Consequently, we revised the criteria for sole IORT treatment to include patients who meet the American Society for Radiation Oncology (ASTRO) eligibility standards.
View Article and Find Full Text PDFPreoperative CT-Scan Angiography Reconstruction Before Right Colectomy with Complete Mesocolon Excision: A Systematic Review and Meta-analysis.
J Gastrointest Cancer
December 2024
Department of Surgery, Universitäts medizin Mannheim, Heidelberg University, Mannheim, Germany.
Background: Complete mesocolon excision (CME) and central vascular ligation for right colonic cancers have been developed to improve oncological outcomes. However, it has been linked with a higher risk of morbidity and technical difficulties in operating near major vessels. This study investigated the impact of preoperative surgical planning utilizing CT reconstruction on surgical outcomes in right colectomy with CME.
View Article and Find Full Text PDFTotal hip arthroplasty was found to be safe in Jehovah's Witness patients: a multi-centered matched study.
Arch Orthop Trauma Surg
December 2024
Duke University Health System, Durham, USA.
Background: Jehovah's Witness patients refuse blood transfusion because of their religious beliefs making total hip arthroplasty (THA) challenging. This study aims to determine the safety of THA in Jehovah's Witness patients using standard perioperative protocols as well as evaluate the effectiveness of tranexamic acid (TXA) in controlling blood loss.
Methods: Databases from two tertiary academic centers were queried from 2003 to 2021 to identify THA patients.
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