Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2015
Genetic variation influences the risk of bleeding after cardiac surgery: novel associations and validation of previous findings.
Severe post-operative bleeding in cardiac surgery is associated with increased morbidity and mortality. We hypothesized that variation in genetic susceptibility contributes to post-operative bleeding in addition to clinical factors. ⋯ We identified five SNPs associated with post-operative bleeding after cardiac surgery, of which two validated previously published associations. Addition of genetic information to models with only clinical variables improved the models. Our results indicate that common genetic variations significantly influence post-operative bleeding after cardiac surgery.
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Acta Anaesthesiol Scand · Jul 2015
Cognitive testing with the Post-Operative Quality of Recovery Scale in pre-surgery cancer patients - a controlled study.
Post-Operative Quality of Recovery Scale (PQRS) has been revised to allow for the normal variation in cognitive performance seen in healthy volunteers. This modification could result in exclusion of test subjects because of poor baseline performance. Our aim was to investigate the impact of severe disease and waiting for cancer surgery on PQRS baseline cognitive performance and exclusion rate, and also on variation in cognitive performance at test re-test. ⋯ Women with breast cancer waiting for surgery expressed a higher level of emotional distress, performed lower at baseline but showed no difference in test re-test variability in cognitive performance according to the PQRS when compared with controls. The considerable exclusion rate among patients waiting for cancer surgery should be acknowledged.
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Acta Anaesthesiol Scand · Jul 2015
Case ReportsFailed needle decompression of bilateral spontaneous tension pneumothorax.
This case report presents a young male admitted with primary bilateral spontaneous tension pneumothorax and severe respiratory distress. This is an extremely rare condition. The patient was on the verge of hypoxic cardiac arrest and the attempted needle thoracocentesis was unsuccessful. ⋯ If needle thoracocentesis is chosen, then insertion in the mid-anterior axillary line of the 3rd-5th intercostal space is an appropriate alternative site. Otherwise, lateral thoracostomy, with or without chest tube insertion, is a safe procedure with a high success rate. It should be considered as the first-line treatment of tension pneumothorax, particularly in the unstable patient.