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American Surgeon

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https://www.readbyqxmd.com/read/29336773/outcomes-of-elderly-patients-undergoing-elective-abdominal-surgery
#1
Evon S L Zoog, Joshua A Worthington, Amar Singh, J Daniel Stanley
No abstract text is available yet for this article.
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336772/tpa-dnase-for-complicated-parapneumonic-effusions-and-empyemas
#2
Amelia Maiga, Rhonda Pinkerman, Stephen A Deppen, Jennifer Scruggs, Philip Mcguire, John L Tarpley, Eric L Grogan
No abstract text is available yet for this article.
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336771/surgical-and-endovascular-management-of-patients-with-chronic-mesenteric-ischemia-a-single-center-experience
#3
Panagiotis Paliogiannis, Giorgio C Ginesu, Alessandro Fancellu, Aldo Pischedda, Mario Maiore, Eleonora Maiore, Antonio Pinna, Michele Barmina, Alberto Porcu
Chronic mesenteric ischemia is a rare intestinal disorder, with a potential evolution toward intestinal infraction. The choice of the appropriate treatment is currently the most crucial issue in the management of patients with chronic mesenteric ischemia. We describe our experience with 16 cases, and we discuss the current diagnostic and therapeutic approaches. A retrospective review of the clinical records was performed, and demographic, clinical, therapeutic, and prognostic data were collected. Six patients were females (37%), and the mean age was 62 years...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336770/limit-crystalloid-resuscitation-after-traumatic-brain-injury
#4
Ara Ko, Megan Y Harada, Galinos Barmparas, Eric J T Smith, Kurtis Birch, Zachary R Barnard, Dorothy A Yim, Eric J Ley
Patients with traumatic brain injury (TBI) are often resuscitated with crystalloids in the emergency department (ED) to maintain cerebral perfusion. The purpose of this study was to evaluate whether crystalloid resuscitation volume impacts mortality in TBI patients. This was a retrospective study of trauma patients with head abbreviated injury scale score ≥2, who received crystalloids during ED resuscitation between 2004 and 2013. Clinical characteristics and volume of crystalloids received in the ED were collected...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336769/processes-of-health-care-delivery-education-and-provider-satisfaction-in-acute-care-surgery-a-systematic-review
#5
DeGirolamo Kristin, Patrick B Murphy, Karan D'Souza, Jacques X Zhang, Neil Parry, Elliott Haut, W Robert Leeper, Ken Leslie, Kelly N Vogt, S Morad Hameed
In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336768/is-routine-continuous-eeg-for-traumatic-brain-injury-beneficial
#6
Lia Aquino, Christopher Y Kang, Megan Y Harada, Ara Ko, Amy Do-Nguyen, Eric J Ley, Daniel R Margulies, Rodrigo F Alban
Severe traumatic brain injury (TBI) is associated with increased risk for early clinical and subclinical seizures. The use of continuous electroencephalography (cEEG) monitoring after TBI allows for identification and treatment of seizures that may otherwise occur undetected. Benefits of "routine" cEEG after TBI remain controversial. We examined the rate of subclinical seizures identified by cEEG in TBI patients admitted to a Level I trauma center. We analyzed a cohort of trauma patients with moderate to severe TBI (head Abbreviated Injury Score ≥3) who received cEEG within seven days of admission between October 2011 and May 2015...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336767/surgery-for-acromioclavicular-dislocation-factors-affecting-functional-recovery
#7
Jun Zhang, Zhengran Ying, You Wang
The objective of the study is to compare the clinical outcomes of two different interventions for Rockwood type III (or above) acromioclavicular dislocation and study the factors influencing postoperative functional recovery. A total of 60 patients with Rockwood type III (or above) acromioclavicular dislocation were included in the study. Patients were divided into two groups based on the surgical intervention: Clavicular Hook Plate Fixation (Group A) and EndoButton technique of Coracoclavicular Ligament Reconstruction (Group B)...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336766/the-implications-of-transfer-to-an-acute-care-surgical-tertiary-service
#8
Rebecca Britt, Pamela Davis, Anjali Gresens, Leonard Weireter, T J Novosel, Jay Collins, L D Britt
Tertiary hospitals are increasingly called on by smaller hospitals and free-standing emergency rooms (ERs) to provide surgical care for complex patients. This study assesses patients transferred to an acute care surgery service. The ER and transfer center logs, as well as billing data, were reviewed for 12 months for all cases evaluated by acute care surgery. The charts were reviewed for demographics, comorbidities, and outcomes. A total of 111 transferred patients with complete data were identified, with 59 transferred from another hospital and 52 from a free-standing ER...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336765/robotic-inguinal-hernia-repair
#9
David S Edelman
Laparoscopic inguinal hernia repair has certain advantages over open repair including less pain and earlier return to normal activity. Concurrent robotic inguinal hernia repair at the time of prostatectomy has been shown to have a lower recurrence rate than open repair. Robotic surgery adds high definition visualization and articulating instruments which enhances dexterity that makes laparoscopic hernia repair more refined. A series of robotic, laparoscopic, inguinal hernia repairs by a single surgeon with an extensive laparoscopic hernia experience at a single institution was undertaken to determine the role of robotic laparoscopic inguinal hernia repair in minimally invasive surgery...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336764/mode-of-transport-and-clinical-outcome-in-rural-trauma-a-helicopter-versus-ambulance-comparison
#10
Mahdi Malekpour, Jabran M Younus, Kathryn Jaap, Nina Neuhaus, Kenneth Widom, Megan Rapp, James Dove, Marie Hunsinger, Joseph Blansfield, Mohsen Shabahang, Denise Torres, Jeffrey Wild
Helicopter Emergency Medical Services (HEMS) is presumably an effective way of patient transport in rural trauma, yet the literature addressing its effectiveness is scarce. In this study, we compared the clinical outcome of rural trauma patients between Ground Emergency Medical Services (GEMS) and HEMS transportation from the beginning of 2006 to the end of 2012. Focus was placed on identifying factors associated with survival to discharge in these patients. Over the seven-year study period, 4492 patients met the inclusion criteria with 2414 patients (54%) being transferred by GEMS and 2078 patients (46%) being transferred by HEMS...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336763/methicillin-resistant-staphylococcus-aureus-in-a-trauma-population-does-decolonization-prevent-infection
#11
Robert A Maxwell, Chasen A Croft, C Buddy Creech, Isaac Thomsen, Nicole Soper, Laura E Brown, Vicente A Mejia, Benjamin W Dart, Donald E Barker
The purpose of this study was to determine if a decolonization regimen reduces the frequency of methicillin-resistant Staphylococcus aureus (MRSA) infections and if colonization isolates are genetically related to subsequent infectious strains. Trauma patients admitted to the intensive care unit with positive MRSA nasal swabs were randomized to either daily chlorhexidine gluconate (CHG) baths and mupirocin (MUP) ointment to the nares or soap and water baths and placebo ointment for five days. Nasal swabs performed at the end of treatment and invasive MRSA infections during the remaining hospitalization were compared with the original nasal isolate via polymerase chain reaction for genetic relatedness as well as CHG and MUP resistance genes...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336762/r-a-cowley-the-golden-hour-the-momentary-pause-and-the-third-space
#12
David E Clark
R Adams Cowley (1917-1991), the Baltimore thoracic and trauma surgeon, was an outstanding politician and promoter of emergency medical services. His skills included the effective use of language, for example, identifying the critical time immediately after injury as a "golden hour," and describing shock as a "momentary pause in the act of death." Conversely, Cowley avoided the tendency of some contemporaries to justify massive crystalloid infusion by invoking a "third space." Cowley is often assumed to have originated the first two phrases, but, in fact, their histories go back at least to the 19th century and illustrate the development of surgical science...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336761/lymphatic-permeation-predicts-systemic-recurrence-in-combination-with-vascular-involvement-in-laparoscopically-resected-n0-colon-cancer
#13
Ken Kojo, Hiroshi Katoh, Masanori Naito, Keishi Yamashita, Takatoshi Nakamura, Takeo Sato, Takahiro Yamanashi, Masahiko Watanabe
High-risk patient selection is required in N0 colon cancer. Although a number of studies have suggested high-risk clinicopathological predictors, most of these are based on analyses in heterogeous patients in terms of surgical procedures. Laparoscopic surgery for colon cancer is becoming a standard procedure worldwide because of its less invasiveness. Accordingly, we aimed to identify bona fide high-risk factors of recurrence in homogeneous N0 patients who underwent laparoscopic surgery. Two hundred and twenty-five patients who underwent laparoscopic curative resection for N0 colon cancer were analyzed...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336760/cancer-frequency-in-retrosternal-goiter
#14
Nuri A Sahbaz, Firat Tutal, Nihat Aksakal, Sami Acar, Kadir I Aksu, Umut Barbaros, Yesim Erbil
Retrosternal goiter prevalence is 5 to 40 per cent according to classifications in goiter series. Goiters with mediastinal extension were reported to be related with higher cancer rates. In our study, we aimed to investigate whether cancer incidence increased in retrosternal goiters compared with the cervical ones. Three hundred and ninety consecutive patients, who had surgery because of retrosternal goiter in Istanbul University Medical Faculty Department of General Surgery between 2005 and 2015 were included in the study (Group 1)...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336759/robotic-rectopexy-for-rectal-prolapse-in-pediatric-patients
#15
David J Hiller, Jaime L Bohl, Kristen A Zeller
Rectal prolapse is the protrusion of the rectum out of the anus. Surgical correction can be accomplished via open and minimally invasive abdominal approaches, as well as from the perineum. Robotic rectopexy is an option for minimally invasive treatment of rectal prolapse. There are no studies that have established the efficacy of robotic rectopexy for rectal prolapse in the pediatric population. The aim of this study was to review the experience of robotic rectopexy at a single institution. This is a retrospective review of our pediatric robotic rectopexy experience from 2012 to 2015...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336758/occult-appendiceal-neoplasms-in-acute-and-chronic-appendicitis-a-single-institution-experience-of-1793-appendectomies
#16
Jamie A Schwartz, Craig Forleiter, David Lee, Grace J Kim
The incidence of appendiceal neoplasms may have been underreported in the past. Patients undergoing incidental appendectomies or appendectomies for chronic appendicitis may be at higher risk for an incidental appendiceal neoplasm. To determine the incidence of occult appendiceal neoplasms and identify risk factors associated with this pathology, a retrospective review of a pathology specimen database was conducted from November 2007 to December 2011, in a single tertiary care hospital center. All patients with appendectomies were included for analysis (n = 1793)...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336757/radiofrequency-thermal-ablation-heat-energy-transfer-in-an-ex-vivo-model
#17
Shivani Thakur, Sandi Lavito, Elizabeth Grobner, Mark Grobner
Little work has been done to consider the temperature changes and energy transfer that occur in the tissue outside the vein with ultrasound-guided vein ablation therapy. In this experiment, a Ex-Vivo model of the human calf was used to analyze heat transfer and energy degradation in tissue surrounding the vein during endovascular radiofrequency ablation (RFA). A clinical vein ablation protocol was used to determine the tissue temperature distribution in 10 per cent agar gel. Heat energy from the radiofrequency catheter was measured for 140 seconds at fixed points by four thermometer probes placed equidistant radially at 0...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336756/risk-factors-for-elevated-preoperative-alkaline-phosphatase-in-patients-with-refractory-secondary-hyperparathyroidism
#18
Meng Yang, Ling Zhang, Linping Huang, Xiaoliang Sun, Haoyang Ji, Yao Lu
Elevated preoperative levels of alkaline phosphatase (ALP) in patients with refractory secondary hyperparathyroidism are correlated with postoperative hypocalcemia and mortality. The aim of this study was to identify the predictors of preoperative ALP in patients with secondary hyperparathyroidism. From April 2012 to December 2015, 220 patients with refractory secondary hyperparathyroidism undergoing total parathyroidectomy without autotransplantation were reviewed. A total of 164 patients presented with elevated preoperative ALP...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336755/incorporation-of-anterior-lumbosacral-spine-exposure-into-a-general-surgical-practice
#19
Michael S Champney, Yousef H Abuhakmeh, Andrew S Chung
Many spine surgeons enlist the aid of an "access surgeon" to provide anterior exposure of the lumbosacral spine. We proposed that a single, community hospital general surgery practice can successfully develop an anterior spine exposure program with acceptable clinical outcomes. One hundred and forty-three consecutive anterior exposures were performed between 2008 and 2014. Morbidity and 30-day mortality were recorded. The effects of American Society of Anesthesiologists Physical Status classification (ASA class) and number of levels exposed on length of stay (LOS) and estimated blood loss (EBL) was reported...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336754/predictors-and-outcomes-of-nondiagnostic-ultrasound-for-acute-appendicitis-in-children
#20
Richard Sola, Blair A Wormer, William E Anderson, Thomas M Schmelzer, Graham H Cosper
Ultrasound assessments of children with possible acute appendicitis (AA) are often nondiagnostic. We aimed to identify the predictors of nondiagnostic ultrasound and to investigate the outcomes. A retrospective review was conducted on children aged 4 to 17 years evaluated in 2013 for AA with ultrasound at a tertiary hospital pediatric emergency department. Demographics, clinical data, and outcomes were analyzed. Of 528 children, 194 (36.7%) had diagnostic ultrasounds and 334 (63.3%) had nondiagnostic ultrasounds...
December 1, 2017: American Surgeon
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