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Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

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https://www.readbyqxmd.com/read/28629870/tumor-stroma-ratio-is-an-independent-predictor-for-overall-survival-and-disease-free-survival-in-gastric-cancer-patients
#1
Paolo Aurello, Giammauro Berardi, Diego Giulitti, Antonio Palumbo, Simone Maria Tierno, Giuseppe Nigri, Francesco D'Angelo, Emanuela Pilozzi, Giovanni Ramacciato
BACKGROUND: Despite different prognostic factors have been already studied, patients undergoing potentially curative resection for gastric cancer, still have a poor outcome. There is therefore the need to identify novel prognostic factors. Recently, Tumor-Stroma Ratio (TSR) was proven to be associated with prognosis in different types of cancers. Aim of this study was to evaluate the prognostic value of TSR in gastric cancer patients. METHODS: 106 patients underwent gastrectomy between January 2004 and December 2015...
June 16, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28624359/new-challenges-in-multimodal-workout-of-locally-advanced-breast-cancer
#2
REVIEW
Alejandro Martin Sanchez, Gianluca Franceschini, Armando Orlandi, Alba Di Leone, Riccardo Masetti
The term "locally advanced breast cancer" (LABC) encompasses a heterogeneous group of breast neoplasms that represent an extremely variable percentage of newly diagnosed breast cancers (4-90%, depending of world regions). These cancers may have different clinical and biological characteristics that can be managed by primary surgery or neoadjuvant integrated treatments. In this paper we review the updated guidelines and discuss most recently reported evidence related to LABC multidisciplinary workout, in order to maximize results of combined systemic therapies, modern surgical procedures and radiotherapy...
June 14, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28619548/review-emerging-concepts-in-the-pathogenesis-of-tendinopathy
#3
REVIEW
Benjamin J F Dean, Stephanie G Dakin, Neal L Millar, Andrew J Carr
Tendinopathy is a common clinical problem and has a significant disease burden attached, not only in terms of health care costs, but also for patients directly in terms of time off work and impact upon quality of life. Controversy surrounds the pathogenesis of tendinopathy, however the recent systematic analysis of the evidence has demonstrated that many of the claims of an absence of inflammation in tendinopathy were more based around belief than robust scientific data. This review is a summary of the emerging research in this topical area, with a particular focus on the role of neuronal regulation and inflammation in tendinopathy...
June 12, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28619547/a-systematic-review-of-the-management-and-outcome-of-ercp-related-duodenal-perforations-using-a-standardized-classification-system
#4
REVIEW
Roberto Cirocchi, Michael Denis Kelly, Ewen A Griffiths, Renata Tabola, Massimo Sartelli, Luigi Carlini, Stefania Ghersi, Salomone Di Saverio
INTRODUCTION: The incidence of duodenal perforation after ERCP ranges from 0.09% to 1.67% and mortality up to 8%. METHODS: This systematic review was registered in Prospective Register of Systematic Reviews, PROSPERO. Stapfer classification of ERCP-related duodenal perforations was used. RESULTS: The systematic search yielded 259 articles. Most frequent post-ERCP perforation was Stapfer type II (58.4%), type I second most frequent perforation (17...
June 12, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28619546/screening-in-developmental-dysplasia-of-the-hip-ddh
#5
REVIEW
Robin W Paton
Screening for Developmental Dysplasia of the Hip (DDH) is a controversial subject. Screening may be by universal neonatal clinical examination (Ortolani or Barlow manoeuvres) with the addition of sonographic imaging of the hip (selective 'at risk' hips or universal screening in the neonate). In the UK, the NIPE guidelines recommend universal neonatal clinical assessment of the hip joints, a General Practitioner 6-8 week clinical 'hip check' and assessment clinically with sonographic imaging at 4-6 weeks for certain 'at risk' hips for pathological DDH...
June 12, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28602482/a-new-anterior-inferior-coronal-patellar-plica
#6
Francesco Sadile, Alessio Bernasconi, Nicola Maffulli
PURPOSE: To date, four synovial plicae are classically described in the knee. We report a previously undescribed new inferior patellar plica, named "bib-like plica" (BLP, referring to its morphology) related to specific symptoms of atypical recurrent anterior knee pain in the presence of a locked or pseudo-locked knee. We describe this anatomical structure, and assess its clinical relevance in daily practice in terms of clinical pattern and long-term follow-up outcome after arthroscopic excision...
June 8, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28601343/troublesome-throat-awareness-tta-as-a-contemporary-alternative-to-globus-pharyngeus
#7
EDITORIAL
J Doody, J E Fenton
No abstract text is available yet for this article.
June 7, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28596062/inflammation-in-tendinopathy
#8
REVIEW
Alessio D'Addona, Nicola Maffulli, Silvestro Formisano, Donato Rosa
Pain and functional limitation are frequent in symptomatic tendinopathy. The essential lesion of tendinopathy is a failed healing response. Understanding the cellular and molecular mechanisms involved in a failed healing response during the early stages of pathogenesis of tendinopathy would help to develop new and effective treatments. The role of inflammation in the development of tendon pathologies has been revived during the last few years, in particular during the first phases of tendinopathies, when "early tendinopathy" may not be clinically evident...
June 6, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28549529/impact-of-obstructive-sleep-apnea-on-quality-of-life-after-laparoscopic-roux-en-y-gastric-bypass
#9
C A L de Raaff, U K Coblijn, E S M de Klerk, M J L Ravesloot, N de Vries, B A van Wagensveld
BACKGROUND: To examine the influence of obstructive sleep apnea (OSA) on the quality of life (QoL) in bariatric surgery. METHODS: All patients who underwent a laparoscopic Roux-and-Y gastric bypass (LRYGB), preoperative poly(somno)graphy and completed an Impact of Weight on QoL-Lite questionnaire before and after surgery were included. RESULTS: A total of 276 patients were included. OSA was diagnosed in 150 (53.3%) patients. All subscale scores improved 15 months post-surgery (p < 0...
May 23, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28549528/the-penalty-points-system-in-ireland-does-it-remain-effective-14-years-on
#10
C Downey, M Donnelly
INTRODUCTION: Road traffic accidents (RTAs) are the leading cause of trauma related mortality in Ireland. The penalty points system (PPS) was introduced in Ireland in 2002 to incentivise safer driving and reduce injury. Its early effect was studied previously(1) which concluded that there was a slight reduction in RTA related femoral shaft fractures (a sensitive indicator of high energy trauma) and a dramatic reduction in RTA related discharges. We hypothesized that over the following 14 years, the penalty points system might lose its effectiveness...
May 23, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28522270/lumbar-microdiscectomy-as-a-day-case-procedure-scope-for-improvement
#11
Neeraj Ahuja, Himanshu Sharma
BACKGROUND AND PURPOSE: There are no significant differences in outcomes between patients receiving inpatient and day-case lumbar microdiscectomy, but the latter is still underused in the NHS. Here we aimed to identify factors contributing to successful same-day discharge in day-case patients. METHODS: This was a retrospective observational study of patients undergoing elective lumbar microdiscectomy between August 2012 and December 2014. Age, gender, day of surgery, distance to hospital, ASA grade, regular opiate use, smoking status, order on the operating list, and side and level of surgery were examined by logistic regression to assess their influence on same-day discharge...
May 15, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28476310/intra-operative-techniques-to-reduce-the-risk-of-capsular-contracture-in-patients-undergoing-aesthetic-breast-augmentation-a-review
#12
REVIEW
J D Horsnell, A E Searle, P A Harris
BACKGROUND: Capsular contracture is a significant complication following aesthetic breast augmentation. Efforts to reduce this incidence have focused on the surgical approach, implant selection and IV antibiotics. Intra-operative methods to reduce the risk have had less investigation. This review focuses on these interventions and will document evidence to support pocket irrigation, nipple shields, drains and the use of an implant insertion funnel. METHODS: A comprehensive review of Pubmed, Scopus and Embase was performed to identify relevant papers published since 2000...
May 2, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27815046/the-impact-of-the-biomolecular-era-on-breast-cancer-surgery
#13
REVIEW
T P McVeigh, M R Boland, A J Lowery
Surgery has always played a central role in the management of breast cancer, with local control via complete tumour resection long established as the cornerstone of effective breast cancer therapy. While extensive surgical resection in the form of the Halstead radical mastectomy dominated treatment up until at least the 1970s, the advent of adjuvant loco-regional and systemic therapies has resulted in a decrease in the magnitude of surgical intervention in recent decades. The Biomolecular or "-omics" era initiated with the discovery of the DNA double helix in 1953 and intensified by the completion of the human genome project in 2003 has seen an unprecedented expansion in our understanding of the molecular and genetic heterogeneity of cancer...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27742406/role-of-transoral-robotic-surgery-in-current-head%C3%A2-%C3%A2-neck-practice
#14
REVIEW
David Hamilton, Vinidh Paleri
Morbidity and mortality associated with increasingly radical doses of chemoradiotherapy have led many to question the current standard of care in head and neck cancer. Recently, surgeons have developed minimally invasive, transoral techniques which have demonstrated excellent survival and favourable functional outcomes. Transoral robotic surgery (TORS) is the most recent, cutting edge in the evolution of transoral techniques; TORS allows surgeons unprecedented access to and visualisation of the upper aerodigestive tract...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27720666/primary-repair-of-the-anterior-cruciate-ligament-a-paradigm-shift
#15
REVIEW
Jelle P van der List, Gregory S DiFelice
Over the last century, many surgical treatments have been developed in the orthopedic field, including treatments of anterior cruciate ligament (ACL) injuries. These treatments ideally evolve in a process of trial and error with prospective comparison of new treatments to the current treatment standard. However, these evolutions are sometimes not linear and periodically undergo paradigm shifts. In this article, we review the evolution of ACL treatment and explain how it underwent a paradigm shift. Open primary ACL repair was the most common treatment in the 1970s and 1980s, but because multiple studies noted deterioration of outcomes at mid-term follow-up, in addition to several randomized clinical trials (RCTs) that noted better outcomes following ACL reconstruction, the open primary repair technique was abandoned...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27720167/coronary-artery-bypass-grafting-for-left-main-disease-and-the-risk-of-stroke-incidence-aetiology-and-prevention
#16
REVIEW
Ana-Catarina Pinho-Gomes, David P Taggart
This review explores the association between left main disease and the increased risk of perioperative stroke following coronary artery bypass grafting, specifically addressing the potential underlying mechanisms and its potential prevention. In particular, this correlation appears stronger for patients with left main disease when compared to patients with isolated triple vessel disease. Even though evidence on this topic is limited and of modest quality, there appears to be a significant association between ascending aorta atherosclerosis and coronary artery disease...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26688059/size-of-common-bile-duct-stones-on-mrcp-predicts-likelihood-of-positive-findings-at-ercp
#17
J Reid, R Dolan, M Patel, R Fleming, D Young, A Hair
OBJECTIVE: To ascertain if direct measurement of the size of common bile duct stones (CBD) on magnetic resonance cholangio-pancreatography (MRCP) can be used to predict the likelihood of a positive endoscopic retrograde cholangio-pancreatography (ERCP) result. Should we be carrying out ERCPs on all patients with CBD stones? METHODS: We retrospectively analysed the records of 1812 consecutive patients undergoing MRCP between November 2009 and November 2014 at the Victoria Infirmary...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26482084/post-traumatic-stress-disorder-amongst-surgical-trainees-an-unrecognised-risk
#18
Christopher V Thompson, David N Naumann, Jodie L Fellows, Douglas M Bowley, Nigel Suggett
BACKGROUND: Experiences of actual/threatened death or serious injury to patients are commonplace in surgery. Pathological symptoms following stress may lead to Acute Stress Reaction (ASR) and Post-Traumatic Stress Disorder (PTSD). PTSD symptoms of insomnia, anger, poor concentration, hyper-vigilance and exaggerated startle have implications for patient safety. The current study investigates the prevalence of occult, untreated psychological morbidity amongst surgical trainees. METHODS: A web-based survey of UK surgical trainees based upon the Impact of Events Scale-Revised (IES-R) was distributed using social media platforms and email...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26283303/postoperative-exercise-training-is-associated-with-reduced-respiratory-infection-rates-and-early-discharge-a-case-control-study
#19
N R Bhatt, G Sheridan, M Connolly, S Kelly, A Gillis, K C Conlon, S Lane, E Shanahan, P F Ridgway
INTRODUCTION: Pulmonary complications are a significant cause of morbidity, mortality and increased hospital stay following complex abdominal surgery. We investigated whether postoperative early aerobic activity with a pedal exerciser reduced respiratory morbidity and length of stay and improved pulmonary function. METHODS: A prospective case-control study on 30 cases and 30 case matched controls aged 18 years or more who underwent major surgery was conducted. Controls were case-mix matched prospectively from a similar general surgical service not utilising postoperative exercising...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/26210939/endovascular-conversion-into-aorto-uniiliac-configuration-of-acute-failed-endovascular-aneurysm-repair-is-associated-with-better-one-year-survival-rates-compared-to-open-conversion
#20
Alexander M Prusa, Andreas G Wibmer, Richard Nolz, Maria Schoder, Harald Teufelsbauer
BACKGROUND: Open conversions (OC) due to failed endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) are technically demanding because of preexisting prostheses and advanced aortic disease. This study evaluates the feasibility and outcomes of aorto-uniiliac endografting (AUI) as an alternative treatment option in acute failed EVAR. METHODS: From March 1995 through February 2012, 26 patients underwent acute conversion of failed EVAR at our tertiary care university center...
June 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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