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Frontiers in Surgery

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https://www.readbyqxmd.com/read/28424776/socially-responsible-surgery-building-recognition-and-coalition
#1
Tyler D Robinson, Thiago M Oliveira, Theresa R Timmes, Jacqueline M Mills, Nichole Starr, Matthew Fleming, Megan Janeway, Diane Haddad, Feroze Sidhwa, Ryan D Macht, Douglas F Kauffman, Tracey A Dechert
IMPORTANCE: Socially responsible surgery (SRS) integrates surgery and public health, providing a framework for research, advocacy, education, and clinical practice to address the social barriers of health that decrease surgical access and worsen surgical outcomes in underserved patient populations. These patients face disparities in both health and in health care, which can be effectively addressed by surgeons in collaboration with allied health professionals. OBJECTIVE: We reviewed the current state of surgical access and outcomes of underserved populations in American rural communities, American urban communities, and in low- and middle-income countries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28367436/severe-aortic-stenosis-and-severe-coarctation-of-the-aorta-a-hybrid-approach-to-treatment
#2
Daniel McLennan, Massimo Caputo, Demetris Taliotis
Hybrid surgery is becoming more popular in the treatment of children with congenital heart disease, particularly small infants and neonates. We report a case of a patient with aortic stenosis (AS) and coarctation of the aorta (CoA). CASE: a 1-month-old baby presented with severe AS and CoA. The decision was made to perform a hybrid surgical procedure. The patient underwent a lateral thoracotomy for repair of the CoA and carotid cutdown for aortic balloon valvuloplasty (AoVP).
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28352629/contained-morcellation-review-of-current-methods-and-future-directions
#3
REVIEW
Enes Taylan, Cagdas Sahin, Burak Zeybek, Ali Akdemir
Power morcellation of surgical specimen during laparoscopic surgery is a practical technology that provides the opportunity to perform several minimally invasive procedures. However, this technology brought forward additional risks and complications associated with dissemination of both benign and malignant tissues inside the abdominal cavity. Based on startling cases, Food and Drug Administration (FDA) announced a discouraging statement on the use of power morcellators that decreased the number of minimally invasive approaches in the following period...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28349051/implementation-of-a-novel-structured-social-and-wellness-committee-in-a-surgical-residency-program-a-case-study
#4
Kathryn E Van Orden, Stephanie D Talutis, Joanna H Ng-Glazier, Aaron P Richman, Elliot C Pennington, Megan G Janeway, Douglas F Kauffman, Tracey A Dechert
This article provides a theoretical and practical rational for the implementation of an innovative and comprehensive social wellness program in a surgical residency program at a large safety net hospital on the East Coast of the United States. Using basic needs theory, we describe why it is particularly important for surgical residency programs to consider the residents sense of competence, autonomy, and belonging during residence. We describe how we have developed a comprehensive program to address our residents' (and residents' families) psychological needs for competence, autonomy, and belongingness...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28321397/the-identification-of-three-cancer-stem-cell-subpopulations-within-moderately-differentiated-lip-squamous-cell-carcinoma
#5
Rachna Ram, Helen D Brasch, Jonathan C Dunne, Paul F Davis, Swee T Tan, Tinte Itinteang
AIM: To identify and characterize cancer stem cells (CSCs) in moderately differentiated lip squamous cell carcinoma (MDLSCC). METHOD: MDLSCC samples underwent 3,3-diaminobenzidine (DAB) immunohistochemical (IHC) staining for squamous cell carcinoma marker EMA, CSC marker CD44 and embryonic stem cell markers NANOG, octamer-binding transcription factor 4 (OCT4), spalt-like transcription factor 4 (SALL4), sex-determining region Y-box 2 (SOX2), and phosphorylated signal transducer and activator of transcription 3 (pSTAT3)...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28321396/popular-hybrid-congenital-heart-procedures-without-cardiopulmonary-bypass
#6
REVIEW
Aamisha Gupta, Zahid Amin
As surgical and catheter interventions advance, patients with congenital heart disease are now offered alternative treatment options that cater to their individual needs. Furthermore, collaboration between interventional cardiologists and cardiac surgeons have led to the development of hybrid procedures, using the best techniques of each respective field to treat these complex cardiac entities from initial treatment in the pediatric patient to repeat intervention in the adult. We present a review of the increased popularity and trend in hybrid procedures in congenital heart disease without the use of cardiopulmonary bypass...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28289682/stent-grafts-can-convert-unusable-upper-arm-arteriovenous-fistulas-into-a-functioning-hemodialysis-access-a-retrospective-case-series
#7
Charudatta S Bavare, Tiffany K Street, Eric K Peden, Mark G Davies, Joseph J Naoum
INTRODUCTION: Not all newly created arteriovenous fistulas (AVFs) successfully mature and develop into a functioning access for hemodialysis. Percutaneous transluminal angioplasty (PTA) and balloon-assisted maturation (BAM) have been utilized to either treat flow-limiting stenoses or to promote and accelerate maturation. We hypothesized that unusable upper arm AVFs can be rescued by conversion to a functional access using the percutaneous placement of a stent graft (SG). METHODS: Clinical data on 12 patients with an early non-usable upper arm AVF underwent percutaneous revision using SGs...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28280722/tissue-engineered-solutions-in-plastic-and-reconstructive-surgery-principles-and-practice
#8
REVIEW
Sarah Al-Himdani, Zita M Jessop, Ayesha Al-Sabah, Emman Combellack, Amel Ibrahim, Shareen H Doak, Andrew M Hart, Charles W Archer, Catherine A Thornton, Iain S Whitaker
Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. In this article, we present an overview of the field of tissue engineering, with the practicing plastic surgeon in mind...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28265561/delayed-start-study-design-for-balloon-dilation-of-the-eustachian-tube-alternative-for-a-randomized-controlled-trial
#9
Shari Van Roeyen, Paul Van de Heyning, Vincent Van Rompaey
No abstract text is available yet for this article.
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28243591/transcranial-motor-evoked-potentials-during-spinal-deformity-corrections-safety-efficacy-limitations-and-the-role-of-a-checklist
#10
Shankar Acharya, Nagendra Palukuri, Pravin Gupta, Manish Kohli
INTRODUCTION: Intraoperative neuromonitoring (IONM) has become a standard of care in spinal deformity surgeries to minimize the incidence of new onset neurological deficit. Stagnara wake up test and ankle clonus test are the oldest techniques described for spinal cord monitoring, but they cannot be solely relied upon as a neuromonitoring modality. Somatosensory evoked potentials monitor only dorsal tracts and give high false positive and negative alerts. Transcranial motor evoked potentials (TcMEPs) monitor the more useful motor pathways...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28232910/hybrid-surgery-options-for-complex-clinical-scenarios-in-adult-patients-with-congenital-heart-disease-three-case-reports
#11
Filippo Rapetto, Damien Kenny, Mark Turner, Andrew Parry, Serban Stoica, Orhan Uzun, Massimo Caputo
The strategy for the management of adult patients with congenital heart disease (CHD) often represents a challenge for cardiac surgeons and cardiologists due to complex anatomy, wide range of clinical presentations, and a high-risk profile. However, hybrid approach may represent an attractive solution. We report three cases of adult patients previously operated for CHD and recently treated with a hybrid approach in our institution. Case 1: a 76-year-old woman with permanent atrial fibrillation, lung disease, chronic kidney disease, microcytic anemia, and type II diabetes mellitus, previously operated for atrial septal defect closure and pulmonary valvotomy, presented with severe pulmonary regurgitation and advanced right ventricular failure...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28232909/calcification-of-human-saphenous-vein-associated-with-endothelial-dysfunction-a-pilot-histopathophysiological-and-demographical-study
#12
Sydney L Pedigo, Christy M Guth, Kyle M Hocking, Alex Banathy, Fan Dong Li, Joyce Cheung-Flynn, Colleen M Brophy, Raul J Guzman, Padmini Komalavilas
While the pathophysiology and clinical significance of arterial calcifications have been studied extensively, minimal focus has been placed on venous calcification deposition. In this study, we evaluated the association between calcium deposition in human saphenous vein (HSV), endothelial function, and patient demographic risk factors. Fifty-four HSV segments were collected at the time of coronary artery bypass graft (CABG) surgery. The presence or absence of calcium deposits was visualized using the Von Kossa staining method...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28224127/early-diagnosis-and-surgical-treatment-for-necrotizing-fasciitis-a-multicenter-study
#13
Evangelos P Misiakos, George Bagias, Iordanis Papadopoulos, Nickolaos Danias, Paul Patapis, Nickolaos Machairas, Theodore Karatzas, Nickolaos Arkadopoulos, Konstantinos Toutouzas, Nickolaos Alexakis, Manousos N Konstantoulakis, George Zografos, Vasilis Smyrniotis, Gregory Kouraklis, Anastasios Machairas
BACKGROUND: Necrotizing fasciitis (NF) is a group of relatively rare infections, usually caused by two or more pathogens. It affects the skin and subcutaneous tissues of lower and upper limbs, perineal area (Fournier's gangrene), and the abdominal wall. Early diagnosis and aggressive surgical management are of high significance for the management of this potentially lethal disease. METHODS: We conducted a retrospective study in patients who presented, during the last decade, at four University Surgical Departments in the area of Athens, Greece, with an admission diagnosis of NF...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28217690/iatrogenic-acute-ascending-aortic-dissection-with-intramural-hematoma-during-coronary-artery-stenting-a-case-report
#14
Mohamad El-Haress, Hicham Daadaa, Shima Shahjouei, Firas El-Bitar, Hisham Bahmad
BACKGROUND: Iatrogenic acute ascending aortic dissection during percutaneous coronary intervention (PCI) is an exceptionally rare and life-threatening sequel that requires early and accurate diagnosis along with rapid management. No guidelines have yet been established to direct decisions on the different treatment options that can be employed in the setting of acute aortic dissections caused by PCI. However, similar cases have been treated either by intracoronary stenting and conservative management as in localized aortocoronary dissections or by surgical intervention in cases of extensive aortic dissections...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28197403/network-plasticity-and-intraoperative-mapping-for-personalized-multimodal-management-of-diffuse-low-grade-gliomas
#15
REVIEW
Cristina Diana Ghinda, Hugues Duffau
Gliomas are the most frequent primary brain tumors and include a variety of different histological tumor types and malignancy grades. Recent achievements in terms of molecular and imaging fields have created an unprecedented opportunity to perform a comprehensive interdisciplinary assessment of the glioma pathophysiology, with direct implications in terms of the medical and surgical treatment strategies available for patients. The current paradigm shift considers glioma management in a comprehensive perspective that takes into account the intricate connectivity of the cerebral networks...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28194399/the-role-of-permissive-and-induced-hypotension-in-current-neuroanesthesia-practice
#16
Suren Soghomonyan, Nicoleta Stoicea, Gurneet S Sandhu, Jeffrey J Pasternak, Sergio D Bergese
BACKGROUND: Induced hypotension (IH) had been used for decades in neurosurgery to reduce the risk for intraoperative blood loss and decrease blood replacement. More recently, this method fell out of favor because of concerns for cerebral and other end-organ ischemia and worse treatment outcomes. Other contributing factors to the decline in its popularity include improvements in microsurgical technique, widespread use of endovascular procedures, and advances in blood conservation and transfusion protocols...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28168190/granulocytic-sarcoma-presenting-as-a-palpable-breast-lump
#17
Victor Fernandes Vieira, Quoc Duy Vo, Jean Bouquet de la Jolinière, Fathi Khomsi, Anis Feki, Henri-Marcel Hoogewoud
We report the case of a 45-year-old woman who palpated a voluminous painless lump in the superior outer quadrant of her left breast. Her past medical history revealed an acute myeloid leukemia (AML) treated and considered in remission 1 month prior to this discovery. Imaging work-up by mammogram, US, and MRI showed multiples masses suspect of malignancy in both breasts. US-guided needle biopsy was performed in the palpable mass and in one of the multiple lesions located in the right breast. Histologic findings were compatible with a granulocytic sarcoma in both breasts, which was considered as a relapse of the AML treated a few months earlier...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/28018904/3d-volumetric-modeling-and-microvascular-reconstruction-of-irradiated-lumbosacral-defects-after-oncologic-resection
#18
Emilio Garcia-Tutor, Marco Romeo, Michael P Chae, David J Hunter-Smith, Warren Matthew Rozen
BACKGROUND: Locoregional flaps are sufficient in most sacral reconstructions. However, large sacral defects due to malignancy necessitate a different reconstructive approach, with local flaps compromised by radiation and regional flaps inadequate for broad surface areas or substantial volume obliteration. In this report, we present our experience using free muscle transfer for volumetric reconstruction, in such cases, and demonstrate three-dimensional (3D) haptic models of the sacral defect to aid preoperative planning...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/28018903/impact-of-lymph-node-burden-on-survival-of-high-risk-prostate-cancer-patients-following-radical-prostatectomy-and-pelvic-lymph-node-dissection
#19
Lisa Moris, Thomas Van den Broeck, Lorenzo Tosco, Anthony Van Baelen, Paolo Gontero, Robert Jeffrey Karnes, Wouter Everaerts, Maarten Albersen, Patrick J Bastian, Piotr Chlosta, Frank Claessens, Felix K Chun, Markus Graefen, Christian Gratzke, Burkhard Kneitz, Giansilvio Marchioro, Rafael Sanchez Salas, Bertrand Tombal, Henk Van Der Poel, Jochen Christoph Walz, Gert De Meerleer, Alberto Bossi, Karin Haustermans, Francesco Montorsi, Hendrik Van Poppel, Martin Spahn, Alberto Briganti, Steven Joniau
AIM: To determine the impact of the extent of lymph node invasion (LNI) on long-term oncological outcomes after radical prostatectomy (RP). MATERIAL AND METHODS: In this retrospective study, we examined the data of 1,249 high-risk, non-metastatic PCa patients treated with RP and pelvic lymph node dissection (PLND) between 1989 and 2011 at eight different tertiary institutions. We fitted univariate and multivariate Cox models to assess independent predictors of cancer-specific survival (CSS) and overall survival (OS)...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27995127/stereotactic-laser-ablation-for-medically-intractable-epilepsy-the-next-generation-of-minimally-invasive-epilepsy-surgery
#20
REVIEW
Michael J LaRiviere, Robert E Gross
Epilepsy is a common, disabling illness that is refractory to medical treatment in approximately one-third of patients, particularly among those with mesial temporal lobe epilepsy. While standard open mesial temporal resection is effective, achieving seizure freedom in most patients, efforts to develop safer, minimally invasive techniques have been underway for over half a century. Stereotactic ablative techniques, in particular, radiofrequency (RF) ablation, were first developed in the 1960s, with refinements in the 1990s with the advent of modern computed tomography and magnetic resonance-based imaging...
2016: Frontiers in Surgery
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