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https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#1
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28642196/gdf5-significantly-augments-the-bone-formation-induced-by-an-injectable-plga-fiber-reinforced-brushite-forming-cement-in-a-sheep-defect-model-of-lumbar-osteopenia
#2
Matthias Bungartz, Elke Kunisch, Stefan Maenz, Victoria Horbert, Long Xin, Francesca Gunnella, Joerg Mika, Juliane Borowski, Sabine Bischoff, Harald Schubert, Andre Sachse, Bernhard Illerhaus, Jens Günster, Jörg Bossert, Klaus D Jandt, Frank Plöger, Raimund W Kinne, Olaf Brinkmann
BACKGROUND CONTEXT: Biodegradable calcium phosphate cement (CPC) represents a promising option for the surgical treatment of osteoporotic vertebral fractures. Due to augmented local bone catabolism, however, additional targeted delivery of bone morphogenetic proteins with the CPC may be needed to promote rapid and complete bone regeneration. PURPOSE: In the present study, an injectable, poly (l-lactide-co-glycolide) acid (PLGA)-fiber reinforced, brushite-forming cement (CPC) containing the bone morphogenetic protein GDF5 was tested in a sheep lumbar osteopenia model...
June 19, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28642091/a-see-and-treat-office-procedure-for-retained-products-of-conception-removal-after-normal-vaginal-delivery-using-manual-vacuum-aspiration-preliminary-efficacy-and-reproductive-outcomes
#3
Karavani Gilad, Bahar Raz, Herzberg Shmuel, Yanai Nili
STUDY OBJECTIVES: To compare efficacy and reproductive outcomes of an ultrasound guided manual vacuum aspiration (MVA) procedure to the widely accepted operative hysteroscopy (OH) procedure in removal of retained products of conception (RPOC) after normal vaginal delivery. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2) SETTING: University-affiliated tertiary medical center PATIENTS: Eighty-six patients after normal vaginal delivery diagnosed with RPOC from 2005 through 2015...
June 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28640149/analysis-of-risk-factors-for-intraoperative-hemorrhage-of-cesarean-scar-pregnancy
#4
Yan Ma, Minfang Shao, Xiaonan Shao
The current commonly used treatments for cesarean scar pregnancy (CSP) include multiple treatments such as medication, uterine artery embolization, curettage and surgery, and their combinations. However, every treatment option has risks of excessive hemorrhage from uterus. In this study, we retrospectively analyzed the risk factors for intraoperative hemorrhage of different treatments for CSP patients, with the hope to provide the guidance for CSP treatment.Fifty-eight cases of CSP patients who were treated with curettage after medication, curettage after uterine artery embolization, or surgery were retrospectively analyzed and compared for the clinical efficacy, length of hospital stay, and hemorrhage rate...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28640029/enacting-pedagogy-in-curricula-on-the-vital-role-of-governance-in-medical-education
#5
Oscar Casiro, Glenn Regehr
Managing curricula and curricular change involves both a complex set of decisions and effective enactment of those decisions. The means by which decisions are made, implemented, and monitored constitute the governance of a program. Thus, effective academic governance is critical to effective curriculum delivery. Medical educators and medical education researchers have been invested heavily in issues of educational content, pedagogy, and design. However, relatively little consideration has been paid to the governance processes that ensure fidelity of implementation and ongoing refinements that will bring curricular practices increasingly in line with the pedagogical intent...
June 20, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28639717/a-prospective-study-on-transvaginal-ultrasound-of-cervical-length-cl-in-the-first-and-second-trimester-in-a-low-risk-population
#6
C B Wulff, L Rode, S Rosthøj, E Hoseth, O B Petersen, A Tabor
OBJECTIVES: To assess cervical length (CL) longitudinally in the first and second trimester and to determine the proportion of women with a short CL. Further, to assess if women with a short CL at 19-24 weeks could be identified at the combined first-trimester screening (cFTS) at 11-14 weeks in relation to a potential implementation of CL screening in the Danish population. METHODS: We recruited singleton pregnant women attending the combined first-trimester screening from 1 November 2013 to 1 December 2014 to a longitudinal prospective study at three University Hospitals in Denmark...
June 22, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28639052/gentamicin-loaded-polysaccharide-membranes-for-prevention-and-treatment-of-post-operative-wound-infections-in-the-skeletal-system
#7
Urszula Cibor, Małgorzata Krok-Borkowicz, Monika Brzychczy-Włoch, Łucja Rumian, Krzysztof Pietryga, Dominika Kulig, Wojciech Chrzanowski, Elżbieta Pamuła
PURPOSE: To develop polysaccharide-based membranes that allow controlled and localized delivery of gentamicin for the treatment of post-operative bone infections. METHODS: Membranes made of gellan gum (GUM), sodium alginate (ALG), GUM and ALG crosslinked with calcium ions (GUM + Ca and ALG + Ca, respectively) as well as reference collagen (COL) were produced by freeze-drying. Mechanical properties, drug release, antimicrobial activity and cytocompatibility of the membranes were assessed...
June 21, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28638156/goal-directed-perfusion-methodology-for-determining-oxygenator-performance-during-clinical-cardiopulmonary-bypass
#8
Alfred H Stammers, Randi Miller, Stephen G Francis, Laszlo Fuzesi, Anthony Nostro, Eric Tesdahl
New generation oxygenators incorporate arterial line filtration either sequential to, or directly in, the gas exchange module. This unique design may affect gas exchange performance by altering the operational characteristics of the device. The present study was designed to evaluate three oxygenators in a clinical setting using a goal-directed perfusion algorithm during cardiopulmonary bypass (CPB). After institutional review board approval, 60 adult patients undergoing cardiac surgery for acquired heart disease were matched for disease state and body size into three groups based on oxygenator type: Terumo SX18(™) (n = 20), Terumo FX15(™) (n = 20), and LivaNova Inspire6F(™) 6 Dual (n = 20)...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28637910/excellent-diagnostic-characteristics-for-ultra-fast-gene-profiling-of-defa1-il1b-ltf-in-the-detection-of-prosthetic-joint-infections
#9
Regina Fillerova, Jiri Gallo, Martin Radvansky, Veronika Kraiczova, Milos Kudelka, Eva Kriegova
The timely and exact diagnosis of prosthetic joint infection (PJI) is crucial for surgical decision-making. Intra-operatively, delivery of the result within an hour is required. Alpha-defensin lateral immunoassay of joint fluid (JF) is precise in the intra-operative exclusion of PJI, however in patients with a limited amount of JF and/or when the JF is bloody this test is unhelpful. Important information is hidden in the periprosthetic tissues that could much better reflect the current status of implant pathology...
June 21, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28637791/store-operated-calcium-entry-suppressed-tgf%C3%AE-1-smad3-signaling-pathway-in-glomerular-mesangial-cells
#10
Sarika Chaudhari, Weizu Li, Yanxia Wang, Hui Jiang, Yuhong Ma, Mark E Davis, Jonathan E Zuckerman, Rong Ma
Our previous study demonstrated that the abundance of extracellular matrix proteins was suppressed by store-operated Ca2+ entry in mesangial cells (MCs). The present study was conducted to investigate the underlying mechanism focused on the transforming growth factor beta 1 (TGFβ1) - Smad3 pathway, a critical pathway for ECM expansion in diabetic kidneys. We hypothesized that SOCE suppressed ECM protein expression by inhibiting this pathway in MCs. In cultured human MCs, we observed that TGFβ1 (5 ng/ml for 15 hours) significantly increased Smad3 phosphorylation as evaluated by immunoblot...
June 21, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28635575/-high-risk-obstetrics-in-tertiary-centres-anaesthetist-hybrid-operating-suite-and-obstetric-critical-care-unit
#11
C D van der Marel, A J Eggink, R J Stolker
The frequency of pregnancy-related morbidity has increased over recent decades, as has the number of patients with complex congenital cardiac anomalies reaching fertile age, resulting in an increasing number of high-risk pregnancies. In order to optimalise maternal and foetal outcome in these patients, not only is the availability of optimal in-hospital facilities (e.g. obstetric critical care unit, hybrid operating suite) important, but also a multidisciplinary approach which is mandatory for successful maternal and foetal outcome...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28635352/a-randomized-controlled-trial-comparing-two-types-of-retractors-at-caesarean-delivery
#12
Abbey J Hardy-Fairbanks, Todd Mackenzie, Martin McCarthy, Marlene B Goldman, Michele R Lauria
The aim of this study was to determine if the use of a self-retaining, symmetrical retractor (OB/Mobius(®)) during caesarean delivery is associated with differences in post-operative pain experience. Consenting women undergoing caesarean delivery were randomly assigned to OB/Mobius(®) versus conventional retraction instruments. Women were blinded to retractor type and filled out surgical pain surveys each post-operative day. Additional outcome variables were collected through a provider survey and chart review...
June 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28634014/chemotherapy-for-resected-colorectal-cancer-pulmonary-metastases-utilization-and-outcomes-in-routine-clinical-practice
#13
S Karim, S Nanji, K Brennan, C S Pramesh, C M Booth
BACKGROUND: The role of chemotherapy in the setting of resected colorectal cancer pulmonary metastases (CRCPM) is not well defined. Here we describe utilization of peri-operative chemotherapy and outcomes among patients with resected CRCPM in the general population. METHODS: All cases of CRCPM who underwent resection from 2002 to 2009 were identified using the Ontario Cancer Registry (OCR). Electronic treatment records identified peri-operative chemotherapy delivered within 16 weeks before or after pulmonary metastasectomy (PM)...
June 1, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28633064/an-innovative-approach-to-bioremediation-of-mercury-contaminated-soils-from-industrial-mining-operations
#14
Damien McCarthy, Grant C Edwards, Mae S Gustin, Andrew Care, Matthieu B Miller, Anwar Sunna
Soils contaminated with mercury (Hg) have proved expensive and logistically difficult to remediate. Research continues into finding suitable environmentally-friendly and efficient ways of achieving this end. Bioremediation is an option, which employs the strategies microorganisms have evolved to deal with Hg. One microbial strategy involves uptake and intracellular volatilisation of mercuric ions, which passively diffuse from the cell and back into the atmosphere. In this work, Pseudomonas veronii cells grown to stationary phase were immobilised in a xanthan gum-based biopolymer via encapsulation...
June 14, 2017: Chemosphere
https://www.readbyqxmd.com/read/28632535/perioperative-surgical-home-evaluation-of-a-new-protocol-focused-on-a-multidisciplinary-approach-to-manage-children-undergoing-posterior-spinal-fusion-operation
#15
Eugene Kim, Brian Lee, Giovanni Cucchiaro
BACKGROUND: The concept of Perioperative Surgical Home has been gaining significant attention in surgical centers. This model is delivering and improving coordinated care in a cost-effective manner to patients undergoing surgical procedures. It starts with the decision for surgical intervention, continues to the intraoperative and postoperative periods, and follows into long-term recovery. Constant re-evaluation of outcomes and modifications of delivery provides a feedback loop for improvement...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28629568/repeatability-of-estimated-fetal-weight-comparison-between-mr-imaging-versus-2d-ultrasound-in-at-and-near-term-patients
#16
Caroline Kadji, Margaux F Camus, Elisa Bevilacqua, Mieke M Cannie, Teresa Cos Sanchez, Jacques C Jani
INTRODUCTION: Our aim was to evaluate the intra- and inter-observer variability and the impact of operator experience on the estimation of fetal weight (EFW) as measured by 2-dimensional ultrasound (2D-US) and magnetic resonance (MR) imaging. MATERIAL AND METHODS: We estimated fetal weight in 46 singleton pregnancies at 35.6-41.4 weeks gestation using 2D-US according to the Hadlock formula and using MR imaging according to the equation developed by Baker. Each examination was performed twice, once by an inexperienced operator and once by an experienced operator...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28629437/evaluation-of-a-low-cost-low-power-syringe-pump-to-deliver-magnesium-sulfate-intravenously-to-pre-eclamptic-women-in-a-malawian-referral-hospital
#17
Erica Skerrett, Edward Kommwa, Kelley Maynard, Alexa Juarez, Ronald Mataya, Rebecca Richards-Kortum, Z Maria Oden
BACKGROUND: Magnesium sulfate is an affordable and effective treatment for pre-eclampsia and eclampsia. In settings where infusion pumps are not available to regulate the flow rate of intravenous delivery, healthcare providers must administer magnesium sulfate (MgSO4) via time-consuming and painful, large-volume intramuscular injections. As an alternative to costly commercially available syringe pumps, we developed AutoSyp, an accurate, low-cost, and low-powered syringe pump designed to meet the needs and constraints these low-resource settings...
June 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28629245/obstetric-risk-factors-for-poor-neonatal-adaptation-at-birth
#18
Francesca Crovetto, Monica Fumagalli, Agnese De Carli, Giulia Maria Baffero, Silvia Nozza, Francesca Dessimone, Patrizia Vergani, Luigi Fedele, Fabio Mosca, Barbara Acaia
PURPOSE: To identify obstetric risk factors of delivering a neonate with poor neonatal adaptation at birth. MATERIAL AND METHODS: Nested-case control study. Poor neonatal adaptation was defined for presence of at least: umbilical cord artery pH < 7.10, base deficit ≥ 12 mmol/L, Apgar score at 1' ≤ 5. Controls were selected from the same population and matched with cases. The association between clinical parameters and poor neonatal adaptation was analyzed by logistic regression...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28628714/advanced-real-time-multi-display-educational-system-armes-an-innovative-real-time-audiovisual-mentoring-tool-for-complex-robotic-surgery
#19
Joong Ho Lee, Eiji Tanaka, Yanghee Woo, Güner Ali, Taeil Son, Hyoung-Il Kim, Woo Jin Hyung
INTRODUCTION: The recent scientific and technologic advances have profoundly affected the training of surgeons worldwide. We describe a novel intraoperative real-time training module, the Advanced Robotic Multi-display Educational System (ARMES). METHODS: We created a real-time training module, which can provide a standardized step by step guidance to robotic distal subtotal gastrectomy with D2 lymphadenectomy procedures, ARMES. The short video clips of 20 key steps in the standardized procedure for robotic gastrectomy were created and integrated with TilePro™ software to delivery on da Vinci Surgical Systems (Intuitive Surgical, Sunnyvale, CA)...
June 19, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28626262/a-case-of-anterior-communicating-artery-aneurysm-successfully-treated-after-a-stent-migration-during-stent-assisted-endovascular-coil-embolization
#20
Tomotaka Ohshima, Andrey Belayev, Shunsaku Goto, Taiki Yamamoto, Kojiro Ishikawa, Yoko Kato
Stent migration is a complication associated with endovascular coil embolization of intracranial aneurysms. We report a case of anterior communicating artery (ACoA) aneurysm that was successfully treated after stent migration during endovascular coil embolization without retrieval of the stent. A 47-year-old man presented with sudden onset severe headache. Patient was noted to have subarachnoid hemorrhage from a ruptured ACoA aneurysm. Emergency endovascular coil embolization was performed. The second coil embolization was scheduled for the neck-remnant portion with a stent after 16 days from the initial operation...
February 2017: Nagoya Journal of Medical Science
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