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Presurgical guidelines

Johanna Olson-Kennedy, Jonathan Warus, Vivian Okonta, Marvin Belzer, Leslie F Clark
Importance: Transmasculine youth, who are assigned female at birth but have a gender identity along the masculine spectrum, often report considerable distress after breast development (chest dysphoria). Professional guidelines lack clarity regarding referring minors (defined as people younger than 18 years) for chest surgery because there are no data documenting the effect of chest surgery on minors. Objective: To examine the amount of chest dysphoria in transmasculine youth who had had chest reconstruction surgery compared with those who had not undergone this surgery...
March 5, 2018: JAMA Pediatrics
Robert B Schonberger, Adambeke Nwozuzu, Jill Zafar, Eric Chen, Simon Kigwana, Miriam M Monteiro, Jean Charchaflieh, Sophisa Sophanphattana, Feng Dai, Matthew M Burg
Blood pressure (BP) measurement during the presurgical assessment has been suggested as a way to improve longitudinal detection and treatment of hypertension. The relationship between BP measured during this assessment and home blood pressure (HBP), a better indicator of hypertension, is unknown. The purpose of the present study was to determine the positive predictive value of presurgical BP for predicting elevated HBP. We prospectively enrolled 200 patients at a presurgical evaluation clinic with clinic blood pressures (CBPs) ≥130/85 mm Hg, as measured using a previously validated automated upper-arm device (Welch Allyn Vital Sign Monitor 6000 Series), to undergo daily HBP monitoring (Omron Model BP742N) between the index clinic visit and their day of surgery...
February 6, 2018: Journal of the American Society of Hypertension: JASH
Jason A Beyea, Emily Rosen, Trina Stephens, Paul Nguyen, Stephen F Hall
Objective Tympanostomy tube (TT) insertion is the most common ambulatory surgery performed on children. American Academy of Otolaryngology-Head and Neck Surgery Founda-tion (AAO-HNSF) Clinical Practice Guidelines (CPGs) recommend hearing testing for all pediatric TT candidates. The aim of this study was to assess audiometric testing in this population. Study Design Retrospective population-based cohort study. Setting All hospitals in the Canadian province of Ontario. Subjects and Methods All patients 12 years of age and younger who underwent at least 1 TT procedure between January 1993 and June 2016...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Aliya Qayyum, Eric P Tamm, Ihab R Kamel, Peter J Allen, Hina Arif-Tiwari, Victoria Chernyak, Tamas A Gonda, Joseph R Grajo, Nicole M Hindman, Jeanne M Horowitz, Harmeet Kaur, Michelle M McNamara, Richard B Noto, Pavan K Srivastava, Tasneem Lalani
Pancreatic adenocarcinoma is associated with poor overall prognosis. Complete surgical resection is the only possible option for cure. As such, increasingly complex surgical techniques including sophisticated vascular reconstruction are being used. Continued advances in surgical techniques, in conjunction with use of combination systemic therapies, and radiation therapy have been suggested to improve outcomes. A key aspect to surgical success is reporting of pivotal findings beyond absence of distant metastases, such as tumor size, location, and degree of tumor involvement of specific vessels associated with potential perineural tumor spread...
November 2017: Journal of the American College of Radiology: JACR
Giovanni Pellegrino, Tanguy Hedrich, Rasheda Arman Chowdhury, Jeffery A Hall, Francois Dubeau, Jean-Marc Lina, Eliane Kobayashi, Christophe Grova
OBJECTIVE: Source localization of interictal epileptic discharges (IEDs) is clinically useful in the presurgical workup of epilepsy patients. It is usually obtained by equivalent current dipole (ECD) which localizes a point source and is the only inverse solution approved by clinical guidelines. In contrast, magnetic source imaging using distributed methods (dMSI) provides maps of the location and the extent of the generators, but its yield has not been clinically validated. We systematically compared ECD versus dMSI performed using coherent Maximum Entropy on the Mean (cMEM), a method sensitive to the spatial extent of the generators...
January 2018: Human Brain Mapping
Ahmet Bindayi, Zachary A Hamilton, Michelle L McDonald, Kendrick Yim, Frederick Millard, Rana R McKay, Steven C Campbell, Brian I Rini, Ithaar H Derweesh
Neoadjuvant Targeted Molecular Therapy in the setting of localized and locally advanced renal cell carcinoma has emerged as a strategy to render primary renal tumors amenable to planned surgical resection in settings where radical resection or nephron-sparing surgery was not thought to be safe or feasible. Presurgical tumor reduction has been demonstrated in a number of studies including a recently published randomized double-blind placebo-controlled study, and an expanding body of literature suggests benefit in select patients...
January 2018: Urologic Oncology
Trichy N Janakiram, Shilpee B Sharma, Ekkehard Kasper, Onkar Deshmukh, Iype Cherian
BACKGROUND: Juvenile nasal angiofibromas (JNA) is a benign lesion with high vascularity and propensity of bone erosion leading to skull base invasion and intracranial extension. It is known to involve multiple compartments, which are often surgically difficult to access. With evolution in surgical expertise and technical innovations, endoscopic and endoscopic-assisted management has become the preferred choice of surgical management. Over the last four decades, various staging systems have been proposed, which are largely based on the extent of nasal angiofibroma...
2017: Surgical Neurology International
Kyung-A Kim, Ji-Won Lee, Jeong-Ho Park, Byoung-Ho Kim, Hyo-Won Ahn, Su-Jung Kim
Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately...
May 2017: Korean Journal of Orthodontics
Harmeet Kaur, Nicole M Hindman, Waddah B Al-Refaie, Hina Arif-Tiwari, Brooks D Cash, Victoria Chernyak, James Farrell, Joseph R Grajo, Jeanne M Horowitz, Michelle M McNamara, Richard B Noto, Aliya Qayyum, Tasneem Lalani, Ihab R Kamel
Liver metastases are the most common malignant liver tumors. The accurate and early detection and characterization of liver lesions is the key to successful treatment strategies. Increasingly, surgical resection in combination with chemotherapy is effective in significantly improving survival if all metastases are successfully resected. MRI and multiphase CT are the primary imaging modalities in the assessment of liver metastasis, with the relative preference toward multiphase CT or MRI depending upon the clinical setting (ie, surveillance or presurgical planning)...
May 2017: Journal of the American College of Radiology: JACR
Siddharth Singh, Andrew J Muir, Douglas T Dieterich, Yngve T Falck-Ytter
Chronic liver diseases (CLDs), due to chronic hepatitis C; hepatitis B; nonalcoholic fatty liver diseases (NAFLD); and alcoholic liver disease, are a leading cause of morbidity and mortality globally. Early identification of patients with cirrhosis at high risk of progression to liver-related complications may facilitate timely care and improve outcomes. With risks and misclassification associated with invasive tests, such as liver biopsy, noninvasive imaging modalities for liver fibrosis assessment have gained popularity...
May 2017: Gastroenterology
Essam Ahmed Al-Moraissi, Larry M Wolford, Daniel Perez, Daniel M Laskin, Edward Ellis
PURPOSE: There is still controversy about whether orthognathic surgery negatively or positively affects temporomandibular disorders (TMDs). The purpose of this study was to determine whether orthognathic surgery has a beneficial or deleterious effect on pre-existing TMDs. MATERIALS AND METHODS: A systematic review and meta-analysis were conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched 3 major databases to locate all pertinent articles published from 1980 to March 2016...
September 2017: Journal of Oral and Maxillofacial Surgery
Magdalena Oledzka, Maureen Suhr
PURPOSE: To present 2 cases with severe congenital muscular torticollis and describe postsurgical physical therapy management. DESCRIPTION: Two children diagnosed with severe congenital muscular torticollis underwent surgical release of the involved sternocleidomastoid muscle with subsequent physical therapy. Presurgical examination findings, surgical technique, and postsurgical rehabilitation guidelines are described. RESULTS: Both cases achieved full range of motion and symmetrical muscle strength...
April 2017: Pediatric Physical Therapy
Vejay N Vakharia, Rachel Sparks, Aidan G O'Keeffe, Roman Rodionov, Anna Miserocchi, Andrew McEvoy, Sebastien Ourselin, John Duncan
OBJECTIVE: Stereoencephalography (SEEG) is a procedure in which electrodes are inserted into the brain to help define the epileptogenic zone. This is performed prior to definitive epilepsy surgery in patients with drug-resistant focal epilepsy when noninvasive data are inconclusive. The main risk of the procedure is hemorrhage, which occurs in 1-2% of patients. This may result from inaccurate electrode placement or a planned electrode damaging a blood vessel that was not detected on the preoperative vascular imaging...
June 2017: Epilepsia
Laura Garcia-Nuño, Carlos Villamil, Araceli González-Cuevas, David Martí, Silvia Capilla, Maria José Vives, Xavier Oncins, Pere Torner, Juan Castellanos, Lluís Font-Vizcarra
INTRODUCTION: While preoperative urinary tract infection (UTI) has the potential to cause bacteremia and postsurgical acute prosthetic joint infections (APJIs), the influence of asymptomatic bacteriuria (AB) in these infections remains unclear. So the majority of guidelines not recommend the treatment of AB prior to the surgery. However, as patients with dementia usually cannot explain the symptoms of dysuria, the differential diagnosis between AB and UTI may be very difficult in this group of patients...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
Jerzy P Szaflarski, David Gloss, Jeffrey R Binder, William D Gaillard, Alexandra J Golby, Scott K Holland, Jeffrey Ojemann, David C Spencer, Sara J Swanson, Jacqueline A French, William H Theodore
OBJECTIVE: To assess the diagnostic accuracy and prognostic value of functional MRI (fMRI) in determining lateralization and predicting postsurgical language and memory outcomes. METHODS: An 11-member panel evaluated and rated available evidence according to the 2004 American Academy of Neurology process. At least 2 panelists reviewed the full text of 172 articles and selected 37 for data extraction. Case reports, reports with <15 cases, meta-analyses, and editorials were excluded...
January 24, 2017: Neurology
Juan C Bulacio, Patrick Chauvel, Aileen McGonigal
Intracranial EEG has been in use for more than 50 years in the presurgical evaluation of patients with medically intractable focal epilepsy. The stereoelectroencephalography (SEEG) method has expanded very significantly over the last 5 years, in parallel with the increase in the number of complex cases (i.e., MRI-negative) being referred with medically intractable focal epilepsy to major epilepsy surgery centers. Some centers with extensive experience in subdural electrodes are indeed changing or have changed to SEEG as the principal exploration technique, which suggests that SEEG might offer specific benefits through its approach to accurately localizing the epileptogenic zone...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Carol M Costello
BACKGROUND: The American Society of Anesthesiology (ASA) guidelines for pediatric preoperative fasting have been a standard for well over a decade. However, use of protocols involving an excessive fasting duration exposes patients to the physiological impacts of fluid volume loss. OBJECTIVES: The current project aimed to improve fluid supplementation during presurgical fasting in pediatric patients at an academic medical center. Specific objectives were to increase clinical staff knowledge regarding ASA fasting standards and implement them in specific pediatric patient populations...
October 2016: JBI Database of Systematic Reviews and Implementation Reports
Steinbjørn Hansen
AIM OF DATABASE: The Danish Neuro-Oncology Registry (DNOR) was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. STUDY POPULATION: DNOR has registered clinical data on diagnostics and treatment of all adult patients diagnosed with glioma since January 1, 2009, which numbers approximately 400 patients each year...
2016: Clinical Epidemiology
Narayan H Gandedkar, Chai Kiat Chng, Vincent Kok Leng Yeow
Thorough planning and execution is the key for successful treatment of dentofacial deformity involving surgical orthodontics. Presurgical planning (paper surgery and model surgery) are the most essential prerequisites of orthognathic surgery, and orthodontist is the one who carries out this procedure by evaluating diagnostic aids such as crucial clinical findings and radiographic assessments. However, literature pertaining to step-by-step orthognathic surgical guidelines is limited. Hence, this article makes an attempt to provide an insight and nuances involved in the planning and execution...
July 2016: Contemporary Clinical Dentistry
Guillaume Leblond, Luis Gaitero, Noel M Moens, Alex Zur Linden, Fiona M K James, Gabrielle Monteith, John Runciman
BACKGROUND: Canine ventral atlantoaxial (AA) stabilization is most commonly performed in very small dogs and is technically challenging due to extremely narrow bone corridors. Multiple implantation sites have been suggested but detailed anatomical studies investigating these sites are lacking and therefore current surgical guidelines are based upon approximate anatomical landmarks. In order to study AA optimal safe implantation corridors (OSICs), we developed a method based on computed tomography (CT) and semi-automated three-dimensional (3D) mathematical modelling using OsiriX™ and Microsoft®Excel software...
September 6, 2016: BMC Veterinary Research
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