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https://www.readbyqxmd.com/read/27893639/surgical-rescue-the-next-pillar-of-acute-care-surgery
#1
Matthew E Kutcher, Jason L Sperry, Matthew R Rosengart, Deepika Mohan, Marcus K Hoffman, Matthew D Neal, Louis H Alarcon, Gregory A Watson, Juan Carlos Puyana, Graciela M Bauzá, Vaishali D Schuchert, Anisleidy Fombona, Tianhua Zhou, Samuel Zolin, Robert D Becher, Timothy R Billiar, Raquel M Forsythe, Brian S Zuckerbraun, Andrew B Peitzman
BACKGROUND: The evolving field of Acute Care Surgery (ACS) traditionally includes trauma, emergency general surgery, and critical care. However, the critical role of ACS in the rescue of patients with a surgical complication has not been explored. We here describe the role of 'surgical rescue' in the practice of Acute Care Surgery (ACS). METHODS: A prospective, electronic medical record-based ACS registry spanning January 2013 to May 2014 at a large urban academic medical center was screened by ICD-9 codes for acute surgical complications of an operative or interventional procedure...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27889845/randomized-trial-comparing-self-gripping-semi-re-absorbable-mesh-progrip-with-polypropylene-mesh-in-open-inguinal-hernioplasty-the-6%C3%A2-years-result
#2
J K M Fan, J Yip, D C C Foo, O S H Lo, W L Law
OBJECTIVES: The use of absorbable polylactic acid hook self-gripping polypropylene mesh in open inguinal hernia may potentially reduce operative time and enhance patient recovery. The objective of this randomized trial is to compare the outcomes following self-gripping mesh repair to polypropylene mesh secured with sutures in open inguinal hernioplasty. METHOD: Eligible patients aged 18-80 years old, who had primary unilateral uncomplicated inguinal hernia, were randomized into either Polypropylene (PL) group or PROGRIP (PG) group just before the placement of mesh intra-operatively by computer generated code...
November 26, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27888917/aspirin-exacerbated-respiratory-disease
#3
REVIEW
Evan S Walgama, Peter H Hwang
Aspirin-exacerbated respiratory disease (AERD) is characterized by the triad of asthma, sinonasal polyposis, and aspirin intolerance. The hallmark of the disease is baseline overproduction of cysteinyl leukotrienes via the 5-lipoxygenase pathway, exacerbated by ingestion of aspirin. Patients with AERD have high rates of recidivistic polyposis following sinus surgery, although the improvement in quality of life following surgery is similar to aspirin-tolerant patients. The diagnosis is secured by a positive aspirin provocation test, usually administered by a medical allergist...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27884729/rationale-and-design-of-the-coronary-artery-calcium-consortium-a-multicenter-cohort-study
#4
Michael J Blaha, Seamus P Whelton, Mahmoud Al Rifai, Zeina A Dardari, Leslee J Shaw, Mouaz H Al-Mallah, Kuni Matsushita, John A Rumberger, Daniel S Berman, Matthew J Budoff, Michael D Miedema, Khurram Nasir
BACKGROUND: Although coronary artery calcium (CAC) has been investigated for over two decades, there is very limited data on the association of CAC with cause of death. The CAC Consortium is a large ongoing multi-center observational cohort of individuals who underwent non-contrast cardiac-gated CAC testing and systematic, prospective, long-term follow-up for mortality with ascertainment of cause of death. METHODS: Four participating institutions from three states within the US (California, Minnesota, and Ohio) have contributed individual-level patient data to the CAC Consortium (spanning years 1991-2010)...
November 11, 2016: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/27879599/total-human-eye-allotransplantation-developing-surgical-protocols-for-donor-and-recipient-procedures
#5
Edward H Davidson, Eric W Wang, Jenny Y Yu, Juan C Fernandez-Miranda, Dawn J Wang, Nikisha Richards, Maxine Miller, Joel S Schuman, Kia M Washington
BACKGROUND: Vascularized composite allotransplantation of the eye is an appealing, novel method for reconstruction of the nonfunctioning eye. The authors' group has established the first orthotopic model for eye transplantation in the rat. With advancements in immunomodulation strategies together with new therapies in neuroregeneration, parallel development of human surgical protocols is vital for ensuring momentum toward eye transplantation in actual patients. METHODS: Cadaveric donor tissue harvest (n = 8) was performed with orbital exenteration, combined open craniotomy, and endonasal approach to ligate the ophthalmic artery with a cuff of paraclival internal carotid artery, for transection of the optic nerve at the optic chiasm and transection of cranial nerves III to VI and the superior ophthalmic vein at the cavernous sinus...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27843421/facility-closure-how-to-get-in-get-out-and-get-what-is-important
#6
Pamela J Lail, Sarah S Laird, Kris McCall, Joe Naretto, April York
This article examines the current state of affairs of the health information management role in facility closure as well as the impact on revenue cycle operations. Health information management professionals are uniquely positioned to assist an organization in closure efforts because of their knowledge of revenue cycle operations, ability to work with the software products used to generate and store patient information, and solid understanding of the process of care and treatment of the patient. This information is integral to ensuring that patient information in a variety of formats and locations is properly secured and saved so that it will be available to patients and caregivers who need it after the facility closes...
2016: Perspectives in Health Information Management
https://www.readbyqxmd.com/read/27836151/violence-in-the-emergency-department
#7
REVIEW
Keith R Stowell, Nolan P Hughes, John S Rozel
Violence is common in the emergency department (ED). The ED setting has numerous environmental risk factors for violence, including poor staffing, lack of privacy, overcrowding, and ready availability of nonsecured equipment that can be used as weapons. Strategies can be taken to mitigate the risk of violence toward health care workers, including staff training, changes to the ED layout, appropriate use of security, and policy-level changes. Health care providers in the ED should be familiar with local case law and standards related to the duty to warn third parties when a violent threat is made by a patient...
December 2016: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/27833500/c-mac-%C3%A2-video-laryngoscope-with-d-blade%C3%A2-and-frova-introducer-for-awake-intubation-in-a-patient-with-parapharyngeal-mass
#8
S Vinayagam, S Dhanger, P Tilak, R Gnanasekar
Parapharyngeal tumors are rare head and neck tumors which can present as an intraoral mass and can pose great challenge to anesthesiologists. The primary concern is the difficult airway due to gross anatomical distortion of the upper airway. Securing the airway in an awake state should be the primary goal of anesthesiologists to avoid catastrophic complications. Herewith, we report the successful use of C-MAC(®) video laryngoscope with the acute-angle D-BLADE™ in combination with Frova introducer for awake intubation in a patient with parapharyngeal mass after multiple attempts of failed fiber-optic intubation...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27833492/submandibular-intubation-in-awake-patient-of-panfacial-trauma
#9
S K Kamra, H K Khandavilli, P Banerjee
Maxillofacial trauma patients present with airway problems. Submandibular intubation is an effective means of intubation to avoid tracheostomy for operative procedures. Airway is secured with oral endotracheal intubation in paralyzed patient and tube is then transplaced in sub mental or submandibular region. However there may be instances when paralyzing such trauma patients is not safe and short term tracheostomy is the only airway channel available for conduction of anesthesia. We report a case of submandibular intubation in awake patient of maxillofacial trauma with anticipated intubation problems...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27827282/primary-wound-closure-of-diabetic-foot-ulcers-by-debridement-and-stitching
#10
M E Ahmed, M S Mohammed, S I Mahadi
OBJECTIVE: The role of stitching in healing diabetic foot ulcers (DFUs) has little attention, with few reports published on the technique. This study aimed to report on the role of stitching in healing of neuropathic DFUs. METHOD: This comparative study was between patients with diabetes with neuropathic foot ulcers who had undergone wound stitching and those on conventional wound care. The study was carried in Jabir Abu Eliz Diabetic Center Khartoum (JADC) during between January 1 2011 and January 1 2013...
November 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27821113/case-report-of-whole-genome-sequencing-in-the-xy-female-identification-of-a-novel-sry-mutation-and-revision-of-a-misdiagnosis-of-androgen-insensitivity-syndrome
#11
Sunita M C De Sousa, Karin S Kassahn, Liam C McIntyre, Chan-Eng Chong, Hamish S Scott, David J Torpy
BACKGROUND: The 46,XY female is characterised by a male karyotype and female phenotype arising due to any interruption in the sexual development pathways in utero. The cause is usually genetic and various genes are implicated. CASE PRESENTATION: Herein we describe a 46,XY woman who was first diagnosed with androgen insensitivity syndrome (testicular feminisation) at 18 years; however, this was later questioned due to the presence of intact Müllerian structures...
November 8, 2016: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/27811584/get-the-picture-a-pilot-feasibility-study-of-telemedical-wound-assessment-using-a-mobile-phone-in-cardiology-patients
#12
John de Heide, C J Vroegh, T Szili Torok, R J J Gobbens, F Zijlstra, M Takens-Lameijer, M J Lenzen, S C Yap, W J M Scholte Op Reimer
BACKGROUND: Postprocedural complications after elective cardiac interventions include hematomas and infections. Telemedical wound assessment using mobile phones with integrated cameras may improve quality of care and help reduce costs. AIMS: We aimed to study the feasibility of telemedical wound assessment using a mobile phone. The primary aim was the number of patients who were able to upload their pictures. Secondary aims were image interpretability, agreement between nurse practitioners, and patient evaluation of the intervention...
November 2, 2016: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/27797797/infrarenal-aortic-clamp-reviving-a-patient-from-acute-surgical-haemorrhagic-shock-a-novel-management-technique
#13
Ranjith Kumar, M V S Satya Prakash, Subhasree Das, Ramanitharan Manikandan
Surgical management of renal cell carcinoma extending into the inferior vena cava (IVC) is almost always accompanied by massive intraoperative blood loss and associated complications. It is a widely recognised problem, and its active management is essential in improving the perioperative morbidity and mortality. We share our experience with a similar case of open radical nephrectomy with massive blood loss of twice the circulating volume in a duration of <8 surgical hours. Although we emphasise the goals of securing haemostasis, restoration of circulating volume, and efficient management by replacing blood components, in the present case, despite the above-mentioned goals being fulfilled, we were unable to extricate the patient from haemorrhagic shock by conventional means and therefore resorted to desperate measures, namely the novel approach of infrarenal aortic clamping along with higher than recommended vasopressor support...
October 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27789525/a-privacy-preserving-solution-for-compressed-storage-and-selective-retrieval-of-genomic-data
#14
Zhicong Huang, Erman Ayday, Huang Lin, Raeka S Aiyar, Adam Molyneaux, Zhenyu Xu, Jacques Fellay, Lars M Steinmetz, Jean-Pierre Hubaux
In clinical genomics, the continuous evolution of bioinformatic algorithms and sequencing platforms makes it beneficial to store patients' complete aligned genomic data in addition to variant calls relative to a reference sequence. Due to the large size of human genome sequence data files (varying from 30GB to 200GB depending on coverage), two major challenges facing genomics laboratories are the costs of storage and the efficiency of the initial data processing. In addition, privacy of genomic data is becoming an increasingly serious concern; yet no standard data storage solutions exist that enable compression, encryption, and selective retrieval...
October 27, 2016: Genome Research
https://www.readbyqxmd.com/read/27786543/assessment-of-safety-of-performing-percutaneous-coronary-intervention-after-a-recent-episode-of-gastrointestinal-bleeding
#15
Saima Karim, Sweetheart T Ador-Dionisio, Munira Karim, Mohammad Karim, Sadaf S Khan, Ashish Atreja, Stephen Ellis
BACKGROUND: Little literature exists on the risk of performing coronary intervention (PCI) on patients who have had recent gastrointestinal bleeding (GIB), although bleeding after PCI has been identified as a risk factor for long-term mortality. METHODS: Patients within the Cleveland Clinic PCI database who had acute GIB within 30 days preceding PCI during the same hospitalization (n = 79) were retrospectively compared to those who had PCI without recent GIB (n = 10 979) for mortality and need for revascularization...
October 27, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27779317/adhesives-for-fixed-orthodontic-bands
#16
REVIEW
Declan T Millett, Anne-Marie Glenny, Rye Cr Mattick, Joy Hickman, Nicky A Mandall
BACKGROUND: Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachments (brackets and bands) being attached securely to the teeth so that they do not become loose during treatment...
October 25, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27779098/effectiveness-of-proximal-intra-operative-salvage-palmaz-stent-placement-for-endoleak-during-endovascular-aneurysm-repair
#17
Y Law, Y C Chan, S Wk Cheng
INTRODUCTION: The use of a proximal Palmaz stent is a well-recognised technique to treat proximal endoleak in endovascular aortic repair. This study aimed to report the effectiveness and safety of an intra-operative Palmaz stent for immediate type 1a endoleak in Hong Kong patients. METHODS: This case series was conducted at a tertiary hospital in Hong Kong. In a cohort of 494 patients who underwent infrarenal endovascular aortic repair from July 1999 to September 2015, 12 (2...
October 24, 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27765025/staphylococcus-aureus-bacteremia-with-iliac-artery-endarteritis-in-a-patient-receiving-ustekinumab
#18
Insa Joost, Johannes Steinfurt, Philipp T Meyer, Winfried V Kern, Siegbert Rieg
BACKGROUND: Ustekinumab (Stelara®), a human monoclonal antibody targeting the p40-subunit of interleukin (IL)-12 and IL-23, is indicated for moderate to severe plaque psoriasis and psoriatic arthritis. In large multicenter, prospective trials assessing efficacy and safety of ustekinumab increased rates of severe infections have not been observed so far. CASE PRESENTATION: Here, we report the case of a 64-year old woman presenting with chills, pain and swelling of her right foot with dark maculae at the sole, and elevated inflammatory markers...
October 20, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27754803/familial-multiplicity-of-estrogen-insensitivity-associated-with-a-loss-of-function-esr1-mutation
#19
Valérie Bernard, Sakina Kherra, Bruno Francou, Jérôme Fagart, Say Viengchareun, Jérôme Guéchot, Asmahane Ladjouze, Anne Guiochon-Mantel, Kenneth S Korach, Nadine Binart, Marc Lombès, Sophie Christin-Maitre
CONTEXT: Estrogens influence many physiological processes in mammals, including reproduction. Estrogen peripheral actions are mainly mediated through estrogen receptors (ER) α and β, encoded by ESR1 and ESR2 genes, respectively. OBJECTIVE: To describe a family in which three members presented with estrogen insensitivity. DESIGN AND SETTING: Clinical evaluation, genetic and mutational analysis were performed in an academic medical center...
October 18, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27754735/acute-hormonal-findings-after-aneurysmal-subarachnoid-hemorrhage-report-from-a-single-center
#20
Riikka S K Takala, Riku Kiviranta, Klaus T Olkkola, Tero Vahlberg, Dan Laukka, Anna Kotkansalo, Melissa Rahi, Matti Sankinen, Jussi Posti, Ari Katila, Jaakko Rinne
PURPOSE: The aim was to assess anterior pituitary hormone levels during the acute phase of aneurysmal subarachnoid hemorrhage (aSAH) and analyze the possible association with the clinical condition and outcome. MATERIAL AND METHODS: Forty patients with aSAH whose aneurysm was secured by endovascular coiling were enrolled. Basal secretions of cortisol, testosterone, luteinizing hormone (LH), prolactin (PRL), and sex hormone binding globulin (SHBG) levels were measured up to 14 days after the incident...
October 18, 2016: Endocrine Research
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