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https://www.readbyqxmd.com/read/28076634/immediate-versus-delayed-treatment-for-recently-symptomatic-carotid-artery-stenosis
#1
Vladimir Vasconcelos, Nicolle Cassola, Edina Mariko Koga da Silva, José Carlos Costa Baptista-Silva
BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days) compared with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28057589/microsurgical-clipping-of-unruptured-intracranial-aneurysms-a-single-surgeon-s-experience-over-sixteen-years
#2
Anil Nanda, Devi Prasad Patra, Shyamal C Bir, Tanmoy K Maiti, Piyush Kalakoti, Papireddy Bollam
INTRODUCTION: Unruptured intracranial aneurysms (UIA) have become an issue of greater significance as their detection rates have increased over the years. We present the overall experience of microsurgical clipping of unruptured aneurysms by a single surgeon over a period of more than 16 years. METHODS: The clinical and radiological data were retrospectively reviewed. Clinical outcome at follow-up was assessed by Glasgow Outcome Scale (GOS), and angiograms were reviewed for the degree of occlusion...
January 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28043841/non-opioid-pain-management-in-benign-minimally-invasive-hysterectomy-a-systematic-review
#3
REVIEW
Emily Blanton, Georgine Lamvu, Insiyyah Patanwala, Kenneth I Barron, Kathryn Witzeman, Frank F Tu, Sawsan As-Sanie
BACKGROUND: Less postoperative pain is typically associated with a minimally invasive hysterectomy compared to a laparotomy approach but poor pain control can still be an issues. Multiple guidelines exist for managing postoperative pain yet most are not specialty-specific and are based on procedures bearing little relevance to a minimally invasive hysterectomy. OBJECTIVE: To determine if there is enough quality evidence within the benign gynecology literature to make non-opioid pain control recommendations for women undergoing a benign minimally invasive hysterectomy...
December 30, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28038759/-medication-errors-in-anesthesia-unacceptable-or-unavoidable
#4
Ira Dhawan, Anurag Tewari, Sankalp Sehgal, Ashish Chandra Sinha
Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated...
December 27, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28034981/a-preliminary-examination-of-the-comparative-efficacy-of-intravenous-vs-oral-acetaminophen-in-the-treatment-of-perioperative-pain
#5
Anthony Plunkett, Chelsey Haley, Amy McCoart, Thomas Beltran, Krista Beth Highland, Cristobal Berry-Caban, Sherry Lamberth, Michael Bartoszek
: OBJECTIVE : The management of postoperative pain is a major health care issue. While the cost of intravenous acetaminophen (IVA) is significantly greater than its oral acetaminophen (OA) counterpart, less is known regarding comparative effectiveness of these routes. The purpose of this study was to determine whether perioperative IVA is equivalent in reducing postoperative pain compared with perioperative OA for laparoscopic cholecystectomy (LapChole). DESIGN:  Double-blinded, prospective, randomized placebo-controlled trial...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28034404/improving-staff-knowledge-of-perioperative-regulated-waste-management
#6
Kristen Perrego
The mismanagement of regulated waste is a costly issue for many health care facilities. Our facility undertook a quality improvement project to determine whether increasing staff members' knowledge of regulated-waste management would reduce its mismanagement in the surgical setting. I designed a mandatory online learning module for all perioperative staff members and obtained consent from participants to use their test scores. I also designed pre- and posteducation audits to identify the total mass of regulated waste produced in the department and to categorize which items were nonregulated according to facility standards...
January 2017: AORN Journal
https://www.readbyqxmd.com/read/28034399/promoting-civility-in-the-or-an-ethical-imperative
#7
Cynthia M Clark, Diane Kenski
Recognizing, addressing, and preventing incivility in the health care environment, including the perioperative area, requires an intentional and informed approach to foster healthy workplaces and protect patient safety. Several important foundational documents and position statements speak directly to the nurse's responsibility to protect patient, coworker, and personal safety and promote civility and respect. In the complex, fast-paced environment of the OR, the pressure to meet patient needs, performance outcomes, and patient safety standards can lead to conflict and incivility...
January 2017: AORN Journal
https://www.readbyqxmd.com/read/28032221/can-laparoscopic-liver-resection-provide-a-favorable-option-for-patients-with-large-or-multiple-intrahepatic-cholangiocarcinomas
#8
Fangqiang Wei, Chen Lu, Liuxin Cai, Hong Yu, Xiao Liang, Xiujun Cai
BACKGROUND: The role of laparoscopic liver resection (LLR) for large or multiple intrahepatic cholangiocarcinomas (ICCs) remains equivocal. The main concerns are potential risks of inadequate resection margin, tumor rupture, uncontrollable bleeding, tumor seeding, and inadequate lymph node sampling. In this study, we aimed to determine the safety, feasibility, and oncological efficacy of LLR for large (≥5 cm) or multiple (≥2) ICCs. METHODS: Among 50 patients receiving liver resection for ICC between May 2004 and January 2016, 12 patients who had undergone LLR for large or multiple ICCs (Group A, n = 12) were compared with 18 patients who had undergone LLR for small solitary ICCs (Group B, n = 18), as well were compared with 20 patients who had undergone open liver resection for large or multiple ICCs (Group C, n = 20)...
December 28, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28028671/anesthesia-considerations-for-patients-with-an-implanted-deep-brain-stimulator-undergoing-surgery-a-review-and-update
#9
Tze Yeng Yeoh, Pirjo Manninen, Suneil K Kalia, Lashmi Venkatraghavan
PURPOSE: Deep brain stimulation (DBS) can be an effective treatment option for patients with essential tremor and Parkinson's disease. This review provides an overview on the functioning of neurostimulators and recent advances in this technology and presents an updated guide on the anesthetic management of patients with an implanted neurostimulator undergoing surgery or medical intervention. SOURCE: A search was conducted on MEDLINE®, EMBASE™, and Cochrane Database of Systematic Reviews databases to identify studies published in English from 1974 to December 2015...
December 27, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28012519/surgical-scheduling-categorization-system-sscs-a-novel-classification-system-to-improve-coordination-and-scheduling-of-operative-cases-in-a-tertiary-pediatric-medical-system
#10
Eric A Gantwerker, Cassandra Bannos, Michael J Cunningham, Reza Rahbar
OBJECTIVE: To describe a surgical categorization system to create a universal nomenclature, delineating patient complexity as a first step toward developing a true risk stratification system. METHODS: Retrospective database review of all otolaryngology surgical procedures performed in a tertiary pediatric hospital system over one academic year (July 2012-June 2013). All otolaryngology surgical procedures were reviewed, encompassing 8478 procedures on 5711 patients...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28012329/total-hip-arthroplasty-for-femoral-neck-fracture-with-pyoderma-gangrenosum-patient-a-case-report
#11
Guo Rong She, Jun Yuan Chen, Zi Qi Zhou, Zhen Gang Zha, Ning Liu
INTRODUCTION: Pyoderma gangrenosum is a rare inflammatory aseptic, ulcerative neutrophilic dermatosis which manifest as skin recurrent, painful ulcers. PRESENTATION OF CASE: A 65-year-old man with pyoderma gangrenosum underwent left total hip arthroplasty because of femoral neck fractures. Glucocorticoid, antibiotic, anticoagulant drug, etc. were given in perioperative period. Complication of pyoderma gangrenosum was prevented successfully in perioperative period...
December 9, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28011323/intensive-care-unit-monitoring-after-pharyngeal-flap-surgery-is-it-necessary
#12
Sashank Reddy, Srinivas Susarla, Nance Yuan, Gurjot Walia, Danielle Rochlin, Richard Redett
PURPOSE: To assess the incidence of perioperative complications and the utility of intensive care monitoring in patients undergoing posterior pharyngeal flap surgery for velopharyngeal dysfunction (VPD). MATERIALS AND METHODS: This study was a retrospective evaluation of patients who underwent posterior pharyngeal flap surgery for treatment of VPD and an assessment of the incidence of perioperative complications. Descriptive statistics were computed. RESULTS: Over an 18-year period, 145 patients underwent pharyngeal flap surgery for VPD; 133 (91...
December 1, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28009427/first-italian-consensus-conference-on-vats-lobectomy-for-nsclc
#13
Mario Nosotti, Andrea Droghetti, Luca Luzzi, Piergiorgio Solli, Roberto Crisci
PURPOSE: Video-assisted thoracoscopic surgery (VATS) lobectomy has become an accepted procedure for the treatment of selected cases of lung cancer. The aim of this project was to establish national practical recommendations for the management of patients suitable for VATS lobectomy. METHODS: The Scientific Committee of the VATS Lobectomy Group (a branch of the Italian Society of Thoracic Surgery) identified the consensus conference as an appropriate tool for a national debate...
December 19, 2016: Tumori
https://www.readbyqxmd.com/read/28004898/tips-and-tricks-in-vascular-access-for-t-evar
#14
Beatrice Fiorucci, Nikolaos Tsilimparis, Fiona Rohlffs, Franziska Heidemann, Sebastian E Debus, Tilo Kölbel
Endovascular repair has become the treatment of choice for thoracic and abdominal aortic pathologies in the last decades, and is associated with excellent results in terms of perioperative, mid- and long-term morbidity and mortality. Access vessels play a central role in these procedures since access-related issues can increase the rates of technical failures and determine clinical complications for the patient. Therefore, accurate preoperative clinical evaluation and review of the preoperative images are mandatory...
December 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28000135/robotic-total-mesorectal-excision-for-rectal-cancer-a-series-of-392-cases-and-mid-term-outcomes-from-a-single-center-in-china
#15
Bo Tang, Chao Zhang, Chuan Li, Jun Chen, Huaxing Luo, Dongzhu Zeng, Peiwu Yu
BACKGROUND: Robotic total mesorectal excision (RTME) for rectal cancer has recently been increasingly used; technical feasibility and short-term outcomes have been reported in detail. Few studies have presented clinical efficacy and mid-term outcomes for a large sample size. The aim of this study is to present oncologic efficacy and mid-term outcomes of robotic total mesorectal excision for rectal cancer and to provide our experiences regarding these surgically challenging issues. METHODS: Three hundred ninety-two patients received RTME between March 2010 and June 2015...
December 20, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27993376/unplanned-readmission-after-lung-resection-complete-follow-up-in-a-1-year-cohort-with-identification-of-associated-risk-factors
#16
Karen J Dickinson, James B Taswell, Mark S Allen, Shanda H Blackmon, Francis C Nichols, Robert Shen, Dennis A Wigle, Stephen D Cassivi
BACKGROUND: Unplanned readmissions are adverse clinical events that negatively impact patients and affect the use of health care resources. Identifying risk factors that can predict readmissions might permit individualized patient management. We compiled a complete account of readmissions after all lung resections over a year to identify potentially modifiable risk factors. METHODS: All patients undergoing elective lung resection between August 1, 2013 and July 31, 2014 were contacted directly to determine whether they had been readmitted to any institution within 30 days of discharge from our service...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27991023/-heart-transplantation-and-long-term-lvad-support-cost-effectiveness-model
#17
Ilona Szentmihályi, János Imre Barabás, Ágnes Bali, Gábor Kapus, Csilla Tamás, Balázs Sax, Endre Németh, Miklós Pólos, László Daróczi, Andrea Kőszegi, Chun Cao, Kálmán Benke, Péter Barnabás Kovács, Levente Fazekas, Zoltán Szabolcs, Béla Merkely, István Hartyánszky
Heart transplantation is a high priority project at Semmelweis University. In accordance with this, the funding of heart transplantation and mechanical circulatory support also constitutes an important issue. In this report, the authors discuss the creation of a framework with the purpose of comparing the cost-effectiveness of heart transplantation and artificial heart implantation. Our created framework includes the calculation of cost, using the direct allocation method, calculating the incremental cost-effectiveness ratio and creating a cost-effectiveness plane...
December 2016: Magyar Sebészet
https://www.readbyqxmd.com/read/27965838/immediate-tumor-resection-in-patients-with-locally-advanced-gastroesophageal-adenocarcinoma-with-nonresponse-to-chemotherapy-after-4%C3%A2-weeks-of-treatment-versus-resection-after-completion-of-chemotherapy-optitreat-trial-drks00004668-study-protocol-for-a-randomized
#18
Susanne Blank, Phillip Knebel, Georg-Martin Haag, Thomas Bruckner, Ulla Klaiber, Maria Burian, Anja Schaible, Leila Sisic, Thomas Schmidt, Markus K Diener, Katja Ott
BACKGROUND: Neoadjuvant chemotherapy is a standard of care for patients with adenocarcinoma of the esophagus and stomach in Europe, but still only 20-40 % respond to therapy and the critical issue; how to treat nonresponding patients is still unclear. So far, there is no randomized trial evaluating the impact of early termination of neoadjuvant chemotherapy and immediate tumor resection in nonresponding patients with locally advanced gastroesophageal cancer on postoperative outcome. With this exploratory pilot trial, we want to get first estimates about the effect of discontinuation of chemotherapy with the aim to plan and conduct a further definitive trial...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27958637/thromboprophylaxis-in-women-undergoing-gynecological-surgery-or-assisted-reproductive-techniques-new-advances-and-challenges
#19
Magdalena Maria Piróg, Robert Jach, Anetta Undas
Venous thromboembolism (VTE) affects 0.1-0.3% people each year. The risk of VTE following gynecological surgery and invasive procedures is well established and presents one of the major challenges in gynecological practice. Moreover, commonly use assisted reproductive techniques (ART) are reported to increase the risk of VTE. Despite continued efforts to reduce its incidence, postoperative VTE remains the second most common perioperative complication and the third most common cause of mortality. Several practice guidelines have been developed regarding prophylaxis and treatment of VTE...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27942485/a-systematic-review-on-robotic-coronary-artery-bypass-graft-surgery
#20
REVIEW
Christopher Cao, Praveen Indraratna, Mathew Doyle, David H Tian, Kevin Liou, Stine Munkholm-Larsen, Ciska Uys, Sohaib Virk
BACKGROUND: Robotic-assisted coronary artery bypass graft surgery (CABG) has been performed over the past decade. Despite encouraging results from selected centres, there is a paucity of robust clinical data to establish its clinical safety and efficacy. The present systematic review aimed to identify all relevant clinical data on robotic CABG. The primary endpoint was perioperative mortality, and secondary endpoints included perioperative morbidities, anastomotic complications, and long-term survival...
November 2016: Annals of Cardiothoracic Surgery
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