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https://www.readbyqxmd.com/read/28719780/venous-thromboembolic-prophylaxis-in-foot-and-ankle-surgery-a-review-of-current-literature-and-practice
#1
Martin H S Weisman, James R Holmes, Todd A Irwin, Paul G Talusan
Venous thromboembolism (VTE) is a well-known and feared complication following foot and ankle surgery, as it is a source of morbidity and mortality in the perioperative phase. The most recent CHEST guidelines recommended against the use of chemoprophylaxis and the majority of the literature has found a low incidence of VTE following foot and ankle surgery. Some authors prefer screening patients for risk factors and recommend the use of chemoprophylaxis on a case-by-case basis. Interestingly, studies that found high incidence of VTE were unable to determine a statistically significant difference between the prophylaxis and placebo groups...
August 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#2
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28718950/radiofrequency-ablation-for-the-management-of-thyroid-nodules-a-critical-appraisal-of-the-literature
#3
REVIEW
Roberto Cesareo, Andrea Palermo, Valerio Pasqualini, Roberto Cianni, Gianluigi Gaspa, Silvia Manfrini, Claudio Maurizio Pacella
The majority of benign thyroid nodules are asymptomatic, remain stable in size, and do not require treatment. However, a minority of patients with growing nodules may have local symptoms or cosmetic concerns, and thus demand surgical therapy. The timely use of ultrasound-guided, minimally invasive thermal therapies has changed the natural history of benign, enlarging thyroid nodules (TNs). These procedures produce persistent shrinkage of TNs and an improvement of local symptoms. Among the various procedures, percutaneous ethanol injection (PEI) represents the first-line treatment for thyroid cysts, while in solid cold nodules, laser and radiofrequency ablation (RFA) have proven to be very effective and safe techniques in producing significant volume reduction that remains stable over several years...
July 18, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28715503/effects-of-preoperative-aspirin-on-perioperative-platelet-activation-and-dysfunction-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-surgery-a-prospective-randomized-study
#4
Jiwon Lee, Chul-Woo Jung, Yunseok Jeon, Tae Kyong Kim, Youn Joung Cho, Chang-Hoon Koo, Yoon Hyeong Choi, Ki-Bong Kim, Ho Young Hwang, Hang-Rae Kim, Ji-Young Park
The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during OPCAB due to preoperative aspirin use, we conducted a randomized controlled trial using flow cytometry and the Multiplate® analyzer. Forty-eight patients scheduled for elective OPCAB were randomized to the aspirin continuation (100 mg/day until operative day) and discontinuation (4 days before the operative day) groups...
2017: PloS One
https://www.readbyqxmd.com/read/28714634/-pectus-excavatumn-and-carinatum-in-children-and-adolescents-what-to-say-what-to-do
#5
Pierre Lascombes, Isabelle Ruchonnet-Métrailler, Maurice Beghetti, Armand Bottani, James Wilde
In children presenting with a pectus excavatum (PE) or pectus carinatum (PC) an underlying syndrome including Marfan's syndrome needs to be excluded. In adolescents, severe chest wall deformities may cause cardiac or respiratory problems but most commonly they have a psychological impact. The conservative treatment is a Vacuum Bell for PE, and a Dynamic Compression System for PC ; they play an increasing role in young patients. These devices need to be worn multiple hours per day for several months for an optimal result...
February 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28713853/factors-associated-with-acute-postoperative-pain-following-breast-reconstruction
#6
Anita R Kulkarni, Andrea L Pusic, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Edwin G Wilkins, Randy S Roth
INTRODUCTION: Post-mastectomy breast reconstruction has become an increasingly important component of breast cancer treatment. Unfortunately, some patients experience severe postoperative pain, placing them at risk for increased clinical morbidity and the development of disabling chronic pain. In an attempt to identify at-risk patients, we prospectively evaluated patient characteristics and medical/surgical variables associated with more severe acute post-reconstruction pain. METHODS: Women (N = 2207; one-week 82...
March 2017: JPRAS Open
https://www.readbyqxmd.com/read/28713693/gasless-trans-axillary-robotic-thyroidectomy-the-introduction-and-principle
#7
REVIEW
Patrick Aïdan, Maroun Bechara
A historic review of the main stages of evolution of the minimally-invasive techniques in thyroid surgery. The endoscopic era is divided into direct and indirect approaches. Examples are the minimally invasive video-assisted thyroidectomy (MIVAT) and the minimally invasive lateral approach. The indirect approach is divided into transaxillary and chest/breast incisions. A brief historic review of the advent of robots to the medical and mainly surgical field. And finally, an introduction to transaxillary robotic thyroidectomy...
June 2017: Gland Surgery
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#8
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/28706850/pneumothorax-caused-by-cystic-and-nodular-lung-metastases-from-a-malignant-uterine-perivascular-epithelioid-cell-tumor-pecoma
#9
Shouichi Okamoto, Moegi Komura, Yasuhisa Terao, Aiko Kurisaki-Arakawa, Takuo Hayashi, Tsuyoshi Saito, Shinsaku Togo, Akira Shiokawa, Keiko Mitani, Etsuko Kobayashi, Toshio Kumasaka, Kazuhisa Takahashi, Kuniaki Seyama
Perivascular epithelioid cell tumors (PEComas) are mesenchymal neoplasms with immunoreactivity for both melanocytic and smooth muscle markers. PEComas occur at multiple sites, and malignant PEComas can undergo metastasis, recurrence and aggressive clinical courses. Although the lung is a common metastatic site of PEComas, they usually appear as multiple nodules but rarely become cystic or cavitary. Here, we describe a female patient whose lungs manifested multiple cystic, cavity-like and nodular metastases 3 years after the resection of uterine tumors tentatively diagnosed as epithelioid smooth muscle tumors with uncertain malignant potential...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28705799/rapid-developing-empyema-by-group-f-beta-streptococcus-anginosus-group
#10
Muhammad Azharuddin, Dy Prudence, Prem Shanker Shukla, Ajay Mathur
A 43-year-old male had progressive pleuritic left-sided chest tightness with shortness of breath. He had dental caries and tenderness on palpation of the left lateral chest. Complete blood count showed leucocytosis. CT scan of the chest with pulmonary emboli protocol showed multiple pulmonary nodules and nodular pleural thickening at left posterior lateral pleura. Forty-eight hours post CTPE scan, CT scan of the chest, abdomen and pelvis displayed right lower lobe consolidation and left-sided pleural effusion with superimposed compressive atelectasis...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28698761/vagus-nerve-stimulation
#11
REVIEW
Hakan Ekmekçi, Hülagu Kaptan
BACKGROUND: The vagus nerve stimulation (VNS) is an approach mainly used in cases of intractable epilepsy despite all the efforts. Also, its benefits have been shown in severe cases of depression resistant to typical treatment. AIM: The aim of this study was to present current knowledge of vagus nerve stimulation. MATERIAL AND METHODS: A new value has emerged just at this stage: VNS aiming the ideal treatment with new hopes. It is based on the placement of a programmable generator on the chest wall...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28698427/-metastatic-atypical-meningioma-of-the-lung-report-of-a-case
#12
Tomomi Isono, Hirokazu Tanaka, Shinya Uematsu, Nobuhisa Yamazaki, Hiroyoshi Watanabe, Toshihide Shimada, Masaharu Nakade
A 56-years-old woman, who had undergone a complete resection for atypical meningioma (grade 2 of World Health Organization classification)8 years before was admitted to our hospital to treat a mass on the right middle lobe detected by chest X-ray. The mass was resected successfully by video-assisted thoracoscopic surgery and pathological diagnosis of the tumor was a metastatic atypical meningioma. We experienced a rare case of extracranial pulmonary metastasis of meningioma. Grade 2 meningioma is thought to have malignant potential of local recurrence and extracranial metastasis compared to grade 1 meningioma, so long-term observation may be necessary after resection of atypical meningioma...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28698426/-seminoma-of-the-mediastinum-with-cystic-change-report-of-a-case
#13
Atsushi Kagimoto, Koichi Akayama, Satoshi Shibata
The patient was a 25-year-old man. He was diagnosed as having a mediastinal tumor based on chest radiography. Chest computed tomography and magnetic resonance imaging revealed a cystic tumor in the anterior mediastinum. Total resection of the tumor with median sternotomy was performed. We anticipated that the tumor was a thymic cyst or teratoma, but pathological findings indicated a seminoma. The patient was discharged without any complication, and no recurrence of the lesion has been observed for 8 years after surgery without adjuvant therapy...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28696965/influence-of-the-learning-effect-on-the-diagnostic-yield-of-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-of-mediastinal-and-hilar-lymph-nodes
#14
Leonello Fuso, Francesco Varone, Daniele Magnini, Antonietta Pecoriello, Giuliano Montemurro, Giulia Angeletti, Salvatore Valente
BACKGROUND: The diagnostic yield of conventional transbronchial needle aspiration (TBNA) is characterized by a learning effect. The aim of this retrospective study was to verify whether a learning curve similarly affected the yield of endobronchial ultrasound-guided (EBUS)-TBNA. To this end, we evaluated the sensitivity and diagnostic accuracy of EBUS-TBNA during the first 3 years of activity. METHODS: EBUS-TBNA was performed by 2 operators with no previous experience in this technique...
July 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28696150/curative-intent-radical-en-bloc-resection-using-a-minimum-of-a-3%C3%A2-cm-margin-in-feline-injection-site-sarcomas-a-retrospective-analysis-of-131-cases
#15
Nina Müller, Martin Kessler
Objectives Owing to its highly infiltrative growth, feline injection-site sarcoma (FISS) carries a significant risk of local tumour recurrence. Parameters of possible prognostic significance (eg, tumour size and location, resection of de novo vs recurrent tumours, and achievement of tumour-free surgical margins) were examined with regard to their influence on recurrence rate (RR), disease-free interval (DFI) and survival time (ST). Methods This was a retrospective analysis of cats with FISSs located on the chest or abdominal wall or the interscapular region treated in a single institution using a standardised radical resection technique with 3 cm lateral margins and full-thickness body wall resection (tumours over chest/abdominal wall) or a minimum of two fascial planes (interscapular tumours)...
July 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28695838/ruptured-pulmonary-cystic-echinococcosis-mimicking-tuberculosis-in-childhood-a-case-report
#16
Elif Ünver Korğalı, Meriç Kaymak Cihan, Özgür Ceylan, Melih Kaptanoğlu
Cystic echinococcosis (CE) is a zoonotic disease; in places such as Turkey where livestock is common, it is an endemic health concern. The most commonly involved organ is the lungs in children. Pulmonary cysts can be asymptomatic; in some cases, they may rupture and become symptomatic. Ruptured lung hydatid cysts may often be confused with tuberculosis (Tbc) radiologically and clinically. . In this report, we present an 8-year-old female patient admitted with cough, fever, and sputum persisting since 2 weeks; her chest radiography and computed tomography (CT) findings initially indicated Tbc, but the follow-up surgery led to a diagnosis of ruptured lung CE...
June 2017: Türkiye Parazitolojii Dergisi
https://www.readbyqxmd.com/read/28693850/early-postoperative-fever-workup-in-children-utilization-and-utility
#17
Kristine S Corkum, Catherine J Hunter, Julia E Grabowski, Timothy B Lautz
BACKGROUND: Early postoperative fever is common. Adult data indicate that workup is unnecessary in the early postoperative period, but comparable data in children is limited. The objectives are to determine the incidence of fever and the utilization and yield of tests ordered in children. METHODS: Single-institution, retrospective analysis of surgical patients undergoing an elective inpatient/observational surgery between 2011 and 2015 was performed. Early fever was defined >38...
June 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28693056/-the-clinical-characteristics-of-pulmonary-benign-metastasizing-leiomyoma
#18
H P Wang, J H Shi, L Zhang
Objective: Pulmonary benign metastasizing leiomyoma (PBML) is a rare entity that leiomyoma of uterus metastasized to the lung. The clinical characteristics of this rare disease were analyzed in this article. Methods: The detailed clinical records of 7 patients diagnosed as PBML at Peking Union Medical College Hospital between January 2001 and June 2015 were reviewed. Results: All patients were women with median age of 44 years (range 28-62). Symptoms included dyspnea (2/7), chest pain (1/7), cyanosis (1/7), cough (1/7) and bloody sputum (1/7), while 4/7 cases were asymptomatic...
July 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28692550/long-term-pulmonary-outcomes-in-pediatric-survivors-of-high-risk-neuroblastoma
#19
Anne Stone, Danielle Novetsky Friedman, Stefan Worgall, Brian H Kushner, Suzanne Wolden, Shakeel Modak, Michael P LaQuaglia, Xian Wu, Nai-Kong Cheung, Charles A Sklar
BACKGROUND: Children with high-risk neuroblastoma are exposed to multimodality therapies early in life and survivors confront late therapy-related toxicities. This study assessed respiratory symptoms, pulmonary function tests (PFTs), and risk factors for abnormalities among survivors. MATERIALS AND METHODS: High-risk neuroblastoma survivors followed in the long-term follow-up clinic at Memorial Sloan Kettering Cancer Center were enrolled. Self-administered symptom questionnaires were completed...
July 7, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28690673/professor-umberto-veronesi-a-physician-a-researcher-a-brilliant-man
#20
Ketti Mazzocco, Chiara Marzorati, Gabriella Pravettoni
Many of those who work in oncology or deal with cancer patients know of Prof. Umberto Veronesi and none of them could deny the importance of his battle against cancer. He devoted his life to improving cancer treatment and quality of life for patients. He was a physician, and a politician, but above all he was a researcher. He embodied the true spirit of research, i.e., to believe in something and investigate every aspect of it until all the questions about it have been satisfactorily answered. He never gave up when faced with challenges, and he never stopped being curious...
2017: Ecancermedicalscience
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