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https://www.readbyqxmd.com/read/29909567/paravertebral-blocks-reduce-the-risk-of-postoperative-urinary-retention-in-inguinal-hernia-repair
#1
E Bojaxhi, J Lee, S Bowers, R D Frank, S H Pak, A Rosales, S Padron, R A Greengrass
PURPOSE: Inguinal hernia repair and general anesthesia (GA) are known risk factors for urinary retention. Paravertebral blocks (PVBs) have been utilized to facilitate enhanced recovery after surgery. We evaluate the benefit of incorporating PVBs into our anesthetic technique in a large cohort of ambulatory patients undergoing inguinal hernia repair. METHODS: Records of 619 adults scheduled for ambulatory inguinal hernia repair between 2010 and 2015 were reviewed and categorized based on anesthetic and surgical approach [GA and open (GAO), GA and laparoscopic (GAL), PVB and open (PVBO), and GA/PVB and open (GA/PVBO)]...
June 16, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29909538/resistant-hypertension-time-to-consider-the-best-fifth-anti-hypertensive-treatment
#2
REVIEW
Andrea Pio-Abreu, Luciano F Drager
PURPOSE OF REVIEW: Resistant hypertension (RH) is a growing clinical condition worldwide associated with target-organ damage and poor prognosis compared to non-resistant counterparts. The purpose of this review is to perform a critical evaluation of preferable drug choices for managing RH highlighting the evidence that significant proportion of patients remained uncontrolled despite using four anti-hypertensive drugs. RECENT FINDINGS: Until recently, the fourth drug therapy was main derived from personal opinion or small interventional studies...
June 16, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29909430/an-intra-oral-approach-to-facial-skin-lumps-a-move-towards-scarless-surgery
#3
Arpan Tahim, Sarah Ali, Leo Cheng
INTRODUCTION: The aim of surgical management of benign facial skin lumps is to remove the lesion in its entirety, with minimal damage to adjacent tissue structures, while maintaining facial aesthetics. A method to achieve these goals is to remove peri-oral lesions in the labial and buccal zones via an intra-oral approach. We report an extended cases series of facial skin lumps that were excised using an intra-oral approach. METHODS: A retrospective analysis was performed on all patients who underwent excisions of benign cutaneous lesions on the face via an intra-oral approach...
June 16, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29909384/common-femoral-artery-aneurysm-repair-using-bifurcated-graft
#4
Sesi Ayodele Hotonu, Charles Henry North Johnson, Nisheeth Kansal, Vish Bhattacharya
Common femoral artery aneurysms are rare, and surgical repair is indicated if they are significantly large, or if they are symptomatic (thrombosis causing limb ischaemia and compression of surrounding structures). Synthetic grafts are preferred, especially in cases involving large aneurysms, or the bifurcation of the common femoral artery. We present a case of bilateral common femoral artery aneurysms extending into the bifurcation repaired using a synthetic graft which is traditionally used for an axillobifemoral bypass...
June 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29909372/an-international-qualitative-study-exploring-patients-experiences-of-cutaneous-leishmaniasis-study-set-up-and-protocol
#5
Astrid Christine Erber, Byron Arana, Issam Bennis, Afif Ben Salah, Aicha Boukthir, Maria Del Mar Castro Noriega, Mamoudou Cissé, Gláucia Fernandes Cota, Farhad Handjani, Mairie Guizaw Kebede, Trudie Lang, Liliana López Carvajal, Kevin Marsh, Dalila Martinez Medina, Emma Plugge, Piero Olliaro
INTRODUCTION: Lack of investments in drug development, lack of standardisation of clinical trials and the complexity of disease presentations contribute to the current lack of effective, safe and adapted treatments for cutaneous leishmaniasis (CL). One aspect concerns outcomes affecting patients' quality of life (QoL): these are hardly assessed in trials, despite potential functional and/or aesthetic impairment caused by CL, which typically affects disadvantaged and vulnerable people living in rural areas...
June 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29908944/optimizing-the-role-of-surgery-and-radiotherapy-in-urethral-cancer-based-on-histology-and-disease-extent
#6
Christina H Son, Stanley L Liauw, Yasmin Hasan, Abhishek A Solanki
BACKGROUND: Urethral cancer is rare, with limited data guiding treatment. A national hospital-based registry was used to evaluate the role of local therapy in these patients. METHODS: We performed a retrospective cohort study of patients with T0-4N0-2 M0 urethral cancer (2004-2013). Local therapy was: radiation (RT), surgery (S), or surgery and radiation (S+RT). The Cox proportional hazards model was used to assess the impact of therapy type on overall survival (primary endpoint)...
June 14, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29908926/factors-associated-with-a-discretionary-upper-extremity-surgery
#7
Tom J Crijns, David N Bernstein, David Ring, Ron Gonzalez, Danielle Wilbur, Warren C Hammert
PURPOSE: Surgery for nontraumatic upper-extremity problems is largely discretionary and preference-sensitive. Psychological and social determinants of health correlate with greater symptoms and limitations and might be associated with discretionary operative treatment. METHODS: We used routinely collected patient-reported outcome measures from patients with de Quervain tendinopathy, ganglion cyst, trapeziometacarpal arthritis, trigger digit, and carpal tunnel syndrome to study factors associated with discretionary surgery using multiple logistic regression...
June 13, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29908627/introduction-to-phalloplasty
#8
REVIEW
Loren S Schechter, Bauback Safa
Phalloplasty represents the most complete genitoperineal transformation. Because it requires complex, staged procedures as well as the use of tissue from remote sites, patients must be well informed as to the nature of surgery. Surgical techniques for phalloplasty continue to evolve. Although many surgeons prefer the radial forearm free flap technique, a visible flap donor site makes this procedure less desirable for some patients. Other surgical options are available and include the anterolateral thigh flap, sometimes in conjunction with secondary flaps, and the musculocutaneous latissimus dorsi flap...
July 2018: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/29908384/assessing-depression-severity-with-a-self-rated-vs-rater-administered-instrument-in-patients-with-epilepsy
#9
Shirin Jamal-Omidi, Christine Collins, Erin Fulchiero, Hongyan Liu, Kari Colon-Zimmermann, Edna Fuentes-Casiano, Curtis Tatsuoka, Kristin A Cassidy, Samden Lhatoo, Martha Sajatovic
RATIONALE: Up to 30-50% of individuals with epilepsy have depressive symptoms, which often complicate seizure management and reduce overall quality of life. To identify and manage depressive symptoms appropriately, clinicians need standardized instruments that can accurately identify and monitor those with clinically significant depression. The self-reported 9-item Patient Health Questionnaire (PHQ-9) has been used relatively widely to screen and monitor depression in epilepsy. The rater-administered Montgomery-Asberg Depression Rating Scale (MADRS) is a rater-administered instrument widely used in depression treatment trials but less widely applied in epilepsy...
June 13, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29908339/radical-hysterectomy-efficacy-and-safety-in-the-dawn-of-minimally-invasive-techniques
#10
Antonio Gil-Moreno, Melchor Carbonell-Socias, Sabina Salicrú, Cristina Centeno-Mediavilla, Silvia Franco-Camps, Eva Colas, Ana Oaknin, Assumpció Pérez-Benavente, Berta Díaz-Feijoo
STUDY OBJECTIVE: To analyze the effect that the introduction of minimally invasive procedures has had on surgical and oncological outcomes when compared with conventional open radical hysterectomy (ORH) in a national reference cancer after 17 years of experience in radical hysterectomy (RH). DESIGN: A prospective controlled study (Canadian Task Force II-2) SETTING: A university teaching hospital PATIENTS: All patients that underwent RH as primary treatment for cervical cancer in our institution between May 1999 and June 2016, with a total of 188 patients...
June 13, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29908227/hypogastric-preservation-using-retrograde-endovascular-bypass
#11
Mathew Wooster, Paul Armstrong, Martin Back
OBJECTIVE: Maintenance of pelvic circulation has been connected to reduced risks of ischemic colitis, buttock claudication, erectile dysfunction, and spinal cord ischemia during the treatment of extensive aorto-iliac aneurysmal disease. We evaluate the mid to late follow up of a cohort of patients treated using one preservation technique, the endovascular external (EIA) to internal (IIA) iliac artery bypass. METHODS: All patients undergoing elective retrograde EIA-IIA endovascular bypass at a single institution were retrospectively reviewed over a ten-year period from 2006-2016...
June 13, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29908101/surgical-versus-non-surgical-treatment-of-actinic-cheilitis-a-systematic-review-and-meta-analysis
#12
REVIEW
Marianne de Vasconcelos Carvalho, Sandra Lúcia Dantas de Moraes, Cleidiel Aparecido Araujo Lemos, Joel Ferreira Santiago Júnior, Belmiro Cavalcanti do Egito Vasconcelos, Eduardo Piza Pellizzer
OBJECTIVE: The aim of this systematic review was to compare outcomes between surgical and non-surgical treatment of actinic cheilitis (AC). MATERIALS AND METHODS: A systematic review and meta-analysis based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline was performed. A search of PubMed/MEDLINE, Web of Science, and Cochrane Library databases was conducted. Articles were selected based on the inclusion criteria: randomized clinical trials, prospective/retrospective studies, and case series with at least 10 patients, with a minimum follow-up period of 6 months...
June 16, 2018: Oral Diseases
https://www.readbyqxmd.com/read/29907553/development-and-evaluation-of-an-ethical-guideline-for-decisions-to-limit-life-prolonging-treatment-in-advanced-cancer-protocol-for-a-monocentric-mixed-method-interventional-study
#13
Katsiaryna Laryionava, Katja Mehlis, Elena Bierwirth, Friederike Mumm, Wolfgang Hiddemann, Pia Heußner, Eva C Winkler
BACKGROUND: Many patients with advanced cancer receive chemotherapy close to death and are referred too late to palliative or hospice care, and therefore die under therapy or in intensive care units. Oncologists still have difficulties in involving patients appropriately in decisions about limiting tumor-specific or life-prolonging treatment. OBJECTIVE: The aim of this Ethics Policy for Advanced Care Planning and Limiting Treatment Study is to develop an ethical guideline for end-of-life decisions and to evaluate the impact of this guideline on clinical practice regarding the following target goals: reduction of decisional conflicts, improvement of documentation transparency and traceability, reduction of distress of the caregiver team, and better knowledge and consideration of patients' preferences...
June 15, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29907505/personalized-automated-treatment-planning-for-breast-plus-locoregional-lymph-nodes-using-hybrid-rapidarc
#14
Mariët J van Duren-Koopman, Jim P Tol, Max Dahele, Ewa Bucko, Philip Meijnen, Ben J Slotman, Wilko F Verbakel
PURPOSE: Breast cancer patients who require locoregional lymph node (LLN) irradiation can be treated using a hybrid RapidArc technique combining 2 tangential and 3 RapidArc fields. Because the creation of hybrid RapidArc plans is complex and labor-intensive, we developed an automated treatment planning workflow using the scripting application programming interface of the Eclipse treatment planning system. METHODS AND MATERIALS: Fifteen patients (5 right- and 10 left-sided) previously treated with breast + LLN radiation therapy were replanned using the script...
March 26, 2018: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29907332/ed-triage-process-improvement-timely-vital-signs-for-less-acute-patients
#15
Stella S Falconer, Corinne M Karuppan, Emily Kiehne, Shravan Rama
PROBLEM: Vital signs can result in an upgrade of patients' Emergency Severity Index (ESI) levels. It is therefore preferable to obtain vital signs early in the triage process, particularly for ESI level 3 patients. Emergency departments have an opportunity to redesign triage processes to meet required protocols while enhancing the quality and experience of care. METHODS: We performed process analyses to redesign the door-to-vital signs process. We also developed spaghetti diagrams to reconfigure the patient arrival area...
June 13, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29907114/amelogenesis-imperfecta-therapeutic-strategy-from-primary-to-permanent-dentition-across-case-reports
#16
Steve Toupenay, Benjamin Philippe Fournier, Marie-Cécile Manière, Chantal Ifi-Naulin, Ariane Berdal, Muriel de La Dure-Molla
BACKGROUND: Hereditary enamel defect diseases are regrouped under the name "Amelogenesis Imperfecta" (AIH). Both dentitions are affected. Clinical expression is heterogeneous and varies between patients. Mutations responsible for this multigene disease may alter various genes and the inheritance can be either autosomal dominant or recessive, or X-linked. Until now, no therapeutic consensus has emerged for this rare disease. CASE PRESENTATION: The purpose of this article was to report treatments of AIH patients from childhood to early adulthood...
June 15, 2018: BMC Oral Health
https://www.readbyqxmd.com/read/29906514/pragmatic-clinical-trials-ethical-imperatives-and-opportunities
#17
EDITORIAL
Shona Kalkman, Ghislaine J M W van Thiel, Diederick E Grobbee, Johannes J M van Delden
Pragmatic clinical trials generate robust real-world evidence that holds great potential to better inform decision making regarding new medicines. For clinicians, patients and regulators, this evidence would preferably be available sooner rather than later. This means that, ideally, market authorization of any given medicine is accompanied by evidence obtained from a pragmatic trial. Given the operational and regulatory complexities of pragmatic trials in general, stakeholders tend to be hesitant to employ more pragmatism at the time of market approval...
June 12, 2018: Drug Discovery Today
https://www.readbyqxmd.com/read/29906322/dressings-and-topical-agents-for-treating-venous-leg-ulcers
#18
REVIEW
Gill Norman, Maggie J Westby, Amber D Rithalia, Nikki Stubbs, Marta O Soares, Jo C Dumville
BACKGROUND: Venous leg ulcers are open skin wounds on the lower leg which can be slow to heal, and are both painful and costly. The point prevalence of open venous leg ulcers in the UK is about 3 cases per 10,000 people, and many people experience recurrent episodes of prolonged ulceration. First-line treatment for venous leg ulcers is compression therapy, but a wide range of dressings and topical treatments are also used. This diversity of treatments makes evidence-based decision-making challenging, and a clear and current overview of all the evidence is required...
June 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29906215/infectious-complications-after-laparoscopic-appendectomy-in-pediatric-patients-with-perforated-appendicitis-is-there-a-difference-in-the-outcome-using-irrigation-and-suction-versus-suction-only-results-of-a-multicentric-international-retrospective-study
#19
Maria Escolino, Francois Becmeur, Amulya Saxena, Holger Till, Lorenzo Masieri, Giuseppe Cortese, George W Holcomb, Ciro Esposito
BACKGROUND: Analyzing the recent literature, it seems that the use of irrigation increases the incidence of intra-abdominal abscesses (IAAs) and infectious complications in perforated appendicitis. The aim of this study was to compare peritoneal irrigation and suction versus suction only during laparoscopic appendectomy (LA) for perforated appendicitis in children. MATERIALS AND METHODS: We retrospectively reviewed the records of 699 patients (460 boys and 239 girls, average age 9...
June 15, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29905977/inspiromatic-safety-and-efficacy-study-of-a-new-generation-dry-powder-inhaler-in-asthmatic-children
#20
Guy Steuer, Dario Prais, Huda Mussaffi, Meir Mei-Zahav, Ophir Bar-On, Hagit Levine, Yulia Gendler, Hannah Blau, Patrick Stafler
BACKGROUND: Dry powder inhalers (DPI) are effective but forceful inhalation required to fluidize the powder may be difficult for children and patients with airway disease. Inspiromatic is a new generation active DPI that actively suspends drugs in synchrony with inhalation. We evaluated safety and efficacy of Formoterol delivery via Inspiromatic, compared to Aerolizer, a conventional DPI, in pediatric asthmatic subjects. METHODS: A phase I/II, randomized, single-center, double-blind, double-dummy, placebo-controlled, cross-over study...
June 15, 2018: Pediatric Pulmonology
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