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https://www.readbyqxmd.com/read/28097242/anterior-to-psoas-atp-fusion-of-the-lumbar-spine-evolution-of-a-technique-facilitated-by-changes-in-equipment
#1
Cristian Gragnaniello, Kevin Seex
BACKGROUND: Lateral interbody cages have been proven useful in spinal fusions. Spanning both lateral cortical rims while sparing the Anterior Longitudinal Ligament, the lateral interbody cages restore and maintain disc height while adding stability prior to supplemental fixation. The standard approach for their insertion is by a 90-degree lateral transpsoas method. This is relatively bloodless compared to other techniques although has its limitations, requiring neuro-monitoring and being, at times, very difficult at L4/5 due to iliac crest obstruction or an anterior plexus position...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28060689/-schwannoma-of-the-upper-extremity-retrospective-analysis-of-17-cases
#2
Ângelo Sá, Leandro Nobre Azevedo, Luísa Cunha
INTRODUCTION: Schwannoma or neurilemmoma is a benign peripheric nerve tumor that usually presents as a slow growing single lesion; it has origin in Schwann cells proliferation. Although it represents a small percentage of the benign tumors of the upper arm, it is the most frequent of neural origin. We present a retrospective study of upper limb schwannomas; our aim is establish the appropriate preoperative approach, to recognise the efficiency of the treatment and the pos-operative follow-up...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28027184/piezosurgery-an-asset-in-treatment-of-pierre-robin-sequence
#3
Divya Singh, Pushkar Gadre, Kiran Gadre, Shandilya Ramanojam
Pierre Robin sequence (formerly a syndrome) is named after the French stomatologist who, in 1923 and 1934, described the problems associated with micrognathia in newborn. It comprises mandibular micrognathia, U-shaped cleft palate, and glossoptosis. The typical symptoms are hypoxaemia, noisy breathing, snoring, stridor, cyanosis, bradycardia, feeding difficulties, and failure to thrive. Distraction osteogenesis has recently been considered as a surgical option for early intervention to lengthen the mandible and relieve respiratory problems...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28018070/accordion-maneuver-with-modified-ilizarov-frame-for-treatment-of-recalcitrant-nonunion-of-shaft-of-femur-in-a-patient-with-pycnodysostosis
#4
Ranjit Kumar Baruah, Russel Haque
Accordion Maneuver is a strong "Bloodless Tool" in the Ilizarov technology, that helps to bring about healing of nonunion of fractures of long bones. A 50 years old male, a rare case of Pycnodysostosis, presented to us with recalcitrant nonunion of the fracture shaft of the femur after two failed surgical attempts, with a broken plate in the last attempt. We treated this very difficult nonunion by Ilizarov monofocal osteosynthesis with Accordion Maneuver that finally yielded union. This appears to be the only case report of treating such a case with Accordion Maneuver...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28007749/intermuscular-technique-for-implantation-of-the-subcutaneous-implantable-cardioverter-defibrillator-long-term-performance-and-complications
#5
Joachim Winter, Markus Siekiera, Dong-In Shin, Christian Meyer, Patric Kröpil, Harald Clahsen, Stephen O'Connor
AIMS: The subcutaneous cardioverter defibrillator was designed to overcome electrode complications of transvenous defibrillation systems. While largely achieved, pocket complications have increased. Subcutaneous implantation of the pulse generator leaves it prone to erosion, extrusion, discomfort, and poor cosmesis. METHODS AND RESULTS: We use a demonstration electrode and pulse generator with fluoroscopy, prior to prepping and draping, to maximize the left ventricular mass between them...
December 22, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27998188/can-the-surgical-tourniquet-be-used-in-patients-with-sickle-cell-disease-or-trait-a-review-of-the-literature
#6
Marco Pignatti, Sara Zanella, Caterina Borgna-Pignatti
In patients with sickle cell disease, circulatory stasis, acidosis, and hypoxemia induce red cell deoxygenation and consequent sickling. Tourniquets are an important adjunct in limb surgery to obtain a bloodless field. Many local and systemic effects, due to the inflation and deflation of the tourniquet, can develop. These effects may have severe consequences if comorbidities are present. The use of a tourniquet in sickle cell patients is controversial because it may provoke vaso-occlusive complications. Areas covered:We reviewed the literature to detect reports of the use of tourniquet in sickle cell disease or sickle trait...
December 27, 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27909278/-surgical-treatment-of-right-atrial-malignant-tumor-thrombus-under-deep-hypothermia-with-intermittent-circulatory-arrest-report-of-two-cases
#7
Akira Fujita, Toshiro Kobayashi, Hideharu Hironaka, Mitsutaka Jinbou, Naomasa Uesugi, Satoshi Saito, Tsuyoshi Takahashi, Hidenori Gohra
Right atrial tumor thrombus is rare in patients with visceral malignant tumors and can cause right heart failure or sudden death. We present 2 cases of right atrial tumor thrombus treated under deep hypothermic intermittent circulatory arrest (DHICA). A 45-year-old man with right heart failure was diagnosed with right renal cancer extending to the right atrium. Computed tomography revealed no metastasis. He underwent right nephrectomy and tumor thrombus resection under DHICA. He was discharged on postoperative day 11 in good clinical course...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27878919/effect-of-health-status-on-fattening-performance-in-young-crossbred-polish-holstein-friesian-%C3%A3-limousin-bulls-and-steers
#8
Zofia Wielgosz-Groth, Monika Sobczuk-Szul, Zenon Nogalski, Paulina Pogorzelska-Przybyłek, Cezary Purwin
The aim of this study was to determine the effect of disease incidence on selected parameters of cattle fattening performance and carcass quality, and the fatty acid profile of beef. The experimental materials comprised 16 bulls and 16 steers, Polish Holstein-Friesian × Limousin crossbreeds (including 10 healthy and six treated animals of each category). At 5 weeks of age, bloodless castration was carried out using a rubber elastrator. The calves were fed milk replacer provided in automatic feeding stations...
November 23, 2016: Animal Science Journal, Nihon Chikusan Gakkaihō
https://www.readbyqxmd.com/read/27874157/excision-of-oral-pyogenic-granuloma-in-a-diabetic-patient-with-940nm-diode-laser
#9
Maha A Al-Mohaya, Abdulaziz M Al-Malik
Pyogenic granuloma (PG) is a common, acquired, benign vascular reactive proliferation that typically develops as a small erythematous papule on the skin or oral mucosal surface. Oral PG is often caused by constant low-grade infection, minor trauma, poor oral hygiene, and due to hormonal disturbances. It shows a striking predilection for the gingiva. Lesions can be excised surgically with removal of the underlying causes. However, this modality may be associated with unnecessary complications. Recently, different laser wavelengths have been used for removal of oral PG...
December 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27821823/-new-intracoronary-shunt-cannula-in-off-pump-coronary-artery-bypass-grafting
#10
Masaki Tabuchi, Ryo Harada, Akitatsu Yamashita, Seiichi Funamoto, Kazutoshi Tachibana, Yasuko Miyaki, Nobuyuki Takagi, Shinya Terada, Daisuke Toritsuka, Akihiko Yamauchi, Tetsuya Higami
In off-pump coronary artery bypass grafting(OPCAB), a bloodless operative field has great influence on the quality of anastomosis. In addition, maintenance of distal coronary flow during anastomosis stabilizes hemodynamics. We introduced a new intracoronary shunt cannula, Mini Shunt Pro (MSP). MSP adopts the step-tip, which allows easy insertion and reduces the risk of intimal injury. The distal and proximal sides of the tips of MSP are 0.25 mm different in diameter, which improves its fitness to the coronary artery and enhances a bloodless operative field...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27805457/laparoscopic-radiofrequency-ablation-combined-with-surgical-excision-for-exophytic-renal-angiomyolipoma-a-novel-technique-based-on-tumor-vasculature-features-of-enhancing-renal-masses-toward-hilar-off-clamping-nephron-sparing-surgery
#11
Wei Xiong, Qing Ran, Yangchun Du, Ji Lv, Fang Chen, Shan Zhong, Pu Guo, Ke Dou, Minghan Sun
OBJECTIVES: Symptomatic angiomyolipoma (AML) and asymptomatic AML larger than 4 cm in size are usually treated with nephron-sparing surgery or transarterial embolization. We used radiofrequency ablation to treat the vascular pedicle of exophytic AML with low R.E.N.A.L. nephrometry score and investigated its feasibility for hilar off-clamping nephron-sparing surgery. METHODS: Contrast-enhanced computed tomography (CT) showed enhanced, well-defined lipomatous tumors with a maximum diameter of 4-8 cm in the kidney of 15 patients...
November 2, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27781991/a-prospective-study-of-100-cases-of-sterile-t-ring%C3%A2-digital-tourniquet-application
#12
C Wapler, P Laronde, G Nedellec, A Aumar, N Sayah, C Fontaine
The ideal finger tourniquet must be easy to use and provide a completely bloodless field with control of the pressure exerted at the compression site. The primary objective of this study was to evaluate the effectiveness of the T-RING™ digital tourniquet in emergency hand surgery; the secondary objective was to define the optimal indications and possible contraindications. This prospective study, undertaken between May 4 and July 30, 2015, comprised the application of 100 finger tourniquets in the following indications: all single or multiple digital wounds, distal from the base of the proximal phalanx, irrespective of their nature and the suspected structural damage...
September 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27708177/neurophysiological-intraoperative-monitoring-during-aortic-arch-surgery
#13
REVIEW
Jeffrey E Keenan, Ehsan Benrashid, Emily Kale, Alina Nicoara, Aatif M Husain, G Chad Hughes
Circulatory management during replacement of the aortic arch is complex and involves a period of circulatory arrest to provide a bloodless field during arch vessel anastomosis. To guard against ischemic brain injury, tissue metabolic demand is reduced by systemically cooling the patient prior to circulatory arrest. Neurophysiological intraoperative monitoring (NIOM) is often used during the course of these procedures to provide contemporaneous assessment of brain status to help direct circulatory management decisions and detect brain ischemia...
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27650344/temporary-extracorporeal-bypass-modalities-during-aortic-surgery
#14
REVIEW
Levi Bassin, David Bell
The key to aortic surgery is protection of the brain, heart, spinal cord, and viscera. For operations involving the aortic arch, the focus is on cerebral protection, while for pathology involving the descending thoracic aorta, the focus is on spinal protection. Optimal cerebral and spinal protection requires an extensive knowledge of the operative steps and an understanding of the cardiopulmonary bypass modalities that are possible. A bloodless field is required when operating on the aorta. As a result, periods of ischemia to the central nervous system and end-organ viscera are often unavoidable...
September 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27641256/-bloodless-neurosurgery-among-jehovah-s-witnesses-a-comparison-with-matched-concurrent-controls
#15
Douglas A Hardesty, Sean Doerfler, Sukhmeet Sandhu, Robert G Whitmore, Patricia Ford, Scott Rushton, Peter D LeRoux
BACKGROUND: Jehovah's Witnesses (JW) are a Christian faith with > 1 million members in the United States who do not accept autologous blood transfusions. The optimal management of these patients undergoing neurosurgical procedures is not well defined. Here, we examined the feasibility and safety of JW undergoing neurosurgery in a blood management program. STUDY DESIGN AND METHODS: Sixty-eight JW patients including 23 males and 45 females (mean age 53 +/- 12 years) who underwent a variety of cranial (n=19) and spinal (n=49) neurosurgical procedures over a 5-year period were identified retrospectively and their hospital charts, anesthetic records and operative reports reviewed...
September 15, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27581524/deep-hypothermia-enhanced-autophagy-protects-pc12-cells-against-oxygen-glucose-deprivation-via-a-mitochondrial-pathway
#16
Dang Tang, Cheng Wang, Yongjun Gao, Jun Pu, Jiang Long, Wei Xu
Deep hypothermia is known for its organ-preservation properties, which is introduced into surgical operations on the brain and heart, providing both safety in stopping circulation as well as an attractive bloodless operative field. However, the molecular mechanisms have not been clearly identified. This study was undertaken to determine the influence of deep hypothermia on neural apoptosis and the potential mechanism of these effects in PC12 cells following oxygen-glucose deprivation. Deep hypothermia (18°C) was given to PC12 cells while the model of oxygen-glucose deprivation (OGD) induction for 1h...
October 6, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27568817/easy-faster-and-not-bloody-providers-perceptions-on-prepex%C3%A2-in-south-africa
#17
Minja Milovanovic, Noah Taruberekera, Karin Hatzold, Neil Martinson, Limakatso Lebina
PrePex™ (Circ MedTech Ltd., Tortola, British Virgin Islands) devices are being evaluated in several countries for scale-up of medical male circumcision (MMC) as an HIV prevention intervention. Health care workers' perceptions should be considered prior to scale-up. A cross-sectional open-ended questionnaire was administered to health care workers from nine MMC programs in South Africa that provided either PrePex™ and surgical circumcision (mixed sites) or surgical circumcision only (surgery-only sites)...
November 2016: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/27531200/new-porcine-test-model-reveals-remarkable-differences-between-algorithms-for-spectrophotometrical-haemoglobin-saturation-measurements-with-vls
#18
John Gade, Gorm Greisen
UNLABELLED: The study created an 'ex vivo' model to test different algorithms for measurements of mucosal haemoglobin saturation with visible light spectrophotometry (VLS). The model allowed comparison between algorithms, but it also allowed comparison with co-oximetry using a 'gold standard' method. This has not been described before. Seven pigs were used. They were perfused with cold Haemaxel, and thus killed, chilled and becoming bloodless. The bronchial artery was perfused with cold blood with known saturation and spectrophotometrical measurements were made through a bronchoscope...
September 2016: Physiological Measurement
https://www.readbyqxmd.com/read/27500146/laparoscopic-pringle-maneuver-how-we-do-it
#19
Tullio Piardi, Martin Lhuaire, Riccardo Memeo, Patrick Pessaux, Reza Kianmanesh, Daniele Sommacale
Laparoscopic liver resection (LLR) is technically possible with new devices which allow a relatively bloodless liver parenchymal transection. Despite, the main concern remains intraoperative hemorrhage. Currently, perioperative excessive blood loss during LLR is difficult to control with necessity of laparotomy conversion. Moreover, major blood loss requires transfusion and increases postoperative morbidity and mortality. When in-flow is limited by the hepatic pedicle clamping, it reduces intraoperative blood loss...
August 2016: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/27473810/bloodless-medicine-current-strategies-and-emerging-treatment-paradigms
#20
Linda M S Resar, Elizabeth C Wick, Talal Nael Almasri, Elizabeth A Dackiw, Paul M Ness, Steven M Frank
BACKGROUND: Advances in our understanding of the risks associated with allogeneic blood transfusions (ABTs) and the growing number of patients who wish to avoid ABTs have led to the emergence of new treatment paradigms for "bloodless" medicine and surgery. STUDY DESIGN AND METHODS: Here, we review prior studies and summarize current strategies for bloodless care used at our institution. We advocate three basic principles: 1) diagnosing and aggressively treating anemia, 2) minimizing blood loss from laboratory testing and invasive procedures, and 3) identifying and managing bleeding diatheses...
October 2016: Transfusion
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