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Advances in general surgery

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https://www.readbyqxmd.com/read/29138380/-three-patients-with-gastric-cancer-who-underwent-surgery-during-ramucirumab-treatment
#1
Hayato Omori, Sadayuki Kawai, Rie Makuuchi, Tomoyuki Irino, Masanori Tokunaga, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Hirofumi Yasui, Masanori Terashima
According to the REGARD and RAINBOW trials, ramucirumab(RAM)was introduced as second-line therapy for advanced or metastatic gastric cancer. RAM may impair wound healing due to the inhibition of angiogenesis; details on the postoperative course of patients who underwent surgery during RAM treatment remain unclear. Between 2011 and 2016, 93 patients with incurable gastric cancer were treated with RAM in our institute. Among them, 3 patients underwent surgery after RAM treatment. Case 1: A 74-year-old man with liver metastasis from gastric cancer was treated with a paclitaxel(PTX)plus RAM regimen...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29135566/management-of-hypertonia-in-cerebral-palsy
#2
Nickolas J Nahm, H Kerr Graham, Mark E Gormley, Andrew G Georgiadis
PURPOSE OF REVIEW: The review provides an update on the treatment of hypertonia in cerebral palsy, including physical management, pharmacotherapy, neurosurgical, and orthopedic procedures. RECENT FINDINGS: Serial casting potentiates the effect of Botulinum neurotoxin A injections for spasticity. Deep brain stimulation, intraventricular baclofen, and ventral and dorsal rhizotomy are emerging tools for the treatment of dystonia and/or mixed tone. The long-term results of selective dorsal rhizotomy and the timing of orthopedic surgery represent recent advances in the surgical management of hypertonia...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29134969/the-prevalence-and-impact-of-overlapping-rome-iv-diagnosed-functional-gastrointestinal-disorders-on-somatization-quality-of-life-and-healthcare-utilization-a-cross-sectional-general-population-study-in-three-countries
#3
Imran Aziz, Olafur S Palsson, Hans Törnblom, Ami D Sperber, William E Whitehead, Magnus Simrén
OBJECTIVES: The population prevalence of Rome IV-diagnosed functional gastrointestinal disorders (FGIDs) and their cumulative effect on health impairment is unknown. METHODS: An internet-based cross-sectional health survey was completed by 5,931 of 6,300 general population adults from three English-speaking countries (2100 each from USA, Canada, and UK). Quota-based sampling was used to generate demographically balanced and population representative samples with regards to age, sex, and education level...
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29134202/a-new-era-of-minimally-invasive-surgery-progress-and-development-of-major-technical-innovations-in-general-surgery-over-the-last-decade
#4
REVIEW
Manjunath Siddaiah-Subramanya, Kor Woi Tiang, Masimba Nyandowe
Minimally invasive surgery (MIS) continues to play an important role in general surgery as an alternative to traditional open surgery as well as traditional laparoscopic techniques. Since the 1980s, technological advancement and innovation have seen surgical techniques in MIS rapidly grow as it is viewed as more desirable. MIS, which includes natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS), is less invasive and has better cosmetic results. The technological growth and adoption of NOTES and SILS by clinicians in the last decade has however not been uniform...
October 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/29133083/jejunal-diverticulitis-review-and-treatment-algorithm
#5
Houssem Harbi, Nizar Kardoun, Sami Fendri, Nouha Dammak, Nozha Toumi, Ahmed Guirat, Rafik Mzali
Diverticulitis is much less common in the jejunum than in colonic diverticula probably because of diverticulum larger size, better intra-luminal flow and relatively sterile jejunal content. Complications of jejunal diverticulitis are acute intestinal obstruction, diverticular bleeding and mainly perforation with mesenteric abscess, localized or generalized peritonitis. The Multi-detector row computed tomography is now the best diagnostic imaging for small bowel diverticulitis as well as its complications. Magnetic resonance enterography is also quite useful but it is still impractical to resort to such an imaging in an abdominal emergency...
November 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29130218/-clinical-significance-and-practice-points-of-conversion-therapy-for-gastric-cancer-with-peritoneal-metastasis
#6
Zhenggang Zhu
Gastric cancer with peritoneal dissemination is usually considered to be oncologically unresectable and is known to have a very poor prognosis. Despite recent advances in systemic chemotherapy, peritoneal dissemination due to advanced gastric cancer (AGC) still remains the most life-threatening type of metastasis and recurrence, which usually causes ascites accumulation, intestinal obstruction, or hydronephrosis, and then seriously impairs the quality of life. In general, the median survival time of these cases is reported to be just only 6-9 months...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29129415/-ivf-and-endometriosis-oocyte-donation-and-fertility-preservation
#7
Emmanuelle Mathieu d'Argent, Jean-Marie Antoine
Endometriosis is a common condition, causing pain and infertility. In infertile woman with superficial peritoneal endometriosis and patent tubes, laparoscopy is recommended, followed by ovarian stimulation alone or in combination with intrauterine inseminations. In case of ovarian or deep endometriosis, the indications of surgery and assisted reproductive technologies remain to be defined precisely. In vitro fertilization is generally proposed after the failure of up to three inseminations, directly for ovarian or deep endometriosis, or in case of an associated factor of infertility, mainly male...
November 9, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29129263/variation-in-post-discharge-opioid-prescriptions-among-members-of-a-surgical-team
#8
Eddie Blay, Michael J Nooromid, Karl Y Bilimoria, Jane L Holl, Bruce Lambert, Julie K Johnson, Jonah J Stulberg
BACKGROUND: Surgeons play a pivotal role in the opioid epidemic but it is unknown how different members of a surgical team vary in the way they prescribe opioids after surgical episodes. STUDY DESIGN: We conducted a retrospective cohort study of all inpatient discharges for 5 common surgeries. Total number of tablets and total milligram equivalents (MME) prescribed were calculated and differences in prescription patterns were determined for attending surgeons, surgical residents and advanced practice providers...
November 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29127018/curriculum-using-the-in-situ-operating-room-setting
#9
Raghavendra Rao, Robert C Caskey, Lily Owei, Kathleen O'Connor, Elijah Riddle, Daniel T Dempsey, Joshua Atkins, Dimitry Baranov, Gregory Motuk, Ari D Brooks, Noel Williams, Jon Morris, Kristoffel Dumon
OBJECTIVE: The American College of Surgeons/Association of Program Directors in Surgery is a comprehensive, simulation-based curriculum for General Surgery residents which exists in 3 phases. While phases 1 and 2 deal with core skills and advanced procedures respectively, phase 3 targets team-based skills. To date, the 3rd phase of this curriculum has not seen wide scale implementation. This is a pilot study to verify the feasibility of implementing the phase 3 curriculum in the in-situ setting...
November 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29126506/surgical-care-of-the-pediatric-crohn-s-disease-patient
#10
Dylan Stewart
Despite the significant advances in the medical management of inflammatory bowel disease over the last decade, surgery continues to play a major role in the management of pediatric Crohn's disease (CD). While adult and pediatric Crohn's disease may share many clinical characteristics, pediatric Crohn's patients often have a more aggressive phenotype, and the operative care given by the pediatric surgeon to the newly diagnosed Crohn's patient is very different in nature to the surgical needs of adult patients after decades of disease progression...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29126406/perceptions-of-the-2011-acgme-duty-hour-requirements-among-residents-in-all-core-programs-at-a-large-academic-medical-center
#11
Benjamin J Sandefur, Diana M Shewmaker, Christine M Lohse, Steven H Rose, James E Colletti
BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. METHODS: The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution...
November 10, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29124039/surgical-management-of-stage-iiia-non-small-cell-lung-cancer
#12
REVIEW
Paul E Van Schil, Lawek Berzenji, Suresh K Yogeswaran, Jeroen M Hendriks, Patrick Lauwers
According to the eighth edition of the tumor-node-metastasis classification, stage III non-small cell lung cancer is subdivided into stages IIIA, IIIB, and IIIC. They represent a heterogeneous group of bronchogenic carcinomas with locoregional involvement by extension of the primary tumor and/or ipsilateral or contralateral lymph node involvement. Surgical indications have not been definitely established but, in general, long-term survival is only obtained in those patients in whom a complete resection is obtained...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/29124012/necrotizing-soft-tissue-infection-of-the-thigh-associated-with-retroperitoneal-abscess-in-a-patient-with-locally-advanced-ascending-colon-cancer-a-case-report
#13
Shotaro Harada, Takaharu Kato, Shinichiro Okada, Kensuke Nakatani, Risa Matsumoto, Kazuhiro Nishida, Hiroyasu Komuro, Ai Yokoyama, Chikara Takase, Toshiyuki Suganuma
Necrotizing soft tissue infection (NSTI) is a rare but rapidly progressing soft-tissue infection. Few reports of NSTI caused by colon cancer have been published. We present a rare case of NSTI of the thigh associated the retroperitoneal spread of ascending colon cancer. A 64-year-old man had noticed right hip pain since 3 months before admission, he felt pain in the right thigh which was reddening, and he had difficulty in walking. He was referred to Yokosuka general hospital Uwamachi. Anterolateral aspect of his right thigh was reddening and swelling...
2017: IDCases
https://www.readbyqxmd.com/read/29123661/the-psychology-of-chronic-post-surgical-pain-new-frontiers-in-risk-factor-identification-prevention-and-management
#14
Aliza Z Weinrib, Muhammad A Azam, Kathryn A Birnie, Lindsay C Burns, Hance Clarke, Joel Katz
In an era of considerable advances in anaesthesiology and pain medicine, chronic pain after major surgery continues to be problematic. This article briefly reviews the known psychological risk and protective factors associated with the development of chronic postsurgical pain (CPSP). We begin with a definition of CPSP and then explain what we mean by a risk/protective factor. Next, we summarize known psychological risk and protective factors for CPSP. Psychological interventions that target risk factors and may impact postsurgical pain are reviewed, including the acceptance and commitment therapy (ACT)-based approach to CPSP prevention and management we use in the Transitional Pain Service (TPS) at the Toronto General Hospital...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29121199/the-next-19-years-of-the-american-head-and-neck-society
#15
Jeffrey N Myers
Jeffrey N. Myers, MD, PhD, president of the American Head and Neck Society (AHNS) for 2016 to 2017, offered his perspectives on the AHNS's history, present-day activities, and future plans at this year's annual meeting of the society. The society was created from the 1998 merger of 2 societies, the Society for Head and Neck Surgeons (SHNS), founded in 1954, and the American Society for Head and Neck Surgery (ASHNS), founded in 1959, to become the largest organization in North America for the advancement of research and education in head and neck oncology...
November 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29118232/healthcare-utilization-and-costs-during-the-initial-phase-of-care-among-elderly-women-with-breast-cancer
#16
Ami Vyas, S Suresh Madhavan, Usha Sambamoorthi, Xiaoyun Lucy Pan, Michael Regier, Hannah Hazard, Sita Kalidindi
Background: Understanding the patterns of healthcare utilization and costs during the initial phase of care (12 months after breast cancer [BC] diagnosis) in older women (aged ≥65 years) is crucial in the allocation of Medicare resources. The objective of this study was to determine healthcare utilization and costs during the initial phase of care in older, female, Medicare fee-for-service beneficiaries diagnosed with BC, and to determine the factors associated with higher costs. Methods: A retrospective observational study using the SEER-Medicare linked database was conducted in 69,307 women aged ≥66 years diagnosed with primary incident BC in 2003-2009 to determine healthcare utilization, average costs, and costs for specific services during the initial phase of care...
November 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29112102/an-assessment-of-the-academic-impact-of-shock-society-members
#17
Daniel P Milgrom, Leonidas G Koniaris, Nakul P Valsangkar, Neha Lad, Teresa M Bell, Brandon Wojcik, Teresa A Zimmers
Professional society membership enhances career development and productivity by offering opportunities for networking and learning about recent advances in the field. The quality and contribution of such societies can be measured in part through the academic productivity, career status, and funding success rates of their members. Here, using Scopus, NIH RePORTER and departmental websites, we compare characteristics of the Shock Society membership to those of the top 55 NIH-funded American university and hospital-based departments of surgery...
November 3, 2017: Shock
https://www.readbyqxmd.com/read/29112029/identifying-risks-and-opportunities-in-outpatient-surgical-patient-safety-a-qualitative-analysis-of-veterans-health-administration-staff-perceptions
#18
Hillary J Mull, Amy K Rosen, Martin P Charns, Kamal M F Itani, Peter E Rivard
OBJECTIVES: Little is known about patient safety risks in outpatient surgery. Inpatient surgical adverse events (AEs) risk factors include patient- (e.g., advanced age), process- (e.g., inadequate preoperative assessment), or structure-related characteristics (e.g., low surgical volume); however, these factors may differ from outpatient care where surgeries are often elective and in younger/healthier patients. We undertook an exploratory qualitative research project to identify risk factors for AEs in outpatient surgery...
November 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29105562/reduced-retinoblastoma-protein-expression-is-associated-with-decreased-patient-survival-in-medullary-thyroid-cancer
#19
Anisley Valenciaga, Elizabeth G Grubbs, Kyle Porter, Paul E Wakely, Michelle D Williams, Gilbert J Cote, Vasyl V Vasko, Motoyasu Saji, Matthew D Ringel
BACKGROUND: The Retinoblastoma (RB) transcriptional corepressor 1 protein functions to slow cell cycle progression. Inactivation of RB by reduced expression and/or hyperphosphorylation allow for enhanced progression through cell cycle. Murine models develop medullary thyroid carcinoma (MTC) after generalized loss of RB; however, RB expression in MTC has been evaluated only in a small number of tumors with differing results. The objective of this study is to determine whether reduced expression of RB and/or overexpression of hyperphosphorylated RB predict MTC aggressive behavior...
November 4, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29105067/similarities-and-differences-in-neuroplasticity-mechanisms-between-brain-gliomas-and-nonlesional-epilepsy
#20
Pierre Bourdillon, Caroline Apra, Marc Guénot, Hugues Duffau
OBJECTIVE: To analyze the conceptual and practical implications of a hodotopic approach in neurosurgery, and to compare the similarities and the differences in neuroplasticity mechanisms between low-grade gliomas and nonlesional epilepsy. METHODS: We review the recent data about the hodotopic organization of the brain connectome, alongside the organization of epileptic networks, and analyze how these two structures interact, suggesting therapeutic prospects. Then we focus on the mechanisms of neuroplasticity involved in glioma natural course and after glioma surgery...
November 3, 2017: Epilepsia
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