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Advances in general surgery

Ramesh Khadka, Wei Jun Tian, Hao Xin, Rakshya Koirala
To review literature addressing determination of the risk factor, early diagnosis and overall survival on outcome among patient of pancreatic cancer associated with diabetes mellitus from the perspective of pancreatic surgery. To identify recent guidelines, clinical pathogenesis, pathological classification, screening methodology and advances in surgical management. It identifies those clinical and surgical variables to predict excellent prognosis in respect of life style changes, ongoing advancement in therapeutic and surgical treatment and postoperative follow up...
March 10, 2018: International Journal of Surgery
Jessica A Zaman, Tejender Paul Singh
Though laparoscopic cholecystectomy (LC) was highly criticized in its early stages, it quickly grew to become a new standard of care and has revolutionized the field of general surgery. Now emerging robotic technology is making its way into the minimally invasive arena. Robotic cholecystectomy (RC) is often disparaged as a costly technology that can lead to increased operative times with outcomes that are quite similar to LC. However, this perspective is skewed as many existing studies were performed in the early phase of learning for this procedure...
February 2018: Hepatobiliary Surgery and Nutrition
Maxine D Fisher, Ancilla W Fernandes, Temitope O Olufade, Paul J Miller, Mark S Walker, Moon Fenton
PURPOSE: The goal of this study was to describe patient characteristics, health resource utilization (HRU), and costs associated with treating recurrent or refractory head and neck cancer (HNC) among patients with disease progression in the community oncology setting. METHODS: This retrospective observational study was conducted by using data from the Vector Oncology Data Warehouse. Patients had been diagnosed with locally advanced or metastatic (stage III-IVc) HNC between January 1, 2007, and October 1, 2015...
March 9, 2018: Clinical Therapeutics
Rocco A Montone, Giampaolo Niccoli
Patients with left main or multivessel coronary artery disease (CAD) and depressed left ventricular function undergoing coronary artery by-pass grafting (CABG) have a markedly worse prognosis compared with general population, making surgical treatment of CAD unattractive especially when features such as poor distal targets, severe comorbidities, reoperation, advanced age, or impaired renal function are present. At the same time, evidence for improved clinical outcome in this high-risk subset of patients using mini-invasive surgical techniques (i...
March 8, 2018: Minerva Cardioangiologica
Shigenari Nukaga, Katsuhiko Naoki, Hiroyuki Yasuda, Ichiro Kawada, Kentaro Ohara, Kenzo Soejima, Tomoko Betsuyaku
Stereotactic radiosurgery (SRS) using the Gamma Knife (GK) is now being increasingly utilized for the treatment of brain metastases. However, there are a few reported cases of SRS-induced brain neoplasms. We herein report the case of a Japanese woman with metastatic non-small cell lung cancer (NSCLC) harboring EGFR-mutations who was treated four times with a GK for brain metastases. She developed glioblastoma 5.7 years after the initial GK surgery. Radiation-induced secondary neoplasms generally appear after a latency period of several years...
March 9, 2018: Internal Medicine
Gina E Bertocci, Nathan P Brown, Patrice M Mich
The objective of this study was to describe the patient population of dogs with cranial cruciate ligament (CrCL) deficiency that were prescribed a stifle orthosis. A total of 215 client-owned dogs with previously diagnosed CrCL deficiency were prescribed a stifle orthosis at a veterinary pain management and mobility clinic. Patient intake data collected included dog signalment, chief medical complaint, home environment and activity description, medical and surgical history, and diagnosing veterinarian. An orthopedic examination was conducted to assess pelvic limb function and determine pelvic limb morphologic measures...
December 2017: Topics in Companion Animal Medicine
Aleksandr Voskoboinik, Paul B Sparks, Joseph B Morton, Geoffrey Lee, Stephen A Joseph, Joshua J Hawson, Peter M Kistler, Jonathan M Kalman
BACKGROUND: Despite technological advances, studies continue to report high complication rates for atrial fibrillation (AF) ablation. We sought to review complication rates for AF ablation at a high-volume centre over a 14-year period and identify predictors of complications. METHODS: We reviewed prospectively collected data from 2750 consecutive AF ablation procedures at our institution using radiofrequency energy (RF) between January 2004 and May 2017. All cases were performed under general anaesthetic with transoesophageal echocardiography (TEE), 3D-mapping and an irrigated ablation catheter...
February 3, 2018: Heart, Lung & Circulation
Adam Mutsaers, Hanbo Chen, Alexander V Louie
PURPOSE OF REVIEW: Significant advances have been made in the field of stereotactic ablative radiotherapy (SABR) for the treatment of pulmonary neoplasms in recent years. This review aims to summarize recent salient evidence on SABR for early-stage nonsmall cell lung cancer (ES-NSCLC). RECENT FINDINGS: In medically inoperable patients, SABR remains the standard of care. The optimal SABR dosing regimen is being studied. Comparisons with non-SABR radiotherapy regimens with lower doses per fraction revealed benefit of SABR...
March 7, 2018: Current Opinion in Pulmonary Medicine
Awy Chua, M J Chua, Pca Kam
Significant surgical advances have been made recently in corneal transplantation. Penetrating keratoplasty was the dominant method from 1905, until selective lamellar keratoplasty emerged as the preferred technique over the last 20 years. Advanced techniques such as corneal limbal stem cell transplant and keratoprosthesis are also available. The major surgical complications of corneal transplantation are extrusion of ocular content and expulsive choroidal haemorrhage. It is essential for an ophthalmic anaesthetist to have a good understanding of these new surgical procedures so as to provide optimal surgical conditions...
March 2018: Anaesthesia and Intensive Care
Akira Iwase, Satoko Osuka, Maki Goto, Tomohiko Murase, Tomoko Nakamura, Sachiko Takikawa, Fumitaka Kikkawa
It has been more than 15 years since the measurement of serum anti-Müllerian hormone (AMH) first allowed the quantitative assessment of ovarian reserve. Meanwhile, the clinical implication of serum AMH has been expanding. The measurement of serum AMH has been applied in various clinical fields, including assisted reproduction, menopause, reproductive disorders and assessment of ovarian damage/toxicity. Well-known findings about the usefulness of serum AMH revealed by numerous studies executed in the early era include decline with aging, a good correlation with oocyte yield in assisted reproduction, upregulation in polycystic ovarian syndrome and a decrease on ovarian surgery and toxic treatment...
March 8, 2018: Journal of Obstetrics and Gynaecology Research
Giuliano Ramadori, Patrizia Bosio, Federico Moriconi, Ihtzaz A Malik
BACKGROUND: After orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC), recurrent HCC mostly develops within 2 years. All cases of de novo HCC described so far occurred later than 2 years after OLT. Prevention of post-transplantation HCC has usually been tried to achieve by curing or controlling recurrent liver disease. This has been rationale for treatment with interferon (IFN)/ribavirin of HCV-recurrence in patients after OLT, transplanted for advanced HCV-induced liver disease and/or HCC...
March 6, 2018: BMC Cancer
Mayo H Fujii, Ashley C Hodges, Ruby L Russell, Kristin Roensch, Bruce Beynnon, Thomas P Ahern, Peter Holoch, Jesse S Moore, S Elizabeth Ames, Charles D MacLean
BACKGROUND: The number of deaths from prescription opioids in the United States continues to increase and remains a major public health concern. Opioid-related deaths parallel prescribing trends and post-operative opioids are a significant source of opioids in the community. Our objective was to identify opioid prescribing and use patterns after surgery to inform evidenced-based practices. STUDY DESIGN: Data from a 340-bed academic medical institution and its affiliated outpatient surgical facility included: 1) retrospective medical record data, 2) prospective telephone questionnaire and medical record data...
February 27, 2018: Journal of the American College of Surgeons
Lucas Goense, Alicia S Borggreve, Sophie E Heethuis, Astrid Lhmw van Lier, Richard van Hillegersberg, Stella Mook, Gert J Meijer, Peter Sn van Rossum, Jelle P Ruurda
OBJECTIVE: The perceived burden of diagnostic tests by patients during the assessment of oesophageal cancer warrants attention with the current increase in repeated imaging for purposes of disease monitoring during and after treatment. The purpose of this prospective study was to evaluate the experienced burden associated with repeated MRI and PET/CT examinations during neoadjuvant treatment for oesophageal cancer from the perspective of the patient. METHODS: In 27 patients receiving neoadjuvant chemoradiotherapy (nCRT) for oesophageal cancer MRI and PET/CT examinations were performed before nCRT, during nCRT and before surgery...
March 2, 2018: British Journal of Radiology
Imen Samaali, Ibtissem Bouasker, Héla Khézami, Akram Sbai, Mohamed Wejih Dougaz, Hichem Jarraya, Ramzi Nouira, Chadli Dziri
BACKGROUND: Patients with malignant obstructive jaundice should undergo surgery on the basis of results of preoperative imaging. However, about half of patients are found to be unsuitable forresection during surgical exploration. Our study aimed to determine the clinicobiologicalcharacteristics that predict the resecability of ampullary and periampullary tumors. METHODS: We retrospectively reviewed the medical records of 49 patients (45% men and 55% women) who had malignant obstructive jaundice collected in the Department B of generalsurgery, Charles Nicolle hospital between July 1, 2008 and December 31, 2013...
April 2017: La Tunisie Médicale
Jinjie Zhang, Jie Wang, Wenqing Hu
In recent years, the incidence of gastric cancer has shown a decreasing trend. However, the incidence of advanced upper gastric cancer in China is steadily increasing. Nowadays, surgery is the only way to cure advanced gastric cancer, and lymph node dissection is the key of operation. Since lymph node metastasis is the main metastatic route of gastric cancer, it is critical for surgeons to be aware of this when performing lymph node dissection during operation. At present, the only possible cure for advanced gastric cancer is surgery...
February 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Hiroyuki Tsuchie, Makoto Emori, Hiroyuki Nagasawa, Naohisa Miyakoshi, Yasutaka Murahashi, Emi Mizushima, Toshihiko Yamashita, Yoichi Shimada
BACKGROUND: Soft tissue sarcoma (STS) mainly occurs in middle-aged and senior citizens. Although a poorer prognosis has been reported for older patients, few studies have examined advanced elderly excessive older patients. We evaluated the clinical features of advanced elderly patients with STS. METHODS: One hundred and forty-four patients were included in this retrospective study, and we divided them into two groups based on a cut-off age of 85 (older and younger groups)...
February 27, 2018: International Journal of Clinical Oncology
J Anderson, J Wealleans, J Ray
Computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies can leverage cone beam computed tomography (CBCT) data for production of objects used in surgical and nonsurgical endodontics and in educational settings. The aim of this article is to review all current applications of 3D printing in endodontics and to speculate upon future directions for research and clinical use within the specialty. A literature search of PubMed, Ovid and Scopus was conducted using the following terms: stereolithography, 3D printing, computer aided rapid prototyping, surgical guide, guided endodontic surgery, guided endodontic access, additive manufacturing, rapid prototyping, autotransplantation rapid prototyping, computer aided design (CAD), computer aided manufacturing (CAM)...
February 27, 2018: International Endodontic Journal
Travis F D Souza, Steven G Hoshal, Ridwaan Albeiruti, Mario P Zambito, Giuseppe M Zambito, Faizan M Khan, Bennett P Samuel, Teri L Crumb, Surender Rajasekaran, Joseph J Vettukattil
BACKGROUND: To develop an understanding of current practices in the management of transient secondary hypothyroidism in pediatric postoperative cardiopulmonary bypass (CPB) patients. METHODS: Electronic survey comprising a 10-item questionnaire was sent to sixty-four high volume pediatric heart centers in the United States and United Kingdom. Survey participants included cardiologist, intensivists, cardiothoracic surgeons, and advanced practice providers. A retrospective chart review was also performed at a large regional referral center in the Midwest on subjects 0-18 years old who underwent CPB from 2005-2015...
February 26, 2018: Current Cardiology Reviews
Georgi Tchernev, Torello Lotti, Ilia Lozev, Georgi Konstantinov Maximov, Uwe Wollina
We present a 103 - year - old patient, with duration of complaints of about ten years. The initial complaint had been presented as a small nodule, located on the eyebrow, which subsequently ulcerated and encompassed larger regions of the upper and lower eyelids. For the past three years, the patient also had complaints of a worsening of his vision, without seeking for medical help. Within the dermatological examination, an intraocular and periocular localised tumour was established, characterised by a raised peripheral edge and central ulceration...
January 25, 2018: Open Access Macedonian Journal of Medical Sciences
Gustavo T Stock, Renata R C Colombo Bonadio, Gilberto de Castro
PURPOSE OF REVIEW: Oropharyngeal cancer (OPC) incidence is increasing worldwide, especially in developed countries where it seems to be etiologically related to the elevating rates of high-risk human papillomavirus (HPV) infection. Considered a distinct disease because of its weak correlation with the traditional risk factors (tobacco use and alcohol), it has different patterns of survival outcomes, locoregional and distant failure, generally with better prognosis independently of the treatment...
February 22, 2018: Current Opinion in Oncology
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