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https://www.readbyqxmd.com/read/29776942/postpartum-pneumomediastinum-and-subcutaneous-emphysema
#1
Diaeddin Sagar, Trevor K Rogers, Aldrin Adeni
We present the case of a 22-year-old primigravida with symptoms of neck swelling and difficulty breathing 3 hours after uneventful vaginal delivery. On examination, there was surgical emphysema. A CT scan confirmed air in the subcutaneous tissues and also revealed pneumomediastinum. There was no evidence of pneumothorax and gastro-oesophageal endoscopy showed no signs of oesophageal rupture. The patient remained clinically stable throughout her admission and was discharged home after 48 hours of observation...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29774765/-staying-safe-a-narrative-review-of-falls-prevention-in-people-with-parkinson-s-pdsafe
#2
Sophia Hulbert, Lynn Rochester, Alice Nieuwboer, Vicki Goodwin, Carolyn Fitton, Kim Chivers-Seymour, Ann Ashburn
BACKGROUND: Parkinson's disease demonstrates a spectrum of motor and non-motor symptoms. Falling is common and disabling. Current medical management shows minimal impact to reduce falls or fall-related risk factors, such as deficits in gait, strength, and postural instability. Despite evidence supporting rehabilitation in reducing fall risk factors, the most appropriate intervention to reduce overall fall rate remains inconclusive. This article aims to 1) synthesise current evidence and conceptual models of falls rehabilitation in Parkinson's in a narrative review; and based on this evidence, 2) introduce the treatment protocol used in the falls prevention and multi-centre clinical trial "PDSAFE"...
May 18, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29769190/pneumoperitoneum-in-a-neonate-weighing-less-than-500-g-what-do-we-really-know-about-it
#3
Audrienne Sammut, Miguel Soares Oliveira, Claire Jackson, Cristine Sortica da Costa
Pneumoperitoneum in preterm infants is a surgical emergency as it is usually indicative of intestinal perforation. Rare cases of idiopathic pneumoperitoneum have been described in the literature, the underlying causes and pathophysiology of which remain uncertain. We present a case of pneumoperitoneum in an extremely preterm infant with severe growth restriction. This occurred while she was receiving high frequency oscillatory ventilation. She had respiratory distress syndrome with pulmonary interstitial emphysema...
May 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#4
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29759289/comprehensive-acute-pain-management-in-the-perioperative-surgical-home
#5
REVIEW
John-Paul J Pozek, Martin De Ruyter, Talal W Khan
The careful coordination of care throughout the perioperative continuum offered by the perioperative surgical home (PSH) is important in the treatment of postoperative pain. Physician anesthesiologists have expertise in acute pain management, pharmacology, and regional and neuraxial anesthetic techniques, making them ideal leaders for managing perioperative analgesia within the PSH. Severe postoperative pain is one of many patient- and surgery-specific factors in the development of chronic postsurgical pain...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29759288/perioperative-surgical-home-for-the-patient-with-chronic-pain
#6
REVIEW
Talal W Khan, Smith Manion
The management of acute pain for the phenotypically different patient who suffers from chronic pain is challenging. The care of these patients is expensive and siloed. The physician-led, multidisciplinary, patient-centric, care coordination framework of the perioperative surgical home is an optimal vehicle for the management of these patients. The engagement of physician anesthesiologists in the optimization, in-hospital management, and postdischarge care of the patient with chronic pain will lead to improved outcomes, reduced health care expenditures, and improve the health of this challenging population...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29758214/transcatheter-aortic-valve-replacement-comparing-transfemoral-transcarotid-and-transcaval-access
#7
Gaetano Paone, Marvin Eng, Loay S Kabbani, Jamil Borgi, Ed Peterson, Brianna Novitsky, Benjamin Burroughs, Dee Dee Wang, William W O'Neill, Adam S Greenbaum
BACKGROUND: Despite newer generation valves using smaller sized sheaths, 10-20 percent of patients undergoing transcatheter aortic valve replacement (TAVR) require non-femoral artery access for valve delivery. To avoid a trans-thoracic procedure, we have utilized transcarotid (TC) and transcaval (TCav) approaches in these patients. This study compared the results of a contemporary experience with TF, TC and TCav approaches. METHODS: Between January 2015 and March 2017, 491 patients underwent TAVR at our institution of which 463 were included in this analysis...
May 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29753817/arch-augmentation-via-median-sternotomy-for-coarctation-of-aorta-with-proximal-arch-hypoplasia
#8
W Hampton Gray, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: Coarctation of the aorta can be associated with hypoplasia of the proximal transverse aortic arch. One approach to manage this condition is via left thoracotomy and extended end-to-end anastomosis with the expectation that the proximal arch will grow over time. Our preferred approach is to augment the aorta via midline sternotomy. We hypothesized that this approach is safe, durable and allows reliable growth of the aorta. METHODS: We identified the records of patients with biventricular anatomy who had coarctation of the aorta, hypoplasia of the proximal transverse arch, and no other cardiac lesion that would mandate cardiopulmonary bypass use and midline sternotomy...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29742719/cauda-equina-syndrome-following-an-uneventful-spinal-anesthesia-in-a-patient-undergoing-drainage-of-the-bartholin-abscess-a-case-report
#9
Waldo Merino-Urrutia, Milca Villagrán-Schmidt, Priscilla Ulloa-Vásquez, Rubén Carrasco-Moyano, Alberto Uribe, Nicoleta Stoicea, Sergio D Bergese
RATIONALE: Neuraxial anesthesia is a commonly used type of regional anesthesia. Cauda equina syndrome is an unusual and severe complication of neuraxial anesthesia, and is caused by damage to the sacral roots of the neural canal. We present a case of cauda equina syndrome following spinal anesthesia in a patient who underwent Bartholin abscess drainage. PATIENT CONCERNS: A 23-year old female scheduled to undergo surgical drainage of Bartholin abscess. Spinal anesthesia was performed with bupivacaine and fentanyl...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29739786/using-mobile-health-technology-and-community-health-workers-to-identify-and-refer-caesarean-related-surgical-site-infections-in-rural-rwanda-a-randomised-controlled-trial-protocol
#10
Kristin A Sonderman, Theoneste Nkurunziza, Fredrick Kateera, Magdalena Gruendl, Rachel Koch, Erick Gaju, Caste Habiyakare, Alexi Matousek, Evrard Nahimana, Georges Ntakiyiruta, Robert Riviello, Bethany L Hedt-Gauthier
INTRODUCTION: Surgical site infections (SSIs) are a significant cause of morbidity and mortality in low-income and middle-income countries, where rates of SSIs can reach 30%. Due to limited access, there is minimal follow-up postoperatively. Community health workers (CHWs) have not yet been used for surgical patients in most settings. Advancements in telecommunication create an opportunity for mobile health (mHealth) tools to support CHWs. We aim to evaluate the use of mHealth technology to aid CHWs in identification of SSIs and promote referral of patients back to healthcare facilities...
May 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29738182/-epididymal-liposarcoma-with-metastases-to-the-retroperitoneal-space-and-peritoneal-cavity-a-case-report-and-literature-review
#11
Jun-Long Li, Jie Fan
Objective: To report a rare case of epididymal liposarcoma with multiple metastases to the retroperitoneal space and peritoneal cavity for the purpose of improving the diagnosis and treatment of the disease. METHODS: We retrospectively analyzed the clinical data about a case of epididymal liposarcoma with multiple metastases to the retroperitoneal space and peritoneal cavity, reviewed relevant literature at home and abroad, and investigated the presentation, diagnosis and treatment of the disease...
December 2017: Zhonghua Nan Ke Xue, National Journal of Andrology
https://www.readbyqxmd.com/read/29735027/intestinal-failure-and-rehabilitation
#12
REVIEW
Alan L Buchman
The rendering of proper care for the patient with intestinal failure requires the provider to have a functional understanding of digestion and absorption, nutrient requirements, and intestinal adaptation. Inherent in those concepts is that not only is nutritional absorption compromised, but medication absorption is as well. The principles of the management of home parenteral nutrition must be mastered and then proper and controlled weaning of parenteral nutrition may be commenced by use of dietary and pharmacologic means with appropriate clinical outcome measures followed...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29733321/noninvasive-high-throughput-determination-of-sleep-duration-in-rodents
#13
R Michelle Saré, Abigail Lemons, Anita Torossian, Carolyn Beebe Smith
Traditionally, sleep is monitored by an electroencephalogram (EEG). EEG studies in rodents require surgical implantation of the electrodes followed by a long recovery period. To perform an EEG recording, the animal is connected to a receiver, creating an unnatural tether to the head-mount. EEG monitoring is time consuming, carries risk to the animal, and is not a completely natural setting for the measurement of sleep. Alternative methods to detect sleep, particularly in a high-throughput fashion, would greatly advance the field of sleep research...
April 18, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29730162/the-readmission-contradiction-toward-clarifying-common-misconceptions-about-bariatric-readmissions-and-quality-improvement
#14
Anthony Petrick, Shannon A Brindle, Ellen Vogels, James Dove, David Parker, Jon Gabrielsen
BACKGROUND: Efforts to improve quality in U.S. medicine have included reimbursement penalties for readmissions. OBJECTIVES: This study's first phase measured readmissions after initial bariatric surgery and analyzed surgical outcomes secondarily. The second phase aimed to identify nonclinical factors associated with bariatric readmissions. SETTING: Rural U.S. academic hospital. METHODS: This retrospective study analyzed a prospective database of patients undergoing initial Roux-en-Y gastric bypass or sleeve gastrectomy between May 1, 2007 and April 30, 2015...
February 21, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#15
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29724148/medical-response-to-the-declaration-of-the-first-world-war-the-case-of-edwin-seaborn
#16
Alexandra C Istl, Vivian C McAlister
At the turn of the 20th century, Dr Edwin Seaborn was starting his surgical and academic career at Western University in Ontario. When war was declared in 1914, Seaborn prevailed upon the university's president to offer the Canadian government a fully staffed hospital for deployment overseas. Initially declined by the War Office in Ottawa, the university's offer was later accepted after mounting casualties stretched the capacity of the Canadian Army Medical Corps, and Seaborn was granted command of the new No...
January 1, 2018: Journal of Medical Biography
https://www.readbyqxmd.com/read/29720142/evaluation-of-three-patient-reported-outcome-measures-following-operative-fixation-of-closed-ankle-fractures
#17
Andrew M Garratt, Markus G Naumann, Ulf Sigurdsen, Stein Erik Utvåg, Knut Stavem
BACKGROUND: Several patient reported outcome measures (PROMs) are available for assessing the outcomes of ankle fracture but few have been compared for recommended measurement properties. This study compares the measurement properties of the Lower Extremity Function Scale (LEFS), Olerud Molander Ankle Score (OMAS) and Self-Reported Foot and Ankle Score (SEFAS) following ankle surgery. METHODS: The retrospective cohort study included 959 patients aged 18 years and over who underwent surgical treatment (ORIF) for unstable and closed ankle fractures in SE Norway...
May 2, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29701417/surgical-thrombectomy-fibrinolysis-angioplasty-and-stenting-a-combined-approach-for-treatment-of-a-may-thurner-syndrome-presenting-as-phlegmasia-cerulea-dolens
#18
Carlos Veiga, João Gonçalves, Pedro Sousa, Carolina Vaz, Ivone Silva, Pedro Sá-Pinto, Rui Almeida
INTRODUCTION: Phlegmasia cerulea dolens (PCD) is a rare complication of deep venous thrombosis (DVT). Massive ileo-femoral DVT is usually the cause and prompt treatment is mandatory as it represents a medical emergency. Reported amputation rates range from 12% to 25% and mortality ranges from 25% to 40%. Limb ischemia results from obstruction to arterial inflow secondary to extreme levels of venous hypertension. Primary treatment goal is restoration of venous outflow and can be achieved by endovascular or surgical techniques...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699589/suicidal-patients-presenting-to-secondary-and-tertiary-emergency-departments-and-referral-to-a-psychiatrist-a-population-based-descriptive-study-from-japan
#19
Izumi Chihara, Ryusuke Ae, Yuka Kudo, Ritei Uehara, Nobuko Makino, Yuri Matsubara, Teppei Sasahara, Yasuko Aoyama, Kazuhiko Kotani, Yosikazu Nakamura
BACKGROUND: In Japan, although many suicidal studies were previously conducted in tertiary emergency department (ED) settings, no published studies have reported on suicidal patients presenting to the secondary EDs. The aim of the study was to describe the characteristics of suicidal patients and the referral rates to a psychiatrist overall and by type of facility. METHODS: Questionnaires were sent to all secondary and tertiary EDs in Tochigi prefecture, Japan. Data were collected for cases who presented in September 2009...
April 25, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29696573/reshape-intragastric-balloon-complicated-by-gastric-perforation-and-peritonitis
#20
Aleksandr Kalabin, Vishnu R Mani, Anant Dinesh, Paritosh Suman, Leaque Ahmed
BACKGROUND: Obesity is a growing global epidemic with tremendous financial burden and health care costs worldwide. Restrictive surgery has emerged as the definitive treatment option to combat morbid obesity and its associated comorbidities. The advent of endoscopy has new grounds in obesity with the introduction of inflatable balloon placed in the stomach that decreases satiety by volume restriction. MATERIALS AND METHODS: We report a first case of gastric perforation with peritonitis after ReShape intragastric balloon placement that needed emergent surgical intervention...
April 26, 2018: Obesity Surgery
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