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https://www.readbyqxmd.com/read/28537937/dexmedetomidine-the-new-all-in-one-drug-in-paediatric-anaesthesia
#1
Cedric E Sottas, Brian J Anderson
PURPOSE OF REVIEW: Dexmedetomidine is a drug with sedative, anxiolytic, sympatholytic and analgesic properties, which is finding widespread practice in paediatric anaesthesia and related practices. The present review summarizes its pharmacology and current experience with the drug. RECENT FINDINGS: Dexmedetomidine is proving useful in many diverse areas in paediatric anaesthesia where its sedative properties are useful for premedication, fibreoptic intubation and radiologic procedures...
May 22, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28535616/drug-induced-osteonecrosis-of-the-jaw-the-state-of-the-art
#2
A Fassio, F Bertoldo, L Idolazzi, O Viapiana, M Rossini, D Gatti
Osteonecrosis of the jaw (ONJ) is a rare adverse event of antiresorptive drugs such as bisphosphonates (BP) and denosumab (DMAb). The diagnosis of ONJ is considered in cases where exposed bone in the maxillofacial region does not heal within 8 weeks in a patient previously treated with an antiresorptive agent. In patients with osteoporosis, ONJ is reported as a very rare adverse event while in oncologic patients with bone metastases or malignant hypercalcemia the incidence is significantly higher (up to the 1-10% of the patients)...
May 22, 2017: Reumatismo
https://www.readbyqxmd.com/read/28535563/the-effectiveness-and-safety-of-selective-lumbar-decompression-in-diagnostic-doubt-patients-a-retrospective-control-study
#3
Li Xiaochuan, Cheng-Fan Zhong, Jian-Hua Tang, Rong-Wei Liang, Shao-Jian Luo, Chun-Ming Huang
BACKGROUND: Our previous study demonstrated that selective nerve root block (SNRB) can influence decision-making in lumbar surgery by guiding the selection of nerve roots targeted for decompression in diagnostic doubt patients (DDPs). However, further studies were needed to determine whether this selective decompression (SD) procedure would result in similar clinical outcomes and reduce the perioperative parameters and postoperative complications as compared to the non-selective decompression (NSD) procedure...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535549/epidural-dexamethasone-influences-postoperative-analgesia-after-major-abdominal-surgery
#4
Jeong-Min Hong, Kyung-Hoon Kim, Hyeon Jeong Lee, Jae-Young Kwon, Hae-Kyu Kim, Hyae-Jin Kim, Ah-Reum Cho, Wang-Seok Do, Hyo Sung Kim
BACKGROUND: Epidurally administered dexamethasone might reduce postoperative pain. However, the effect of epidural administration of dexamethasone on postoperative epidural analgesia in major abdominal surgery has been doubtful. OBJECTIVES: To investigate the effects and optimal dose of epidural dexamethasone on pain after major abdominal surgery. STUDY DESIGN: A prospective randomized, double-blind study. SETTING: University hospital...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535237/effect-of-intravenous-ferric-carboxymaltose-on-hemoglobin-response-among-patients-with-acute-isovolemic-anemia-following-gastrectomy-the-fairy-randomized-clinical-trial
#5
Young-Woo Kim, Jae-Moon Bae, Young-Kyu Park, Han-Kwang Yang, Wansik Yu, Jeong Hwan Yook, Sung Hoon Noh, Mira Han, Keun Won Ryu, Tae Sung Sohn, Hyuk-Joon Lee, Oh Kyoung Kwon, Seung Yeob Ryu, Jun-Ho Lee, Sung Kim, Hong Man Yoon, Bang Wool Eom, Min-Gew Choi, Beom Su Kim, Oh Jeong, Yun-Suhk Suh, Moon-Won Yoo, In Seob Lee, Mi Ran Jung, Ji Yeong An, Hyoung-Il Kim, Youngsook Kim, Hannah Yang, Byung-Ho Nam
Importance: Acute isovolemic anemia occurs when blood loss is replaced with fluid. It is often observed after surgery and negatively influences short-term and long-term outcomes. Objective: To evaluate the efficacy and safety of ferric carboxymaltose to treat acute isovolemic anemia following gastrectomy. Design, Setting, and Participants: The FAIRY trial was a patient-blinded, randomized, phase 3, placebo-controlled, 12-week study conducted between February 4, 2013, and December 15, 2015, in 7 centers across the Republic of Korea...
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28535202/clinical-implications-of-hypothermic-ventricular-fibrillation-versus-beating-heart-technique-during-cardiopulmonary-bypass-for-pulmonary-valve-replacement-in-patients-with-repaired-tetralogy-of-fallot
#6
Ji-Hyun Lee, Ji-Eun Lee, Jungho Shin, In-Kyung Song, Hee-Soo Kim, Chong-Sung Kim, Woong-Han Kim, Jin-Tae Kim
OBJECTIVES: This study aimed to compare the effects of hypothermic ventricular fibrillation and beating-heart techniques during cardiopulmonary bypass (CPB) on postoperative outcomes after simple pulmonary valve replacement in patients with repaired tetralogy of Fallot (TOF). METHODS: We retrospectively reviewed the data of 47 patients with repaired tetralogy of Fallot at a single institution, who received pulmonary valve replacement under the ventricular fibrillation or beating-heart technique without cardioplegic cardiac arrest during CPB between January 2005 and April 2015...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28530768/perioperative-management-of-rheumatoid-medications-in-orthopedic-surgery
#7
Kunal Sindhu, Brian Cohen, Joseph A Gil
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder known to cause progressive joint destruction. Over time, untreated RA can lead to pain and increasing disability, making orthopedic intervention necessary. The treatment of RA revolves around a variety of medications that blunt the overall immune response. However, this may increase the risk of infection and impair wound healing. Given the nature of this disease, orthopedists frequently encounter patients with RA in the operative setting. To optimize surgical outcomes, orthopedists must carefully manage and pay special attention to the adverse side effects of the complicated medication regimens of these patients perioperatively...
May 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#8
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529168/opioids-in-gastroenterology-treating-adverse-effects-and-creating-therapeutic-benefits
#9
Michael Camilleri, Anthony Lembo, David A Katzka
The use of opioid medications on both an acute and chronic basis is ubiquitous in the U.S. As opioid receptors densely populate the gastrointestinal tract, symptoms and side effects can be expected in these patients. In the esophagus, dysmotility may result manifesting with dysphagia and a syndrome indistinguishable from primary achalasia. In the stomach, a marked delay in gastric emptying may ensue with postprandial nausea and early satiety. Postoperatively, particularly with abdominal surgery, opioid induced ileus may ensue...
May 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28527678/patient-reported-quality-of-life-after-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#10
Andrew J Meltzer, Peter H Connolly, Sharif Ellozy, Darren B Schneider
OBJECTIVE: The purpose of this study was to assess patient-reported physical and emotional well-being during follow-up after endovascular repair of TAAA. METHODS: All patients were treated in the context of a physician-sponsored investigational device exemption clinical study for patients at high risk for open TAAA repair. The SF-36 instrument was administered preoperatively, and at 1, 6, and 12 months. Results were analyzed using paired t-tests, with sub-group comparisons to assess impact of adverse events and technical results on quality of life...
May 17, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28527547/the-optimal-time-and-method-for-surgical-prewarming-a-comprehensive-review-of-the-literature
#11
Lauren Connelly, Emily Cramer, Quinn DeMott, Jennifer Piperno, Bethany Coyne, Clara Winfield, Michael Swanberg
PURPOSE: Inadvertent hypothermia is a common problem in the operating room. This can contribute to many unfavorable outcomes --rising costs, increased complications, and higher morbidity rates. DESIGN: This review determined the optimal method and time to prewarm a surgical patient to prevent perioperative hypothermia. METHODS: CINAHL and PubMed were searched. Fourteen articles were ultimately included in this review. FINDINGS: Based on the literature reviewed, it was suggested that forced-air warming was most effective in preventing perioperative hypothermia...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28526903/compartmental-tongue-resection-with-submental-island-flap-reconstruction-for-large-carcinoma-of-the-oral-tongue
#12
Sameh Roshdy, Mohamed Elbadrawy, Ashraf Khater, Tamer Fady, Hend A El-Hadaad, Nazem Shams, Hany M Elbarbary
BACKGROUND: Tongue resection is a surgical challenge because of its adverse effects on language articulation, swallowing, respiration, the eventual quality of life, and poor prognosis of advanced disease. To date, the currently accepted standard treatment has been based on excision of the primary lesion with a 1.5-2-cm circumferential macroscopic margin. Compartmental tongue surgery (CTS) is a surgical technique that removes an anatomo-functional compartment containing the primary tumor...
May 19, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28525981/combination-of-gabapentin-and-ramosetron-for-the-prevention-of-postoperative-nausea-and-vomiting-after-gynecologic-laparoscopic-surgery-a-prospective-randomized-comparative-study
#13
Kyung Mi Kim, Jin Huh, Soo Kyung Lee, Eun Young Park, Jung Min Lee, Hyo Ju Kim
BACKGROUND: As a drug originally introduced for its anticonvulsant effects, gabapentin has been recently shown to be effective in the treatment of nausea and vomiting in various clinical settings. This study compared the antiemetic efficacy of oral gabapentin, intravenous ramosetron and gabapentin plus ramosetron in patients receiving fentanyl-based patient-controlled analgesia after laparoscopic gynecologic surgery. METHODS: One hundred and thirty two patients undergoing laparoscopic gynecologic surgery under general anesthesia were allocated randomly into three groups: group G received 300 mg oral gabapentin 1 h before anesthesia, group R received 0...
May 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28525490/surgeon-procedure-volume-and-complication-rates-in-anterior-cervical-discectomy-and-fusions-analysis-of-a-national-longitudinal-database
#14
Tyler Cole, Anand Veeravagu, Michael Zhang, John K Ratliff
STUDY DESIGN: Retrospective study using the MarketScan longitudinal database (2006-2010). OBJECTIVE: Compare complication rates between groups of patients undergoing anterior cervical discectomy and fusion (ACDF) procedures performed by surgeons with high versus low mean annual ACDF volume. SUMMARY OF BACKGROUND DATA: Over the past decade the volume of ACDFs performed has increased, concurrent with greater appreciation of potential for associated complications...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525415/effects-of-collagenase-digestion-and-stromal-vascular-fraction-supplementation-on-volume-retention-of-fat-grafts
#15
Jonathan B Olenczak, Scott A Seaman, Kant Y Lin, Angela Pineros-Fernandez, Catherine E Davis, Lisa S Salopek, Shayn M Peirce, Patrick S Cottler
OBJECTIVE: The use of autologous fat as a soft tissue filler has increased over the past decade in both reconstructive and aesthetic surgeries. Enhancement of autologous fat grafts with the addition of the stromal vascular fraction (SVF) has been reported to improve long-term volume retention. Stromal vascular fraction is most commonly isolated using enzymatic digestion, but it is unknown what effect the digestion process has on the adipocytes and SVF cells that comprise the graft. Some clinicians have reported use of enzymatically digested fat grafts to alter the physical properties of the tissue in specialized applications...
June 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28525411/beta-blockers-and-traumatic-brain-injury-a-systematic-review-meta-analysis-and-eastern-association-for-the-surgery-of-trauma-guideline
#16
Aziz S Alali, Kaushik Mukherjee, Victoria A McCredie, Eyal Golan, Prakesh S Shah, James M Bardes, Susan E Hamblin, Elliott R Haut, James C Jackson, Kosar Khwaja, Nimitt J Patel, Satish R Raj, Laura D Wilson, Avery B Nathens, Mayur B Patel
OBJECTIVE: To determine if beta-(β)-blockers improve outcomes after acute traumatic brain injury (TBI). BACKGROUND: There have been no new inpatient pharmacologic therapies to improve TBI outcomes in a half-century. Treatment of TBI patients with β-blockers offers a potentially beneficial approach. METHODS: Using MEDLINE, EMBASE, and CENTRAL databases, eligible articles for our systematic review and meta-analysis (PROSPERO CRD42016048547) included adult (age ≥ 16 years) blunt trauma patients admitted with TBI...
May 18, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28524705/beneficial-effect-of-educational-and-nutritional-intervention-on-the-nutritional-status-and-compliance-of-gastric-cancer-patients-undergoing-chemotherapy-a-randomized-trial
#17
Feng-Lan Xie, Yong-Qian Wang, Li-Fen Peng, Fang-Yu Lin, Yu-Long He, Zhuo-Qin Jiang
Surgery combined with chemotherapy is the standard treatment for gastric cancer (GC); however, chemotherapy-relative adverse effects are common and result in malnutrition and a poor prognosis. In addition, compliance to postoperative chemotherapy remains a problem. This study aimed to prospectively investigate the effect of educational and nutritional interventions on the nutritional status and compliance of GC patients undergoing postoperative chemotherapy. A total of 144 GC patients were randomized into an intervention group that received intensive individualized nutritional and educational interventions during the entire course of chemotherapy and control group that received basic nutrition care and health education during hospitalization...
May 19, 2017: Nutrition and Cancer
https://www.readbyqxmd.com/read/28522956/fecal-microbiota-transplantation-for-refractory-crohn-s-disease
#18
Seon Ho Bak, Hyun Ho Choi, Jinhee Lee, Mi Hee Kim, Youn Hee Lee, Jin Su Kim, Young-Seok Cho
Approximately one-third of patients with Crohn's disease do not respond to conventional treatments, and some experience significant adverse effects, such as serious infections and lymphoma, and many patients require surgery due to complications. Increasing evidence suggests that specific changes in the composition of gut microbiota, termed as dysbiosis, are a common feature in patients with inflammatory bowel disease (IBD). Dysbiosis can lead to activation of the mucosal immune system, resulting in chronic inflammation and the development of mucosal lesions...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28522221/comparative-efficacy-and-safety-of-different-circumcisions-for-patients-with-redundant-prepuce-or-phimosis-a-network-meta-analysis
#19
REVIEW
Chuiguo Huang, Pan Song, Changbao Xu, Ruofan Wang, Lei Wei, Xinghua Zhao
BACKGROUND: Phimosis and redundant prepuce are defined as the inability of the foreskin to be retracted behind the glans penis in uncircumcised males. To synthesize the evidence and provide the hierarchies of different circumcisions for phimosis and redundant prepuce, we performed an overall network meta-analysis (NMA) based on their comparative efficacy and safety. MATERIAL AND METHODS: Electronic databases including PubMed, Embase, Wan Fang, VIP, CNKI and CBM database were researched from randomized controlled trials (RCTs) for redundant prepuce or phimosis...
May 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28521574/treatment-of-recurrent-pilonidal-cysts-with-nd-yag-laser-report-of-our-experience
#20
F Dragoni, S Moretti, G Cannarozzo, P Campolmi
Purpose Surgical treatment remains the first-line therapy of pilonidal cyst but is associated with high levels of post-operative pain, adverse events and a recurrence rate of 30%. We report our experience with laser hair removal using the Nd-YAG laser for the treatment of pilonidal cyst. Materials and methods Ten patients affected by pilonidal cyst were examined and treated from October 2011 to November 2016. Treatments were carried out using the Nd-YAG laser (Deka M.E.L.A, Calenzano, Florence, Italy) at a wavelength of 1064 nm at 30-day intervals...
May 18, 2017: Journal of Dermatological Treatment
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