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Safety protocols in surgery

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https://www.readbyqxmd.com/read/28927211/a-pivotal-randomized-clinical-trial-evaluating-the-safety-and-effectiveness-of-a-novel-hydrogel-dural-sealant-as-an-adjunct-to-dural-repair
#1
Michael J Strong, G Alexander West, Henry Woo, Daniel E Couture, John A Wilson, Lorenzo F Munoz, Charles L Rosen, Jeremy D Greenlee, Harry R van Loveren, Mark Iantosca, Clinton J Baird, Mark Smith, Matt McGirt, Jonathan Parish, Anthony L Asher
BACKGROUND: A watertight dural repair is critical to minimizing the risk of postoperative complications secondary to cerebrospinal fluid (CSF) leaks. OBJECTIVE: To evaluate the safety and efficacy of a novel hydrogel, Adherus Dural Sealant, when compared with control, DuraSeal Dural Sealant System, as an adjunct to standard methods of dural repair. METHODS: In this 17-center, prospective, randomized clinical trial designed as a noninferiority, single-blinded study, 124 patients received Adherus Dural Sealant (test sealant) and 126 received DuraSeal (control)...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28927206/preoperative-magnetic-resonance-and-intraoperative-computed-tomography-fusion-for-real-time-neuronavigation-in-intramedullary-lesion-surgery
#2
Francesco Costa, Alessandro Ortolina, Andrea Cardia, Marco Riva, Martina Revay, Guido Pecchioli, Carla Daniela Anania, Francesco Asteggiano, Maurizio Fornari
BACKGROUND: Image-guided surgery techniques in spinal surgery are usually based upon fluoroscopy or computed tomography (CT) scan, which allow for a real-time navigation of bony structures, though not of neural structures and soft tissue remains. OBJECTIVE: To verify the effectiveness and efficacy of a novel technique of imaging merging between preoperative magnetic resonance imaging (MRI) and intraoperative CT scan during removal of intramedullary lesions. METHODS: Ten consecutive patients were treated for intramedullary lesions using a navigation system aid...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28923562/intralesional-injection-of-collagenase-clostridium-histolyticum-may-increase-the-risk-of-late-onset-penile-fracture
#3
REVIEW
Jonathan A Beilan, Jared J Wallen, Adam S Baumgarten, Kevin N Morgan, Justin L Parker, Rafael E Carrion
INTRODUCTION: The use of intralesional injection of collagenase Clostridium histolyticum (CCH) has become a valid treatment option in the management of Peyronie's disease (PD). Multiple studies have shown the drug's safety and efficacy. However, sparse literature exists on the utility of the injection protocol's 14-day "observation period," in which patients are instructed to abstain from all sexual activity. AIM: To summarize the contemporary literature and report on our series of patients treated with CCH in an effort to explore the effectiveness of the postinjection observation period...
September 8, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28922710/paediatric-mild-head-injury-is-routine-admission-to-a-tertiary-trauma-hospital-necessary
#4
Krishna Tallapragada, Ratna Soundarya Peddada, Mark Dexter
BACKGROUND: Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. METHODS: We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28910150/phase-i-ii-trial-of-anticarcinoembryonic-antigen-radioimmunotherapy-gemcitabine-and-hepatic-arterial-infusion-of-fluorodeoxyuridine-postresection-of-liver-metastasis-for-colorectal-carcinoma
#5
Benjamin Cahan, Lucille Leong, Lawrence Wagman, David Yamauchi, Stephen Shibata, Sharon Wilzcynski, Lawrence E Williams, Paul Yazaki, David Colcher, Paul Frankel, Anna Wu, Andrew Raubitschek, John Shively, Jeffrey Y C Wong
OBJECTIVES: Report the feasibility, toxicities, and long-term results of a Phase I/II trial of (90)Y-labeled anticarcinoembryonic antigen (anti-CEA) (cT84.66) radioimmunotherapy (RIT), gemcitabine, and hepatic arterial infusion (HAI) of fluorodeoxyuridine (FUdR) after maximal hepatic resection of metastatic colorectal cancer to the liver. METHODS: Patients with metastatic colorectal cancer to the liver postresection or ablation to minimum disease were eligible. Each cohort received HAI of FUdR for 14 days on a dose escalation schedule...
September 2017: Cancer Biotherapy & Radiopharmaceuticals
https://www.readbyqxmd.com/read/28872484/effect-of-xenon-anesthesia-compared-to-sevoflurane-and-total-intravenous-anesthesia-for-coronary-artery-bypass-graft-surgery-on-postoperative-cardiac-troponin-release-an-international-multicenter-phase-3-single-blinded-randomized-noninferiority-trial
#6
Jan Hofland, Alexandre Ouattara, Jean-Luc Fellahi, Matthias Gruenewald, Jean Hazebroucq, Claude Ecoffey, Pierre Joseph, Matthias Heringlake, Annick Steib, Mark Coburn, Julien Amour, Bertrand Rozec, Inge de Liefde, Patrick Meybohm, Benedikt Preckel, Jean-Luc Hanouz, Luigi Tritapepe, Peter Tonner, Hamina Benhaoua, Jan Patrick Roesner, Berthold Bein, Luc Hanouz, Rob Tenbrinck, Ad J J C Bogers, Bert G Mik, Alain Coiffic, Jochen Renner, Markus Steinfath, Helga Francksen, Ole Broch, Assad Haneya, Manuella Schaller, Patrick Guinet, Lauren Daviet, Corinne Brianchon, Sebastien Rosier, Jean-Jacques Lehot, Hauke Paarmann, Julika Schön, Thorsten Hanke, Joachym Ettel, Silke Olsson, Stefan Klotz, Amir Samet, Giedrius Laurinenas, Adrien Thibaud, Mircea Cristinar, Olivier Collanges, François Levy, Rolf Rossaint, Ana Stevanovic, Gereon Schaelte, Christian Stoppe, Nora Ait Hamou, Sarah Hariri, Astrid Quessard, Aude Carillion, Hélène Morin, Jacqueline Silleran, David Robert, Anne-Sophie Crouzet, Kai Zacharowski, Christian Reyher, Sonja Iken, Nina C Weber, Marcus Hollmann, Susanne Eberl, Giovanni Carriero, Daria Collacchi, Alessandra Di Persio, Olivier Fourcade, Stefan Bergt, Angela Alms
BACKGROUND: Ischemic myocardial damage accompanying coronary artery bypass graft surgery remains a clinical challenge. We investigated whether xenon anesthesia could limit myocardial damage in coronary artery bypass graft surgery patients, as has been reported for animal ischemia models. METHODS: In 17 university hospitals in France, Germany, Italy, and The Netherlands, low-risk elective, on-pump coronary artery bypass graft surgery patients were randomized to receive xenon, sevoflurane, or propofol-based total intravenous anesthesia for anesthesia maintenance...
September 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28871439/one-normal-void-and-residual-following-mus-surgery-is-all-that-is-necessary-in-most-patients
#7
Paul Ballard, Sami Shawer, Colette Anderson, Aethele Khunda
INTRODUCTION AND HYPOTHESIS: There is considerable variation worldwide on how the assessment of voiding function is performed following midurethral sling (MUS) surgery. There is potentially a financial cost, and reduction in efficiency when patient discharge is delayed. Using our current practice of two normal void and residual (V&R) readings before discharge, the aim of this retrospective study was to evaluate the likelihood of an abnormal second V&R test if the first V&R test was normal in order to determine if a policy of discharge after only one satisfactory V&R test is reasonable...
September 4, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28870735/percutaneous-osteotomies-in-hallux-valgus-a-systematic-review
#8
REVIEW
Ana Bia, Francisco Guerra-Pinto, Bruno S Pereira, Nuno Corte-Real, Xavier Martin Oliva
Percutaneous and minimally invasive surgery is one of the greatest advances in the operating field of orthopedic since the late 1990s. The potential advantages include a shorter operative time, quicker recovery, and reduced hospital stay compared with traditional open surgery. However, scientific validation of the safety and efficacy of hallux valgus (HV) percutaneous surgery remains inconclusive. The objective of the present study was to systematically review the published data and clinical evidence for percutaneous HV surgery, evaluate the scientific method of the reports, and clarify the indications, safety, efficacy, and potential risks of these surgical techniques...
September 1, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28861859/sodium-hydroxide-as-a-sclerosing-agent-in-patients-with-neoplastic-pleural-effusion-non-candidates-for-vats-results-of-a-minimally-invasive-protocol
#9
Micaela Raices, Matías E Czerwonko, Agustin Dietrich, Alejandro Da Lozzo, Enrique Beveraggi, David Smith
Symptomatic neoplastic pleural effusion (SNPE) is a significant cause of morbidity in patients with advanced neoplastic disease. These patients often present a deteriorated general condition which prevents them from undergoing pleurodesis with video-assisted thoracic surgery (VATS). We developed a minimally invasive therapeutic protocol specially designed for this population, achieved by combining chemical pleurodesis with placement of small-bore pleural catheters (PC), which resulted in early hospital discharge, low morbimortality and good therapeutic results...
August 31, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28858553/liposomal-bupivacaine-use-in-third-molar-impaction-surgery-innovate-study
#10
Stuart E Lieblich, Hassan Danesi
The analgesic efficacy and safety of liposomal bupivacaine (LB) in third molar extraction was evaluated in this phase 3, double-blind, placebo-controlled study of subjects undergoing bilateral third molar extraction. Subjects were randomized 2 : 1 to infiltration with LB (133 mg/10 mL) or placebo, and received opioid rescue medication as needed. Primary efficacy measure was cumulative area under the curve (AUC) of numeric rating scale (NRS) pain severity scores through 48 hours (AUC of NRS0-48) postsurgery...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28856829/efficacy-and-safety-of-very-early-medical-termination-of-pregnancy-a-cohort-study
#11
Isabella Bizjak, Christian Fiala, Linus Berggren, Helena Hognert, Ingrid Sääv, Johan Bring, Kristina Gemzell-Danielsson
OBJECTIVE: To assess the efficacy and safety of medical termination of pregnancy (MTOP) where no intrauterine pregnancy (IUP) is confirmed on ultrasound. DESIGN: Retrospective case note review. SETTING: Two gynecological clinics in Vienna, Austria and Gothenburg, Sweden. POPULATION: All women with gestations of ≤49 days undergoing an MTOP during 2004-2014 (Vienna) and 2012-2015 (Gothenburg). METHODS: Two study cohorts were created; women with and women without a confirmed IUP...
August 30, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28854533/safety-aspects-of-preoperative-high-dose-glucocorticoid-in-primary-total-knee-replacement
#12
C C Jørgensen, F T Pitter, H Kehlet
Background: Preoperative single high-dose glucocorticoid may have early outcome benefits in total hip arthroplasty (THA) and knee arthroplasty (TKA), but long-term safety aspects have not been evaluated. Methods: From October 2013, the departments reporting to the prospective Lundbeck Foundation Database for Fast-track Hip and Knee Replacement introduced preoperative methylprednisolone (MP) 125 mg as part of a multimodal analgesic protocol in TKA. We analysed the risk of length of hospital stay (LOS) >4 days, 30 and 90 day readmissions in patients with MP vs patients having TKA before the use of MP and adjusted for comorbidity and place of surgery...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28853815/a-safe-teaching-protocol-of-lrp-laparoscopic-radical-prostatectomy
#13
Marcos Tobias-Machado, Cristiano Linck Pazeto, Oseas Castro Neves-Neto, Igor Nunes-Silva, Hamilton de Campos Zampolli
PURPOSE: The LRP has a steep learning curve to obtain proficiency during which patient safety may be compromised. We present an adapted modular training system which purpose to optimize the learning curve and perform a safe surgery. MATERIALS AND METHODS: A retrospective analysis of the LRP safe learning protocol applied during a fellowship program over eight years (2008-2015). The surgery was divided in 12 steps and 5 levels of difficulty. A maximum time interval was stipulated in 240 minutes...
August 30, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28852967/recent-advances-in-pancreatic-cancer-surgery
#14
REVIEW
Laura Maggino, Charles M Vollmer
Pancreatic cancer surgery is a continuously evolving field. Despite tremendous advances in perioperative outcomes, pancreatic resection is still associated with substantial morbidity, and mortality is not nil. Institutional caseload is a well-established determinant of patient outcomes, and centralization to experienced centers is essential to the safety and oncological appropriateness of the resection. Minimally invasive approaches are increasingly applied for pancreatic resection, even in cancer patients...
August 29, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28851403/a-rectal-cancer-feasibility-study-with-an-embedded-phase-iii-trial-design-assessing-magnetic-resonance-tumour-regression-grade-mrtrg-as-a-novel-biomarker-to-stratify-management-by-good-and-poor-response-to-chemoradiotherapy-trigger-study-protocol-for-a-randomised
#15
Nick J Battersby, Mit Dattani, Sheela Rao, David Cunningham, Diana Tait, Richard Adams, Brendan J Moran, Shelize Khakoo, Paris Tekkis, Shahnawaz Rasheed, Alex Mirnezami, Philip Quirke, Nicholas P West, Iris Nagtegaal, Irene Chong, Anguraj Sadanandam, Nicola Valeri, Karen Thomas, Michelle Frost, Gina Brown
BACKGROUND: Pre-operative chemoradiotherapy (CRT) for MRI-defined, locally advanced rectal cancer is primarily intended to reduce local recurrence rates by downstaging tumours, enabling an improved likelihood of curative resection. However, in a subset of patients complete tumour regression occurs implying that no viable tumour is present within the surgical specimen. This raises the possibility that surgery may have been avoided. It is also recognised that response to CRT is a key determinant of prognosis...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28847021/characterisation-and-safety-of-intraperitoneal-perioperative-administration-of-antibacterial-agents-a-systematic-review
#16
Siv Fonnes, Barbara Juliane Holzknecht, Magnus Arpi, Jacob Rosenberg
Background Intraperitoneal drug administration applies treatment at the site of diseases with gynaecological, urological, or gastrointestinal origin. The objective of this systematic review was to investigate perioperative intraperitoneal administration of antibacterial agents to characterise the drugs used and their safety profile. Methods A protocol was registered at PROSPERO (CRD42016038956). A systematic review was conducted and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
August 28, 2017: Drug Research
https://www.readbyqxmd.com/read/28846822/extended-pharmacologic-thromboprophylaxis-in-oncologic-liver-surgery-is-safe-and-effective
#17
Bradford J Kim, Ryan W Day, Catherine H Davis, Nisha Narula, Michael H Kroll, Ching-Wei D Tzeng, Thomas A Aloia
BACKGROUND: The incidence of venous thromboembolism remains high after liver surgery. OBJECTIVE: To evaluate the safety and efficacy of extended pharmacologic thromboprophylaxis in liver surgery for the prevention of venous thromboembolism (VTE). PATIENT/METHODS: From August 2013 to April 2015, 124 patients who underwent liver resection for malignancy were placed on an extended pharmacologic thromboprophylaxis protocol. Intraoperative VTE prophylaxis included Thrombo-Embolic Deterrent hose and sequential compression devices...
August 28, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28841109/one-hundred-consecutive-endoscopic-repairs-of-sagittal-craniosynostosis-an-evolution-in-care
#18
Dennis C Nguyen, Scott J Farber, Gary B Skolnick, Sybill D Naidoo, Matthew D Smyth, Alex A Kane, Kamlesh B Patel, Albert S Woo
OBJECTIVE Endoscope-assisted repair of sagittal craniosynostosis was adopted at St. Louis Children's Hospital in 2006. This study examines the first 100 cases and reviews the outcomes and evolution of patient care protocols at our institution. METHODS The authors performed a retrospective chart review of the first 100 consecutive endoscopic repairs of sagittal craniosynostosis between 2006 and 2014. The data associated with length of hospital stay, blood loss, transfusion rates, operative times, cephalic indices (CIs), complications, and cranial remolding orthosis were reviewed...
August 25, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28840147/perioperative-testosterone-supplementation-increases-lean-mass-in-healthy-men-undergoing-anterior-cruciate-ligament-reconstruction-a-randomized-controlled-trial
#19
Brian Wu, Dan Lorezanza, Ido Badash, Max Berger, Christianne Lane, Jonathan C Sum, George F Hatch, E Todd Schroeder
BACKGROUND: Rehabilitation after repair of the anterior cruciate ligament (ACL) is complicated by the loss of leg muscle mass and strength. Prior studies have shown that preoperative rehabilitation may improve muscle strength and postoperative outcomes. Testosterone supplementation may likewise counteract this muscle loss and potentially improve clinical outcomes. PURPOSE: The purpose was to investigate the effect of perioperative testosterone administration on lean mass after ACL reconstruction in men and to examine the effects of testosterone on leg strength and clinical outcome scores...
August 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28839987/effect-of-huisheng-oral-solution-on-coagulation-function-in-perioperative-period-in-patients-with-primary-lung-cancer
#20
Xiaoguang Yang, Helin Zhang, Fanyi Kong, Guochen Wang, Qianyu Gu, Zheng Zhao, Tiezhi Li, Mingming Ren, Zuosheng Li, Yang Guo
BACKGROUND: The incidence of venous thromboembolism (VTE) is about 4-10% in lung cancer patients. Huisheng oral solution (HSOS) has been previously demonstrated to inhibit carageenan induced acute thrombosis in rats, reduce the incidence of thrombosis in the lungs and mesentery of tumor-bearing mice and inhibit tumor cell metastasis. The purpose of this study was to assess the anticoagulant effect of HSOS in lung cancer patients in the perioperative period. METHODS: This study was a multicenter, randomized, single-blind, blank-controlled clinical trial...
July 2017: Journal of Thoracic Disease
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