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https://www.readbyqxmd.com/read/28944942/paramedian-forehead-flap-for-repair-of-refractory-high-flow-anterior-skull-base-csf-leak
#1
Jeremy Ciporen, Brandon Lucke-Wold, Haley Gillham, David Cua, Jason Kim, Paul Akins
AIM: The paramedian forehead flap (PMFF) has been well described for nasal reconstruction. However, it has never been reported for use in the repair of high flow anterior skull base cerebral spinal fluid (CSF) leaks. MATERIAL AND METHODS: The patient is a 55 yo African American male cocaine abuser who initially presented with a high flow anterior skull base CSF leak, extensive pneumocephalus, and intra-cerebral and intra-ventricular abscesses with an oro-nasal-cerebral fistula...
July 11, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28944624/immediate-autologous-breast-reconstruction-after-neoadjuvant-chemoradiotherapy-for-breast-cancer-initial-results-of-the-first-29-patients
#2
Damien Grinsell, Meron Pitcher, Shirley Wong, Mario Guerrieri, Hans H M Nielsen
BACKGROUND: Breast reconstruction after mastectomy in the treatment of locally advanced breast cancer is often done in stages and before radiotherapy. We have previously published an algorithm for immediate free autologous reconstruction after neoadjuvant chemotherapy and preoperative radiotherapy. This protocol was designed to provide a shorter and simpler reconstructive path whilst improving cosmesis and maintaining oncological efficiency. METHODS: A total of 29 patients were included and underwent surgery for 30 cancers by the first author between 2010 and September 2015...
September 24, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28944324/surgeons-approach-toward-clinical-nutrition-a-survey-based-study
#3
Bahadır Osman Bozkırlı, Rıza Haldun Gündoğdu, Soner Akbaba, Turgay Sayın, Pamir Eren Ersoy
OBJECTIVE: Although many surgical patients face postoperative problems due to a poor nutritional status, there is evidence that many cases of malnutrition still go unnoticed and untreated in surgical wards. This study aims to define the current attitudes of surgeons toward nutritional screening and support. MATERIAL AND METHODS: A questionnaire with 13 questions was e-mailed to 1500 surgeons. Cross-queries were made over the responses. RESULTS: The response rate was 20...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28943914/metastatic-gastric-cancer-from-breast-carcinoma-a-report-of-78-cases
#4
Liang Xu, Shujing Liang, Ningning Yan, Le Zhang, Hailiang Gu, Xiaochun Fei, Yingchun Xu, Fengchun Zhang
The metastatic spread of breast carcinoma to the stomach is rare. There are a small number of previous studies that report metastases from the breast to the stomach and these provide limited information regarding this infrequent event. Consequently, the clinicopathological features, clinical outcomes and the optimal treatment for these patients remain to be elucidated. In the present study, 78 cases of gastric metastases from breast cancer, including the current case, were identified from previous studies between 1960 and 2015...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28943213/evaluating-the-feasibility-of-phrenoesophagopexy-during-hiatal-hernia-repair-in-sleeve-gastrectomy-patients
#5
Nathaniel R Ellens, Joshua E Simon, Kimberly D Kemmeter, Tyler W Barreto, Paul R Kemmeter
BACKGROUND: Both hiatal hernias (HH) and morbid obesity significantly contribute to gastroesophageal reflux disease, which increases the risk for esophagitis and esophageal cancer. Therefore, concomitant HH repair is recommended during bariatric surgery procedures. Unfortunately, recurrence of HH after repair is not uncommon and the optimal surgical technique has yet to be established. OBJECTIVE: To evaluate the feasibility of recreating the phrenoesophageal ligaments by adding phrenoesophagopexy to HH repair during sleeve gastrectomy...
August 26, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28942833/effect-of-retrograde-colonic-electrical-stimulation-on-colonic-transit-and-stress-induced-visceral-hypersensitivity-in-rats-with-irritable-bowel-syndrome
#6
Xiao-Ri Qin, Yan Tan, Xiao-Ning Sun
OBJECTIVE: To evaluate the effects of retrograde colonic electrical stimulation (RCES) with trains of short pulses and RCES with long pulses on colonic transit in irritable bowel syndrome (IBS) rats and to investigate whether stress-induced visceral hypersensitivity could be alleviated by RCES so as to find a valuable new approach for IBS treatment. METHODS: A total of 48 male rats were randomly divided into model group and control group. Visceral hypersensitivity model was induced by a 6-day HIS protocol composed of two stressors, restraint stress for 40 min and forced swimming stress for 20 min...
August 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28942543/suture-to-wound-length-ratio-in-abdominal-wall-closure-how-well-are-we-doing
#7
Z F Williams, P Tenzel, W B Hooks, W W Hope
PURPOSE: Research has established that a ≥4:1 suture to wound (S:W) length ratio decreases incisional hernias. We evaluated our ability to obtain a 4:1 S:W length ratio in a surgery residency program. METHODS: Consecutive abdominal wall closures from 12/1/2013 through 4/9/2015 were reviewed. The length of the incisions and amount of suture used were measured. Patient demographics and operative variables were documented and compared related to inability to obtain a 4:1 ratio...
September 23, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28942541/surgical-site-infections-in-emergency-abdominal-surgery-at-tamale-teaching-hospital-ghana
#8
Stephen Tabiri, Edwin Yenli, Martin Kyere, Theophilus T K Anyomih
BACKGROUND: Surgical site infections (SSIs) result in delayed wound healing, increased use of antibiotics and increased length of hospital stay, putting remarkable physical and financial burden on patients, their relatives and the healthcare facilities. Patient-related factors, such as pre-existing colonization with antibiotic-resistant bacteria, and clinical-related factors, such as adherence to sterile techniques, contribute to the development of SSIs. The objective of this study, therefore, was to determine the SSI rate and risk factors for emergency abdominal surgeries at Tamale Teaching Hospital, Ghana...
September 23, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28942415/confusion-and-abdominal-symptoms-following-a-rugby-tackle
#9
Demetris Ioannides, Madeleine Davies, Stefan Kluzek
A 19-year-old man was sent to the emergency department following a pitch-side assessment for suspected concussion, unexplained upper abdominal tenderness and vomiting, following a high-impact tackle during a rugby match. A Focussed Assessment with Sonography for Trauma (FAST) scan performed in the emergency department suggested intra-abdominal free fluid, and subsequent head and abdominal CT imaging showed no intracranial lesion but confirmed a significant haemoperitoneum due to large splenic tear and bleeding...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28941659/comment-on-unexplained-abdominal-pain-after-bariatric-surgery
#10
EDITORIAL
Kenneth Jones
No abstract text is available yet for this article.
July 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28941593/laparoendoscopic-single-site-nephrectomy-in-children-is-it-a-good-alternative-to-conventional-laparoscopic-approach
#11
Belén Aneiros Castro, Daniel Cabezalí Barbancho, Cristina Tordable Ojeda, Isabel Carrillo Arroyo, Jesús Redondo Sedano, Andrés Gómez Fraile
BACKGROUND: Minimally invasive surgery is considered to be the gold standard treatment for nephrectomy in children. In recent decades it has been proposed that laparoendoscopic single-site (LESS) surgery is a feasible alternative to perform laparoscopic nephrectomies. OBJECTIVE: The aim of our study was to compare the safety and efficacy of LESS against conventional laparoscopic (CL) nephrectomy. STUDY DESIGN: From March 2010 to November 2012 charts of pediatric patients who underwent laparoscopic nephrectomy at our tertiary center were revised...
August 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28940780/prolonged-azathioprine-treatment-reduces-the-need-for-surgery-in-early-crohn-s-disease
#12
Yun Qiu, Bai-Li Chen, Rui Feng, Sheng-Hong Zhang, Yao He, Zhi-Rong Zeng, Shomron Ben-Horin, Laurent Peyrin-Biroulet, Ren Mao, Min-Hu Chen
BACKGROUND AND AIM: Whether an early use of azathioprine (AZA) can alter the natural history of Crohn's disease (CD) remains debated. To evaluate the impact of AZA on disease progression in a cohort of patients with early CD. METHODS: This longitudinal cohort study examined patients with early CD defined as disease duration ≤18 months and no previous use of disease-modifying agents according to Paris definition. The primary outcome was the proportion of CD-related intestinal surgery...
September 22, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28940230/outcome-after-restorative-proctocolectomy-and-ileal-pouch-anal-anastomosis-in-children-and-adults
#13
K Diederen, S S Sahami, M M Tabbers, M A Benninga, A Kindermann, P J Tanis, M W Oomen, J R de Jong, W A Bemelman
BACKGROUND: Studies comparing the outcome of ileal pouch-anal anastomosis (IPAA) in children and adults are scarce. This complicates decision-making in young patients. The aim of this study was to compare adverse events and pouch function between children and adults who underwent IPAA. METHODS: This cross-sectional cohort study included all consecutive children (aged less than 18 years) and adults with a diagnosis of inflammatory bowel disease or familial adenomatous polyposis who underwent IPAA in a tertiary referral centre between 2000 and 2015...
September 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28940219/meta-analysis-of-immunonutrition-in-major-abdominal-surgery
#14
REVIEW
P Probst, S Ohmann, U Klaiber, F J Hüttner, A T Billeter, A Ulrich, M W Büchler, M K Diener
BACKGROUND: The objective of this study was to evaluate the potential benefits of immunonutrition in major abdominal surgery with special regard to subgroups and influence of bias. METHODS: A systematic literature search from January 1985 to July 2015 was performed in MEDLINE, Embase and CENTRAL. Only RCTs investigating immunonutrition in major abdominal surgery were included. Outcomes evaluated were mortality, overall complications, infectious complications and length of hospital stay...
September 22, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28938975/factors-predicting-catheter-related-bladder-discomfort-in-surgical-patients
#15
Namhee Lim, Haesang Yoon
PURPOSE: The study was conducted to identify the factors predicting catheter-related bladder discomfort (CRBD) in the postanesthesia care unit, to assess the level of CRBD and urinary catheter-related pain for the first 24 hours postoperatively, and to compare UCRP with the postoperative pain in the surgical site. BACKGROUND: About 20% of hospitalized patients receive an indwelling urinary catheter, and more than half of these patients complain of CRBD or urinary catheter-related pain...
October 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28938298/safety-and-efficacy-of-epidural-analgesia
#16
Elke M E Bos, Markus W Hollmann, Philipp Lirk
PURPOSE OF REVIEW: Epidural analgesia remains a widely used analgesic technique. This article aims to assess the safety of epidural analgesia by balancing efficacy and complications, of epidural analgesia for acute, labor and chronic pain. RECENT FINDINGS: Main indications for epidural analgesia include major open abdominal surgery, thoracotomy and labor analgesia. Past and current literature show that epidural analgesia leads to statistically significant, but possibly clinically less meaningful, reductions in pain scores compared with intravenous analgesia...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28936682/early-versus-delayed-source-control-in-open-abdomen-management-for-severe-intra-abdominal-infections-a-retrospective-analysis-on-111-cases
#17
Stefano Rausei, Vincenzo Pappalardo, Laura Ruspi, Antonio Colella, Simone Giudici, Vincenzo Ardita, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi
BACKGROUND: Time to source control plays a determinant prognostic role in patients having severe intra-abdominal infections (IAIs). Open abdomen (OA) management became an effective treatment option for peritonitis. Aim of this study was to analyze the correlation between time to source control and outcome in patients presenting with abdominal sepsis and treated by OA. METHODS: We retrospectively analyzed 111 patients affected by abdominal sepsis and treated with OA from May 2007 to May 2015...
September 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28936613/chronic-inflammatory-demyelinating-polyradiculoneuropathy-and-anesthesia-a-case-series
#18
Andrew R Mortenson, Juraj Sprung, James C Watson, P James B Dyck, Toby N Weingarten
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune demyelinating polyneuropathy characterized by symmetrical diffuse weakness that also can rarely affect bulbar and respiratory muscles. The study objective was to describe perioperative outcomes of patients with CIDP who received general anesthesia. This retrospective observational study evaluated patients with active (diagnosed or treated within the previous year) CIDP who underwent general anesthesia at our institution between January 1, 2010, and December 31, 2015...
September 21, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28935854/comparison-of-helical-tomotherapy-and-direct-tomotherapy-in-bilateral-whole-breast-irradiation-in-a-case-of-bilateral-synchronous-grade-1-and-stage-1-breast-cancer
#19
Valentina Lancellotta, Martina Iacco, Elisabetta Perrucci, Claudio Zucchetti, Anna Concetta Dipilato, Lorenzo Falcinelli, Isabella Palumbo, Cynthia Aristei
BACKGROUND Synchronous bilateral breast cancer is rare. A case is presented where whole breast irradiation (WBI) was planned after breast conserving surgery in a patient with synchronous bilateral breast cancer. A comparison was made between the feasibility of helical tomotherapy and direct tomotherapy. CASE REPORT A 60-year-old woman was found to have bilateral breast nodules on routine mammographic screening, resulting in bilateral lumpectomy and sentinel lymph node biopsy. Histopathology showed a 6 mm diameter invasive ductal carcinoma in the right breast (Grade 1, hormone receptor positive, HER2 negative) and an 8mm diameter tubular carcinoma in the left breast (Grade 1, hormone receptor positive, HER2 negative)...
September 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#20
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
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