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https://www.readbyqxmd.com/read/28430850/trends-in-hospitalization-for-hypertensive-emergency-and-relationship-of-end-organ-damage-with-in-hospital-mortality
#1
Mahek Shah, Shantanu Patil, Brijesh Patel, Shilpkumar Arora, Nilay Patel, Lohit Garg, Sahil Agrawal, Larry Jacobs, Susan P Steigerwalt, Matthew W Martinez
BACKGROUND: There are no comprehensive guidelines on management of hypertensive emergency (HTNE) and complications. Despite advances in antihypertensive medications HTNE is accompanied with significant morbidity and mortality. METHODS: We queried the 2002-2012 nationwide inpatient sample database to identify patients with HTNE. Trends in incidence of HTNE and in-hospital mortality were analyzed. Logistic regression analysis was used to assess the relationship between end-organ complications and in-hospital mortality...
April 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28425611/a-simple-assessment-tool-for-evaluation-of-cadaveric-temporal-bone-dissection
#2
Sarah E Mowry, Erika Woodson, Samuel Gubbels, Matt Carfrae, Marlan R Hansen
EDUCATIONAL OBJECTIVE: Objective metrics in skilled-based educational courses allow trainees and instructors to assess performance and monitor progress. The objective is to validate a concise, easy-to-use instrument for assessment of resident skill during a timed cadaveric temporal-bone (CTB) dissection. STUDY DESIGN: Retrospective analysis. METHODS: An instrument was developed to assess resident performance on a yearly timed microdissection of CTB...
April 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28423232/a-psychometric-evaluation-of-the-anatomy-learning-experiences-questionnaire-and-correlations-with-learning-outcomes
#3
Derek L Choi-Lundberg, Anne-Marie M Williams, Craig Zimitat
The Anatomy Learning Experiences Questionnaire (ALEQ) was designed by Smith and Mathias to explore students' perceptions and experiences of learning anatomy. In this study, the psychometric properties of a slightly altered 34-item ALEQ (ALEQ-34) were evaluated, and correlations with learning outcomes investigated, by surveying first- and second-year undergraduate medical students; 181 usable responses were obtained (75% response rate). Psychometric analysis demonstrated overall good reliability (Cronbach's alpha of 0...
April 17, 2017: Anatomical Sciences Education
https://www.readbyqxmd.com/read/28417703/central-pedicle-reduction-mammaplasty-with-a-vertical-scar-a-technical-modification
#4
Yeon Soo Kim, Kun Hwang, Joo Ho Kim, Tae Ho Kim, Hyung Mook Kim
BACKGROUND: This study introduces a central pedicle reduction mammaplasty with a vertical scar technique. OBJECTIVES: This study is aimed to create a more conical breast shape and long-lasting better projection by modifying reduction mammaplasty by central pedicle flap. METHOD: Preoperative markings were made including the meridian line of breast and the new location of the nipple-areola complex (NAC). The new location of the inframammary fold was marked ∼2 ∼ 4 cm above the original inframammary fold...
April 18, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28417663/is-neck-dissection-associated-with-an-increased-risk-of-postoperative-stroke
#5
John D Cramer, Urjeet A Patel, Matthew B Maas, Sandeep Samant, Stephanie Shintani Smith
Objective Prior studies have reported widely disparate rates of postoperative stroke, with conflicting analyses of whether neck dissection is an independent risk factor. Study Design Cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2013. Subjects and Methods We compared the 30-day rate of postoperative stroke between patients undergoing complete or modified radical neck dissection and a control cohort composed of those undergoing resections in the oral cavity, oropharynx, larynx, or hypopharynx without neck dissection...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28417428/outcomes-of-minimally-invasive-inguinal-hernia-repair-at-the-time-of-robotic-radical-prostatectomy
#6
REVIEW
Francois G Soto-Palou, Ricardo F Sánchez-Ortiz
Abdominal straining associated with voiding dysfunction or constipation has traditionally been associated with the development of abdominal wall hernias. Thus, classic general surgery dictum recommends that any coexistent bladder outlet obstruction should be addressed by the urologist before patients undergo surgical repair of a hernia. While organ-confined prostate cancer is usually not associated with the development of lower urinary tract symptoms, a modest proportion of patients treated with radical prostatectomy may have coexisting benign prostatic hyperplasia with elevated symptom scores and hernias may be incidentally detected at the time of surgery...
June 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28416088/a-novel-mis-technique-for-posterior-cruciate-ligament-avulsion-fractures
#7
Ashok S Gavaskar, Bhupesh Karthik, Hitesh Gopalan, Parthasarathy Srinivasan, Naveen C Tummala
OBJECTIVE: Open surgical approaches to treat tibial avulsion fractures of the posterior cruciate ligament (PCL) often use large incisions involving extensive muscle dissection and retraction. The objective of this study was to describe a new mini-invasive approach targeting the fractured zone, to minimize surgical dissection and improve recovery and rehabilitation. METHODS: The new approach was used in 15 males and seven females with isolated PCL avulsions. The length of the surgical incision, surgical time, need for conversion to open technique, visual analog scores (VAS) and duration of hospital stay were studied to assess the efficacy, learning curve and advantages of the new technique...
April 13, 2017: Knee
https://www.readbyqxmd.com/read/28414571/the-novel-technique-of-transabdominal-preperitoneal-hernioplasty-herniorrhaphy-for-direct-inguinal-hernia-suture-repair-of-hernia-defect-wall
#8
Sung Ryul Lee, Sung-Soo Park
BACKGROUND: Conventional laparoscopic surgeries of direct inguinal hernia include two methods, transabdominal preperitoneal hernioplasty (TAPP) and totally extraperitoneal hernioplasty. Both methods are performed using synthetic mesh without suturing the hernia defect and require extensive mesh coverage for not only Hesselbach's triangle but also indirect ring. For minimally invasive operation, suture of direct hernia defect was devised and performed. The purpose of this study is to evaluate the efficacy of defect wall suture of laparoscopic herniorrhaphy for direct inguinal hernia patients...
April 17, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28413555/dissecting-intracranial-aneurysm-in-pregnancy-a-rare-association
#9
Manasi Mehrotra, Anant Mehrotra, Anup Nair, Arun Srivastava, Rabi Narayan Sahu, Mandakini Pradhan, Raj Kumar
We report a case of dissecting aneurysm of the right posterior cerebral artery presenting with sudden onset headache and altered behavior during labor. A 26-year-old P1001 with uncomplicated antenatal period, except history of headache off and on since 32 weeks of pregnancy, developed sudden onset headache and altered behavior during 3(rd) stage of labor. She had vaginal delivery and a live born male baby was delivered with good Apgar score. The CT was suggestive of subarachnoid hemorrhage and DSA was suggestive of dissecting aneurysm of the right P2 segment with hypoplasia of right P1 segment and A1 segment of posterior and anterior cerebral artery, respectively...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28413307/laparoscopic-assisted-anorectoplasty-a-single-center-experience
#10
Rajamani Gurusamy, S Vijay Raj, Raghul Maniam, S R Regunandan
AIM: To assess the modifications in the technique of laparoscopic-assisted anorectal pull-through (LAARP) practiced at our institute and to analyze the postoperative outcome and associated complications. MATERIALS AND METHODS: A retrospective study was done to analyze the results for LAARP procedure done for high anorectal malformations (ARMs) from January 2001 to May 2016. A total of 68 patients had undergone LAARP, with 62 male and 6 female children. Staged procedure was done in 55 patients and one child with rectovestibular fistula of 5 months of age had a single-stage procedure...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28412719/combined-measurement-of-factor-xiii-and-d-dimer-is-helpful-for-differential-diagnosis-in-patients-with-suspected-pulmonary-embolism
#11
Ning Tang, Ziyong Sun, Dengju Li, Jun Yang, Shiyu Yin, Qing Guan
BACKGROUND: D-dimer has been used to rule out pulmonary embolism (PE). Based on previous reports of decreased concentrations of coagulation factor XIII (FXIII) in venous thromboembolism, and no change in FXIII concentration in patients with acute cardiovascular disease, we evaluated the benefit of simultaneously measuring D-dimer and FXIII concentrations for diagnosing PE. METHODS: In this prospective single-center study, we enrolled 209 patients initially suspected of having PE, and measured their D-dimer and FXIII concentrations...
April 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28409743/pet-neck-a-multicentre-randomised-phase-iii-non-inferiority-trial-comparing-a-positron-emission-tomography-computerised-tomography-guided-watch-and-wait-policy-with-planned-neck-dissection-in-the-management-of-locally-advanced-n2-n3-nodal-metastases-in-patients
#12
Hisham Mehanna, Chris C McConkey, Joy K Rahman, Wai-Lup Wong, Alison F Smith, Chris Nutting, Andrew Gj Hartley, Peter Hall, Claire Hulme, Dharmesh K Patel, Sandra Ventorin von Zeidler, Max Robinson, Bal Sanghera, Lydia Fresco, Janet A Dunn
BACKGROUND: Planned neck dissection (ND) after radical chemoradiotherapy (CRT) for locally advanced nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Thirty per cent of ND specimens show histological evidence of tumour. Consequently, a significant proportion of clinicians still practise planned ND. Fludeoxyglucose positron emission tomography (PET)-computerised tomography (CT) scanning demonstrated high negative predictive values for persistent nodal disease, providing a possible alternative paradigm to ND...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28408853/tumescent-mastectomy-the-current-indications-and-operative-tips-and-tricks
#13
Ashraf Khater, Alaa Mazy, Mona Gad, Ola Taha Abd Eldayem, Mohamed Hegazy
BACKGROUND: Tumescent mastectomy refers to usage of a mixture of lidocaine and epinephrine in a diluting saline solution that makes flaps firm and tense, thus minimizing systemic drugs toxicity and making surgery possible with minimal bleeding. This technique is very useful in elder women and those with American Society of Anesthesiologists; score III and IV. The objective was to establish an alternative safe technique to general anesthesia in some selected mastectomy patients. PATIENTS AND METHODS: Twenty candidate women for total mastectomy and axillary dissection were enrolled and consented to participate...
2017: Breast Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28405951/posterior-retroperitonoscopic-adrenalectomy-a-back-door-access-with-an-unusually-rapid-learning-curve
#14
Sohail Bakkar, Gabriele Materazzi, Lorenzo Fregoli, Piermarco Papini, Paolo Miccoli
Posterior retroperitonoscopic adrenalectomy (PRA) has become a standard approach to the adrenal gland. The aim of this study was to report an initial experience with the procedure following a proper preparatory phase highlighting the rapidity, safety and effectiveness by which it could be introduced into a surgeon's practice. Between May 2015 and July 2016, 14 PRAs were performed in 14 patients (9 females and 5 males). The average age was 46 years, BMI: 25.5 kg/m(2), and ASA score: 2. Indications included: incidenatloma (n = 5), Conn's adenoma (n = 5), and Cushing's adenoma (n = 4)...
April 12, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28405879/histopathological-and-genetic-characterization-of-aldosterone-producing-adenomas-with-concurrent-subclinical-cortisol-hypersecretion-a-case-series
#15
Francesco Fallo, Isabella Castellano, Celso E Gomez-Sanchez, Yara Rhayem, Catia Pilon, Valentina Vicennati, Donatella Santini, Valeria Maffeis, Ambrogio Fassina, Paolo Mulatero, Felix Beuschlein, Martin Reincke
PURPOSE: Aldosterone-producing adenomas with concurrent subclinical cortisol hypersecretion are reported in an increasing number of patients. Five aldosterone-producing adenomas from patients with primary aldosteronism and subclinical hypercortisolism were examined. THE AIMS OF OUR STUDY WERE: (1) to analyze pathological features and immunohistochemical expression of CYP11B1 (11β-hydroxylase) and CYP11B2 (aldosterone synthase) in these tumors; (2) to investigate somatic mutations involved in adrenal steroid hypersecretion and/or tumor growth...
April 12, 2017: Endocrine
https://www.readbyqxmd.com/read/28403821/defining-the-transcriptomic-landscape-of-the-developing-enteric-nervous-system-and-its-cellular-environment
#16
Sweta Roy-Carson, Kevin Natukunda, Hsien-Chao Chou, Narinder Pal, Caitlin Farris, Stephan Q Schneider, Julie A Kuhlman
BACKGROUND: Motility and the coordination of moving food through the gastrointestinal tract rely on a complex network of neurons known as the enteric nervous system (ENS). Despite its critical function, many of the molecular mechanisms that direct the development of the ENS and the elaboration of neural network connections remain unknown. The goal of this study was to transcriptionally identify molecular pathways and candidate genes that drive specification, differentiation and the neural circuitry of specific neural progenitors, the phox2b expressing ENS cell lineage, during normal enteric nervous system development...
April 12, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28402517/posterior-inferior-cerebellar-artery-vertebral-artery-subarachnoid-hemorrhage-a-comparison-of-saccular-vs-dissecting-aneurysms
#17
Mitchell T Foster, Amit Herwadkar, Hiren C Patel
BACKGROUND: Two distinct categories of aneurysms are described in relation to the posterior inferior cerebellar artery (PICA) and vertebral artery (VA): saccular (SA) and dissecting (DA) types. This distinction is often unrecognized because abnormalities here are uncommon and most studies are small. OBJECTIVE: To determine if there are any differences in the clinical presentation, in-hospital course, or outcomes in patients with DA vs SA of the PICA or VA. METHODS: Thirty-eight patients with a VA or PICA aneurysm were identified from a departmental subarachnoid hemorrhage database and categorized into DA or SA types...
April 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28397873/a-scoring-system-to-stratify-curability-after-endoscopic-submucosal-dissection-for-early-gastric-cancer-ecura-system
#18
Waku Hatta, Takuji Gotoda, Tsuneo Oyama, Noboru Kawata, Akiko Takahashi, Yoshikazu Yoshifuku, Shu Hoteya, Masahiro Nakagawa, Masaaki Hirano, Mitsuru Esaki, Mitsuru Matsuda, Ken Ohnita, Kohei Yamanouchi, Motoyuki Yoshida, Osamu Dohi, Jun Takada, Keiko Tanaka, Shinya Yamada, Tsuyotoshi Tsuji, Hirotaka Ito, Yoshiaki Hayashi, Naoki Nakaya, Tomohiro Nakamura, Tooru Shimosegawa
OBJECTIVES: Although radical surgery is recommended for patients not meeting the curative criteria for endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) because of the potential risk of lymph node metastasis (LNM), this recommendation may be overestimated and excessive. We aimed to establish a simple scoring system for decision making after ESD. METHODS: This multicenter retrospective study consisted of two stages. First, the risk-scoring system for LNM was developed using multivariate logistic regression analysis in 1,101 patients who underwent radical surgery after having failed to meet the curative criteria for ESD of EGC...
April 11, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28397011/long-term-outcome-of-endoscopic-submucosal-dissection-is-comparable-to-that-of-surgery-for-early-gastric-cancer-a-propensity-matched-analysis
#19
Hye Kyung Jeon, Gwang Ha Kim, Bong Eun Lee, Do Youn Park, Geun Am Song, Dae Hwan Kim, Tae Yong Jeon
BACKGROUND: Data concerning the long-term outcomes of endoscopic submucosal dissection (ESD) versus surgery for early gastric cancer (EGC) are limited. We aimed to compare the long-term outcomes of ESD and surgery for patients with EGC. METHODS: Data were reviewed from patients treated by ESD or surgery for EGC in 2005-2010. The primary outcome was overall survival (OS). Secondary outcomes were disease-specific survival (DSS), disease-free survival (DFS), recurrence-free survival (RFS), treatment-related complications, and hospital stay duration...
April 10, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28395508/characteristics-of-primary-and-metachronous-gastric-cancers-discovered-after-helicobacter-pylori-eradication-a-multicenter-propensity-score-matched-study
#20
Yuji Maehata, Shotaro Nakamura, Motohiro Esaki, Fumie Ikeda, Tomohiko Moriyama, Risa Hida, Ema Washio, Junji Umeno, Minako Hirahashi, Takanari Kitazono, Takayuki Matsumoto
Background/Aims: Gastric cancers develop even after successful Helicobacter pylori eradication. We aimed to clarify the characteristics of early gastric cancers discovered after H. pylori eradication. Methods: A total of 1,053 patients with early gastric cancer treated by endoscopic submucosal dissection were included. After matching the propensity score, we retrospectively investigated the clinicopathological features of 192 patients, including 96 patients who had undergone successful H...
April 11, 2017: Gut and Liver
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