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https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#1
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28417594/real-world-supported-unprotected-left-main-percutaneous-coronary-intervention-with-impella-device-data-from-the-uspella-registry
#2
Theodore Schreiber, Wah Wah Htun, Nimrod Blank, Tesfaye Telila, Nestor Mercado, Alexandros Briasoulis, Amir Kaki, Ashok Kondur, Ahmad Munir, Cindy Grines
BACKGROUND: Patients with left main (LM) coronary artery disease are increasingly being treated with percutaneous revascularization (PCI). The safety, feasibility, and efficacy of unprotected LM intervention (ULMI) with hemodynamic support by Impella device have not been evaluated previously. OBJECTIVE: Using a large retrospective single center database from the USpella registry, we evaluated the safety, feasibility, and potential benefits of periprocedural left ventricular assist with axial flow Impella 2...
April 18, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28416826/-surgical-technique-and-early-clinical-outcomes-of-direct-anterior-approach-to-total-hip-arthroplasty
#3
M Lv, J Q Zhang, X S Wang, Y Huang, W Li, C Y Zhang
OBJECTIVE: To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes. METHODS: A series of 100 consecutive, unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed. There were 50 male patients and 50 female patients. The average patient age was 51 years, and the average body mass index was 24...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28403222/comorbidity-and-dementia-a-nationwide-survey-in-taiwan
#4
Ting-Bin Chen, Szu-Yu Yiao, Yu Sun, Huey-Jane Lee, Shu-Chien Yang, Ming-Jang Chiu, Ta-Fu Chen, Ker-Neng Lin, Li-Yu Tang, Chung-Chih Lin, Pei-Ning Wang
BACKGROUND: Comorbid medical diseases are highly prevalent in the geriatric population, imposing hardship on healthcare services for demented individuals. Dementia also complicates clinical care for other co-existing medical conditions. This study investigated the comorbidities associated with dementia in the elderly population aged 65 years and over in Taiwan. METHODS: We conducted a nationwide, population-based, cross-sectional survey; participants were selected by computerized random sampling from all 19 Taiwan counties between December 2011 and March 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28396721/resection-of-complex-pancreatic-injuries-benchmarking-postoperative-complications-using-the-accordion-classification
#5
Jake E Krige, Eduard Jonas, Sandie R Thomson, Urda K Kotze, Mashiko Setshedi, Pradeep H Navsaria, Andrew J Nicol
AIM: To benchmark severity of complications using the Accordion Severity Grading System (ASGS) in patients undergoing operation for severe pancreatic injuries. METHODS: A prospective institutional database of 461 patients with pancreatic injuries treated from 1990 to 2015 was reviewed. One hundred and thirty patients with AAST grade 3, 4 or 5 pancreatic injuries underwent resection (pancreatoduodenectomy, n = 20, distal pancreatectomy, n = 110), including 30 who had an initial damage control laparotomy (DCL) and later definitive surgery...
March 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28393309/free-non-vascularized-fibular-graft-for-treatment-of-large-bone-defect-around-the-elbow-in-pediatric-patients
#6
Kamolporn Kaewpornsawan, Perajit Eamsobhana
BACKGROUND: Large bone defect is a challenging problem in orthopedics practice. Several methods are available for bridging of these bone defects, including cancellous bone graft, free vascularized fibula graft, and bone transport with external ring fixator. The aim of this study was to describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint...
April 9, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28390603/velopharyngeal-insufficiency-managed-by-autologous-fat-grafting-in-patients-with-aberrant-courses-of-internal-carotid-arteries
#7
Emilie Bois, Charlotte Celerier, Kahina Belhous, Michel Maulet, Nicolas Leboulanger, Noël Garabedian, Françoise Denoyelle
INTRODUCTION: Velopharyngeal insufficiency (VPI) is usually managed, besides speech therapy, by performing a velopharyngoplasty. An alternative approach is autologous fat grafting (AFG) of the posterior pharyngeal wall. About 5% of the population has internal carotid arteries (ICA) with an aberrant course. This anatomic variation can be responsible for surgical difficulties while when performing a velopharyngoplasty, and therefore lead surgeons to only consider a speech reeducation of VPI...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28388992/long-term-outcomes-of-560-consecutive-patients-treated-with-transcatheter-aortic-valve-implantation-and-propensity-score-matched-analysis-of-early-versus-new-generation-valves
#8
Amos Levi, Uri Landes, Abid R Assali, Katia Orvin, Ram Sharony, Hanna Vaknin-Assa, Ashraf Hamdan, Yaron Shapira, Shmuel Schwartzenberg, Pablo Codner, Aviv A Shaul, Mordechai Vaturi, Ariel Gutstein, Alexander Sagie, Ran Kornowski
Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis in patients at high or prohibitive surgical risk. Nevertheless, long-term clinical and echocardiographic data are still lacking. We carried out an analysis of 560 consecutive patients who underwent TAVI at our institution from 2008 to 2016 to evaluate temporal changes in TAVI characteristics, predictors of 1-year and long-term outcomes, and to compare the performance of the early- and new-generation valve systems...
March 16, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#9
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28384177/application-of-surgical-apgar-score-in-intracranial-meningioma-surgery
#10
Shih-Yuan Hsu, Chien-Yu Ou, Yu-Ni Ho, Yu-Hua Huang
Surgical resection is the main therapeutic option for intracranial meningiomas, but it is not without significant morbidities. The Surgical Apgar Score (SAS), assessed by intraoperative blood pressure, heart rate, and blood loss, was developed for prognostic prediction in general and vascular surgery. We aimed to examine whether the application of SAS in patients undergoing craniotomy for meningioma resection can predict postoperative major complications. We retrospectively enrolled 99 patients that had undergone intracranial meningioma surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28378184/vascular-age-as-a-predictor-of-side-effects-after-facial-lipofilling
#11
Brakica Tepavcevic, Djordje Radak, Milan Jovanovic, Sandra Radak, Darija Kisic Tepavcevic
BACKGROUND: Vascular age (VA) represents chronological age adjusted for an individual's atherosclerotic burden. Keeping in mind the fact that facial vascularization could influence the success of esthetic interventions, we aimed to investigate the predictive value of VA in development of side effects following facial lipofilling. METHODS: In the period from October 1, 2014, to October 1, 2015, 106 consecutive subjects who underwent a facial lipofilling were included in the study...
April 4, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28374304/septum-enhanced-mammaplasty-in-inferocentral-pedicled-breast-reduction-for-macromastia-and-gigantomastia-patients
#12
Aurelio Portincasa, Francesco Ciancio, Luigi Cagiano, Alessandro Innocenti, Domenico Parisi
BACKGROUND: Inferior pedicle and free nipple grafting are commonly used as breast reduction techniques for patients with breast hypertrophy and gigantomastia. Limitations of these techniques are, respectively, possible vascular compromise and total/partial necrosis of the nipple-areola complex (NAC). The authors describe the innovative inferocentral pedicled reduction mammaplasty (ICPBR) enhanced by preservation of Würinger's septum for severe hypertrophic breasts. MATERIALS AND METHODS: Among 287 breast reductions performed between January 2001 and 2015, 83 (28...
April 3, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28363423/new-technique-for-nephron-sparing-surgery-in-polar-tumours-a-modification-of-the-kim-technique
#13
C Ameri, F M Lopez, G J Vitagliano, H Rios Pita, J M Guglielmi, L Blas
INTRODUCTION AND OBJECTIVES: Nephron-sparing surgery (NSS) is the indication, provided it is feasible and meets the international treatment guidelines. One of the objectives of performing NSS is to reduce the ischemia time as much as possible. We propose a surgical technique for treating polar renal tumours and those larger than 4cm based on the principle of the technique described by Kim in 1964. METHOD: The technique performs a continuous circular suture on the base of the tumour, achieving compression of the renal pole without vascular clamping, facilitating haemostasis and avoiding the blind transfixion performed in Kim's original technique...
March 28, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28355685/-clinical-outcome-and-placenta-characteristics-of-spontaneous-twin-anemia-polycythemia-sequence
#14
X J Wang, L Y Li, Y Wei, Y Y Zhao, P B Yuan
Objective: To investigate the clinical outcome and placental characteristics of spontaneous twin anemia-polycythemia sequence (sTAPS). Methods: Twelve cases with sTAPS delivered in Peking University Third Hospital from May 2013 to August 2016. The data of ultrasound characteristics, gestational age at delivery, and 1 minute Apgar score were analyzed, retrospectively. Placental superficial vascular anastomoses, placental territory discordance and the ratio of umbilical cords insertion distance to the longest placental diameter were also analyzed...
March 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28344522/vascularized-bone-grafting-in-scaphoid-nonunion-a-review-of-patient-centered-outcomes
#15
REVIEW
Ram K Alluri, Christine Yin, Matthew L Iorio, Hyuma Leland, Jason Wong, Ketan Patel
Background: The radiographic and clinical outcomes following vascularized bone grafting (VBG) for scaphoid nonunion have previously been reported in the literature; however, few studies report on patient-derived outcomes. The purpose of this study was to determine the effect of VBG for scaphoid nonunion on patient-derived outcomes. Methods: The MEDLINE and PubMed databases were queried for the use of VBG in scaphoid nonunion. We included studies that reported on patient-derived outcomes. We excluded studies with less than 10 patients or less than 6 months of follow-up...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28337055/diabetic-retinopathy-knowledge-awareness-and-practices-of-physicians-in-primary-care-centers-in-riyadh-saudi-arabia
#16
Raghad Al Rasheed, Fadwa Al Adel
PURPOSE: Diabetic retinopathy (DR) is a serious cause of irreversible blindness and is the most common complication of diabetes. Annual fundus examination for diabetics aids in the prevention of blindness and allows intervening at a timely manner. As primary care physicians (PCP) are the main providers for diabetic care in Saudi Arabia, we aim to evaluate the current knowledge and awareness, and to assess practices among PCP regarding DR. METHODS: We conducted a cross-sectional study covering 46 randomly selected primary-care centers in Riyadh during October 2015...
January 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28330434/is-there-an-effect-of-race-ethnicity-on-early-complications-of-iliac-vein-stenting
#17
Ahmad Alsheekh, Anil Hingorani, Samson Ferm, Pavel Kibric, Afsha Aurshina, Natalie Marks, Enrico Ascher
Background There have been well-documented implications of race/ethnicity on the outcome of various vascular diseases. Little literature has examined the effect of race/ethnicity on venous disease. Iliac vein stenting is an emerging technology in treating chronic venous insufficiency. To further characterize this disease and its treatment, we chose to study the effect of selected clinical factors including race/ethnicity on the early complications of non-thrombotic iliac vein stenting. Methods In this observational study, data analysis was performed for 623 patients with chronic venous insufficiency who underwent iliac vein stenting during the time period from August 2012 to September 2014...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28327941/degree-of-vascular-encasement-in-sphenoid-wing-meningiomas-predicts-postoperative-ischemic-complications
#18
D Jay McCracken, Raymond A Higginbotham, Jason H Boulter, Yuan Liu, John A Wells, Sameer H Halani, Amit M Saindane, Nelson M Oyesiku, Daniel L Barrow, Jeffrey J Olson
BACKGROUND: Sphenoid wing meningiomas (SWMs) can encase arteries of the circle of Willis, increasing their susceptibility to intraoperative vascular injury and severe ischemic complications. OBJECTIVE: To demonstrate the effect of circumferential vascular encasement in SWM on postoperative ischemia. METHODS: A retrospective review of 75 patients surgically treated for SWM from 2009 to 2015 was undertaken to determine the degree of circumferential vascular encasement (0°-360°) as assessed by preoperative magnetic resonance imaging (MRI)...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326805/a-retrospective-analysis-of-care-in-patients-with-dementia-hospitalized-at-a-tertiary-medical-center
#19
Riddhi Patira, Huaqing Zhao, Ausim Azizi
BACKGROUND: Hospitalization is an opportunity to address various aspects related to management of dementia, including the goals of care to avoid futile care. We studied the prevalence of these factors when patients with dementia are hospitalized. DESIGN: One hundred and thirty-one charts of patients with dementia admitted to a single university-based hospital were retrospectively reviewed. Data were collected and analyzed for age, gender, the severity of dementia, co-morbidities, co-existing vascular dementia, reversible causes of dementia, mental status scores, medications, consultations, procedures, complications, availability of advance directives, decision-maker, code status, and goals of care discussion...
March 22, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#20
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
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