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https://www.readbyqxmd.com/read/28103628/treatment-of-a-vulvar-paget-s-disease-by-photodynamic-therapy-with-a-new-light-emitting-fabric-based-device
#1
Claire Vicentini, Olivier Carpentier, Fabienne Lecomte, Elise Thecua, Laurent Mortier, Serge R Mordon
INTRODUCTION: The non-invasive vulvar Paget's disease is an intra-epidermal carcinoma with glandular characteristics. It appears like an erythematous plaque. The main symptoms are pruritus and pain. The standard treatment is surgical excision in depth. This treatment is complicated with a severe morbidity and photodynamic therapy can be an alternative choice. However, the pain experienced during the photodynamic treatment of vulvar lesion is intense and leads to a premature interruption of the treatment...
January 19, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28103572/low-rate-of-positive-margins-and-re-excision-after-partial-mastectomy-in-highly-selected-breast-cancer-patients-a-chinese-single-institution-experience
#2
Siyu Wu, Yanyan Zhu, Zhaozhi Yang, Miao Mo, Hongbo Gao, Wentao Yang, Guangyu Liu
A recent randomized controlled trial firstly demonstrated that cavity shaving significantly decreased the rate of positive margins and re-excision among partial mastectomy (PM) patients. However, it remains unknown whether cavity shaving should be routinely applied to Chinese breast cancer patients undergoing PM. A total of 408 PM patients undergoing 410 PMs among 1796 surgically treated breast cancer patients at Fudan University Shanghai Cancer Centre from January 2015 to June 2015 were included in our study...
January 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28103536/evidence-based-guidelines-for-the-use-of-tracheostomy-in-critically-ill-patients
#3
Néstor Raimondi, Macarena R Vial, José Calleja, Agamenón Quintero, Albán Cortés, Edgar Celis, Clara Pacheco, Sebastián Ugarte, José M Añón, Gonzalo Hernández, Erick Vidal, Guillermo Chiappero, Fernando Ríos, Fernando Castilleja, Alfredo Matos, Enith Rodriguez, Paulo Antoniazzi, José Mario Teles, Carmelo Dueñas, Jorge Sinclair, Lorenzo Martínez, Ingrid von der Osten, José Vergara, Edgar Jiménez, Max Arroyo, Camilo Rodríguez, Javier Torres, Sebastián Fernandez-Bussy, Joseph L Nates
OBJECTIVES: To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A taskforce composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28102961/assessing-the-use-of-4dct-ventilation-in-pre-operative-surgical-lung-cancer-evaluation
#4
Yevgeniy Vinogradskiy, Matthew Jackson, Leah Schubert, Bernard Jones, Richard Castillo, Edward Castillo, Thomas Guerrero, John Mitchell, Chad Rusthoven, Moyed Miften, Brian Kavanagh
PURPOSE: A primary treatment option for lung cancer patients is surgical resection. Patients who have poor lung function prior to surgery are at increased risk of developing serious and life-threatening complications after surgical resection. Surgeons use nuclear medicine ventilation-perfusion (VQ) scans along with pulmonary function test (PFT) information to assess a patient's pre-surgical lung function. The nuclear medicine images and pre-surgery PFTs are used to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung tissue that would be lost with surgical resection...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28101839/surgical-treatment-of-ischemic-mitral-regurgitation-valve-repair-versus-replacement
#5
REVIEW
Abhishek Sharma, Sahil Agrawal, Sunny Goel, Jeffrey S Borer
PURPOSE OF REVIEW: Ischemic mitral regurgitation (MR), which occurs in about 20-30% patients with a prior myocardial infarction, is associated with worsening heart failure and an increase in cardiovascular mortality. It should be treated surgically if certain hemodynamic severity criteria are met and in patients who continue to experience symptoms of heart failure despite optimal medical therapy. However, current guidelines do not suggest which of the available approaches to mitral valve surgery-mitral valve (MV) repair or replacement (MVR) is superior for this indication...
January 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28101792/medical-management-of-diabesity-do-we-have-realistic-targets
#6
REVIEW
Joseph M Pappachan, Ananth K Viswanath
PURPOSE OF REVIEW: The global prevalence of "diabesity"-diabetes related to obesity-is increasing steadily over the past few decades because of the obesity epidemic. Although bariatric surgery is an effective treatment option for patients with diabesity, its limited availability, invasiveness, relatively high costs and the potential for surgical and postsurgical complications restrict its widespread use. Therefore, medical management is the only option for a majority of patients with diabesity...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28101722/the-effect-of-antibiotic-coated-sutures-on-the-incidence-of-surgical-site-infections-in-abdominal-closures-a-meta-analysis
#7
Basheer Elsolh, Lisa Zhang, Sunil V Patel
OBJECTIVE: This meta-analysis aims to determine if antibiotic-impregnated sutures for abdominal fascial closure prevent postoperative surgical site infections (SSIs), hernias, and/or dehiscence. METHODS: MEDLINE and EMBASE databases (1946-2016) were searched. Randomized controlled trials comparing antibiotic-impregnated sutures to standard sutures for abdominal closure were eligible. Risk of bias was evaluated using the Cochrane Handbooks definitions. RESULTS: Four-hundred fifty articles were reviewed; five eligible studies (N = 3117) were identified...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28101302/robot-assisted-laparoscopic-gastrectomy-for-gastric-cancer
#8
REVIEW
Stefano Caruso, Franco Franceschini, Alberto Patriti, Franco Roviello, Mario Annecchiarico, Graziano Ceccarelli, Andrea Coratti
Phase III evidence in the shape of a series of randomized controlled trials and meta-analyses has shown that laparoscopic gastrectomy is safe and gives better short-term results with respect to the traditional open technique for early-stage gastric cancer. In fact, in the East laparoscopic gastrectomy has become routine for early-stage gastric cancer. In contrast, the treatment of advanced gastric cancer through a minimally invasive way is still a debated issue, mostly due to worries about its oncological efficacy and the difficulty of carrying out an extended lymphadenectomy and intestinal reconstruction after total gastrectomy laparoscopically...
January 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28101148/cell-therapy-for-cerebral-hemorrhage-five-year-follow-up-report
#9
Zhitian Chang, Gengsheng Mao, Lizhong Sun, Qiang Ao, Yongquan Gu, Ying Liu
The aim of the study was to examine treatment of cerebral hemorrhages with bone-marrow or human umbilical cord-derived mesenchymal stem cells (BMSCs or Hu-MSCs) and conventional surgical approaches, and determine and compare the effectiveness, feasibility, safety and reproducibility of each method. A retrospective analysis was performed on a cohort of cell-treated cerebral hemorrhage patients from October 1, 2007 to October 1, 2009. A total of 24 patients, all of whom received conventional surgical treatment, were classified as follows: i) The control group consisted of 8 patients who received only hematoma removal surgery, ii) the autologous group consisted of 7 patients who received additional autologous bone marrow mononuclear cell transplantation, and iii) the allograft group consisted of 9 patients who received additional umbilical cord mononuclear cell transplantation...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28100529/children-and-parental-anxiolysis-in-paediatric-ambulatory-surgery-a-randomized-controlled-study-comparing-0-3%C3%A2-mg-kg-1-midazolam-to-tablet-computer-based-interactive-distraction
#10
C Marechal, J Berthiller, S Tosetti, B Cogniat, H Desombres, L Bouvet, B Kassai, D Chassard, M de Queiroz Siqueira
BACKGROUND: The operating theatre, anaesthesia induction and separation from parents create fear and anxiety in children. Anxiety leads to adverse behavioral changes appearing and sometimes persisting during the postoperative period. Our aim was to compare the effects of midazolam (0.3 mg kg(-)(1): MDZ) for premedication with age-appropriate tablet game apps (TAB) on children anxiety during and after ambulatory surgery. METHODS: A randomized controlled trial was conducted from May 16th, 2013 to March 25th, 2014 at the Children Hospital of Lyon...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100522/intraoperative-dexamethasone-does-not-increase-the-risk-of-postoperative-wound-infection-a-propensity-score-matched-post-hoc-analysis-of-the-enigma-ii-trial-endex
#11
T Corcoran, J Kasza, T G Short, E O'Loughlin, M T V Chan, K Leslie, A Forbes, M Paech, P Myles
BACKGROUND: In a post hoc analysis of the ENIGMA-II trial, we sought to determine whether intraoperative dexamethasone was associated with adverse safety outcomes. METHODS: Inverse probability weighting with estimated propensity scores was used to determine the association of dexamethasone administration with postoperative infection, quality of recovery, and adverse safety outcomes for 5499 of the 7112 non-cardiac surgery subjects enrolled in ENIGMA-II. RESULTS: Dexamethasone was administered to 2178 (40%) of the 5499 subjects included in this analysis and was not associated with wound infection [189 (8...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100519/paravertebral-block-in-paediatric-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-trials
#12
E A Page, K L Taylor
The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus been recommended for open cholecystectomy and other less painful surgeries such as inguinal herniorraphy and appendectomy. We performed a systematic review of PVB in paediatric abdominal conditions to assess its clinical efficacy and side effects compared with other analgesic therapies.A search of Medline, Embase, and Web of Science and hand-searching references from inception date to May 2016 was done...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100249/intraoperative-radiation-therapy-iort-in-soft-tissue-sarcoma
#13
REVIEW
Falk Roeder, Robert Krempien
Soft-tissue sarcoma (STS) represent a rare tumor entity, accounting for less than 1% of adult malignancies. The cornerstone of curative intent treatment is surgery with free margins, although the extent of the surgical approach has been subject to change in the last decades. Multimodal approaches usually including radiation therapy have replaced extensive surgical procedures in order to preserve functionality while maintaining adequate local control. However, the possibility to apply adequate radiation doses by external beam radiation therapy (EBRT) can be limited in some situation especially in case of directly adjacent organs at risk with low radiation tolerance...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28100242/intraoperative-radiotherapy-in-gynaecological-and-genito-urinary-malignancies-focus-on-endometrial-cervical-renal-bladder-and-prostate-cancers
#14
REVIEW
Marco Krengli, Carla Pisani, Letizia Deantonio, Daniela Surico, Alessandro Volpe, Nicola Surico, Carlo Terrone
Intraoperative radiotherapy (IORT) refers to the delivery of a single radiation dose to a limited volume of tissue during a surgical procedure. A literature review was performed to analyze the role of IORT in gynaecological and genito-urinary cancer including endometrial, cervical, renal, bladder and prostate cancers.Literature search was performed by Pubmed and Scopus, using the words "intraoperative radiotherapy/IORT", "gynaecological cancer", "uterine/endometrial cancer", "cervical/cervix cancer", "renal/kidney cancer", "bladder cancer" and "prostate cancer"...
January 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28099736/systematic-review-of-same-day-discharge-after-minimally-invasive-hysterectomy
#15
REVIEW
Malene Korsholm, Ole Mogensen, Mette M Jeppesen, Vibeke K Lysdal, Koen Traen, Pernille T Jensen
BACKGROUND: Same-day discharge has been suggested to safe and acceptable following minimally invasive hysterectomy. OBJECTIVES: To evaluate the feasibility of same-day discharge following minimally invasive hysterectomy and to identify associated factors. SEARCH STRATEGY: Medline, Embase and the Cochrane Central Register of Controlled Trials were systematically searched using the terms "same day discharge", "minimally invasive surgery", and "hysterectomy" between October 1 and October 31, 2015...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099685/meta-analysis-comparing-the-safety-of-laparoscopic-and-open-surgical-approaches-for-suspected-adnexal-mass-during-the-second-trimester
#16
REVIEW
Yi-Xuan Liu, Yang Zhang, Jin-Feng Huang, Li Wang
BACKGROUND: The safety of laparoscopic surgery during the second trimester of pregnancy remains a controversial subject. OBJECTIVES: To compare the safety of laparoscopic surgery and laparotomy for suspected adnexal mass during the second trimester. SEARCH STRATEGY: Articles published in any language prior to April 31, 2016, were retrieved from PubMed, Scopus, EMBSCO, and the Cochrane Library using keywords including pregnant, adnexal mass, laparoscopy, laparotomy, pregnancy outcomes, and surgical outcomes...
November 25, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099377/what-is-the-current-role-of-laparoscopic-lavage-in-perforated-diverticulitis
#17
Walter L Biffl, Frederick A Moore, Ernest E Moore
Patients with perforated diverticulitis suffer high morbidity and mortality. For decades, sigmoid colectomy with colostomy (Hartman's procedure) has been considered the standard surgical management. Over the past several years, less-morbid alternatives have been advocated. Laparoscopic lavage showed promise in retrospective studies. However, recent prospective randomized clinical trials have suggested that outcomes may not be better compared with the Hartman's procedure. A critical analysis of the literature leads the authors to the conclusion that there is still a role for laparoscopic lavage in selected patients, as a bridge to elective colectomy or, in some cases, as definitive management...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099357/bilayered-negative-pressure-wound-therapy-preventing-leg-incision-morbidity-in-coronary-artery-bypass-graft-patients-a-randomized-controlled-trial
#18
Yongchao Yu, Zhigang Song, Zhiyun Xu, Xiaofei Ye, Chunyu Xue, Junhui Li, Hongda Bi
BACKGROUNDS: The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial. METHODS: A single-center, pilot randomized controlled trial was conducted...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099320/closed-loop-delivery-systems-versus-manually-controlled-administration-of-total-iv-anesthesia-a-meta-analysis-of-randomized-clinical-trials
#19
Laura Pasin, Pasquale Nardelli, Margherita Pintaudi, Massimiliano Greco, Massimo Zambon, Luca Cabrini, Alberto Zangrillo
Bispectral Index Scale (BIS)-guided closed-loop delivery of anesthetics has been extensively studied. We performed a meta-analysis of all the randomized clinical trials comparing efficacy and performance between BIS-guided closed-loop delivery and manually controlled administration of total IV anesthesia. Scopus, PubMed, EMBASE, and the Cochrane Central Register of clinical trials were searched for pertinent studies. Inclusion criteria were random allocation to treatment and closed-loop delivery systems versus manually controlled administration of total IV anesthesia in any surgical setting...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099081/controversies-in-the-treatment-of-ductal-carcinoma-in-situ
#20
Andrea V Barrio, Kimberly J Van Zee
Ductal carcinoma in situ (DCIS) accounts for 20% of all newly diagnosed breast cancers. Mastectomy was once the gold standard for the treatment of DCIS; however, breast-conserving surgery (BCS) has been adopted as the treatment of choice for patients with small, screen-detected lesions. Both adjuvant radiation and hormonal therapy following BCS have been demonstrated in randomized trials to reduce the risk of both invasive and DCIS recurrence, but neither affects survival. With the variety of surgical and adjuvant treatment options available, there has been great interest in tailoring the treatment to the individual, with the goal of optimizing the balance of risks and benefits according to the values and priorities of the woman herself...
January 14, 2017: Annual Review of Medicine
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