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https://www.readbyqxmd.com/read/29033819/an-unusual-presentation-of-pyoderma-gangrenosum-leading-to-systemic-inflammatory-response-syndrome
#1
Ali Didan, Alan Donnelly, Hock Chua
This is a report of an atypical presentation of pyoderma gangrenosum (PG) in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU) admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS) secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest...
September 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/29033526/complexity-of-comprehensive-care-treatments-in-undergraduate-dental-programs-the-benefits-of-observing-and-assisting-experienced-faculty-members
#2
Moataz Elgezawi, Khalid Hassan, Adel Alagl, Ahmad M Al-Thobity, Basel Al-Mutairi, Thamir Al-Houtan, Shazia Sadaf
OBJECTIVE: To improve the confidence of the final year dental students in completing occlusal and oral rehabilitation of patients, with complexities beyond their scope, based on full analysis of the biomechanical and esthetic considerations of each case. MATERIAL & METHODS: Two comprehensive patient situations presenting with special difficulties including extensive, reduced vertical dimension of occlusion, limited interocclusal space and maxillary alveolar bone for implant insertion necessitating bone augmentation and a sinus lift surgery was managed by two students at our institute...
October 2017: Saudi Dental Journal
https://www.readbyqxmd.com/read/29029905/perioperative-complications-with-new-oral-anticoagulants-dabigatran-apixaban-and-rivaroxaban-in-mohs-micrographic-surgery-a-retrospective-study
#3
Camila Antia, Natalie Hone, Hugh Gloster
No abstract text is available yet for this article.
November 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29026957/autologous-buccal-micro-mucosa-free-graft-combined-with-posterior-scrotal-flap-transfer-for-vaginoplasty-in-male-to-female-transsexuals-a-pilot-study
#4
Shu-Yi Wei, Feng-Yong Li, Qiang Li, Sen-Kai Li, Chuan-De Zhou, Yu Zhou, Yu-Jiao Cao, Si-Ya Zhang, Yang Zhao
BACKGROUND: The inverted peno-scrotal flap method is considered the standard method of vaginoplasty in male-to-female genital reassignment surgery. Though with numerous advantages, the method has its limitations regarding skin texture, lack of inherent lubrication, and that the tissues for creating the labia depend on the amount of tissues remaining after vaginoplasty. Our purpose was to describe the procedure and outcome of vaginoplasty applying a new technique: autologous buccal micro-mucosa free graft combined with posterior scrotal flap transfer, which could solve some of the problems the previous methods had...
October 12, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29026405/lateral-retroperitoneoscopic-adrenalectomy-for-complicated-adrenal-tumor-larger-than-5-centimeters
#5
Wei Chen, Wei Lin, Deng-Jun Han, Yong Liang
BACKGROUND: The role of lateral retroperitoneoscopic adrenalectomy (LRA) for complicated tumor with large diameter remains controversial, this study aimed to evaluate the effectiveness of this procedure on the management of tumor larger than 5cm in diameter. METHODS: A retrospective comparison was conducted of 67 patients with large complicated adrenal tumor (>5cm). 41 patients received LRA, and 26 received open adrenalectomy (OA) in our hospital between January 2011 and June 2015...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/29025081/the-long-term-effects-of-early-oral-feeding-following-minimal-invasive-esophagectomy
#6
Gijs H K Berkelmans, Laura Fransen, Teus J Weijs, Merel Lubbers, Grard A P Nieuwenhuijzen, Jelle P Ruurda, Ewout A Kouwenhoven, Marc J van Det, Camiel Rosman, Richard van Hillegersberg, Misha D P Luyer
A nil-by-mouth regime with enteral nutrition via an artificial route is frequently applied following esophagectomy. However, early initiation of oral feeding could potentially improve recovery and has shown to be beneficial in many types of abdominal surgery. Although short-term nutritional safety of oral intake after an esophagectomy has been documented, long-term effects of this feeding regimen are unknown. In this cohort study data from patients undergoing minimal invasive Ivor-Lewis esophagectomy between 04-2012 and 09-2015 in three centers in The Netherlands were collected...
August 31, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29022538/preoperative-fasting-times-prescribed-and-actual-fasting-times-at-universitas-hospital-annex-bloemfontein-south-africa
#7
G Lamacraft, C Labuschagne, S Pretorius, M C Prinsloo, M D Smit, J-R Steyn
BACKGROUND: Guidelines recommend a preoperative fasting period of 6 hours for solid food and 2 hours for clear fluids. Because of fixed meal times and imprecise operation starting times, patients often fast for an extended period of time. OBJECTIVE: To investigate the prescribed preoperative fasting times, and the actual duration of fasting, compared with the internationally accepted fasting times for solid food and clear fluids. METHODS: Patients (N=105) aged 14 - 60 years, who were scheduled for elective surgery in the morning session (list starting time 07h00), were included in this prospective study...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29019875/anterograde-injection-of-low-dose-urokinase-salvages-free-anterolateral-thigh-flap-a-case-report-of-safe-and-effective-treatment
#8
Shao-Yun Hsu, Hsu-Tang Cheng, Oscar Manrique, Yung-Chang Hsu
RATIONALE: A 54-year-old Taiwanese male came to our hospital presented with right retromolar mucoepidermoid carcinoma. Composite resection and right modified radical neck dissection were performed. We then use free anteral lateral thigh flap to reconstruct the defect. However, venous congestion was found 32 h after the surgery. PATIENT CONCERNS: The main concerns of the patient is complete salvage of the free flap, and avoiding the secondary free flap harvesting and reconstruction surgeries...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29016813/epicardial-left-atrial-appendage-atriclip-occlusion-reduces-the-incidence-of-stroke-in-patients-with-atrial-fibrillation-undergoing-cardiac-surgery
#9
Etem Caliskan, Ayhan Sahin, Murat Yilmaz, Burkhardt Seifert, Ricarda Hinzpeter, Hatem Alkadhi, James L Cox, Tomas Holubec, Diana Reser, Volkmar Falk, Jürg Grünenfelder, Michele Genoni, Francesco Maisano, Sacha P Salzberg, Maximilian Y Emmert
Aims: Left atrial appendage (LAA) occlusion has emerged as an interesting alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF). We report the safety, efficacy, and durability of concomitant device-enabled epicardial LAA occlusion during open-heart surgery. In addition to long-term follow-up, we evaluate the impact on stroke risk in this selected population. Methods and results: A total of 291 AtriClip devices were deployed epicardially in patients (mean CHA2DS2-VASc-Score: 3...
July 18, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28991089/retained-needle-following-transanal-hemorrhoidal-dearterialization
#10
Valerio Celentano, Anjan Banerjee, Federico Luvisetto, Syed Naqvi, Jim Khan
INTRODUCTION: A needle was retained during transanal hemorrhoidal dearterialization. This rare complication has not been described before. TECHNIQUE: A spinal needle was inserted from the perianal skin to localize the retained foreign body that was located at 7 cm from the anal margin. A decision was made to proceed to intersphincteric dissection, and a 3-cm incision was made in the perianal skin from 2 to 4 o'clock. Deep pararectal dissection continued, and the needle was eventually found lying in the muscular layer, parallel to the plane of the dissection...
November 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28991056/ultrafast-track-robotic-assisted-minimally-invasive-coronary-artery-surgical-revascularization
#11
Christopher L Tarola, Hussein A Al-Amodi, Sankar Balasubramanian, Stephanie A Fox, Christopher C Harle, Ivan Iglesias, Kumar Sridhar, Patrick J Teefy, Michael W A Chu, Bob B Kiaii
OBJECTIVE: Contemporary anesthetic techniques have enabled shorter sedation and early extubation in off-pump and minimally invasive coronary artery bypass (CABG) surgery. Robotic-assisted CABG represents the optimal surgical approach for ultrafast track anesthesia, with patients able to bypass the cardiac surgical intensive care unit with recovery in the postanesthesia care unit (PACU) and inpatient ward. METHODS: In-hospital postoperative outcomes from ninety patients who underwent either elective or urgent robotically-assisted CABG at our institution were reviewed...
October 4, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28990694/suprafascial-versus-traditional-harvesting-technique-for-free-antero-lateral-thigh-flap-a-case-control-study-to-assess-the-best-functional-and-aesthetic-result-in-extremity-reconstruction
#12
Michele Maruccia, Nefer Fallico, Emanuele Cigna, Pedro Ciudad, Fabio Nicoli, Emilio Trignano, Eleonora Nacchiero, Giuseppe Giudice, Diego Ribuffo, Hung-Chi Chen
Clinical applications of ALT flap have currently extended to extremity (hand and foot) as well as oral cavity reconstruction. In these anatomical areas, the traditional harvesting technique presents a few disadvantages such as bulkiness of the recipient site and potential donor site morbidity including damage to the deep fascia and skin graft adhesions. The purpose of the present study was to compare the functional and aesthetic outcomes of upper and lower extremity reconstruction with either suprafascial or subfascial harvested anterolateral (ALT) flaps...
October 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28988455/safety-profiles-of-percutaneous-left-atrial-appendage-closure-devices-an-analysis-of-the-food-and-drug-administration-manufacturer-and-user-facility-device-experience-maude-database-from-2009-2016
#13
Mohammad-Ali Jazayeri, Venkat Vuddanda, Mohit K Turagam, Valay Parikh, Madhav Lavu, Donita Atkins, Matthew Earnest, Luigi Di Biase, Andrea Natale, David Wilber, Yeruva Madhu Reddy, Dhanunjaya Lakkireddy
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) is a viable option for AF patients who are unable to tolerate long term oral anticoagulation (OAC). OBJECTIVE: We sought to assess the safety of two commonly used percutaneous devices for LAA closure in the United States by analysis of surveillance data from the FDA Manufacturer and User Facility Device Experience (MAUDE) database. METHODS: The MAUDE database was queried between May 1, 2006 and May 1, 2016 for LARIAT® (SentreHEART Inc...
October 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28987224/controversies-in-traditional-oral-and-maxillofacial-reconstruction
#14
REVIEW
John S Vorrasi, Antonia Kolokythas
Traditional reconstruction of the head and neck and significantly evolved over the last 20 to 30 years with advances in microvascular surgery, biologic materials such as bone morphogenic protein, and dental implant predictability. Earlier and more definitive reconstruction can now be achieved with combining therapies, allowing patients immediate restoration of function and improved cosmetics. Antiresorptive medications, such as Denosumab and bisphosphonates, have complicated bony reconstruction treatments with altered biology and less-predictable results...
November 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28985843/total-parenteral-nutrition-in-patients-following-pancreaticoduodenectomy-lessons-from-1184-patients
#15
Cullen E Worsh, Talar Tatarian, Awinder Singh, Michael J Pucci, Jordan M Winter, Charles J Yeo, Harish Lavu
BACKGROUND: Total parenteral nutrition (TPN) has historically been used conservatively in the management of patients after pancreaticoduodenectomy (PD). Herein, we evaluate the indications for and outcomes associated with TPN use in a high-volume pancreatic surgery center. MATERIALS AND METHODS: We retrospectively queried our institution's pancreatic surgery database for patients who received TPN after PD from 2006 through 2015. RESULTS: Of 1184 patients who underwent PD, 232 (19...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28984645/advances-in-the-endoscopic-management-of-gastric-outflow-disorders
#16
Andrew C Storm, Marvin Ryou
PURPOSE OF REVIEW: Disorders of gastric outflow and outlet obstruction include a variety of benign and malignant disorders such as peptic strictures, foreign bodies, gastroparesis, and cancers of the stomach, duodenum, and pancreas. Historically, a majority of patients presenting with gastric outlet obstruction (GOO) were to the result of peptic ulcers and surgical management of peptic ulcer complications was a mainstay of general surgical training. Invasive surgery is being performed less frequently today due to realization of the role of Helicobacter pylori in peptic ulcer disease and the introduction of novel endoscopic techniques for management of GOO...
November 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28983908/interventions-for-managing-medication-related-osteonecrosis-of-the-jaw
#17
REVIEW
Natalie H Beth-Tasdogan, Benjamin Mayer, Heba Hussein, Oliver Zolk
BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse reaction experienced by some individuals to certain medicines commonly used in the treatment of cancer and osteoporosis (e.g. bisphosphonates, denosumab and antiangiogenic agents) and involves the progressive destruction of bone in the mandible or maxilla. Depending on the drug, its dosage, and the duration of exposure, the occurrence of this adverse drug reaction may be rare (e.g. following the oral administration of bisphosphonate or denosumab treatments for osteoporosis, or antiangiogenic agent-targeted cancer treatment) or common (e...
October 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28980383/incidence-of-venous-thromboembolic-events-in-enhanced-recovery-after-surgery-for-colon-cancer-a-retrospective-population-based-cohort-study
#18
Momo M I Vendler, Tamim A Haidari, Jo E Waage, Jakob Kleif, Bent Kristensen, Ismail Gögenur, Claus A Bertelsen
AIM: Both the Danish and NICE guidelines recommend prolonged thromboprophylaxis (PT) with low-molecular-weight heparin (LMWH) for 28 days postoperatively after elective surgery for colon cancer. The evidence relies on two RCTs that included not only colon cancers but also other abdominal cancers or benign colorectal diseases. Neither of those studies investigated the risk of venous thromboembolism (VTE) under Enhanced Recovery After Surgery (ERAS). We aim to describe the risk of VTE and estimate the cost of preventing one case of VTE by PT under ERAS...
October 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28969192/effect-of-2-nasal-mupirocin-ointment-on-decreasing-complications-of-nasotracheal-intubation-a-randomized-controlled-trial
#19
Kourosh Taheri Talesh, Reza Movassaghi Gargary, Seyed Ahmad Arta, Javad Yazdani, Monireh Roshandel, Milad Ghanizadeh, Hossein Samadi Kafil, Mir Naser Seyyed Mousavi
INTRODUCTION: In oral and maxillofacial surgeries, nasotracheal intubation is carried out to increase the surgeon's access to the oral cavity. During nasotracheal intubation the risk of trauma is higher than that in orotracheal intubation as there is passage of the tube through the mucosa of the nasal tract due to which bacteria might get transported into the trachea. AIM: To evaluate the effect of 2% nasal mupirocin ointment before and after nasotracheal intubation on decreasing the complications of intubation for oral and maxillofacial surgeries...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28968280/suprascapular-and-interscalene-nerve-block-for-shoulder-surgery-a-systematic-review-and-meta-analysis
#20
Nasir Hussain, Ghazaleh Goldar, Neli Ragina, Laura Banfield, John G Laffey, Faraj W Abdallah
BACKGROUND: Interscalene block provides optimal shoulder surgery analgesia, but concerns over its associated risks have prompted the search for alternatives. Suprascapular block was recently proposed as an interscalene block alternative, but evidence of its comparative analgesic effect is conflicting. This meta-analysis compares the analgesic effect and safety of suprascapular block versus interscalene block for shoulder surgery. METHODS: Databases were searched for randomized trials comparing interscalene block with suprascapular block for shoulder surgery...
October 10, 2017: Anesthesiology
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