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https://www.readbyqxmd.com/read/28534215/-acute-haematogenous-osteomyelitis-in-children-diagnostic-algorithm-and-treatment-strategies
#1
M Willegger, A Kolb, R Windhager, C Chiari
Acute haematogenous osteomyelitis (AHO) in children is a severe condition. A delay in diagnosis and insufficient treatment may result in deformities, chronicity and sepsis. Therefore a structured diagnostic workup has to be followed in order to diagnose or rule out osteomyelitis. To identify the causative agent for targeted antibiotic treatment, a bone biopsy or puncture should be performed. However, approximately 25% of cases are culture-negative even after biopsy. The knowledge of the typical age-dependent bacterial spectrum is essential for empirical antibiotic therapy...
May 22, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28528388/fertility-sparing-for-young-patients-with-gynecologic-cancer-how-mri-can-guide-patient-selection-prior-to-conservative-management
#2
REVIEW
Sinead H McEvoy, Stephanie Nougaret, Nadeem R Abu-Rustum, Hebert Alberto Vargas, Elizabeth A Sadowski, Christine O Menias, Fuki Shitano, Shinya Fujii, Ramon E Sosa, Joanna G Escalon, Evis Sala, Yulia Lakhman
Historically, cancer treatment has emphasized measures for the "cure" regardless of the long-term consequences. Advances in cancer detection and treatment have resulted in improved outcomes bringing to the fore various quality of life considerations including future fertility. For many young cancer patients, fertility preservation is now an integral component of clinical decision-making and treatment design. Optimal fertility-sparing options for young patients with gynecologic cancer are influenced by patient age, primary cancer, treatment regimens, and patient preferences...
May 20, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28527684/patient-perceptions-regarding-outpatient-hip-and-knee-arthroplasties
#3
R Michael Meneghini, Mary Ziemba-Davis
BACKGROUND: There has been increasing interest in outpatient total joint arthroplasty (TJA) in the orthopedic community, but how patients feel about outpatient TJA is unknown. The purpose of this study was to understand patient perspectives on hip and knee replacements performed in an outpatient setting. METHODS: We surveyed 110 consecutive patients scheduled for primary TJA in an academic suburban arthroplasty practice regarding their knowledge and perceptions of outpatient TJA...
April 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28523415/pictorial-review-of-vascular-involvement-and-complex-vascular-reconstructions-in-borderline-to-minimally-advanced-pancreatic-malignancies
#4
REVIEW
Donald L Ly, Seng Thipphavong, Boraiah Sreeharsha
PURPOSE: To review borderline resectability criteria for pancreatic malignancies, show examples of few surgically treated minimally advanced pancreatic malignancies, discuss various complex vascular reconstructions, and highlight the imaging appearances. BACKGROUND: Often aggressive surgical approaches are used to treat borderline to minimally advanced pancreatic malignancies in specialist centers. As abdominal radiologists it is essential to have up-to-date knowledge to distinguish such tumors with accuracy and also be well versed with the various vascular reconstructions used in such surgeries...
May 18, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28516202/-plastic-reconstruction-of-radiation-injuries
#5
P M Vogt, T R Mett, C Henkenberens, C Radtke, R Ipaktchi
In addition to surgical and drug therapy, radiotherapy (or radiation therapy) is one of the three mainstays of modern oncological therapy regimes. It uses ionizing radiation to control tumors by damaging the DNA of cancerous tissue leading to cellular death. Although advances have been made in recent years resulting in a reduced dosage to the surrounding tissues, radiation injuries and tissue-related side effects cannot be completely avoided. Knowledge of the pathophysiology, treatment modalities and interdisciplinary treatment approaches are essential for effective therapy whilst limiting side effects...
May 17, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28515060/barriers-and-facilitators-experienced-in-collaborative-prospective-research-in-orthopaedic-oncology-a-qualitative-study
#6
J S Rendon, M Swinton, N Bernthal, M Boffano, T Damron, N Evaniew, P Ferguson, M Galli Serra, W Hettwer, P McKay, B Miller, L Nystrom, W Parizzia, P Schneider, A Spiguel, R Vélez, K Weiss, J P Zumárraga, M Ghert
OBJECTIVES: As tumours of bone and soft tissue are rare, multicentre prospective collaboration is essential for meaningful research and evidence-based advances in patient care. The aim of this study was to identify barriers and facilitators encountered in large-scale collaborative research by orthopaedic oncological surgeons involved or interested in prospective multicentre collaboration. METHODS: All surgeons who were involved, or had expressed an interest, in the ongoing Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial were invited to participate in a focus group to discuss their experiences with collaborative research in this area...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28514867/acute-temporary-unilateral-facial-nerve-palsy-after-dermatologic-surgery-a-report-of-3-cases
#7
Jacquelyn Majerowski, Yaohui G Xu
Facial nerve dysfunction can be functionally and cosmetically debilitating and is commonly associated with high anxiety for patients. We report 3 cases of temporary, unilateral facial nerve palsy following dermatologic surgery under local anaesthesia over the preauricular cheek and mandibular angle, which, to our knowledge, has not been reported in the literature. Given its frightening presentation mimicking a stroke, it is essential for dermatologists to become aware of this complication to inform their patients more thoroughly...
May 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28511520/effect-of-trauma-to-primary-tooth-on-permanent-maxillary-incisors-a-clinical-case-report
#8
Bhawana Gupta, Sachin Gupta, Jitesh Wadhwa, Alpa Gupta
Trauma to primary tooth leads to abnormal variations in crown and root canals of permanent teeth that presents a challenge in diagnosis and clinical management to the practitioner. This article presents a detailed case report of the endodontic treatment of a three canalled maxillary central incisor and maxillary lateral incisor having single canal with open apex linked with periodontal defect. Root canals were prepared with hand files and canals were irrigated with 2.5% sodium hypochlorite solution. Calcium hydroxide was placed as an intracanal medicament...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509331/anatomic-landmarks-in-lacrimal-surgery-from-an-ophthalmologist-s-point-of-view
#9
REVIEW
Jens Heichel, Hans-Gert Struck, Anja Viestenz, Thomas Hammer, Arne Viestenz, Miltiadis Fiorentzis
Epiphora is a common clinical symptom of nasolacrimal duct obstruction. However, it is present in several pathologies and can lead to decreased quality of life for patients. A careful clinical examination including a detailed patient's history and diagnostic tests such as the fluorescein dye disappearance test and diagnostic syringing of the lacrimal duct are essential. Depending on the time of presentation (congenital, primary or secondary acquired), grade (subtotal or total) and location of the stenosis, different surgical approaches can be considered...
May 16, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28506309/social-isolation-and-cancer-management-advanced-rectal-cancer-with-patient-delay-following-the-2011-triple-disaster-in-fukushima-japan-a-case-report
#10
Akihiko Ozaki, Claire Leppold, Toyoaki Sawano, Masaharu Tsubokura, Manabu Tsukada, Tetsuya Tanimoto, Masahiro Kami, Hiromichi Ohira
BACKGROUND: Little is known about the effects of social isolation in the elderly on their process of gaining health information and seeking health care. CASE PRESENTATION: In March 2011, Fukushima, Japan experienced an earthquake, tsunami, and nuclear disaster, also known as Japan's triple disaster. In June 2016, an 80-year-old Japanese man, who lived alone after divorce at the age of 42, presented to our hospital with bloody stools and dizziness. Although his bloody stools initially occurred in May 2015, a year earlier, he did not pursue the possibility of malignancy...
May 16, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28489448/immediate-postoperative-management-and-complications-on-the-intensive-care-unit
#11
Eleanor Bates, Daniel Martin
The postoperative management of patients immediately after liver transplantation requires knowledge of this complex surgery and the physiology that accompanies liver failure. A multidisciplinary approach to the care of these patients is essential in order to reduce postoperative complications and preserve function in the transplanted organ. By their nature, patients undergoing liver transplantation have complicated medical problems before surgery which must be borne in mind when managing them after surgery...
May 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28483205/aortic-diameter-growth-in-children-with-a-bicuspid-aortic-valve
#12
Remy Merkx, Anthonie L Duijnhouwer, Evelien Vink, Jolien W Roos-Hesselink, Michiel Schokking
Knowledge of aortic growth in patients with bicuspid aortic valve (BAV) is essential to identify patients at risk for dissection, but data on children remain unclear. We retrospectively evaluated the aortic diameters of all pediatric BAV patients, identified through an echocardiographic database (2005 to 2013). Medical records were reviewed and aortic diameters re-measured on echocardiographic images at diagnosis and if available on variable mid- and endpoints follow-up. Dilatation (z-score >2) was based on 2 different z-score equation methods (Gautier/Campens)...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28469459/cardiac-evaluation-and-monitoring-of-patients-undergoing-noncardiac-surgery
#13
REVIEW
Arsalan Rafiq, Eduard Sklyar, Jonathan N Bella
Surgical management of disease has a tremendous impact on our health system. Millions of people worldwide undergo surgeries every year. Cardiovascular complications in the perioperative period are one of the most common events leading to increased morbidity and mortality. Although such events are very small in number, they are associated with a high mortality rate making it essential for physicians to understand the importance of perioperative cardiovascular risk assessment and evaluation. Its involves a detailed process of history taking, patient's medical profile, medications being used, functional status of the patient, and knowledge about the surgical procedure and its inherent risks...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28458830/duplicated-common-bile-duct-a-recipe-for-biliary-injury-report-of-a-new-variant
#14
Nabil M Nuamah, Cem Ibis, Ali F K Gok, Feza Ekiz, Bulent Acunas
Duplicated common bile duct, often associated with conditions like lithiasis, biliary cysts and pancreatobiliary maljunction, could result in highly morbid and potentially fatal biliary injuries. Precise preoperative diagnosis and classification still remain a challenge. A female patient undergoing emergency laparoscopic cholecystectomy for acute calculous cholecystitis sustained iatrogenic bile duct injury. A drainage tube was placed into the injured duct for post-operative conservative management. Post-operative tube cholangiogram revealed a double common bile duct with cystic duct opening distally...
February 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28447062/modified-palliative-biliary-stenting-in-situs-inversus-totalis-patient-with-carcinoma-gallbladder-feasibility-and-technical-details
#15
Nishant Gupta, Pradeep Goyal, Itisha Bansal, Shuo Li, Yogesh Kumar, Sanjay S Baijal
Knowledge of the anatomical variants is essential for all invasive hepatobiliary procedures such as endoscopy, surgery and radiologic interventions. Modification in standard therapeutic interventions may be required based on variant anatomy. We report a technical modification in a 75-year-old female with known situs inversus (SI) totalis with carcinoma gallbladder. Present case highlights the finer technical details of the modified percutaneous transhepatic biliary drainage (PTBD) procedure and biliary stenting in a SI patient with carcinoma gallbladder causing malignant biliary obstruction...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28415885/fatigue-and-pain-limit-independent-mobility-and-physiotherapy-after-hip-fracture-surgery
#16
Kristine H Münter, Christopher G Clemmesen, Nicolai B Foss, Henrik Palm, Morten T Kristensen
PURPOSE: The patient's ability to complete their planned physiotherapy session after hip fracture surgery has been proposed as an independent predictor for achieving basic mobility independency upon hospital discharge. However, knowledge of factors limiting mobility is sparse. We therefore examined patient reported factors limiting ability to complete planned physiotherapy sessions as well as limitations for not achieving independency in basic mobility early after hip fracture surgery...
April 17, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28403403/objective-model-using-only-gender-age-and-medication-list-predicts-in-hospital-morbidity-after-elective-surgery
#17
J D Blitz, K S Mackersey, J C Miller, S M Kendale
Background.: Most current surgical risk models contain many variables: some of which may be esoteric, require a physician's assessment or must be obtained intraoperatively. Early preoperative risk stratification is essential to identify high risk, elective surgical patients for medical optimization and care coordination across the perioperative period. We sought to create a simple, patient-driven scoring system using: gender, age and list of medications to predict in-hospital postoperative morbidity...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#18
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28394009/anatomical-variations-of-testicular-artery-a-review
#19
Ilangovan Kayalvizhi, Ravi Kant Narayan, Piyush Kumar
The testicular arteries (TAs) also known as Internal spermatic arteries are long and slender arteries usually arising from the anterolateral aspect of the abdominal aorta (AA), 2.5 cm to 5 cm caudal to the renal arteries (RA). The variation in testicular arteries may be found with respect to their origin, number or course. They can originate from the abdominal aorta itself at an abnormal level. If not arising from abdominal aorta the TA variants may arise from renal artery, supra renal artery or any one of the lumbar arteries...
April 10, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28386927/microsurgical-techniques-in-temporal-lobe-epilepsy
#20
Mario A Alonso Vanegas, Sean M Lew, Michiharu Morino, Stenio A Sarmento
Temporal lobe resection is the most prevalent epilepsy surgery procedure. However, there is no consensus on the best surgical approach to treat temporal lobe epilepsy. Complication rates are low and efficacy is very high regarding seizures after such procedures. However, there is still ample controversy regarding the best surgical approach to warrant maximum seizure control with minimal functional deficits. We describe the most frequently used microsurgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (corticoamygdalohippocampectomy and selective amygdalohippocampectomy)...
April 2017: Epilepsia
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