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Surgical Pathway

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https://www.readbyqxmd.com/read/27914764/enhanced-recovery-pathway-in-patients-undergoing-distal-pancreatectomy-a-case-matched-study
#1
Nicolò Pecorelli, Giovanni Capretti, Gianpaolo Balzano, Renato Castoldi, Marianna Maspero, Luigi Beretta, Marco Braga
BACKGROUND: Enhanced recovery (ER) pathways have improved outcomes across multiple surgical specialties, but reports concerning their application in distal pancreatectomy (DP) are lacking. The aim of this study was to assess compliance with an ER protocol and its impact on short-term outcomes in patients undergoing DP. METHODS: Prospectively collected data were reviewed. One hundred consecutive patients undergoing DP were treated within an ER pathway comprising 18 care elements...
November 30, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27914724/medical-students-understanding-of-oral-and-maxillofacial-surgery-an-irish-perspective
#2
P G C Kielty, B R O'Connor, C J Cotter, A M C Goodson, K F B Payne, A Tahim
Oral and Maxillofacial Surgery (OMFS) remains an enigmatic specialty in Irish medicine and many students are unaware of its scope and the unique career pathway involved. We performed a multicentre cross-sectional study to identify their ability to identify the requirements for entry to specialty training year 3 (ST3) in OMFS, to assess their awareness of OMFS surgeons, and their general awareness of, and exposure to, the specialty. Data were collected through an electronic questionnaire. Participants were asked to select the most suitable surgical specialty to treat a number of common conditions in the head and neck, and to choose the requirements they deemed essential for specialist training...
November 30, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27910913/loss-of-egfr-asap1-signaling-in-metastatic-and-unresectable-hepatoblastoma
#3
Sarangarajan Ranganathan, Mylarappa Ningappa, Chethan Ashokkumar, Brandon W Higgs, Jun Min, Qing Sun, Lori Schmitt, Shankar Subramaniam, Hakon Hakonarson, Rakesh Sindhi
Hepatoblastoma (HBL), the most common childhood liver cancer is cured with surgical resection after chemotherapy or with liver transplantation if local invasion and multifocality preclude resection. However, variable survival rates of 60-80% and debilitating chemotherapy sequelae argue for more informed treatment selection, which is not possible by grading the Wnt-β-catenin over activity present in most HBL tumors. A hypothesis-generating whole transcriptome analysis shows that HBL tumors removed at transplantation are enriched most for cancer signaling pathways which depend predominantly on epidermal growth factor (EGF) signaling, and to a lesser extent, on aberrant Wnt-β-catenin signaling...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27910068/endometrial-carcinoma-specific-targeted-pathways
#4
Nuria Eritja, Andree Yeramian, Bo-Juen Chen, David Llobet-Navas, Eugenia Ortega, Eva Colas, Miguel Abal, Xavier Dolcet, Jaume Reventos, Xavier Matias-Guiu
Endometrial cancer (EC) is the most common gynecologic malignancy in the western world with more than 280,000 cases per year worldwide. Prognosis for EC at early stages, when primary surgical resection is the most common initial treatment, is excellent. Five-year survival rate is around 70 %.Several molecular alterations have been described in the different types of EC. They occur in genes involved in important signaling pathways. In this chapter, we will review the most relevant altered pathways in EC, including PI3K/AKT/mTOR, RAS-RAF-MEK-ERK, Tyrosine kinase, WNT/β-Catenin, cell cycle, and TGF-β signaling pathways...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27906752/recent-developments-in-emerging-therapeutic-targets-of-osteoarthritis
#5
Margaret Man-Ger Sun, Frank Beier, Michael A Pest
PURPOSE OF REVIEW: Despite the tremendous individual suffering and socioeconomic burden caused by osteoarthritis, there are currently no effective disease-modifying treatment options. This is in part because of our incomplete understanding of osteoarthritis disease mechanism. This review summarizes recent developments in therapeutic targets identified from surgical animal models of osteoarthritis that provide novel insight into osteoarthritis pathology and possess potential for progression into preclinical studies...
January 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/27905158/metastatic-spinal-cord-compression-from-basal-cell-carcinoma-of-the-skin-treated-with-surgical-decompression-and-vismodegib-case-report-and-review-of-hedgehog-signalling-pathway-inhibition-in-advanced-basal-cell-carcinoma
#6
J McGrane, S Carswell, T Talbot
We report a case of a 66-year-old man with locally advanced and metastatic basal cell carcinoma (BCC) causing spinal cord compression, which was treated with spinal surgery and subsequent vismodegib. The patient presented with a large fungating chest wall lesion and a metastasis in T8 that was causing cord compression. He had neurosurgical decompression of the T8 lesion and fixation of the spine. Punch biopsy from the fungating chest wall lesion showed a BCC with some malignant squamous differentiation (basosquamous)...
November 30, 2016: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/27903126/potential-evolution-of-neurosurgical-treatment-paradigms-for-craniopharyngioma-based-on-genomic-and-transcriptomic-characteristics
#7
Leslie C Robinson, Sandro Santagata, Todd C Hankinson
The recent genomic and transcriptomic characterization of human craniopharyngiomas has provided important insights into the pathogenesis of these tumors and supports that these tumor types are distinct entities. Critically, the insights provided by these data offer the potential for the introduction of novel therapies and surgical treatment paradigms for these tumors, which are associated with high morbidity rates and morbid conditions. Mutations in the CTNNB1 gene are primary drivers of adamantinomatous craniopharyngioma (ACP) and lead to the accumulation of β-catenin protein in a subset of the nuclei within the neoplastic epithelium of these tumors...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27902767/towards-a-non-human-primate-model-of-alpha-synucleinopathy-for-development-of-therapeutics-for-parkinson-s-disease-optimization-of-aav1-2-delivery-parameters-to-drive-sustained-expression-of-alpha-synuclein-and-dopaminergic-degeneration-in-macaque
#8
James B Koprich, Tom H Johnston, Gabriela Reyes, Vanessa Omana, Jonathan M Brotchie
Recent failures in clinical trials for disease modification in Parkinson's disease have highlighted the need for a non-human primate model of the synucleinopathy underpinning dopaminergic neuron degeneration. The present study was defined to begin the development of such a model in cynomolgus macaque. We have validated surgical and vector parameters to define a means to provide a robust over-expression of alpha-synuclein which is associated with Lewy-like pathology and robust degeneration of the nigrostriatal pathway...
2016: PloS One
https://www.readbyqxmd.com/read/27902469/the-mir-196b-mirna-inhibits-the-gata6-intestinal-transcription-factor-and-is-upregulated-in-colon-cancer-patients
#9
Sebastian Fantini, Valentina Salsi, Luca Reggiani, Antonino Maiorana, Vincenzo Zappavigna
OBJECTIVE: To explore the possible misexpression of the microRNA miR-196b in colorectal cancer (CRC) and its role in controlling the expression of GATA6, a putative target gene crucial to intestinal cell homeostasis and tumorigenesis. DESIGN: The expression of miR-196b was analysed by qRT-PCR in surgical resection samples from a cohort of sporadic colon cancer patients. Manipulations of miR-196b expression were performed to demonstrate its inhibition of GATA6 protein levels...
November 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/27899961/the-ras-raf-mek-erk-signaling-pathway-and-its-role-in-the-occurrence-and-development-of-hcc
#10
Lei Li, Guo-Dong Zhao, Zhe Shi, Li-Li Qi, Li-Yuan Zhou, Ze-Xian Fu
Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide and has a very poor prognosis. Its occurrence has been on the increase in recent years. Surgical resection and liver transplantation are the primary methods of treatment for HCC patients, but can only be applied to 15% of patients. The median survival time of unresectable or metastasizing HCC patients is only a few months. Existing systemic treatment methods are not effective for advanced HCC patients and a new method of treatment is needed for these patients...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27898067/the-need-for-multidisciplinarity-in-specialist-training-to-optimize-future-patient-care
#11
REVIEW
Alison C Tree, Victoria Harding, Aneel Bhangu, Venkatesh Krishnasamy, Dion Morton, Justin Stebbing, Bradford J Wood, Ricky A Sharma
Harmonious interactions between radiation, medical, interventional and surgical oncologists, as well as other members of multidisciplinary teams, are essential for the optimization of patient care in oncology. This multidisciplinary approach is particularly important in the current landscape, in which standard-of-care approaches to cancer treatment are evolving towards highly targeted treatments, precise image guidance and personalized cancer therapy. Herein, we highlight the importance of multidisciplinarity and interdisciplinarity at all levels of clinical oncology training...
November 29, 2016: Nature Reviews. Clinical Oncology
https://www.readbyqxmd.com/read/27896819/extracorporeal-membrane-oxygenation-outcomes-after-the-comprehensive-stage-ii-procedure-in-patients-with-single-ventricles
#12
Daniel Gomez, Vicky Duffy, Diane Hersey, Carl Backes, Peter Rycus, Patrick McConnell, Jordan Voss, Mark Galantowicz, Clifford L Cua
Outcomes for extracorporeal membrane oxygenation (ECMO) have been described for patients with single ventricle physiology (SVP) undergoing cavopulmonary connection (Glenn procedure). An alternative surgical pathway for patients with SVP consists of an initial hybrid procedure followed by a comprehensive Stage II procedure. No data exist describing the outcomes of patients requiring ECMO after the comprehensive Stage II procedure. The goal of this study is to describe the outcomes for patients who required ECMO after the comprehensive Stage II procedure...
November 29, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27894435/pediatric-appendicitis
#13
REVIEW
Rebecca M Rentea, Shawn D St Peter
Appendicitis is one of the most common surgical pathologies in children. It can present with right lower quadrant pain. Scoring systems in combination with selective imaging and surgical examination will diagnose most children with appendicitis. Clinical pathways should be used. Most surgical interventions for appendicitis are now almost exclusively laparoscopic, with trials demonstrating better outcomes for children who undergo index hospitalization appendectomies when perforated. Nonoperative management has a role in the treatment of both uncomplicated and complicated appendicitis...
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27894339/the-identification-of-human-pituitary-adenoma-initiating-cells
#14
Branavan Manoranjan, Sujeivan Mahendram, Saleh A Almenawer, Chitra Venugopal, Nicole McFarlane, Robin Hallett, Thusyanth Vijayakumar, Almunder Algird, Naresh K Murty, Doron D Sommer, John P Provias, Kesava Reddy, Sheila K Singh
Classified as benign central nervous system (CNS) tumors, pituitary adenomas account for 10% of diagnosed intracranial neoplasms. Although surgery is often curative, patients with invasive macroadenomas continue to experience significant morbidity and are prone to tumor recurrence. Given the identification of human brain tumor-initiating cells (TICs) that initiate and maintain tumor growth while promoting disease progression and relapse in multiple CNS tumors, we investigated whether TICs also drive the growth of human pituitary adenomas...
November 28, 2016: Acta Neuropathologica Communications
https://www.readbyqxmd.com/read/27893633/the-study-of-medial-superficial-perforator-of-the-superficial-circumflex-iliac-artery-perforator-flap-using-ct-angiography-and-surgical-anatomy-in-142-patients
#15
Hyun Suk Suh, Hyung Hwa Jeong, Joon Pio Hong
BACKGROUND: The two major perforators supplying the superficial circumflex iliac artery perforator (SCIP) flap are the medial (superficial) and lateral (deep) perforators but lacks detailed description. The purpose of this study was to clarify the anatomy. MATERIAL AND METHOD: In a prospective analysis of 142 patients, CT angiograms of 284 SCIP regions were evaluated and 142 SCIP flaps were surgically correlated. The origin of the SCIA, the origin of the medial perforator, the location where it penetrates the deep fascia, and its pattern of pathway after penetration of the superficial fascia were evaluated...
November 21, 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27889756/liquid-chromatography-mass-spectrometry-reveals-the-effect-of-lactobacillus-treatment-on-the-faecal-metabolite-profile-of-rats-with-chronic-renal-failure
#16
Bin Wu, Hongli Jiang, Quan He, Meng Wang, Jinhong Xue, Hua Liu, Kehui Shi, Meng Wei, Shanshan Liang, Liwen Zhang
BACKGROUND/AIM: Chronic kidney disease is accompanied by changes in the gut microbiome and by an increase in the number of gut pathogenic bacteria. The aim of this study was to investigate the difference of the faecal metabolic profiles in rats with uremia, and to determine whether the altered metabolites in the rats with uremia can be restored by Lactobacillus. METHODS: Thirty rats were randomly divided into 3 groups: sham, uremia and uremia + probiotic (UP) groups...
November 26, 2016: Nephron
https://www.readbyqxmd.com/read/27888751/remote-ischemic-preconditioning-attenuates-egr-1-expression-following-myocardial-ischemia-reperfusion-injury-through-activation-of-the-jak-stat-pathway
#17
H Mudaliar, B Rayner, M Billah, N Kapoor, W Lay, A Dona, R Bhindi
BACKGROUND/OBJECTIVES: Remote ischemic preconditioning (RIPC) protects the myocardium from ischemia/reperfusion (I/R) injury however the molecular pathways involved in cardioprotection are yet to be fully delineated. Transcription factor Early growth response-1 (Egr-1) is a key upstream activator in a variety of cardiovascular diseases. In this study, we elucidated the role of RIPC in modulating the regulation of Egr-1. METHODS: This study subjected rats to transient blockade of the left anterior descending (LAD) coronary artery with or without prior RIPC of the hind-limb muscle and thereafter excised the heart 24h following surgical intervention...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27888085/high-definition-fiber-tractography-in-evaluation-and-surgical-planning-of-thalamopeduncular-pilocytic-astrocytomas-in-pediatric-population-case-series-and-review-of-literature
#18
Emrah Celtikci, Pinar Celtikci, David Tiago Fernandes-Cabral, Murat Ucar, Juan Carlos Fernandez-Miranda, Alp Ozgun Borcek
OBJECTIVE: Thalamopeduncular tumors (TPTs) of the childhood present a challenge for neurosurgeons due to their eloquent location. Preoperative fiber tracking provides total or near-total resection, without additional neurological deficit. High-definition fiber tractography (HDFT) is an advanced white matter imaging technique derived from magnetic resonance imaging diffusion data, shown to overcome limitation of diffusion tensor imaging. We aimed to investigate alterations of corticospinal tract (CST) and medial lemniscus (ML) caused by TPTs and to demonstrate the application of HDFT in preoperative planning...
November 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27887932/assessing-national-provision-of-care-variability-in-bariatric-clinical-care-pathways
#19
Dana A Telem, Saniea F Majid, Kinga Powers, Eric DeMaria, John Morton, Daniel B Jones
BACKGROUND: The American Society for Metabolic and Bariatric Surgery (ASMBS) Quality Improvement and Patient Safety (QIPS) Committee hypothesized that collecting and sharing clinical pathways could provide a valuable resource to new and existing bariatric programs. OBJECTIVE: To shed light on the variability in practice patterns across the country by analyzing pathways. SETTING: United States Centers of Excellence METHODS: From June 2014 to April 2015, clinical pathways pertaining to preoperative, intraoperative, and postoperative management of bariatric patients were solicited from the ASMBS executive council (EC), QIPS committee members, and state chapter presidents...
August 3, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27885957/visual-pathway-impairment-by-pituitary-adenomas-quantitative-diagnostics-by-diffusion-tensor-imaging
#20
Ylva Lilja, Oscar Gustafsson, Maria Ljungberg, Göran Starck, Bertil Lindblom, Thomas Skoglund, Henrik Bergquist, Karl-Erik Jakobsson, Daniel Nilsson
OBJECTIVE Despite ample experience in surgical treatment of pituitary adenomas, little is known about objective indices that may reveal risk of visual impairment caused by tumor growth that leads to compression of the anterior visual pathways. This study aimed to explore diffusion tensor imaging (DTI) as a means for objective assessment of injury to the anterior visual pathways caused by pituitary adenomas. METHODS Twenty-three patients with pituitary adenomas, scheduled for transsphenoidal tumor resection, and 20 healthy control subjects were included in the study...
November 25, 2016: Journal of Neurosurgery
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