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https://www.readbyqxmd.com/read/29679726/late-presenting-dural-tear-incidence-risk-factors-and-associated-complications
#1
Wesley M Durand, J Mason DePasse, Eren O Kuris, JaeWon Yang, Alan H Daniels
BACKGROUND CONTEXT: Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), though estimates of LPDT range from 0.6 - 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29679194/posterior-cranial-fossa-and-spinal-local-infections
#2
Federico Bianchi, Gianpiero Tamburrini
OBJECT: The aim of this paper is to review the current knowledge on the management of local infections in posterior cranial fossa (PCF) and spinal surgery; the center of our paper will be the diagnosis and management of infections of the wound, the subcutaneous tissue, and muscle strata. RESULTS AND CONCLUSIONS: Very few papers address the problem of local infections in posterior cranial fossa and spinal surgery. The largest amount of the literature data is indeed centered on how to deal with deep infections, CSF leak, and secondary meningitis or hardware infection...
April 20, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29678699/acute-communicating-hydrocephalus-as-spinal-cord-surgery-complication-in-a-patient-with-lumbar-lipomyelocele-case-report
#3
Alessandro Prior, Mariasavina Severino, Andrea Rossi, Marco Pavanello, Gianluca Piatelli, Alessandro Consales
BACKGROUND: A lumbar lipomyelocele is a closed spinal dysraphism that can cause tethered cord syndrome. Between 5-15% of spinal dysraphism surgery cases are burdened with complications, the most common being wound infections or dehiscence and cerebrospinal fluid leak. Acute communicating hydrocephalus has never been described as a complication of this type of surgery. CASE DESCRIPTION: A 6-year-old girl, who had undergone several surgeries in another Institution for lumbar lipomyeloschisis, came to our attention for a second opinion about the management of her spinal dysraphism...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29678204/are-large-clinical-trials-in-orthopaedic-trauma-justified
#4
Sheila Sprague, Paul Tornetta, Gerard P Slobogean, Nathan N O'Hara, Paula McKay, Brad Petrisor, Kyle J Jeray, Emil H Schemitsch, David Sanders, Mohit Bhandari
BACKGROUND: The objective of this analysis is to evaluate the necessity of large clinical trials using FLOW trial data. METHODS: The FLOW pilot study and definitive trial were factorial trials evaluating the effect of different irrigation solutions and pressures on re-operation. To explore treatment effects over time, we analyzed data from the pilot and definitive trial in increments of 250 patients until the final sample size of 2447 patients was reached. At each increment we calculated the relative risk (RR) and associated 95% confidence interval (CI) for the treatment effect, and compared the results that would have been reported at the smaller enrolments with those seen in the final, adequately powered study...
April 20, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29676943/impact-of-preoperative-thrombocytopenia-on-the-outcome-after-coronary-artery-bypass-grafting
#5
Wail Nammas, Magnus Dalén, Stefano Rosato, Riccardo Gherli, Daniel Reichart, Giuseppe Gatti, Francesco Onorati, Giuseppe Faggian, Marisa De Feo, Ciro Bancone, Sidney Chocron, Sorosh Khodabandeh, Giuseppe Santarpino, Antonino S Rubino, Daniele Maselli, Saverio Nardella, Antonio Salsano, Tiziano Gherli, Francesco Nicolini, Marco Zanobini, Matteo Saccocci, Karl Bounader, Paola D'Errigo, Tuomas Kiviniemi, Eeva-Maija Kinnunen, Andrea Perrotti, Juhani Airaksinen, Giovanni Mariscalco, Vito G Ruggieri, Fausto Biancari
The impact of thrombocytopenia on postoperative bleeding and other major adverse events after cardiac surgery is unclear. This issue was investigated in a series of patients who underwent isolated coronary artery bypass grafting (CABG) from the prospective, multicenter E-CABG registry. Preoperative thrombocytopenia was defined as preoperative platelet count <150 × 109 /L and it was considered moderate-severe when preoperative platelet count was <100 × 109 /L. Multilevel mixed-effects regression analysis was performed to adjust the effect of thrombocytopenia on outcomes for baseline and operative covariates as well as for interinstitutional differences in patient-blood management...
April 20, 2018: Platelets
https://www.readbyqxmd.com/read/29676346/formal-saline-versus-honey-as-escharotic-in-the-conservative-management-of-major-omphaloceles
#6
Christopher O Bode, Adesoji O Ademuyiwa, Olumide A Elebute
Background: The use of honey as an escharotic agent in the conservative management of omphalocele major has not been widely explored in spite of its proven benefits in chronic wound management. We explored the use of local honey as an escharotic agent by comparing its use with 2.5% formal saline in the conservative management of major omphaloceles at the Lagos University Teaching Hospital, Lagos, Nigeria. Methods: From January 2006 to December 2009, 43 consecutive newborns with intact omphalocele major were alternately assigned into either Honey (H) or formal saline (FS) group...
January 2018: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29673671/a-case-control-study-to-compare-the-outcome-of-women-treated-by-two-minimally-invasive-procedures-ultraminilaparotomy-myomectomy-and-laparoscopic-myomectomy
#7
Kuo-Chang Wen, Pi-Lin Sung, Wen-Hsun Chang, Huann-Cheng Horng, Yi-Jen Chen, Wen-Ling Lee, Peng-Hui Wang
OBJECTIVE: Ultraminilaparotomy myomectomy (UMLT-M with less 4 cm transverse skin incision) and conventional 3-port wound laparoscopic myomectomy (LM) approaches were proposed as alternative minimally invasive procedures in the management of women with symptomatic uterine myomas but few studies have compared the outcomes of both procedures. MATERIALS AND METHODS: Between January 2002 and December 2003, 71 patients undergoing UMLT-M were compared with those 71 women undergoing LM...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29673558/incidence-and-treatment-of-complications-in-patients-who-had-third-molars-or-other-teeth-extracted
#8
I Miclotte, J O Agbaje, Y Spaey, P Legrand, C Politis
The aim of this study was to compare the incidence of complications after extraction of third molars (M3) or other teeth, and to describe their management. We made a retrospective cohort study of patients having M3 or other teeth extracted, and recorded complications up to two years' follow-up. A total of 142 complications developed after 2355 procedures (6%) - 7% after extraction of M3 compared with 5% after extractions of other teeth (p=0.024). The three most common complications were wound infection (2%), pain without apparent cause (<1%), and oroantral communication (<1%)...
April 16, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29673261/medical-surgical-and-wound-care-management-of-ulcerated-infantile-hemangiomas-a-systematic-review
#9
Jane Y Wang, Arvin Ighani, Ana P Ayala, Sadanori Akita, Irene Lara-Corrales, Afsaneh Alavi
Ulcerated infantile hemangiomas may present a therapeutic challenge, especially if there is concurrent hemorrhage or infection. The aim of this study was to systematically review the published evidence on the treatment of ulcerated hemangiomas, focusing on wound healing as the outcome of interest. We searched MEDLINE, Embase, SCOPUS, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science from inception to July 2016. Seventy-seven studies met our inclusion criteria. One study was a randomized controlled trial, 30 were observational studies, and 46 were case reports or case series...
April 1, 2018: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29670801/nonoperative-management-of-multiple-penetrating-cardiac-and-colon-wounds-from-a-shotgun-a-case-report-and-literature-review
#10
Paula M Jaramillo, Jaime A Montoya, David A Mejia, Salin Pereira Warr
Introduction: Surgery for cardiac trauma is considered fatal and for wounds of the colon by associated sepsis is normally considered; however, conservative management of many traumatic lesions of different injured organs has progressed over the years. Presentation of the Case: A 65-year-old male patient presented with multiple shotgun wounds on the left upper limb, thorax, and abdomen. On evaluation, he was hemodynamically stable with normal sinus rhythm and normal blood pressure, no dyspnea, or abdominal pain...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29670505/selective-fiber-degeneration-in-the-peripheral-nerve-of-a-patient-with-severe-complex-regional-pain-syndrome
#11
Adrien Yvon, Alessandro Faroni, Adam J Reid, Vivien C Lees
Aims: Complex regional pain syndrome (CRPS) is characterized by chronic debilitating pain disproportional to the inciting event and accompanied by motor, sensory, and autonomic disturbances. The pathophysiology of CRPS remains elusive. An exceptional case of severe CRPS leading to forearm amputation provided the opportunity to examine nerve histopathological features of the peripheral nerves. Methods: A 35-year-old female developed CRPS secondary to low voltage electrical injury. The CRPS was refractory to medical therapy and led to functional loss of the forelimb, repeated cutaneous wound infections leading to hospitalization...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29666894/-conservative-management-of-varicosis-and-postthrombotic-syndrome
#12
J Knupfer, S Reich-Schupke, M Stücker
Both varicosis and postthrombotic syndrome are manifestations of chronic venous disease - a widespread disease. Even at an early stage there are visible vascular symptoms, feeling of heaviness and tendency to swelling. In advanced stages, skin alterations and chronic wounds follow. Chronic venous insufficiency as a progressive disease can lead to significant limitations in the quality of life. Adequate diagnosis and therapy is therefore essential. A causal therapy that removes varices or occluding processes should be targeted whenever possible...
April 17, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/29664893/occupational-exposure-during-emergency-department-thoracotomy-a-prospective-multi-institution-study
#13
Andrew Nunn, Priya Prakash, Kenji Inaba, Alvarez Escalante, Zoë Maher, Seiji Yamaguchi, Dennis Y Kim, James Maciel, William C Chiu, Byron Drumheller, Joshua P Hazelton, Kaushik Mukherjee, Xian Luo-Owen, Rachel M Nygaard, Ashley P Marek, Bryan C Morse, Caitlin A Fitzgerald, Patrick L Bosarge, Randeep S Jawa, Susan E Rowell, Louis J Magnotti, Adrian W Ong, Tejal S Brahmbhatt, Michael D Grossman, Mark J Seamon
BACKGROUND: Occupational exposure is an important consideration during emergency department thoracotomy (EDT). While HIV/hepatitis prevalence in trauma patients (0-16.8%) and occupational exposure rates during operative trauma procedures (1.9-18.0%) have been reported, exposure risk during EDT is unknown. We hypothesized that occupational exposure risk during EDT would be greater than other operative trauma procedures. METHODS: A prospective, observational study at 16 US trauma centers was performed (2015-2016)...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29664508/oral-self-mutilation-in-lesch-nyhan-syndrome-case-report
#14
Andrés Campolo González, Alex Vargas Díaz, Daniel Fontboté Riesco, Marta Hernández Chávez
INTRODUCTION: Lesch-Nyhan syndrome (LNS) is an inherited recessive X-related disorder caused by the deficiency of the enzyme hypoxanthin-guanine phosphorribosyl transferase (HPRT). Compul sive self-mutilation and dystonia occurs before the first year of age and is expressed by persistent bites on the oral mucosa, lips, tongue, fingers, and shoulders. The dental intervention performed on most of these patients is multiple tooth extraction to prevent serious secondary lesions. OBJECTIVE: To present a clinical case of LNS and describe pediatric dentistry management in patients with self-mutilating behavior...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29662886/high-prevalence-of-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-among-clinical-isolates-from-cats-and-dogs-admitted-to-a-veterinary-hospital-in-switzerland
#15
Anna Lena Zogg, Sabrina Simmen, Katrin Zurfluh, Roger Stephan, Sarah N Schmitt, Magdalena Nüesch-Inderbinen
Objectives: This study aimed to identify and characterize extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae among clinical samples of companion animals. Methods: A total of 346 non-duplicate Enterobacteriaceae isolates were collected between 2012 and 2016 from diseased cats ( n  = 115) and dogs ( n  = 231). The presence of bla ESBL , PMQR genes, and the azithromycin resistance gene mph(A) was confirmed by PCR and sequencing of bla genes...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29662256/analysis-of-combat-casualties-admitted-to-the-emergency-department-during-the-negotiation-of-the-comprehensive-colombian-process-of-peace
#16
Carlos A Ordoñez, Ramiro Manzano Nunez, Michael W Parra, Juan Pablo Herrera, Maria Paula Naranjo, Sara Sofia Escobar, Marisol Badiel, Monica Morales, Cecibel Cevallos, Juan G Bayona, Alvaro Ignacio Sanchez, Juan Carlos Puyana, Alberto F García
Aim: Our objective was to describe the variations in casualties admitted to the emergency department during the period of the negotiation of the comprehensive peace agreement in Colombia between 2011 and 2016. Methods: A retrospective study of all hostile military casualties managed at a regional Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (negotiation period)...
December 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/29660388/outcomes-of-gracilis-muscle-flaps-in-the-management-of-groin-complications-after-arterial-bypass-with-prosthetic-graft
#17
Anahita Dua, Vy T Ho, Christina Rao, Sapan S Desai
INTRODUCTION: This study details two-year outcomes of a modified gracilis muscle flap (GMF) technique in providing tissue coverage for groin complications after arterial bypass surgery with synthetic graft. METHODS: All patients who developed groin infections after lower extremity arterial bypass with synthetic graft that underwent a GMF were included from June 2014 to March 2017 from a prospectively collected, purpose-built institutional database. Modifications to the standard technique included identification of the muscle using ultrasound to ensure precise skip incisions, preservation of the segmental blood supply, widening of the tunnel through which the muscle is retroflexed, placement of a wound VAC for healing, and lifelong antibiotics...
April 13, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29659472/evaluation-and-management-of-abdominal-stab-wounds-a-western-trauma-association-critical-decisions-algorithm
#18
Matthew J Martin, Carlos V R Brown, David V Schatz, Hasan Alam, Karen Brasel, Carl Hauser, Marc de Moya, Ernest E Moore, Susan Rowell, Gary Vercruysse, Bonny Baron, Kenji Inaba
No abstract text is available yet for this article.
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659182/ropivacaine-wound-infiltration-for-pain-management-after-breast-cancer-mastectomy-a-population-pharmacokinetic-analysis
#19
Camille Riff, Romain Guilhaumou, Amelie Marsot, Marc Beaussier, Monique Cohen, Olivier Blin, Daniel Francon
Ropivacaine continuous wound infusions (CWIs) are extensively used as a component of multimodal analgesia. The rational application of CWI of ropivacaine requires a thorough understanding of its pharmacokinetics to investigate the risk of potential systemic toxicity. A population pharmacokinetic (popPK) study was undertaken to describe the pharmacokinetics of ropivacaine CWI during 75 hours. Women undergoing a unilateral mastectomy were scheduled to receive CWI for 40 hours for postoperative analgesia. A 10-mL ropivacaine 0...
April 16, 2018: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/29651952/special-traumatized-populations-burns-and-hypothermia
#20
Shruti Mehrotra, Amita Misir
It is important for physicians treating children to be aware of unique presentation that require expertise and knowledge. Two areas of importance when caring for traumatized children are Thermal Burn Injuries, and Hypothermia. Burns commonly result in morbidity in children; as such, the appropriate identification of the severity of the burn and appropriate management are integral to minimize the complications of burns during the acute phase. Attention to proper fluid management is paramount. Knowledge of types of solutions to use during Burn treatment is important...
April 11, 2018: Current Pediatric Reviews
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