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https://www.readbyqxmd.com/read/28637118/asymptomatic-chiari-type-i-malformation-should-patients-be-advised-against-participation-in-contact-sports
#1
Robert Spencer, Paul Leach
BACKGROUND: Chiari type I malformation (CM-I) is characterised by caudal displacement of the cerebellar tonsils through the foramen magnum, crowding the craniocervical junction. It is being increasingly diagnosed in asymptomatic patients due to the widespread availability of MRI, and there are case reports of these patients suffering sudden death or neurological injury following head or neck trauma, raising the issue of whether they should be prohibited from contact sport participation, given the likelihood of frequent trauma...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28636747/do-different-characteristics-of-two-emasculators-make-the-difference-in-equine-castration
#2
F Comino, G Giusto, V Caramello, M Gandini
BACKGROUND: Serra and Reimer emasculators are frequently used during equine orchiectomy. They differ in their jaw profile and haemostatic mechanism provided. OBJECTIVES: (1) To evaluate whether there is a difference between the haemostatic capacity of Reimer and Serra emasculators in open and closed castration and (2) compare haemostatic capacity of each emasculator in both open and closed castration; (3) to assess whether there is a difference in the tensile strength of the parietal tunic when using a Reimer emasculator or a Serra emasculator in closed castration...
June 21, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28636254/pirfenidone-reduces-subchondral-bone-loss-and-fibrosis-after-murine-knee-cartilage-injury
#3
Deva D Chan, Jun Li, Wei Luo, Dan N Predescu, Brian J Cole, Anna Plaas
Pirfenidone is an anti-inflammatory and anti-fibrotic drug that has shown efficacy in lung and kidney fibrosis. Because inflammation and fibrosis have been linked to the progression of osteoarthritis, we investigated the effects of oral Pirfenidone in a mouse model of cartilage injury, which results in chronic inflammation and joint-wide fibrosis in mice that lack hyaluronan synthase 1 (Has1(-/-) ) in comparison to wild-type. Femoral cartilage was surgically injured in wild-type and Has1(-/-) mice, and Pirfenidone was administered in food starting after 3 days...
June 21, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28636108/understanding-the-influences-and-impact-of-patient-clinician-communication-in-cancer-care
#4
Jennifer Elston Lafata, Laura A Shay, Jodi M Winship
BACKGROUND: Patient-clinician communication is thought to be central to care outcomes, but when and how communication affects patient outcomes is not well understood. OBJECTIVE: We propose a conceptual model and classification framework upon which the empirical evidence base for the impact of patient-clinician communication can be summarized and further built. DESIGN: We use the proposed model and framework to summarize findings from two recent systematic reviews, one evaluating the use of shared decision making (SDM) on cancer care outcomes and the other evaluating the role of physician recommendation in cancer screening use...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28635352/a-randomized-controlled-trial-comparing-two-types-of-retractors-at-caesarean-delivery
#5
Abbey J Hardy-Fairbanks, Todd Mackenzie, Martin McCarthy, Marlene B Goldman, Michele R Lauria
The aim of this study was to determine if the use of a self-retaining, symmetrical retractor (OB/Mobius(®)) during caesarean delivery is associated with differences in post-operative pain experience. Consenting women undergoing caesarean delivery were randomly assigned to OB/Mobius(®) versus conventional retraction instruments. Women were blinded to retractor type and filled out surgical pain surveys each post-operative day. Additional outcome variables were collected through a provider survey and chart review...
June 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28635237/-comparison-of-the-short-term-and-long-term-outcomes-of-laparoscopic-surgery-and-open-surgery-for-early-stage-cervical-cancer
#6
H Y He, Z J Yang, D Y Zeng, D S Yao, J T Fan, R F Zhao, J Q Zhang, X X Hu, Z Lin, Y M Jiang, L Li
Objective: To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer. Methods: We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ(2) test were used to compare the short-term and long-term outcomes...
June 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28634839/outcomes-of-kidney-donors-over-60%C3%A2-years-old-a-single-center-cohort-study
#7
Daniel Gero, Fadia Dib, Maurice Matter, Manuel Pascual, Jean-Pierre Venetz, Nicolas Demartines, Emmanuel Melloul
AIM: To evaluate outcomes and post-donation kidney function of older living kidney donors (LKD). METHODS: Retrospective analysis of prospective database including all consecutive LKD undergoing laparoscopic nephrectomy in a single center (09/1998-12/2013). LKD aged ≥60 years were compared to younger LKD. Renal function assessed by creatinine levels and estimated glomerular filtration rates (eGFR). Surgical complications classified according to the Clavien-Dindo classification...
June 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28634632/can-a-virtual-reality-surgical-simulation-training-provide-a-self-driven-and-mentor-free-skills-learning-investigation-of-the-practical-influence-of-the-performance-metrics-from-the-virtual-reality-robotic-surgery-simulator-on-the-skill-learning-and-associated
#8
Gyusung I Lee, Mija R Lee
BACKGROUND: While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system's performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28634630/development-and-validation-of-a-tool-for-non-technical-skills-evaluation-in-robotic-surgery-the-icars-system
#9
Nicholas Raison, Thomas Wood, Oliver Brunckhorst, Takashige Abe, Talisa Ross, Ben Challacombe, Mohammed Shamim Khan, Giacomo Novara, Nicolo Buffi, Henk Van Der Poel, Craig McIlhenny, Prokar Dasgupta, Kamran Ahmed
BACKGROUND: Non-technical skills (NTS) are being increasingly recognised as vital for safe surgical practice. Numerous NTS rating systems have been developed to support effective training and assessment. Yet despite the additional challenges posed by robotic surgery, no NTS rating systems have been developed for this unique surgical environment. This study reports the development and validation of the first NTS behavioural rating system for robotic surgery. METHODS: A comprehensive index of all relevant NTS behaviours in robotic surgery was developed through observation of robotic theatre and interviews with robotic surgeons...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28634364/lipid-changes-8-years-post-gastric-bypass-in-adolescents-with-severe-obesity-fabs-5-study
#10
Amy S Shah, Todd Jenkins, Zhiqian Gao, Stephen R Daniels, Elaine M Urbina, Shelley Kirk, Robert Siegel, Thomas H Inge
OBJECTIVE: Severe obesity in adolescents is increasing and few effective treatments exist. Bariatric surgery is one option, but the extent to which surgery influences cardiovascular risk factors over time in youth is not clear. We hypothesized that Roux-en Y gastric bypass (RYGB) would be associated with sustained improvements in lipids over time (>5 years). PARTICIPANTS/METHODS: Youth who underwent RYGB from 2001-2007 were recruited for the Follow-up of Adolescent Bariatric Surgery-5+ (FABS-5+) in 2011-2014...
June 21, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28634003/spasticity-video-challenge-a-look-at-methods-for-addressing-difficult-cases
#11
Katharine E Alter, Mark Gormley, Atul T Patel
As seen in this CME online activity (available at http://courses.elseviercme.com/spasticity/662e), treatment of patients with spasticity due to upper motor neuron syndromes, including traumatic brain injury, stroke, and cerebral palsy, is multifaceted, involving chemodenervation, systemic medications, surgical therapy, rehabilitation efforts, and home care. Optimal care begins with the recognition that each patient's impairments are unique and must be assessed carefully to determine the impact of muscle overactivity, loss of dexterity, and weakness on passive and active function in the context of the patients' goals...
June 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28633768/comparing-different-surgical-techniques-for-addressing-the-posterior-malleolus-in-supination-external-rotation-ankle-fractures-and-the-need-for-syndesmotic-screw-fixation
#12
Mengnai Li, Rachel C Collier, Brian W Hill, Nathaniel Slinkard, Thuan V Ly
Trimalleolar ankle fractures are unstable injuries with possible syndesmotic disruption. Recent data have described inherent morbidity associated with screw fixation of the syndesmosis, including the potential for malreduction, hardware irritation, and post-traumatic arthritis. The posterior malleolus is an important soft tissue attachment for the posterior inferior syndesmosis ligament. We hypothesized that fixation of a sizable posterior malleolar (PM) fracture in supination external rotation type IV (SER IV) ankle fractures would act to stabilize the syndesmosis and minimize or eliminate the need for trans-syndesmotic fixation...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633637/seroma-change-during-magnetic-resonance-imaging-guided-partial-breast-irradiation-and-its-clinical-implications
#13
Seung Hyuck Jeon, Kyung Hwan Shin, So-Yeon Park, Jung-In Kim, Jong Min Park, Jin Ho Kim, Eui Kyu Chie, Hong-Gyun Wu
BACKGROUND: To investigate the patterns of post-lumpectomy seroma volume (SV) change and related clinical factors to determine the benefits of adaptive planning in magnetic resonance imaging (MRI)-guided partial breast irradiation (PBI). METHODS: MRI data obtained from 37 women with early breast cancer acquired at simulation and at the 1st, 6th, and 10th fractions were analyzed. The planning target volume (PTV) was defined as unequal margins of 10-15 mm added according to the directional surgical margin status of each seroma...
June 20, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28633171/examining-accuracy-of-self-assessment-of-in-training-examination-performance-in-a-context-of-guided-self-assessment
#14
Oksana Babenko, Denise Campbell-Scherer, Shirley Schipper, John Chmelicek, Tanya Barber, Kimberley Duerksen, Shelley Ross
BACKGROUND AND OBJECTIVES: In our family medicine residency program, we have established a culture of guided self-assessment through a systematic approach of direct observation of residents and documentation of formative feedback. We have observed that our residents have become more accurate in self-assessing their clinical performance. The objective of this study was to examine whether this improved accuracy extended to residents' self-assessment of their medical knowledge and clinical reasoning on the In-Training Examination (ITE)...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28632750/renal-sodium-handling-and-blood-pressure-changes-in-gestational-protein-restricted-offspring-role-of-renal-nerves-and-ganglia-neurokinin-expression
#15
Augusto H Custódio, Marcelo C de Lima, Bárbara Vaccari, Patrícia A Boer, José A R Gontijo
BACKGROUND: Considering long-term changes in renal sodium handling and blood pressure in maternal protein-restricted (LP) offspring, we assumed that the development of LP hypertension results from abnormal dorsal root ganglia (DRG) neurokinin expression associated with impaired responsiveness of renal sensory receptors, promoting a reduced urinary excretion of sodium. The present study investigates whether increased blood pressure in protein-restricted offspring would be associated with changes in the DRG cells and in renal pelvic wall expression of NK1R, SP and CGRP when compared to NP offspring...
2017: PloS One
https://www.readbyqxmd.com/read/28632644/do-former-smokers-exhibit-a-distinct-profile-before-and-after-lumbar-spine-surgery
#16
Ehsan Jazini, Steven D Glassman, Erica F Bisson, Eric A Potts, Leah Y Carreon
STUDY DESIGN: Retrospective longitudinal cohort OBJECTIVES.: To determine if former smokers undergoing lumbar spine surgery have distinct baseline and post-operative Patient Reported Outcomes (PROs) compared to never smokers and current smokers SUMMARY OF BACKGROUND DATA.: Smoking has known deleterious effects on patients undergoing lumbar spine surgery. However, former smokers have not been extensively evaluated. There are few studies regarding the relationship between pack-years or duration of smoking cessation, and subsequent clinical outcome...
June 19, 2017: Spine
https://www.readbyqxmd.com/read/28632543/stroke-volume-variation-guided-versus-central-venous-pressure-guided-low-central-venous-pressure-with-milrinone-during-living-donor-hepatectomy-a-randomized-double-blinded-clinical-trial
#17
Jiwon Lee, Won Ho Kim, Ho-Geol Ryu, Hyung-Chul Lee, Eun-Jin Chung, Seong-Mi Yang, Chul-Woo Jung
BACKGROUND: We previously demonstrated the usefulness of milrinone for living donor hepatectomy. However, a less-invasive alternative to central venous catheterization and perioperative contributors to good surgical outcomes remain undetermined. The current study evaluated whether the stroke volume variation (SVV)-guided method can substitute central venous catheterization during milrinone-induced profound vasodilation. METHODS: We randomly assigned 42 living liver donors to receive either SVV guidance or central venous pressure (CVP) guidance to obtain milrinone-induced low CVP...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631985/effect-of-a-standardized-protocol-of-antibiotic-therapy-on-surgical-site-infection-after-laparoscopic-surgery-for-complicated-appendicitis
#18
Hyoung-Chul Park, Min Jeong Kim, Bong Hwa Lee
BACKGROUND: Although it is accepted that complicated appendicitis requires antibiotic therapy to prevent post-operative surgical infections, consensus protocols on the duration and regimens of treatment are not well established. This study aimed to compare the outcome of post-operative infectious complications in patients receiving old non-standardized and new standard antibiotic protocols, involving either 5 or 10 days of treatment, respectively. METHODS: We enrolled 1,343 patients who underwent laparoscopic surgery for complicated appendicitis between January 2009 and December 2014...
June 20, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28631870/thalamic-deep-brain-stimulation-for-neuropathic-pain-efficacy-at-three-years-follow-up
#19
Vasco Abreu, Rui Vaz, Virgínia Rebelo, Maria José Rosas, Clara Chamadoira, Martin J Gillies, Tipu Z Aziz, Erlick A C Pereira
OBJECT: Chronic neuropathic pain is estimated to affect 3-4.5% of the worldwide population, posing a serious burden to society. Deep Brain Stimulation (DBS) is already established for movement disorders and also used to treat some "off-label" conditions. However, DBS for the treatment of chronic, drug refractory, neuropathic pain, has shown variable outcomes with few studies performed in the last decade. Thus, this procedure has consensus approval in parts of Europe but not the USA. This study prospectively evaluated the efficacy at three years of DBS for neuropathic pain...
June 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28631835/suprameatal-urethrolysis-with-martius-flap-for-refractory-bladder-outflow-obstruction-following-stress-incontinence-surgery-in-females
#20
Janine L Oliver, Shlomo Raz
AIMS: To present our technique of suprameatal urethrolysis with Martius flap (SMUM) and outcomes of this procedure for refractory female bladder outflow obstruction (BOO). METHODS: A retrospective chart review was performed to identify female patients who underwent SMUM between January 2010 and August 2016 after failed transvaginal urethrolysis (TVU) for BOO due to prior stress urinary incontinence (SUI) surgery. The primary outcome measure was surgical success defined as patient ability to void volitionally without need for catheterization or additional surgery for BOO...
June 20, 2017: Neurourology and Urodynamics
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