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Monitoring surgical patient

Derek T Cawley, Joseph Butler, Adam Benton, Farhaan Altaf, Kia Rezajooi, Charalampia Kyriakou, Susanne Selvadurai, Sean Molloy
Discuss the relevant literature on surgical and non-surgical treatments for multiple myeloma (MM) and their complementary effects on overall treatment. Existing surgical algorithms designed for neoplasia of the spine may not suit the management of spinal myeloma. Less than a fifth of metastatic, including myelomatous lesions occur in the cervical spine but have a poorer prognosis and surgery in this area carries a higher morbidity. With the advances of chemotherapy, early access to radiotherapy, early orthosis management and high definition imaging including CT and MRI, surgical indications in MM have changed...
October 17, 2018: Hematological Oncology
Guilherme Gozzoli Podolsky-Gondim, Luciano Lopes Furlanetti, Dinark Conceição Viana, Matheus Fernando Manzolli Ballestero, Ricardo Santos de Oliveira
INTRODUCTION: Head injury is a significant economic, social, and medical problem in developing countries and remains one of the leading causes of pediatric morbidity and mortality. The association of traumatic brain injury and coagulopathy in children is linked with an increase in mortality and poor functional outcomes. However, its impact on long-term outcome has not been discussed in the literature so far. OBJECTIVES: The aim of this paper was to investigate the effect of coagulopathy diagnosed by routine laboratory tests on neurological outcome following traumatic brain injury in children...
October 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
R Philpott, K Gulabivala, R Leeson, Y-L Ng
AIMS: To investigate the prevalence, pain catastrophizing and other predictive factors, and clinical course of persistent pain/discomfort associated with teeth displaying periapical healing following non-surgical root canal treatment (NSRCT). METHODOLOGY: One-hundred-ninety-eight patients (264 teeth) who had NSRCT were reviewed at 5-14 months, post-operatively. Teeth with persistent post-treatment pain or discomfort, plus evidence of periapical healing were further monitored 0...
October 17, 2018: International Endodontic Journal
Eduardo Crema, Júverson Alves Terra Júnior, Marisa Carvalho Borges, Carlos Alfredo Salci Queiroz, Luciana Arantes Soares, Alex Augusto da Silva
PURPOSE: To evaluate the outcome of transhiatal esophagectomy without thoracotomy and with preservation of the vagal trunks for the treatment of advanced megaesophagus. METHODS: Between March 2006 and September 2017, it was performed 136 transhiatal esophagectomies without thoracotomy by laparoscopy, with preservation of the vagus nerves. All patients were evaluated pre and postoperatively for respiratory and nutritional aspects Post operatively, some surgical aspects were evaluated like radiology and endoscopy of the digestive tract...
September 2018: Acta Cirúrgica Brasileira
Florence R A Hogg, Mathew J Gallagher, Suliang Chen, Argyro Zoumprouli, Marios C Papadopoulos, Samira Saadoun
BACKGROUND/OBJECTIVES: We recently developed techniques to monitor intraspinal pressure (ISP) and spinal cord perfusion pressure (SCPP) from the injury site to compute the optimum SCPP (SCPPopt ) in patients with acute traumatic spinal cord injury (TSCI). We hypothesized that ISP and SCPPopt can be predicted using clinical factors instead of ISP monitoring. METHODS: Sixty-four TSCI patients, grades A-C (American spinal injuries association Impairment Scale, AIS), were analyzed...
October 16, 2018: Neurocritical Care
Dóra Mihály, Noémi Nagy, Gergő Papp, Zsuzsanna Pápai, Zoltán Sápi
BACKGROUND: Synovial sarcoma is a rare soft tissue tumor which contains the unique SS18-SSX1, SS18-SSX2 - or, rarely, SS18-SSX4 - fusion transcripts. It is well known that some soft tissue tumors, like Ewing sarcomas and myxoid liposarcomas, can spread via the blood with free circulating tumor cells (CTC); this can be detected by several sensitive molecular biology methods. Here we report a study of fifteen synovial sarcoma patients with varied clinical backgrounds. METHOD: After blood withdrawal and nucleic acid isolation, we attempted to detect the SS18-SSX fusion genes from circulating tumor cells or cell-free nucleic acids with nested PCR and droplet digital PCR...
October 17, 2018: Diagnostic Pathology
Eshini Panditharatna, Lindsay B Kilburn, Mariam S Aboian, Madhuri Kambhampati, Heather Gordish-Dressman, Suresh N Magge, Nalin Gupta, John S Myseros, Eugene I Hwang, Cassie Kline, John R Crawford, Katherine E Warren, Soonmee Cha, Winnie S Liang, Michael E Berens, Roger J Packer, Adam C Resnick, Michael Prados, Sabine Mueller, Javad Nazarian
Purpose: Pediatric diffuse midline glioma (DMG) are highly malignant tumors with poor clinical outcomes. Over 70% of patients with DMG harbor the histone 3 p.K27M (H3K27M) mutation, which correlates with a poorer clinical outcome, and is also used as a criterion for enrollment in clinical trials. Because complete surgical resection of DMG is not an option, biopsy at presentation is feasible, but rebiopsy at time of progression is rare. While imaging and clinical-based disease monitoring is the standard of care, molecular-based longitudinal characterization of these tumors is almost nonexistent...
October 15, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Lorraine A T Boakye, Mitchell S Fourman, Nicholas T Spina, Dann Laudermilch, Joon Y Lee
Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'postdecompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood...
October 16, 2018: Asian Spine Journal
Jacob K Dey, Jamie J Van Gompel, John I Lane, Matthew L Carlson
OBJECTIVE: Spontaneous cerebrospinal fluid (CSF) leak from the fallopian canal is extremely rare, with only fourteen cases reported in the extant literature. We present a case of spontaneous CSF otorrhea from a fallopian canal meningocele involving the geniculate fossa. We also reviewed all cases of fallopian canal CSF leak reported in the literature with discussion of their management and outcomes. PATIENT: A 53-year-old woman with history of morbid obesity and hypertension presented to a tertiary care referral center with unilateral high volume CSF otorrhea...
October 12, 2018: World Neurosurgery
Rienk Dekker, Yoanna V Hristova, Juha M Hijmans, Jan H B Geertzen
BACKGROUND: Major lower-limb amputation (LLA) predisposes patients post-operatively to a significant decline in daily-life functioning. The physical condition of amputee patients prior to surgery is significantly deteriorated due to chronic peripheral vascular disease (PVD) and diabetes, which accounts for the majority of LLAs in the adult population. A common strategy called pre-rehabilitation has been used in multiple patient populations to prepare the patient for undergoing a surgical event and to improve post-operative patient outcomes...
2018: PloS One
Guillermo Martín-Palomeque, Lidia Cabañes-Martínez, Gema de Blas Beorlegui, M Del Mar Moreno Galera, Jaime R López, Francisco Javier Burgos, Ignacio Regidor Bailly-Baillière
PURPOSE: The occurrence of urinary incontinence and erectile dysfunction after surgical treatment for prostate cancer is a significant and lingering problem. The aim of this study is to revise and improve older techniques of intraoperative cavernous nerve mapping already in use to improve accuracy and reliability. METHODS: We prospectively studied this technique in 12 patients suffering from prostate cancer. Inhalation or intravenous anesthetic regimen was used with nondepolarizing muscle relaxants...
October 10, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Ryan K van Laar, Mitchel T Lincoln, Barton J van Laar
New tools for monitoring response to primary melanoma treatment are needed to reduce recurrence rates and patient anxiety. A previously developed plasma-based microRNA signature (MEL38) was measured in four melanoma patient samples obtained before and 12-14 days after treatment (i.e. surgical excision), as well as in two nonmelanoma controls. The value of the MEL38 score and selected individual genes were compared between the time points. The MEL38 scores of the four patients with melanoma became more 'normal like' after tumour excision, with a statistically significant 15% mean reduction...
October 12, 2018: Melanoma Research
M Rouprêt, E Xylinas, P Colin, N Houédé, E Compérat, F Audenet, S Larré, A Masson-Lecomte, G Pignot, S Brunelle, M Roumiguié, Y Neuzillet, A Méjean
INTRODUCTION: To propose an update of the French guidelines from the national committee ccAFU on upper tract urothelial carcinomas (UTUC). METHODS: A systematic Medline search was performed between 2016 and 2018, with regards to the diagnosis, the options of treatment and the follow-up of UTUC, to evaluate the different studies with levels of evidence. RESULTS: The diagnosis of this rare disease is based on CT-scan acquisition during excretion and ureteroscopy with histological biopsies...
October 11, 2018: Progrès en Urologie
S Guida, P L Bencini, G Pellacani
Surgical excision can be followed by non-aesthetic scar development, despite the use of modern suture technique. Skin site involved is important since the location of scars in "aesthetic" sites, such as the face, can cause psychological problems for patients. In order to improve scar appearance, different therapeutic approaches have been employed. This article is protected by copyright. All rights reserved.
October 14, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Jean Dubuisson
Uterine leiomyomas are the most common benign tumors in women of reproductive age. Most of leiomyomas are asymptomatic. They are often found incidentally, and require neither monitoring nor treatment. For symptomatic women who wish to become pregnant, surgical myomectomy remains the conservative treatment of choice. It can be performed in various routes depending on the location and the number of leiomyomas and the experience of the surgeon. A minimally invasive procedure should always be the preferred option so as to improve woman satisfaction and to decrease perioperative morbidity...
October 11, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Ashika D Maharaj, Liane Ioannou, Daniel Croagh, John Zalcberg, Rachel E Neale, David Goldstein, Neil Merrett, James G Kench, Kate White, Charles H C Pilgrim, Lorraine Chantrill, Peter Cosman, Andrew Kneebone, Lara Lipton, Mehrdad Nikfarjam, Jennifer Philip, Charbel Sandroussi, Peter Tagkalidis, Richard Chye, Koroush S Haghighi, Jaswinder Samra, Sue M Evans
BACKGROUND: Best practise care optimises survival and quality of life in patients with pancreatic cancer (PC), but there is evidence of variability in management and suboptimal care for some patients. Monitoring practise is necessary to underpin improvement initiatives. We aimed to develop a core set of quality indicators that measure quality of care across the disease trajectory. METHODS: A modified, three-round Delphi survey was performed among experts with wide experience in PC care across three states in Australia...
October 10, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Simone Garzon, Ricciarda Raffaelli, Umberto Montin, Fabio Ghezzi
OBJECTIVE: To report a case of primary hepatic pregnancy complicated by acute hemoperitoneum that was treated with a laparoscopic approach. DESIGN: Case report and review of the literature. SETTING: Obstetrics and gynecology unit of a university hospital. PATIENT(S): A 37-year-old pregnant woman who presented with vaginal bleeding. INTERVENTION(S): Diagnosis by abdominal ultrasound and computed tomography...
October 2018: Fertility and Sterility
K Iwamoto, J Iizuka, Y Hashimoto, T Kondo, T Takagi, K Hata, K Unagami, M Okumi, H Ishida, K Tanabe
OBJECTIVES: We aimed to evaluate the feasibility and efficacy of surgical prostatectomy in renal transplant recipients (RTRs). METHODS: Between January 2008 and February 2017, we identified 13 RTRs who were diagnosed with localized prostate cancer and underwent radical prostatectomy. We reviewed all available clinicopathologic data for these 13 patients. RESULTS: The median patient age was 61 years and median serum prostate-specific antigen (PSA) was 8...
October 2018: Transplantation Proceedings
Sara Franceschi, Debora Corsinovi, Francesca Lessi, Elena Tantillo, Paolo Aretini, Michele Menicagli, Claudia Scopelliti, Prospero Civita, Francesco Pasqualetti, Antonio G Naccarato, Michela Ori, Chiara M Mazzanti
BACKGROUND: Glioblastoma (GBM) is the most frequent and malignant primary brain tumor in adults and despite the progress in surgical procedures and therapy options, the overall survival remains very poor. Glutamate and α-KG are fundamental elements necessary to support the growth and proliferation of GBM cells. Glutamate oxidative deamination, catalyzed by GLUD2, is the predominant pathway for the production of α-KG. METHODS: GLUD2 emerged from the RNA-seq analysis of 13 GBM patients, performed in our laboratory and a microarray analysis of 77 high-grade gliomas available on the Geo database...
October 9, 2018: EBioMedicine
Woo Yong Lee, Ki Deok Park, Yongbum Park
RATIONALE: Radiating leg pain usually originates from the lumbar spine and occasionally from peripheral lesions. Here we report a case involving a patient with radiating pain in the right leg who exhibited 2 suspicious lesions, including 1 spinal lesion and 1 extraspinal cystic mass lesion, on magnetic resonance imaging. Polydeoxyribonucleotide sodium (PDRN) was recently noted as such a substitute. PDRN has anti-inflammatory effects, as it lowers the expression of inflammatory cytokines including interleukin-6 and tumor necrosis factor-alpha...
October 2018: Medicine (Baltimore)
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