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Monitoring surgical patient

Antonia Dastamani, Maria Güemes, Catherine Pitfield, Kate Morgan, Mansoor Rajab, Christof Rottenburger, Jamshed Bomanji, Paolo De Coppi, Mehul Dattani, Pratik Shah
BACKGROUND: A long-acting somatostatin analogue (lanreotide) is used in the management of a diazoxide-unresponsive diffuse form of congenital hyperinsulinism (CHI). However, no reports of its use in patients with the focal form of CHI exist. Case 1: A 1-month-old boy diagnosed with diazoxide-unresponsive CHI due to a paternal heterozygous ABCC8 gene mutation showed partial response to octreotide. 18F-DOPA-PET/CT scan revealed a focal lesion in the pancreatic head. Surgical removal of the lesion was unsuccessful...
August 16, 2018: Hormone Research in Pædiatrics
Atousa Deljou, Toby N Weingarten, Michael A Mahr, Juraj Sprung, David P Martin
BACKGROUND: Previous studies of postoperative corneal injury rates relied on provider-initiated incident reports, which may underestimate the true incidence. Postoperative administration of proparacaine eye drops is used almost exclusively to diagnose corneal injury; therefore, identifying instances of administration may provide a better estimate of corneal injuries. We compared proparacaine administration versus provider-initiated reports to determine rates of corneal injury. In addition, potential associations between clinical variables and injury were assessed with a matched case-control study...
August 14, 2018: Anesthesia and Analgesia
Eike Sebastian Debus, Levente Kriston, Thea Schwaneberg, Sandra Hischke, Henrik Christian Rieß, Martin Härter, Ursula Marschall, Hannes Federrath, Christian-Alexander Behrendt
BACKGROUND: Atherosclerotic disease of the lower extremity arteries (PAD) remains a significant burden on global healthcare systems with increasing prevalence. Various guidelines on the diagnosis and treatment of patients with PAD are available but they often lack a sufficient evidence base for high-grade recommendations since randomized and controlled trials (RCT) remain rare or are frequently subject to conflicts of interest. This registry trial aims to evaluate the outcomes of catheter-based endovascular revascularisations vs...
August 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
T Krejčí, Z Večeřa, O Krejčí, D Šalounová, M Houdek, Radim Lipina
BACKGROUND: Prospective randomized data is currently lacking which compares endoscopically assisted surgery with open surgical techniques in the treatment of cubital tunnel syndrome (CUTS). The aim of this study is to compare patient outcome in both techniques. METHOD: This prospective study comprised of 45 patients who, between October 2014 and February 2017, were randomly assigned to undergo either endoscopic or open surgery (22 and 23 patients respectively) for decompression of the ulnar nerve...
August 15, 2018: Acta Neurochirurgica
Xiao-Ming Ai, Li-Chen Ho, Lu-Lu Han, Jin-Jing Lu, Xiong Yue, Nian-Yin Yang
The extensive performance of splenectomy worldwide for patients suffered from splenic trauma has given rise to high risks of postoperative complications, which has been attracting increasing attention in recent years. Nowadays the spleen is regarded as a versatile organ of the human body, invested with various excellent properties. The spleen has been recognized to take a great part in lipid metabolism. While removal of the spleen intends to alter lipid values, especially with an elevated LDL, splenic autotransplantation is able to normalize these lipid alterations...
August 16, 2018: Lipids in Health and Disease
Christopher R Williams, Angela Jellison, Luke Martin, Chong Zhang, Angela P Presson, Larry W Kraiss, Benjamin S Brooke
OBJECTIVE: Optimizing medical management through glucose control, smoking cessation, and drug therapy (ie, antiplatelet and statin agents) is recommended as first-line therapy for patients with claudication. The aims of this study were to determine how frequently veterans with claudication received optimal medical management (OMM) before undergoing elective open lower extremity bypass procedures nationwide and whether preoperative OMM was associated with improved surgical outcomes. METHODS: We reviewed all patients within the Veterans Affairs (VA) Surgical Quality Improvement Program database who underwent elective open lower extremity bypass procedures for claudication at nationwide VA medical centers from 2005 until 2015...
August 11, 2018: Journal of Vascular Surgery
Amanda Ricciuto, Jasbir Dhaliwal, Thomas D Walters, Anne M Griffiths, Peter C Church
Background and aims: We undertook a systematic review and meta-analysis examining the effectiveness of therapeutic drug monitoring (TDM) to improve clinical outcomes in anti-TNF-treated IBD patients. Methods: We searched MEDLINE, Epub Ahead of Print, EMBASE and Cochrane through October 2017 for randomized trials (RCTs) and cohort studies comparing proactive or reactive TDM to each other or empiric care. Outcomes included clinical remission (primary), clinical relapse, endoscopic remission, anti-TNF response durability, cost and adverse events (secondary)...
August 10, 2018: Journal of Crohn's & Colitis
Lee C Mangum, Nathan A Franklin, Gerardo R Garcia, Kevin S Akers, Joseph C Wenke
BACKGROUND: Dakin's solution (buffered sodium hypochlorite) has been used as a topical adjunct for the treatment of invasive fungal infections in trauma patients. Prudent use of Dakin's solution (DS) for complex musculoskeletal wound management implies balancing antimicrobial efficacy and human tissue toxicity, but little empirical evidence exists to inform clinical practice. To identify potentially efficacious DS concentrations and application methods, we conducted two animal studies to evaluate the ability of DS to reduce bacterial burden in small and large animal models of contaminated musculoskeletal wounds...
August 6, 2018: Injury
Kohei Nakamura, Kentaro Nakayama, Nagisa Tatsumi, Toshiko Minamoto, Tomoka Ishibashi, Kaori Ohnishi, Hitomi Yamashita, Ruriko Ono, Hiroki Sasamori, Sultana Razia, Shanta Kamrunnahar, Masako Ishikawa, Satoru Kyo
The aim of the present study was to assess the prognostic significance of the pre-treatment neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR) and other clinicopathological characteristics in patients with non-surgically treated uterine cervical carcinoma. The correlations of clinicopathological characteristics with overall and progression-free survival were determined in 98 Japanese patients who received non-surgical treatment for uterine cervical carcinoma between January 1997 and July 2013...
August 2018: Molecular and Clinical Oncology
David L Penn, Kyle C Wu, Kayla R Presswood, Coleman P Riordan, R Michael Scott, Edward R Smith
Children with arteriovenous malformations (AVMs) are at cumulative, life-long risk of debilitating and fatal intracranial hemorrhage, especially with syndromes such as hereditary hemorrhagic telangiectasia. Cerebral angiography is the gold standard for diagnosis and allows simultaneous adjunctive embolization limiting radiation and contrast exposure and intraoperative blood loss, important in pediatric patients with low blood volume. Microsurgical resection of low-grade AVMs offers cure with minimal morbidity...
August 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
J F Cornelius, J Schipper, A Tortora, Z Krause-Molle, M Smuga, A K Petridis, H J Steiger
OBJECTIVE: To evaluate a new surgical tool combining suction and monopolar neurostimulation ("stimulation-sucker") for tumors of the cerebello-pontine angle (CPA). The usefulness for continuous (time) and dynamic (space) facial nerve mapping was studied. METHODS: Patients operated with the stimulation-sucker for a CPA tumor between April 2016 and May 2017 in a tertiary care center were identified. Clinical charts were retrospectively evaluated. The minimum follow-up time of patients was 12 months...
August 9, 2018: World Neurosurgery
Ian C Gibbs, Oluwole Fadahunsi, Natoya Reid, Andrea M Bonnick
Malignant hyperthermia is a rare condition that occurs in susceptible patients exposed to triggering anesthetic agents. It is associated with a high mortality rate if not recognized immediately and treated appropriately. A 52-year-old man presented to our clinic 2 days after an assault for management of jaw pain. A minimally displaced right parasymphyseal fracture and moderately displaced left body fracture of the mandible were diagnosed. There were no known drug allergies. The patient reported no previous difficulty with anesthesia, as well as no known prior adverse reactions to anesthesia in any relatives...
July 19, 2018: Journal of Oral and Maxillofacial Surgery
Fouzi Benboujja, Sarah Bowe, Caroline Boudoux, Christopher Hartnick
Importance: Recurrent respiratory papillomatosis (RRP) is a viral-induced disease caused by human papillomavirus and the second leading cause of dysphonia in children; however, neither a cure nor a definitive surgical treatment is currently available for RRP. Although laser therapy is often used in the treatment of RRP, the lack of real-time laser-tissue interaction feedback undermines the ability of physicians to provide treatments with low morbidity. Therefore, an intraoperative tool to monitor and control laser treatment depth is needed...
August 9, 2018: JAMA Otolaryngology—Head & Neck Surgery
Hong-Man Cho, Jae-Woong Seo, Hyun-Ju Lee, Kyu-Bok Kang, Jung-Ryul Kim, Ho-Wook Wee
OBJECTIVE: There is limited literature concerning the outcomes and role of THA as a surgical option for amputee patients. The aim of this study is to determine the mid-to long-term survival and complication rates of cementless total hip arthroplasty (THA) in patients with contralateral below knee amputations. METHODS: A retrospective review of 54 patients with below knee amputation were perfomed who underwent THA for osteoarthritis of the contralateral hip over a 5-year period between 1999 and 2014...
August 7, 2018: Acta Orthopaedica et Traumatologica Turcica
Bin Wang, An-Ping Su, Teng-Fei Xing, Han Luo, Wan-Jun Zhao, Jing-Qiang Zhu
To evaluate the function of carbon nanoparticles during the thyroid reoperation for carcinoma, we conducted this study by retrospectively analyzing the data of patients who underwent at least completion thyroidectomy with bilateral central lymph nodes dissection for thyroid carcinoma from January 2009 to June 2016. The clinicopathologic characteristics and surgical details were compared between the patient who accepted intraoperative carbon nanoparticles injection and those who accepted nothing injection during the surgery...
August 2018: Medicine (Baltimore)
Sue Carol Verrillo, Maria Cvach, Krysia Warren Hudson, Bradford D Winters
BACKGROUND: Episodic vital sign collection (eVSC), as single data points, gives an incomplete picture of adult patients' postoperative physiologic status. LOCAL PROBLEM: Late detection of patient deterioration resulted in poor patient outcomes on a postsurgical unit. METHODS: Baseline demographic and outcome data were collected through retrospective chart review of all patients admitted to the surgical unit for 12 weeks prior to this quality improvement project...
August 7, 2018: Journal of Nursing Care Quality
Christa Boer, Hugo R Touw, Stephan A Loer
PURPOSE OF REVIEW: This narrative review summarizes recent insights into the role of remote monitoring of vital signs in the postoperative period in surgical wards. RECENT FINDINGS: Despite recent improvements in the safety of anesthesia and surgical procedures, postoperative complication rates are still unacceptably high. This is partly attributable to the intermittent provision of personal care to patients by nurses and ward physicians. Continuous remote monitoring of vital functions in the early postoperative period may reduce these complication rates...
August 7, 2018: Current Opinion in Anaesthesiology
Andrew Evans, Rubina M Trimboli, Alexandra Athanasiou, Corinne Balleyguier, Pascal A Baltzer, Ulrich Bick, Julia Camps Herrero, Paola Clauser, Catherine Colin, Eleanor Cornford, Eva M Fallenberg, Michael H Fuchsjaeger, Fiona J Gilbert, Thomas H Helbich, Karen Kinkel, Sylvia H Heywang-Köbrunner, Christiane K Kuhl, Ritse M Mann, Laura Martincich, Pietro Panizza, Federica Pediconi, Ruud M Pijnappel, Katja Pinker, Sophia Zackrisson, Gabor Forrai, Francesco Sardanelli
This article summarises the information that should be provided to women and referring physicians about breast ultrasound (US). After explaining the physical principles, technical procedure and safety of US, information is given about its ability to make a correct diagnosis, depending on the setting in which it is applied. The following definite indications for breast US in female subjects are proposed: palpable lump; axillary adenopathy; first diagnostic approach for clinical abnormalities under 40 and in pregnant or lactating women; suspicious abnormalities at mammography or magnetic resonance imaging (MRI); suspicious nipple discharge; recent nipple inversion; skin retraction; breast inflammation; abnormalities in the area of the surgical scar after breast conserving surgery or mastectomy; abnormalities in the presence of breast implants; screening high-risk women, especially when MRI is not performed; loco-regional staging of a known breast cancer, when MRI is not performed; guidance for percutaneous interventions (needle biopsy, pre-surgical localisation, fluid collection drainage); monitoring patients with breast cancer receiving neo-adjuvant therapy, when MRI is not performed...
August 9, 2018: Insights Into Imaging
Gnanaselvam Pamathy, Umesh Jayarajah, Tshering Wangmo, Anura S K Banagala
Lithium induced primary hyperparathyroidism is an uncommon endocrine side effect of long term lithium therapy. We studied the case of a 67-year-old female patient on long term lithium therapy for bipolar affective disorder, who developed resistant hypercalcaemia and parathyroid adenoma which required parathyroidectomy. Furthermore, the effect of chronic lithium therapy on parathyroid glands and serum calcium levels, its pathogenesis, and management were reviewed. Periodic monitoring of serum calcium levels in patients on long term lithium therapy should be practiced...
July 2018: Indian Journal of Psychological Medicine
Rohesh J Fernando, Emily Williamson, Eduardo J Goenaga Díaz, Sean D Johnson
Intraoperative transesophageal echocardiography currently is used routinely for many cardiothoracic surgical procedures. Although it is often used for intraoperative cardiac monitoring and to confirm preoperative echocardiographic findings, it may sometimes result in the discovery of unexpected pathology. In this e-challenge, a patient was found to have a mitral valve abnormality that was not previously detected on the preoperative transthoracic echocardiogram. The mitral valve anomaly subsequently was evaluated to characterize the anatomy, interrogate the valve, and provide a diagnosis...
July 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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