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Surgical clinics

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https://www.readbyqxmd.com/read/28732219/perioperative-systemic-corticosteroids-in-orthognathic-surgery-a-systematic-review-and-meta-analysis
#1
REVIEW
Simon Jean, Pierre-Luc Dionne, Carl Bouchard, Luc Giasson, Alexis F Turgeon
PURPOSE: Perioperative systemic corticosteroids are broadly used in orthognathic surgery to prevent postoperative complications, but it is unclear whether this practice is beneficial and concerns about potential side effects have been raised. The purpose of this systematic review and meta-analysis was to assess the effects of perioperative systemic corticosteroids on clinically important outcomes in patients undergoing orthognathic surgery. MATERIALS AND METHODS: The authors conducted a systematic review of randomized controlled trials evaluating the effect of systemic corticosteroids in orthognathic surgery compared with placebo or any other intervention...
June 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28732177/inguinal-hernia-in-athletes-role-of-dynamic-ultrasound
#2
William Kelton Vasileff, Mikhail Nekhline, Patricia A Kolowich, Gary B Talpos, Willam R Eyler, Marnix van Holsbeeck
BACKGROUND: Inguinal hernia is a commonly encountered cause of pain in athletes. Because of the anatomic complexity, lack of standard imaging, and the dynamic condition, there is no unified opinion explaining its underlying pathology. HYPOTHESIS: Athletes with persistent groin pain would have a high prevalence of inguinal hernia with dynamic ultrasound, and herniorrhaphy would successfully return athletes to activity. STUDY DESIGN: Case-control study...
July 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28731995/-update-on-chronic-pancreatitis-review-article
#3
Frank Czul, Emmanuel Coronel, Jean A Donet
Chronic pancreatitis is a progressive fibro-inflammatory disease of the pancreas characterized by irreversible fibrosis of the gland with eventual failure of exocrine and endocrine functions and hallmark features of abdominal pain, malabsorption, malnutrition, diabetes mellitus and pancreatic calcifications. In many patients this disease results from a complex mix of environmental (eg, alcohol, cigarettes, and occupational chemicals), genetic factors and a few patients with hereditary or autoimmune disease...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28731950/totally-laparoscopic-resection-for-low-sigmoid-and-rectal-cancer-using-natural-orifice-specimen-extraction-techniques
#4
Hideharu Shimizu, Kensuke Adachi, Hideo Ohtsuka, Itaru Osaka, Kunio Takuma, Kijuro Takanishi, Jun Matsumoto
BACKGROUND: A minilaparotomy for specimen extraction during laparoscopy occasionally results in postoperative wound complications. We have performed a totally laparoscopic resection for early colorectal cancer using the natural orifice specimen extraction technique. METHODS: From 2008 to 2013, we have performed a totally laparoscopic resection for clinical stage I and IIA low sigmoid colon and rectal cancers. A prospectively maintained database was reviewed to assess the outcomes after surgery...
July 20, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28731946/treatment-minimization-in-older-patients-with-early-stage-breast-cancer
#5
Tara M Hansen, Richard C Zellars
The management of early-stage breast cancer in older patients is complex and requires a careful balance of the risk of cancer death with the competing risks of comorbidities and treatment-related toxicity in women with largely favorable disease. As the US population continues to age, oncologists will increasingly encounter this clinical challenge. Several strategies involving each core component of breast cancer therapy have been investigated to minimize treatment in these patients while still maintaining acceptable outcomes...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#6
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28731842/role-of-pepsin-and-oropharyngeal-ph-monitoring-to-assess-the-postoperative-outcome-of-patients-with-laryngopharyngeal-reflux-results-of-a-pilot-trial
#7
Michael Weitzendorfer, Richard Pfandner, Stavros A Antoniou, Werner Langsteger, Kai Witzel, Klaus Emmanuel, Oliver O Koch
BACKGROUND: The aim of this study was to evaluate the value of salivary pepsin and oropharyngeal pH-monitoring to assess the surgical outcome of patients with laryngopharyngeal reflux (LPR). MATERIALS AND METHODS: Twenty consecutive patients with LPR despite proton pump inhibitor treatment received laparoscopic antireflux surgery. Twenty-four hour esophageal pH-monitoring (multichannel intraluminal impedance monitoring [MII]-pH) and esophageal manometry (high-resolution manometry) data were documented preoperatively and at 3-month follow-up...
July 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28731535/ultrasound-guided-drainage-for-pediatric-soft-tissue-abscesses-decreases-clinical-failure-rates-compared-to-drainage-without-ultrasound-a-retrospective-study
#8
Romolo Joseph Gaspari, Alexandra Sanseverino
OBJECTIVES: Soft tissue abscesses are common in the pediatric emergency department (ED). Ultrasound (US) can be used to both diagnose soft tissue abscesses as well as guide drainage. We hypothesized that clinical failure rates would be less in pediatric patients with suspected skin abscesses when evaluated with US. METHODS: We performed a retrospective review of suspected pediatric skin abscesses at 4 EDs over a 22-month period. Cases were identified through electronic medical record descriptions, discharge diagnoses, and US database records...
July 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#9
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28731396/contralateral-posterior-interhemispheric-approach-to-deep-medial-parietooccipital-vascular-malformations-surgical-technique-and-results
#10
Jan-Karl Burkhardt, Ethan A Winkler, Michael T Lawton
OBJECTIVE Deep medial parietooccipital arteriovenous malformations (AVMs) and cerebral cavernous malformations (CCMs) are traditionally resected through an ipsilateral posterior interhemispheric approach (IPIA), which creates a deep, perpendicular perspective with limited access to the lateral margins of the lesion. The contralateral posterior interhemispheric approach (CPIA) flips the positioning, with the midline positioned horizontally for retraction due to gravity, but with the AVM on the upper side and the approach from the contralateral, lower side...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28731391/malpractice-litigation-following-spine-surgery
#11
Alan H Daniels, Roy Ruttiman, Adam E M Eltorai, J Mason DePasse, Bielinsky A Brea, Mark A Palumbo
OBJECTIVE Adverse events related to spine surgery sometimes lead to litigation. Few studies have evaluated the association between spine surgical complications and medical malpractice proceedings, outcomes, and awards. The aim of this study was to identify the most frequent causes of alleged malpractice in spine surgery and to gain insight into patient demographic and clinical characteristics associated with medical negligence litigation. METHODS A search for "spine surgery" spanning February 1988 to May 2015 was conducted utilizing the medicolegal research service VerdictSearch (ALM Media Properties, LLC)...
July 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28731057/idiopathic-macular-holes-and-direction-of-vitreomacular-traction-structural-changes-and-surgical-outcomes
#12
C-Y Tsai, Y-T Hsieh, T-T Lai, C-M Yang
PurposeTo compare the structural changes, clinical course, and treatment outcomes of vertical and horizontal vitreomacular traction (VMT) induced impending macular holes (IMHs) and full-thickness macular holes (FTMHs).MethodsIn this retrospective study, 23 and 32 cases of IMHs and FTMHs, respectively, were analyzed. The IMH cases were divided into two subgroups: IMH with and without foveal detachment. Vitreofoveal traction angles (TAs) between the inner retinal surface and posterior hyaloid were measured from horizontal and vertical optical coherence tomography (OCT) images by using the trigonometric function (the angle equals the arctangent of the height over the base) after adjustments for magnification factors...
July 21, 2017: Eye
https://www.readbyqxmd.com/read/28730989/users-guide-to-the-surgical-literature-how-to-assess-an-article-using-surrogate-end-points
#13
Lucas Gallo, Cagla Eskicioglu, Luis H Braga, Forough Farrokhyar, Achilleas Thoma
Phase 3 randomized controlled trials are the widely accepted gold standard through which treatment decisions are made, as they assess the efficacy of a novel treatment against the control on the relevant patient population. The effectiveness of the novel treatment should be derived by measuring patient-important outcomes; however, to accurately assess these outcomes, clinical trials often require extensive patient follow-up and large sample sizes that can incur substantial expense. For this reason, investigators substitute surrogate end points to reduce the sample size and duration of a trial, ultimately reducing cost...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730988/radiostereometric-analysis-of-keeled-versus-pegged-glenoid-components-in-total-shoulder-arthroplasty-a-randomized-feasibility-study
#14
Trevor C Gascoyne, Sheila M B McRae, Sara L Parashin, Jeff R S Leiter, Martin J Petrak, Eric R Bohm, Peter B MacDonald
BACKGROUND: This study aimed to assess differences in the fixation and functional outcomes between pegged and keeled all-polyethylene glenoid components for standard total shoulder arthroplasty. METHODS: Patients were randomized to receive a keeled or pegged all-polyethylene glenoid component. We used model-based radiostereometric analysis (RSA) to assess glenoid fixation and subjective outcome measures to assess patient function. Follow-up examinations were completed at 6 weeks and 6, 12 and 24 months after surgery...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730987/evaluation-of-an-advanced-practice-physiotherapist-in-triaging-patients-with-lumbar-spine-pain-surgeon-physiotherapist-level-of-agreement-and-patient-satisfaction
#15
Susan Robarts, Paul Stratford, Deborah Kennedy, Barry Malcolm, Joel Finkelstein
BACKGROUND: Surgery for lumbar spine pain is indicated for specific etiologies. Given the majority of individuals referred to spine surgeons are not surgical candidates, care delivery is inefficient, with consultations being of limited value for most. Using specially trained physiotherapists in triage is a human resource strategy that may optimize surgeons' time and the patient experience. METHODS: An advanced-practice physiotherapist (APP) and a surgeon assessed consecutive patients with lumbar spine pain presenting at an academic health centre's spine surgery clinic...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730965/efficient-non-invasive-plasmid-dna-administration-into-tibialis-cranialis-muscle-of-little-mice
#16
C R Cecchi, E Higuti, E R Lima, D P Vieira, P L Squair, C N Peroni, P Bartolini
An alternative treatment for growth hormone deficiency based on hGH-DNA administration, followed by electro gene transfer, was investigated by injecting the plasmid into surgically exposed or non-exposed quadriceps or tibialis muscle of immunodeficient "little" mice. Previously optimized electrotransfer conditions were also improved via a new combination of high/low voltage pulses: after 3 days, serum hGH was determined. Both groups exhibited similar results: 5.0 ± 2.2 (SD) and 3.5 ± 0.9 ng hGH/ml (P>0...
July 21, 2017: Current Molecular Medicine
https://www.readbyqxmd.com/read/28730909/dramatic-response-of-acute-disseminated-intravascular-coagulation-to-erlotinib-in-a-patient-with-lung-adenocarcinoma-with-activating-egfr-mutation
#17
Jung Soo Kim, Jeong-Seon Ryu, Sang Hoon Jeon, Hyun-Jung Kim, Hae-Seong Nam, Jae Hwa Cho, Seung Min Kwak, Hong Lyeol Lee
Disseminated intravascular coagulation (DIC) is a commonly encountered clinical situation characterized by thrombotic occlusion or bleeding in patients with lung cancer. DIC in patients with cancer is usually asymptomatic, taking a chronic form as a compensatory mechanism. Although acute DIC in patients with lung cancer is rarely reported, it can be fatal. We herein describe a patient with lung adenocarcinoma with an activating mutation of the epidermal growth factor receptor (EGFR) gene who developed acute DIC after minor surgical excision...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28730890/the-biopsychosocial-model-of-illness-a-model-whose-time-has-come
#18
Derick T Wade, Peter W Halligan
The biopsychosocial model outlined in Engel's classic Science paper four decades ago emerged from dissatisfaction with the biomedical model of illness, which remains the dominant healthcare model. Engel's call to arms for a biopsychosocial model has been taken up in several healthcare fields, but it has not been accepted in the more economically dominant and politically powerful acute medical and surgical domains. It is widely used in research into complex healthcare interventions, it is the basis of the World Health Organisation's International Classification of Functioning (WHO ICF), it is used clinically, and it is used to structure clinical guidelines...
August 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28730784/single-center-retrospective-analysis-of-162-cases-with-thymoma-complicating-myasthenia-gravis
#19
Qing Lin, Ye Zhang, Liuchun Yang
PURPOSE: We conducted this study to retrospectively analyze the clinical effects of surgical resection for patients with myasthenia gravis (MG) complicated with thymoma. METHODS: 162 patients with myasthenia gravis complicated with thymoma, that were admitted to our hospital and underwent surgical disease resection from Nov. 1993 to Nov. 2015, were selected for this study. Analyzed were the pathology (2004 WHO), Masaoka clinical stage, myasthenia gravis types (Osserman types), myasthenic crisis during the perioperative period, and the relationship between recurrence and survival rates during follow-up visits...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28730779/a-comparative-study-on-postoperative-mortality-prediction-of-sfli-scoring-system-and-child-pugh-classification-in-patients-with-hepatocellular-carcinoma
#20
Jun Zheng, Rong-Chun Xing, Wei-Hong Zheng, Wei Liu, Ru-Cheng Yao, Xiao-Song Li, Jian-Ping Du, Lin Li
PURPOSE: In our previous study, we have established the clinical significance of the SFLI (scoring formula of liver injury), the purpose of this study was to compare the SFLI system and the Child-Pugh grading system in the prediction of postoperative mortality in patients with hepatocellular carcinoma (HCC). METHODS: 114 patients with HCC who underwent surgical treatment were enrolled. According to the requirement of the indicators for the Child-Pugh classification, various indices (including albumin [ALB], total bilirubin [TBIL], prothrombin time [PT], ascites, and hepatic encephalopathy) were considered in these patients before surgery, and then Child-Pugh grading was performed...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
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