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https://www.readbyqxmd.com/read/30101529/re-evaluating-the-utility-of-stress-ulcer-prophylaxis-in-the-critically-ill-patient-a-clinical-scenario-based-meta-analysis
#1
Paul M Reynolds, Rob MacLaren
STUDY OBJECTIVE: As recent studies have challenged the efficacy of stress ulcer prophylaxis (SUP) in the critically ill patient, the objective of this study was to evaluate the efficacy of SUP with proton pump inhibitors (PPIs) or histamine2 receptor antagonists (H2 RAs) against placebo, control, no therapy, or enteral nutrition alone in critically ill adults. DESIGN: Meta-analysis with trial sequential analysis (TSA) of 34 randomized controlled trials. PATIENTS: A total of 3220 critically ill adults who received PPIs or H2 RAs versus placebo, control, no therapy, or enteral nutrition...
August 13, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/30101207/goniosynechialysis-for-secondary-angle-closure-glaucoma-in-aphakic-patient-after-pars-plana-vitrectomy
#2
Nasser A Alsobaie, Asma I Almohizea, Yahya Al-Zahrani, Rizwan Malik
Purpose: To report the effectiveness of Goniosynechialysis (GSL) treating elevated intraocular pressure (IOP) in an aphakic eye with peripheral anterior synechiae (PAS) formation after vitrectomy. Observations: A 39-year-old gentleman with history of lamellar keratoplasty for corneal ectasia and blunt trauma to the right eye necessitating vitrectomy and lensectomy presented to our glaucoma unit with a secondary angle closure and an IOP of 50 mmHg. This was successfully treated with GSL and one year after surgery, the patient maintains a normal IOP without the use of medication...
December 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/30099190/continous-and-dynamic-facial-nerve-mapping-during-surgery-of-cerebello-pontine-angle-tumors-clinical-pilot-series
#3
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
https://www.readbyqxmd.com/read/30098814/efficiency-of-care-and-cost-for-common-emergency-general-surgery-conditions-comparison-by-surgeon-training-and-practice
#4
Husayn A Ladhani, Sarah E Posillico, Brenda M Zosa, Emily A Verbus, Christopher P Brandt, Jeffrey A Claridge
BACKGROUND: Our institutional emergency general surgery service is staffed by both trauma and critical care-trained surgeons and other boarded general surgeons and subspecialists. We compared efficiency of care for common emergency general surgery conditions between trauma and critical care-trained surgeons and boarded general surgeons and subspecialists. METHODS: Adults admitted between February 2014 and May 2017 with acute appendicitis, acute cholecystitis, intestinal obstruction, incarcerated hernia, or other acute abdominal diagnoses seen by emergency general surgery service were included...
August 8, 2018: Surgery
https://www.readbyqxmd.com/read/30098351/the-asia-cornea-society-infectious-keratitis-study-a-prospective-multicenter-study-of-infectious-keratitis-in-asia
#5
Wei-Boon Khor, Venkatesh N Prajna, Prashant Garg, Jodhbir S Mehta, Lixin Xie, Zuguo Liu, Ma Dominga B Padilla, Choun-Ki Joo, Yoshitsugu Inoue, Panida Goseyarakwong, Fung-Rong Hu, Kohji Nishida, Shigeru Kinoshita, Vilavun Puangsricharern, Ai-Ling Tan, Roger Beuerman, Alvin Young, Namrata Sharma, Benjamin Haaland, Francis S Mah, Elmer Y Tu, Fiona J Stapleton, Richard L Abbott, Donald Tiang-Hwee Tan
PURPOSE: To survey the demographics, risk factors, microbiology and outcomes for infectious keratitis in Asia. DESIGN: Prospective, non-randomized clinical study METHODS: Thirteen study centers and 30 sub-centers recruited consecutive subjects over 12 - 18 months, and performed standardized data collection. A microbiological protocol standardized the processing and reporting of all isolates. Treatment of the infectious keratitis was decided by the managing ophthalmologist...
August 8, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/30097693/neuroimaging-of-central-diabetes-insipidus-when-how-and-findings
#6
REVIEW
N C Adams, T P Farrell, A O'Shea, A O'Hare, J Thornton, S Power, P Brennan, S Looby
Central or neurogenic diabetes insipidus (CDI) is due to deficient synthesis or secretion of antidiuretic hormone (ADH), also known as arginine vasopressin peptide (AVP). It is clinically characterised by polydipsia and polyuria (urine output > 30 mL/kg/day) of dilute urine (< 250 mOsm/L). It is the result of a defect in one of more sites involving the hypothalamic osmoreceptors, supraoptic or paraventricular nuclei of the hypothalamus, median eminence of the hypothalamus, infundibulum or the posterior pituitary gland...
August 10, 2018: Neuroradiology
https://www.readbyqxmd.com/read/30097311/bilateral-low-dose-computed-tomography-assessment-for-post-operative-rotational-malalignment-after-intramedullary-nailing-for-tibial-shaft-fractures-reliability-of-a-practical-imaging-technique
#7
Nils Jan Bleeker, Megan Cain, Mariana Rego, Aimane Saarig, Andrew Chan, Inger Sierevelt, Job N Doornberg, Ruurd L Jaarsma
INTRODUCTION: The purpose of this study is to evaluate the intra- and inter-observer reliability of low-dose protocolled bilateral postoperative Computed Tomography (CT)-assessment of rotational malalignment after intramedullary nailing (IMN) of tibial shaft fractures. MATERIALS AND METHODS: 156 patients were prospectively included with tibial shaft fractures that were treated with IMN in a Level-I Trauma Centre. All patients underwent post-operative bilateral low-dose CT-assessment (effective dose of 0...
July 29, 2018: Injury
https://www.readbyqxmd.com/read/30096427/outcomes-comparison-between-ligation-and-repair-following-major-lower-extremity-venous-injury
#8
Shokei Matsumoto, Kyoungwon Jung, Alan Smith, Raul Coimbra
BACKGROUND: The necessity of repair remains controversial following major lower extremity venous injuries (MLEVIs). Ligation may cause venous hypertension which should be managed with fasciotomies. Previous studies have shown fasciotomy rate are not affected by the type of management of MLEVIs. The aim of this study is to examine the rate of fasciotomy, amputation, and other complications from a difference between ligation and repair of MLEVIs. METHODS: The National Trauma Data Bank (NTDB) for 2010-2014 was reviewed...
August 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30095793/the-impact-of-comorbidity-burden-on-complications-length-of-stay-and-direct-hospital-costs-after-minimally-invasive-transforaminal-lumbar-interbody-fusion
#9
Benjamin Khechen, Brittany E Haws, Mundeep S Bawa, Dil V Patel, Kaitlyn L Cardinal, Jordan A Guntin, Simon P Lalehzarian, Kern Singh
STUDY DESIGN: Retrospective Cohort OBJECTIVE.: To determine if comorbidity as determined by Charlson Comorbidity Index (CCI) is associated with inpatient complication rate, length of stay (LOS), or direct hospital costs after minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF). SUMMARY OF BACKGROUND DATA: In the spine literature, comorbidity burden has been associated with an increased risk for complications, prolonged LOS, and greater hospital costs...
August 7, 2018: Spine
https://www.readbyqxmd.com/read/30095679/effect-of-deformity-and-malunion-of-the-anterior-pelvic-ring
#10
Michael T Archdeacon, Cory A Collinge, Adam P Schumaier, Georgina Glogovac
Pelvic fractures are common after high-energy trauma and are often associated with ligamentous injury. Treatment is guided by assessing stability of the pelvic ring, and unstable injuries frequently require surgery to achieve a desirable outcome. Assessment of pelvic ring stability is often possible with physical examination and standard imaging studies (plain radiographs and computed tomography); however, these "static" imaging modalities may not adequately identify dynamically unstable pelvic injuries that require surgery...
September 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/30095515/use-of-intrawound-antibiotics-in-orthopaedic-surgery
#11
Antonia F Chen, Andrew Fleischman, Matthew S Austin
Intrawound antibiotics have been used in orthopaedic surgery procedures to prevent the development of surgical site infections. Local delivery of antibiotic powder has demonstrated a notable reduction in surgical site infection in rabbit and rodent in vivo models, as well as in other surgical fields, including vascular, colorectal, cardiothoracic, and dermatologic surgery. Intrawound antibiotic powder has been used in many orthopaedic applications, including spine surgery, total joint arthroplasty, trauma, foot and ankle reconstruction, and elbow surgery...
August 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30095514/glenohumeral-osteoarthritis-in-the-young-patient
#12
Bryan M Saltzman, Timothy S Leroux, Nikhil N Verma, Anthony A Romeo
Glenohumeral osteoarthritis in the young patient (aged <60 years) is a difficult condition, given both age and functional demands. Primary osteoarthritis is the most common etiology in this patient demographic, but secondary causes include osteonecrosis, previous trauma (eg, fracture-dislocation), previous infection (eg, septic arthritis), previous capsulorrhaphy, previous arthroscopic surgery (eg, chondrolysis), and glenoid dysplasia. Nonsurgical modalities, including activity modification, pharmacotherapy, physical therapy, and intra-articular injections, are the mainstay of management; however, in young patients who have exhausted nonsurgical management, surgical options include arthroscopic débridement, humeral head replacement with or without glenoid treatment (ie, biologic glenoid resurfacing, glenoid reaming), and total or reverse total shoulder arthroplasty...
August 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30094942/-i-think-we-ve-had-a-health-screen-new-offshore-screening-new-refugee-health-guidelines-new-syrian-and-iraqi-cohorts-recommendations-reality-results-and-review
#13
Rachel C Heenan, Thomas Volkman, Simon Stokes, Shidan Tosif, Hamish Graham, Andrea Smith, David Tran, Georgia Paxton
AIM: To examine refugee health assessments in Syrian and Iraqi children in the context of changes to offshore immigration screening, updated Australian refugee health guidelines and the primary care refugee health model in Victoria. METHODS: This is a retrospective audit of Syrian and Iraqi children aged 0-17 years attending a specialist immigrant health service from January 2015 to September 2017. RESULTS: We saw 128 children (7 months-16 years, 64...
August 9, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/30094494/endovascular-management-of-a-giant-petrous-internal-carotid-artery-aneurysm-in-a-child-case-report-and-literature-review
#14
Alin Borha, Vincent Patron, Herve Huet, Evelyne Emery, Charlotte Barbier
BACKGROUND: Aneurysms of the petrosal segment of the internal carotid artery are rare in children and are usually found secondary to trauma and infection or can have a congenital origin. Management includes endovascular therapy, surgery, and in rare cases observation. DISCUSSION: Here, we report our experience with a giant petrous internal carotid artery aneurysm in a 16-year-old boy successfully managed endovascularly by parent artery occlusion.
August 9, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/30093364/variations-in-the-delivery-of-emergency-general-surgery-care-in-the-era-of-acute-care-surgery
#15
Vijaya T Daniel, Angela M Ingraham, Jasmine A Khubchandani, Didem Ayturk, Catarina I Kiefe, Heena P Santry
BACKGROUND: Acute care surgery (ACS) was proposed to improve emergency general surgery (EGS) care; however, the extent of ACS model adoption in the United States is unknown. A national survey was conducted to ascertain factors associated with variations in EGS models of care, with particular focus on ACS use. METHODS: A hybrid mail/electronic survey was sent in 2015 to 2,811 acute care hospitals with an emergency room and an operating room. If a respondent indicated that the approach to EGS was a dedicated clinical team whose scope encompasses EGS (± trauma, ± elective general surgery, ± burns), the hospital was considered an ACS hospital...
August 6, 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/30093336/does-a-written-tool-to-guide-structured-debriefing-improve-discourse-implications-for-interprofessional-team-simulation
#16
Ryan Thompson, Sarah Sullivan, Krystle Campbell, Ingie Osman, Brianna Statz, Hee Soo Jung
PURPOSE: Timely debriefing following a simulated event supports learners in critically reflecting on their performance and areas for improvement. Content of debriefing has been shown to affect learner skill acquisition and retention. The use of good judgment statements from debriefing facilitators is considered superior to judgmental or nonjudgmental statements. Ideally, the majority of the conversation will consist of learner self-reflection and focused facilitation rather than directive performance feedback...
August 6, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/30093334/a-structured-review-instrument-improves-the-quality-of-orthopaedic-journal-club
#17
Sean T Campbell, John P Kleimeyer, Jeffrey L Young, Michael J Gardner, Kirkham B Wood, Julius A Bishop
OBJECTIVE: We asked the following questions: 1. Does the use of an structured review instrument (SRI) at journal club increase presentation quality, as measured objectively by a standardized evaluation rubric? 2. Does SRI use increase the time required to prepare for journal club? 3. Does SRI use positively impact presenter perceptions about confidence while presenting, satisfaction, and journal club effectiveness, as measured by postparticipation surveys? DESIGN: A prospective study was designed in which a grading rubric was developed to evaluate journal club presentations...
August 7, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/30089089/evolution-of-glaucoma-surgery-in-the-last-25-years
#18
REVIEW
Laura Bar-David, Eytan Z Blumenthal
Glaucoma is a chronic neurodegenerative optic nerve disease. Treatment is intended to prevent the development and progression of optic nerve damage by lowering intraocular pressure (IOP). Current therapy options include topical/systemic drugs that increase aqueous humor outflow or decrease its production, laser therapy that targets the trabecular meshwork and ciliary body, and incisional surgery. Trabeculectomy as well as glaucoma drainage devices are often performed, given their high efficacy in lowering IOP...
July 30, 2018: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/30087752/lingual-artery-pseudoaneurysm-after-severe-facial-trauma
#19
Leyre Margallo, Estibaliz Ortiz de Zárate, Maria Franco, Maria Garcia-Iruretagoyena, Rosa Cherro, Luis Barbier, Josu Mendiola, Thomas Constantinescu
The mortality associated with high-energy trauma has several time peaks and variable prognosis. In the particular case of isolated head and neck trauma, management initially includes stabilizing the patient, especially the airway and circulation, and then proceeding to treat injured structures with debridement and often fracture fixation and coverage. We present a case of a male patient who suffered a severe facial trauma at his workplace. He underwent an initial uneventful emergency surgery for control of bleeding and mandibular osteosynthesis...
September 2018: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/30087751/surgical-treatment-of-posttraumatic-laterognathia-a-case-report-and-a-literature-review-focused-on-the-effects-of-a-condylar-fracture-on-the-face
#20
Felipe Ladeira Pereira, Luísa de Marilac de Alencar Pinheiro, Phelype Maia Araújo, Letícia Liana Chihara, Renato Luiz Maia Nogueira, Eduardo Sant'Ana
Facial asymmetry, following early childhood condylar trauma, is a common complaint among patients who seek surgical treatment. G.D.M., a 27-year-old male patient, sought professional help to correct his cosmetic flaw, caused by a condylar fracture when he was 8-years-old. After the proper orthodontic treatment, he underwent a double jaw orthognathic surgery and, 9 months later, a second one to correct the remaining asymmetry. Two years after this second procedure, the patient is still under surveillance and has no complaints...
September 2018: Craniomaxillofacial Trauma & Reconstruction
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