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https://www.readbyqxmd.com/read/30027283/effect-of-stress-ball-use-or-hand-holding-on-anxiety-during-skin-cancer-excision-a-randomized-clinical-trial
#1
Arianna F Yanes, Alexandra Weil, Karina C Furlan, Emily Poon, Murad Alam
Importance: Patients undergoing skin surgery under local anesthesia can experience anxiety. Adjuvant intraoperative anxiety reduction methods may help. Objectives: To assess whether hand-holding or holding a stress ball reduces patient anxiety during excisional surgery of head or neck skin cancer with the patient under local anesthesia and to measure pain and patient satisfaction. Design, Setting, and Participants: In this nonblinded, single-center randomized clinical trial, performed from January 24 through April 26, 2017, at a dermatology outpatient service in an urban, academic medical center, a consecutive sample of 135 adults who required excisional removal of nonmelanoma skin cancer of the head or neck was randomized and studied...
July 18, 2018: JAMA Dermatology
https://www.readbyqxmd.com/read/29968420/extensive-clinical-experience-hypothalamic-pituitary-adrenal-axis-recovery-after-adrenalectomy-for-corticotropin-independent-cortisol-excess
#2
Maria Daniela Hurtado, Tiffany Cortes, Neena Natt, William F Young, Irina Bancos
OBJECTIVE: To identify predictors of hypothalamic-pituitary-adrenal (HPA) axis recovery interval and severity of glucocorticoid withdrawal symptoms (GWS) in patients undergoing adrenalectomy for corticotropin-independent cortisol excess. DESIGN: This is a retrospective study of patients with mild autonomous cortisol excess (MACE), moderate and severe Cushing syndrome (CS) who developed adrenal insufficiency after unilateral adrenalectomy between 1998 and 2017. RESULTS: Adrenalectomy was performed in 81 patients (79% women, median age 52 years [IQR 42-62])...
July 3, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29967931/long-term-oral-bisphosphonates-delay-healing-after-tooth-extraction-a-single-institutional-prospective-study
#3
A Shudo, H Kishimoto, K Takaoka, K Noguchi
Tooth extraction in patients receiving bisphosphonates is thought to be a risk factor for osteonecrosis of the jaw (ONJ); however, ONJ did not develop, even when tooth extraction was performed with continued oral bisphosphonate therapy. A drug holiday from bisphosphonates before tooth extraction may not be necessary. INTRODUCTION: It is controversial whether bisphosphonate withdrawal is necessary prior to invasive procedures such as tooth extraction in order to prevent bisphosphonate-related osteonecrosis of the jaw (BRONJ)...
July 2, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29911573/managing-post-thoracotomy-pain-epidural-or-systemic-analgesia-and-extended-care-a-randomized-study-with-an-as-usual-control-group
#4
Elina Tiippana, Kaisa Nelskylä, Eija Nilsson, Eero Sihvo, Matti Kataja, Eija Kalso
Background and aims Thoracotomies can cause severe pain, which persists in 21-67% of patients. We investigated whether NSAID + intravenous patient-controlled analgesia (IV-PCA) with morphine is an efficacious alternative to thoracic epidural analgesia (TEA). We also wanted to find out whether an extended controlled pain management protocol within a clinical study can decrease the incidence of persistent post-thoracotomy pain. Methods Thirty thoracotomy patients were randomized into 3 intervention groups with 10 patients in each...
October 1, 2014: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29905630/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-neuromodulation-of-the-sciatic-nerve-for-postoperative-analgesia-following-ambulatory-foot-surgery-a-proof-of-concept-study
#5
Brian M Ilfeld, Rodney A Gabriel, Engy T Said, Amanda M Monahan, Jacklynn F Sztain, Wendy B Abramson, Bahareh Khatibi, John J Finneran, Pia T Jaeger, Alexandra K Schwartz, Sonya S Ahmed
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surgery. However, it remains unknown if this analgesic technique may be used in ambulatory subjects following foot procedures beginning within the recovery room immediately following surgery, and with only short series of patients reported to date, the only available data are derived from strictly observational studies...
August 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29800263/plasmapheresis-for-management-of-antiphospholipid-syndrome-in-the-neurosurgical-patient
#6
Eric J Arias, Brent Bruck, Ananth K Vellimana, Charles Eby, Matthew R Reynolds, Morey A Blinder, Gregory J Zipfel
BACKGROUND AND IMPORTANCE: Antiphospholipid syndrome (APS) is an autoimmune disorder associated with a hypercoagulable state and increased risk of intraoperative and postoperative thrombosis. Few neurosurgical studies have examined the management of these patients, though the standard of care in most other disciplines involves the use of anticoagulation therapy. However, this is associated with risks such as hemorrhage, thrombosis due to warfarin withdrawal, and is not compatible with operative intervention...
May 24, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29798584/-application-of-three-dimensional-printing-technology-for-closed-reduction-and-percutaneous-cannulated-screws-fixation-of-displaced-intraarticular-calcaneus-fractures
#7
Min Wu, Jianzhong Guan, Yuzhou Xiao, Zhaodong Wang, Xiaotian Chen, Zhi Zhao, Kuankuan Zhang, Jun Zhu
Objective: To evaluate the effectiveness of three-dimensional (3-D) printing assisting minimally invasive for intraarticular calcaneal fractures with percutaneous poking reduction and cannulate screw fixation. Methods: A retrospective analysis was performed of the 19 patients (19 feet) with intraarticular calcaneal fracture who had been treated between March 2015 and May 2016. There were 13 males and 6 females with an average age of 38.2 years (range, 24-73 years)...
November 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29771804/preemptive-analgesia-decreases-pain-following-anorectal-surgery-a-prospective-randomized-double-blinded-placebo-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
July 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29687342/predictors-of-preoperative-program-non-completion-in-adolescents-referred-for-bariatric-surgery
#9
Cassie Brode, Megan Ratcliff, Jennifer Reiter-Purtill, Sanita Hunsaker, Michael Helmrath, Meg Zeller
BACKGROUND: Factors contributing to adolescents' non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery. OBJECTIVES: The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery ("completers") or withdrew from treatment ("non-completers")...
April 23, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29628658/internal-tunneling-resorption-associated-with-invasive-cervical-resorption
#10
Pallav Mahesh Patni, Pradeep Jain, Sumeet Jain, Hemalatha Hiremath, Rolly Agarwal, Mona Jain Patni
Treating pathological defects that are caused by resorption in teeth can be challenging. The task is complicated further if the resorption extends beyond the restrains of the root. The aim of this report is to describe a case of extensive internal tunneling resorption (ITR) associated with invasive cervical resorption (ICR) in a maxillary right lateral incisor and its nonsurgical treatment. A 22-year-old male was referred to the department of endodontics with a chief complaint of discolored maxillary right lateral incisor or tooth 12 and a history of trauma...
January 2018: Journal of Conservative Dentistry: JCD
https://www.readbyqxmd.com/read/29596097/repeated-morphine-prolongs-postoperative-pain-in-male-rats
#11
Peter M Grace, Erika L Galer, Keith A Strand, Kaci Corrigan, Debra Berkelhammer, Steven F Maier, Linda R Watkins
BACKGROUND: Opioids are effective postoperative analgesics. Disturbingly, we have previously reported that opioids such as morphine can worsen inflammatory pain and peripheral and central neuropathic pain. These deleterious effects are mediated by immune mediators that promote neuronal hyperexcitability in the spinal dorsal horn. Herein, we tested whether perioperative morphine could similarly prolong postoperative pain in male rats. METHODS: Rats were treated with morphine for 7 days, beginning immediately after laparotomy, while the morphine was tapered in a second group...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29579885/intraoperative-heparinization-during-simultaneous-pancreas-kidney-transplantation-is-it-really-necessary
#12
A Arjona-Sánchez, L Rodríguez-Ortiz, J M Sánchez-Hidalgo, J Ruiz Rabelo, J J Salamanca-Bustos, A Rodríguez-Benot, P Campos-Hernández, J Briceño-Delgado
INTRODUCTION: The use of intraoperative sodium heparin during simultaneous pancreas-kidney transplantation (SPKT) remains as a routine practice in some referral centers to minimize pancreatic graft thrombosis rate. One of its disadvantages is the theoretical increased risk of postoperative bleeding. In our center, we have abandoned its use since 2011. MATERIALS AND METHODS: We performed a retrospective analysis among 198 SPKTs performed in our center between the years 1989 and 2017...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29416346/prediction-of-emergence-agitation-using-withdrawal-reaction-following-rocuronium-injection-in-preschool-aged-patients-undergoing-inguinal-herniorrhaphy-a-preliminary-exploratory-observational-trial
#13
Dae Hee Kim, Go Un Roh, Young Bok Lee, Chang Ik Choi, Jae Moon Lee, Yun Jeong Chae
Purpose: The development of emergence agitation (EA) is associated with several factors including age, preoperative anxiety, postoperative pain, anesthesia method, and surgery type. No studies have investigated whether the withdrawal reaction following rocuronium injection can predict the occurrence of EA. Therefore, we investigated this relationship in preschool-aged children undergoing inguinal herniorrhaphy, and which grade of withdrawal reaction is appropriate for identifying patients at risk of experiencing EA...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29396602/subthalamic-deep-brain-stimulation-under-general-anesthesia-and-neurophysiological-guidance-while-on-dopaminergic-medication-comparative-cohort-study
#14
Mohammed Jamil Asha, Benjamin Fisher, Jamilla Kausar, Hayley Garratt, Hari Krovvidi, Colin Shirley, Anwen White, Ramesh Chelvarajah, Ismail Ughratdar, James A Hodson, Hardev Pall, Rosalind D Mitchell
OBJECTIVES: The authors have previously reported on the technical feasibility of subthalamic nucleus deep brain stimulation (STN DBS) under general anesthesia (GA) with microelectrode recording (MER) guidance in Parkinsonian patients who continued dopaminergic therapy until surgery. This paper presents the results of a prospective cohort analysis to verify the outcome of the initial study, and report on wider aspects of clinical outcome and postoperative recovery. METHODS: All patients in the study group continued dopaminergic therapy until GA was administered...
April 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29389817/early-myocardial-surgical-revascularization-after-st-segment-elevation-myocardial-infarction-in-multivessel-coronary-disease-bridge-therapy-is-the-solution
#15
Maria V Polito, Stefania Asparago, Gennaro Galasso, Rosario Farina, Antonio Panza, Severino Iesu, Federico Piscione
BACKGROUND: Many ST-segment elevation myocardial infarction (STEMI) patients have a multivessel disease that initially require percutaneous coronary intervention (PCI) of the culprit vessel but subsequently may require coronary artery bypass graft (CABG) of nonculprit vessels. Evidence supports staged revascularization, but the identification of optimal strategies (percutaneous or surgical), the timing and the management of antiplatelet therapy after recent PCI with stenting are matters of great controversies...
March 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29382308/endomyocardial-biopsy-guided-by-intracardiac-echocardiography-as-a-key-step-in-intracardiac-mass-diagnosis
#16
Marco Zanobini, Antonio Dello Russo, Matteo Saccocci, Sergio Conti, Elisa De Camilli, Giulia Vettor, Valentina Catto, Maurizio Roberto, Cesare Fiorentini, Giuseppe Viale, Claudio Tondo, Michela Casella
BACKGROUND: Based on a plenty of different applications, intracardiac echocardiography (ICE) is now a well-established technology in complex electrophysiological procedures. Recently, ICE has become the most widely used ultrasound-based imaging tool to guide diagnostic endomyocardial biopsy (EMB). EMB of cardiac mass guided by ICE is an interesting application of ICE. Allowing a correct positioning of the bioptome, ICE reduce the procedure-related risks and the need of a diagnostic open-chest procedure reserving the more invasive approach to selected cases...
January 30, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29089238/-clinical-and-pathological-definition-of-temporal-medium-epilepsy-subtypes-with-hypocampic-sclerosis
#17
Gonzalo Olivares-Granados, Rosa María Ríos-Pelegrina, Jesús Ruiz-Giménez, Alberto Galdón-Castillo, Teresa Escobar-Delgado, Raimundo García Del Moral
BACKGROUND AND OBJECTIVE: Mesial temporal lobe epilepsy with hippocampal sclerosis is the most common cause of refractory epilepsy, and the most common indication for surgery. Although effective, surgery fails in up to 40% of patients. The objective of our study was to establish a correlation between the different histological subtypes of mesial temporal lobe epilepsy with hippocampal sclerosis and the prognosis, seizures control, side effects and anticonvulsivant drug withdrawal in patients with refractory epilepsy...
January 2018: Neurocirugía
https://www.readbyqxmd.com/read/29051981/preoperative-optimization-of-patients-with-inflammatory-bowel-disease-undergoing-gastrointestinal-surgery-a-systematic-review
#18
REVIEW
Marie Strøm Zangenberg, Nir Horesh, Uri Kopylov, Alaa El-Hussuna
PURPOSE: Surgical management of inflammatory bowel disease (IBD) is a challenging task. The aim of preoperative optimization (PO) is to decrease the risk of complications and reduce the length of postoperative stay. The aim of this study was to review and grade the available evidence, attain clear recommendations, and point out potential future research. METHODS: Studies were identified from electronic databases (PubMed, Embase, and Cochrane Library) and scanning reference lists in relevant papers...
December 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29038080/a-stent-retrieving-into-an-aspiration-catheter-with-proximal-balloon-asap-technique-a-technique-of-mechanical-thrombectomy
#19
Shunsaku Goto, Tomotaka Ohshima, Kojiro Ishikawa, Taiki Yamamoto, Shinji Shimato, Toshihisa Nishizawa, Kyozo Kato
OBJECTIVE: The best technique for the first attempt at mechanical thrombectomy for acute ischemic stroke is a still matter of debate. In this study, we evaluate the efficacy of a stent-retrieving into an aspiration catheter with proximal balloon (ASAP) technique that uses a series of thrombus extraction by withdrawing the stent retriever into the aspiration catheter and continuous aspiration from the aspiration catheter at the first attempt. METHODS: We performed a retrospective analysis of 42 consecutive patients with acute ischemic stroke caused by occlusions in the anterior circulation who were treated with the ASAP technique at our institution...
January 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29034090/pre-to-postoperative-coagulation-profile-of-307-patients-undergoing-oesophageal-resection-with-epidural-blockade-over-a-10-year-period-in-a-single-hospital-implications-for-the-risk-of-spinal-haematoma
#20
Owain Thomas, Emanuel Lybeck, Per Flisberg, Ulf Schött
BACKGROUND: Epidural anaesthesia and analgesia are indicated for oesophageal surgery. A rare but serious complication is spinal haematoma, which can occur on insertion, manipulation or withdrawal of catheters. Evidence and guidelines are vague regarding which tests are appropriate and how to interpret their results. We aimed to describe how routine coagulation test results change during oesophagectomy's perioperative course. METHODS: Following ethical approval, we retrospectively identified patients who had undergone oesophagectomy between 2002 and 2012...
2017: Perioperative Medicine
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