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https://www.readbyqxmd.com/read/30326522/long-term-outcome-after-successful-lower-extremity-free-flap-salvage
#1
Amir K Bigdeli, Emre Gazyakan, Volker J Schmidt, Christoph Bauer, Günter Germann, Christian A Radu, Ulrich Kneser, Christoph Hirche
BACKGROUND:  Vascular occlusion after free flap surgery has become a rare complication but still poses a major challenge. It necessitates urgent re-exploration, but the logistic challenge to provide sufficient resources for the emergency intervention remains. The aim of this study was to analyze the long-term outcome after successful lower extremity free flap salvage. METHODS:  A single-center retrospective study including long-term follow-up was approved by the local ethics committee...
October 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/30326313/vagal-nerve-stimulation-for-epilepsy-in-adults-a-database-risk-analysis-and-review-of-the-literature
#2
Ashley N Selner, Clayton L Rosinski, Ryan G Chiu, David Rosenberg, Anisse N Chaker, Hamidou Drammeh, Darian R Esfahani, Ankit I Mehta
BACKGROUND: Epilepsy is one of the most common neurologic disorders, and often remains refractory despite pharmacologic treatment. In patients unamenable to surgical resection of seizure foci, vagal nerve stimulation (VNS) may provide benefit. Multiple case series have attempted to construct a risk profile for VNS, yet are largely confined to pediatric or single-center populations. OBJECTIVE: To compile a risk profile for adults undergoing VNS, utilizing multi-center patient data from an international database...
October 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30326312/lumbar-total-disc-replacement-by-the-lateral-approach-up-to-10-year-follow-up
#3
Gabriel Pokorny, Luís Marchi, Rodrigo Amaral, Rubens Jensen, Luiz Pimenta
OBJECTIVE: This study aimed to analyze radiological and clinical results with a minimum 5-year follow-up (FUP) of lateral lumbar total disc replacement (TDR) for the treatment of symptomatic lumbar degenerative disc disease. METHODS: Prospective, single-center, clinical and radiological study. Patients treated with lumbar total disc replacement (XL-TDR) done by a lateral transpsoas approach. From 2005 to 2012, 60 cases were enrolled (31 male, 29 female; total 66 levels; average age 42...
October 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30326309/application-of-a-thrombin-gelatin-matrix-in-the-management-of-intractable-hemorrhage-during-stereotactic-biopsy-a-technical-note
#4
Cristian de Quintana-Schmidt, Andreas Leidinger, Joan Molet Teixidó, Gerardo Conesa Bertrán
BACKGROUND: Few studies have been published about percutaneous techniques for the management of surgical bed hemorrhage during a stereotactic biopsy, a serious complication that may affect patient outcome. We describe the injection of a thrombin-gelatin matrix through the biopsy cannula as an effective method to arrest surgical bed bleeding that does not respond to conventional methods of hemostasis. METHODS: We prospectively documented image-guided stereotactic brain biopsy procedures on 30 awake patients between July 2014 and July 2017 at our center...
October 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30326304/characteristics-and-outcomes-of-primary-central-nervous-system-lymphoma-patients-in-the-real-word-a-retrospective-study-of-91-cases-in-a-chinese-population
#5
Chengliang Mao, Feili Chen, Yanwen Li, Xinmiao Jiang, Sichu Liu, Hanguo Guo, Ling Huang, Xiaojuan Wei, Zhanli Liang, Wenyu Li, Kai Tang
BACKGROUND: Primary central nervous system lymphoma (PCNSL) is a rare disease affecting the brain, leptomeninges, spinal cord, cerebrospinal fluid, or vitreoretinal compartment, without evidence of systemic disease. Prognosis is still poor after intensive methotrexate-based chemotherapy. METHODS: Clinical data of 91 cases treated in a tertiary referral center during a 13-year period were retrospectively reviewed. RESULTS: The estimated median PFS and OS for all cohort was 39...
October 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30326054/outcomes-of-open-vs-endoscopic-skull-base-surgery-in-patients-70-years-or-older
#6
Elizabeth D Stephenson, Saangyoung Eric Lee, Katherine Adams, Douglas R Farquhar, Zainab Farzal, Charles S Ebert, Matthew Ewend, Deanna Sasaki-Adams, Brian D Thorp, Adam M Zanation
Importance: The use of skull base surgery in patients 70 years or older is increasing, but its safety in this age group has not been evaluated to date. Objectives: To describe outcomes in a cohort of patients 70 years or older undergoing skull base surgery and to evaluate whether age, type of disease process, and approach (endoscopic vs traditional open surgery) are associated with increased intraoperative and postoperative complications in this population. Design, Setting, and Participants: This retrospective cohort study analyzed a population-based sample of 219 patients 70 years or older from a database of 1720 patients who underwent skull base surgery at University of North Carolina Hospitals, Chapel Hill, a tertiary referral center, between October 2007 and June 2017...
September 20, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/30326042/clinical-application-of-3-dimensional-printing-technology-for-patients-with-nasal-septal-deformities-a-multicenter-study
#7
Do Hyun Kim, Won-Soo Yun, Jin-Hyung Shim, Keun-Ho Park, Dami Choi, Moon Il Park, Se Hwan Hwang, Sung Won Kim
Importance: Studies have shown the controllability and porosity of polycaprolactone as well as the use of 3-dimensional (3-D) printing for nasal reconstruction in animal models. The utility of polycaprolactone with 3-D technology in nasal cartilaginous framework reconstruction in humans remains unknown. Objective: To investigate the safety and efficacy of 3-D printed, bioresorbable polycaprolactone nasal implants. Design, Setting, and Participants: This multicenter clinical trial comprised 20 patients with caudal septal deviations who underwent septoplasty, which used a 3-D printed polycaprolactone mesh, at 2 centers in South Korea...
September 20, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/30326035/effect-of-apoyo-con-cari%C3%A3-o-support-with-caring-trial-of-a-patient-navigator-intervention-to-improve-palliative-care-outcomes-for-latino-adults-with-advanced-cancer-a-randomized-clinical-trial
#8
Stacy M Fischer, Danielle M Kline, Sung-Joon Min, Sonia Okuyama-Sasaki, Regina M Fink
Importance: Strategies to increase access to palliative care, particularly for racial/ethnic minorities, must maximize primary palliative care and community-based models to meet the ever-growing need in a culturally sensitive and congruent manner. Objective: To investigate if a culturally tailored patient navigator intervention can improve palliative care outcomes for Latino adults with advanced cancer. Design, Setting, and Participants: The Apoyo con Cariño (Support With Caring) randomized clinical trial was conducted from July 2012 to March 2016...
September 20, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/30326006/effect-of-gabapentin-vs-pregabalin-on-pain-intensity-in-adults-with-chronic-sciatica-a-randomized-clinical-trial
#9
Kelvin Robertson, Laurence A G Marshman, David Plummer, Elena Downs
Importance: Optimal pharmacologic treatment for chronic sciatica (CS) is currently unclear. While gabapentin (GBP) and pregabalin (PGB) are both used to treat CS, equipoise exists. Nevertheless, pharmaceutical regulation authorities typically subsidize one drug over the other. This hinders interchange wherever the favored drug is either ineffective or ill-tolerated. Objective: To assess GBP vs PGB head to head for the treatment of CS. Design, Setting, and Participants: A preplanned interim analysis of a randomized, double-blind, double-dummy crossover trial of PGB vs GBP for management of CS at half the estimated final sample size was performed in a single-center, tertiary referral public hospital...
October 15, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/30326004/assessment-of-attitudes-toward-deprescribing-in-older-medicare-beneficiaries-in-the-united-states
#10
Emily Reeve, Jennifer L Wolff, Maureen Skehan, Elizabeth A Bayliss, Sarah N Hilmer, Cynthia M Boyd
Importance: Use of harmful and/or unnecessary medications in older adults is prevalent. This can lead to avoidable harms such as adverse drug reactions, falls, hospitalization, and mortality. Primary care physicians report that patient resistance to discontinuing medication use is a significant barrier to deprescribing. Objective: To describe the attitudes of older adults toward deprescribing and to determine whether individual characteristics are associated with these attitudes...
October 15, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/30325989/association-of-system-level-factors-with-secondary-overtriage-in-trauma-patients
#11
Priti P Parikh, Pratik Parikh, Logan Mamer, Mary C McCarthy, Joseph V Sakran
Importance: Studies show that secondary overtriage (SO) contributes significantly to the economic burden of injured patients; thus, the association of SO with use of the trauma system has been examined. However, the association of the underlying trauma system design with such overtriage has yet to be evaluated. Objectives: To evaluate whether the distribution of trauma centers in a statewide trauma system is associated with SO and to identify clinical and demographic factors that may lead to SO...
September 19, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/30325987/association-of-proton-pump-inhibitors-with-hospitalization-risk-in-children-with-oropharyngeal-dysphagia
#12
Daniel R Duncan, Paul D Mitchell, Kara Larson, Maireade E McSweeney, Rachel L Rosen
Importance: Proton pump inhibitors (PPI) are commonly prescribed to children with oropharyngeal dysphagia and resultant aspiration based on the assumption that these patients are at greater risk for reflux-related lung disease. There is little data to support this approach and the potential risk for increased infections in children treated with PPI may outweigh any potential benefit. Objective: The aim of this study was to determine if there is an association between hospitalization risk in pediatric patients with oropharyngeal dysphagia and treatment with PPI...
October 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/30325983/comparison-of-objective-outcomes-in-dynamic-lower-facial-reanimation-with-temporalis-tendon-and-gracilis-free-muscle-transfer
#13
Samuel L Oyer, Jason Nellis, Lisa E Ishii, Kofi D Boahene, Patrick J Byrne
Importance: Facial paralysis affects patients' physical, social, and psychological function. Dynamic smile reanimation can mitigate these effects, but there are limited data to guide the surgeon in selecting the best reanimation procedure for each patient. Objective: To compare quantitative changes in oral commissure symmetry and smile excursion following temporalis tendon transfer (T3) and gracilis free muscle transfer. Design, Setting, and Participants: Retrospective case series of 28 adults with unilateral facial paralysis seeking dynamic lower facial reanimation at a tertiary academic medical center between July 1, 2010, and July 30, 2014...
October 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/30325977/evaluation-of-clinical-outcomes-of-sutureless-vs-sutured-closure-techniques-in-gastroschisis-repair
#14
Russell G Witt, Michael Zobel, Benjamin Padilla, Hanmin Lee, Tippi C MacKenzie, Lan Vu
Importance: Sutureless gastroschisis repair offers an alternative to the traditional sutured method and has been associated with decreased intubation time. Published study results are inconsistent regarding the advantages of sutureless closure. Objective: To compare the clinical outcomes of sutureless and sutured gastroschisis repair. Design, Setting, and Participants: A single-center cohort review was performed of all consecutive patients (n = 97) who underwent gastroschisis repair from February 1, 2007, to April 30, 2017, at the University of California, San Francisco...
September 19, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/30325940/risk-factors-for-surgical-site-infection-after-lumbar-laminectomy-and-or-discectomy-for-degenerative-diseases-in-adults-a-prospective-multicenter-surveillance-study-with-registry-of-4027-cases
#15
Satoshi Ogihara, Takashi Yamazaki, Hirohiko Inanami, Hiroyuki Oka, Toru Maruyama, Kota Miyoshi, Yuichi Takano, Hirotaka Chikuda, Seiichi Azuma, Naohiro Kawamura, Kiyofumi Yamakawa, Nobuhiro Hara, Yasushi Oshima, Jiro Morii, Rentaro Okazaki, Yujiro Takeshita, Sakae Tanaka, Kazuo Saita
Surgical site infection (SSI) is a significant complication after spinal surgery and is associated with increased hospital length of stay, high healthcare costs, and poor patient outcomes. Accurate identification of risk factors is essential to develop strategies to prevent wound infections. The aim of this prospective multicenter study was to determine the independent factors associated with SSI in posterior lumbar surgeries without fusion (laminectomy and/or herniotomy) for degenerative diseases in adult patients...
2018: PloS One
https://www.readbyqxmd.com/read/30325861/international-study-group-of-pediatric-pancreatitis-in-search-for-a-cure-cohort-study-design-and-rationale-for-insppire-2-from-the-consortium-for-the-study-of-chronic-pancreatitis-diabetes-and-pancreatic-cancer
#16
Aliye Uc, Emily R Perito, John F Pohl, Uzma Shah, Maisam Abu-El-Haija, Bradley Barth, Melena D Bellin, Kate M Ellery, Douglas S Fishman, Cheryl E Gariepy, Matthew J Giefer, Tanja Gonska, Melvin B Heyman, Ryan W Himes, Sohail Z Husain, Asim Maqbool, Maria R Mascarenhas, Brian A McFerron, Veronique D Morinville, Tom K Lin, Quin Y Liu, Jaimie D Nathan, Sue J Rhee, Chee Y Ooi, Zachary M Sellers, Sarah Jane Schwarzenberg, Jose Serrano, David M Troendle, Steven L Werlin, Michael Wilschanski, Yuhua Zheng, Ying Yuan, Mark E Lowe
We created the INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE (INSPPIRE 2) cohort to study the risk factors, natural history, and outcomes of pediatric acute recurrent pancreatitis and chronic pancreatitis (CP). Patient and physician questionnaires collect information on demographics, clinical history, family and social history, and disease outcomes. Health-related quality of life, depression, and anxiety are measured using validated questionnaires. Information entered on paper questionnaires is transferred into a database managed by Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer's Coordinating and Data Management Center...
November 2018: Pancreas
https://www.readbyqxmd.com/read/30325858/accelerating-the-drug-delivery-pipeline-for-acute-and-chronic-pancreatitis-summary-of-the-working-group-on-drug-development-and-trials-in-chronic-pancreatitis-at-the-national-institute-of-diabetes-and-digestive-and-kidney-diseases-workshop
#17
Christopher E Forsmark, Dana K Andersen, John T Farrar, Megan Golden, Aida Habtezion, Sohail Z Husain, Liang Li, Julia Mayerle, Stephen J Pandol, Aliye Uc, Zixi Zhu, Dhiraj Yadav
The lack of effective therapeutic agents specifically tailored for chronic pancreatitis (CP) has hampered clinical care and negatively impacted patients' lives. New mechanistic insights now point to novel therapies, which involve both recently developed and/or repurposed agents. This working group focused on 2 main outcomes for CP: pain and progression of disease. The goal is to frame the essential aspects of trial design including patient-centered outcomes, proposed methods to measure the outcomes of pain and progression, and study design considerations for future trials to facilitate rapid drug development for patients with CP...
November 2018: Pancreas
https://www.readbyqxmd.com/read/30325849/hemoadsorption-does-not-affect-hemolysis-during-cardiopulmonary-bypass
#18
Martin H Bernardi, Harald Rinoesl, Robin Ristl, Ulrike Weber, Dominik Wiedemann, Michael J Hiesmayr
Cardiopulmonary bypass (CPB) induces hemolysis, which manifests as plasma free hemoglobin. We investigated in a post hoc analysis of a single-center, blinded, controlled study whether the use of a novel hemoadsorption device (CytoSorb, CytoSorbents Europe GmbH, Berlin, Germany) affects hemolysis during CPB. A total of 35 patients undergoing elective CPB surgery with an expected CPB duration of more than 120 min were included in the analysis. The hemoadsorption device was used in 17 patients (intervention group) and not used in 18 patients (control group)...
October 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30325847/preoperative-predictors-of-mortality-in-short-term-continuous-flow-ventricular-assist-devices
#19
Sabin J Bozso, Holger Buchholz, Tara Pidborochynski, Darren H Freed, Roderick G MacArthur, Jennifer Conway
Short-term continuous-flow ventricular assist devices (STCF-VADs) are increasingly being utilized to support critically ill patients, despite limited information regarding overall outcomes. All adult patients supported with an STCF-VAD between June 2009 and December 2015 were included in this retrospective single-center study. Associations between preoperative characteristics and unsuccessful bridge (death on device or within 30 days postdecannulation) were assessed using logistic regression. A total of 61 patients (77% male) were identified with a median age at implant of 54...
October 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/30325602/first-line-non-cryopreserved-autologous-stem-cell-transplant-for-poor-risk-germ-cell-tumors-experience-in-a-developing-country
#20
Eucario Leon-Rodriguez, Monica M Rivera-Franco, Dennis Lacayo-Leñero, Andrea Campos-Castro, Monica I Meneses-Medina
PURPOSE: The current first - line treatment for non - seminomatous germ cell tumor (NSGCT) consists of four cycles of cisplatin, etoposide, and bleomycin (BEP), which results in 5 - year overall survival < 60% in patients with poor - risk features. Autologous hematopoietic stem cell transplantation (auto - HSCT) as a method for overcoming high toxicity after high dose chemotherapy (HDC) has been explored in different solid tumors, but has remained standard practice only for NSGCT. Our objective was to describe outcomes of patients with poor - risk NSGCT who underwent first - line autologous HSCT in a tertiary center in Mexico...
September 15, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
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