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https://www.readbyqxmd.com/read/28087505/2016-update-of-the-asas-eular-management-recommendations-for-axial-spondyloarthritis
#1
Désirée van der Heijde, Sofia Ramiro, Robert Landewé, Xenofon Baraliakos, Filip Van den Bosch, Alexandre Sepriano, Andrea Regel, Adrian Ciurea, Hanne Dagfinrud, Maxime Dougados, Floris van Gaalen, Pál Géher, Irene van der Horst-Bruinsma, Robert D Inman, Merryn Jongkees, Uta Kiltz, Tore K Kvien, Pedro M Machado, Helena Marzo-Ortega, Anna Molto, Victoria Navarro-Compàn, Salih Ozgocmen, Fernando M Pimentel-Santos, John Reveille, Martin Rudwaleit, Jochen Sieper, Percival Sampaio-Barros, Dieter Wiek, Jürgen Braun
To update and integrate the recommendations for ankylosing spondylitis and the recommendations for the use of tumour necrosis factor inhibitors (TNFi) in axial spondyloarthritis (axSpA) into one set applicable to the full spectrum of patients with axSpA. Following the latest version of the European League Against Rheumatism (EULAR) Standardised Operating Procedures, two systematic literature reviews first collected the evidence regarding all treatment options (pharmacological and non-pharmacological) that were published since 2009...
January 13, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28087285/apert-syndrome-a-consensus-on-the-management-of-apert-hands
#2
David A Pettitt, Zeeshaan Arshad, Anuj Mishra, Paul McArthur
INTRODUCTION: Apert Syndrome is a congenital condition characterised by primary craniosynostosis, midfacial malformations and complex symmetrical malformations of the hands and feet. The hands demonstrate one of the most complex collections of congenital upper limb deformities, posing a significant challenge for the paediatric hand surgeon. This study examines the extant literature and current practice of the four UK specialist craniofacial units regarding the management of Apert hands in order to provide a basis for guideline development...
December 10, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28087188/operative-fusion-of-multilevel-cervical-spondylotic-myelopathy-impact-of-patient-demographics
#3
Shearwood McClelland, Bryan J Marascalchi, Peter G Passias, Themistocles S Protopsaltis, Anthony K Frempong-Boadu, Thomas J Errico
Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in patients older than age 55, with operative management being a widely adopted approach. Previous work has shown that private insurance status, gender and patient race are predictive of the operative approach patients receive (anterior-only, posterior-only, combined anterior-posterior). The Nationwide Inpatient Sample from 2001 to 2010 was used to assess the potential role of multilevel CSM as a contributing factor in determining which operative approach CSM patients receive, as it is rare for an anterior-only approach to be sufficient for CSM patients requiring fusion of four or more involved levels...
January 10, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28087156/french-national-consensus-clinical-guidelines-for-the-management-of-crohn-s-disease
#4
Laurent Peyrin-Biroulet, Yoram Bouhnik, Xavier Roblin, Guillaume Bonnaud, Hervé Hagège, Xavier Hébuterne
BACKGROUND: Crohn's disease (CD) is a chronic and disabling condition. There is no curative medical treatment but current treatments provide increasingly sustainable control of the disease and allow patients a better quality of life. There is limited evidence supporting CD management in specific clinical situations, thus precluding an evidence-based approach. AIMS: To help clinicians in making informed treatment decisions, a group of 59 French gastroenterologists with experience in the management of CD met to develop straightforward and practical algorithms based on the European Crohn's and Colitis Organisation (ECCO) recommendations...
December 22, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28087066/use-of-water-soluble-contrast-medium-gastrografin-does-not-decrease-the-need-for-operative-intervention-nor-the-duration-of-hospital-stay-in-uncomplicated-acute-adhesive-small-bowel-obstruction-a-multicenter-randomized-clinical-trial-adhesive-small-bowel-obstruction
#5
Michel Scotté, Francois Mauvais, Michael Bubenheim, Cyril Cossé, Leslie Suaud, Celine Savoye-Collet, Isabelle Plenier, Aurelien Péquignot, Thierry Yzet, Jean Marc Regimbeau
BACKGROUND: This study evaluated the association between oral gastrografin administration and the need for operative intervention in patients with presumed adhesive small bowel obstruction. METHODS: Between October 2006 and August 2009, 242 patients with uncomplicated acute adhesive small bowel obstruction were included in a randomized, controlled trial (the Adhesive Small Bowel Obstruction Study, NCT00389116) and allocated to a gastrografin arm or a saline solution arm...
January 10, 2017: Surgery
https://www.readbyqxmd.com/read/28086914/delivering-hiv-services-in-partnership-factors-affecting-collaborative-working-in-a-south-african-hiv-programme
#6
Geoffrey A Jobson, Cornelis J Grobbelaar, Moyahabo Mabitsi, Jean Railton, Remco P H Peters, James A McIntyre, Helen E Struthers
BACKGROUND: The involvement of Global Health Initiatives (GHIs) in delivering health services in low and middle income countries (LMICs) depends on effective collaborative working at scales from the local to the international, and a single GHI is effectively constructed of multiple collaborations. Research is needed focusing on how collaboration functions in GHIs at the level of health service management. Here, collaboration between local implementing agencies and departments of health involves distinct power dynamics and tensions...
January 13, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28086855/postoperative-fluid-overload-is-a-risk-factor-for-adverse-surgical-outcome-in-patients-undergoing-esophagectomy-for-esophageal-cancer-a-retrospective-study-in-335-patients
#7
Torben Glatz, Birte Kulemann, Goran Marjanovic, Svenja Bregenzer, Frank Makowiec, Jens Hoeppner
BACKGROUND: Restrictive intraoperative fluid management is increasingly recommended for patients undergoing esophagectomy. Controversy still exists about the impact of postoperative fluid management on perioperative outcome. METHODS: We retrospectively examined 335 patients who had undergone esophagectomy for esophageal cancer at the University Hospital Freiburg between 1996 and 2014 to investigate the relation between intra- and postoperative fluid management and postoperative morbidity after esophagectomy...
January 13, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28081317/hormone-therapy-in-hypospadias-surgery-a-survey-on-the-current-practice-in-turkey
#8
Gülnur Göllü Bahadır, Ergun Ergün, Onur Telli, Farid Khanmammadov, Ahmet Murat Çakmak
BACKGROUND/AIM: Nowadays surgical intervention is possible in smaller phalluses and younger children with hypospadias disease. Different hormone treatments with different doses, modalities, indications, and treatment times come along with some disputes. The aim of this study is to evaluate the management approaches in hypospadias surgery of surgeons in regards to hormone preparations. MATERIALS AND METHODS: Questionnaires were sent via e-mail to 110 actively working pediatric surgeons and urologists...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28080215/laparoscopy-assisted-duhamel-z-anastomosis-for-total-colonic-aganglionosis-outcome-assessed-by-fecal-continence-evaluation
#9
Go Miyano, Hiroki Nakamura, Shogo Seo, Ryo Sueyoshi, Manabu Okawada, Takashi Doi, Hiroyuki Koga, Geoffrey J Lane, Tadaharu Okazaki, Atsuyuki Yamataka
BACKGROUND: A Z-shaped colorectal side-to-side anastomosis was introduced to improve the Duhamel procedure by eliminating the rectal blind pouch. We retrospectively reviewed all total colonic aganglionosis patients treated by laparoscopy-assisted Duhamel-Z (LapDZ) between 2009 and 2014 focusing on annual fecal continence evaluation scores (CES) as an indicator of outcome. METHODS: LapDZ was performed conventionally. Postoperatively, defecation was regulated with medications and enemas according to our standard protocol...
January 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#10
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079575/cystic-biliary-atresia-and-choledochal-cysts-are-distinct-histopathologic-entities
#11
Inna N Lobeck, Rachel Sheridan, Mark Lovell, Phylicia Dupree, Greg M Tiao, Kevin E Bove
Cystic biliary atresia (CBA), a rare cystic expansion of atretic extrahepatic bile ducts in young infants, overlaps in age at presentation and imaging features with early choledochal cysts (CC). Treatment and prognosis differ; histologic differences are unsettled. We compared 10 patients with CBA, 1975 to 2015, to an age-similar cohort of 13 infants, and to older patients who had surgery for CC. Operative details, imaging, and clinical courses were correlated to pathologic specimens. Immunostains for smooth muscle actin and myosin heavy chain were used to evaluate cyst walls and atretic segments...
January 10, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28079556/cardiac-arrest-obstetric-cpr-acls
#12
Benjamin Cobb, Steven Lipman
In contrast with other high-resource countries, maternal mortality has seen an increase in the United States. Caring for pregnant women in cardiac arrest may prove uniquely challenging given the rarity of the event coupled by the physiological changes of pregnancy. Optimization of resuscitative efforts warrants special attention as described in the 2015 American Heart Association's "Scientific Statement on Maternal Cardiac Arrest." Current recommendations address a variety of topics ranging from the basic components of chest compressions and airway management to some of the logistical complexities and operational challenges involved in maternal cardiac arrest...
January 10, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28079432/primary-tumors-of-the-facial-nerve-misdiagnosed-a-case-series-and-review-of-the-literature
#13
Haijin Yi, Bin Hu, Guoping Yin, Xin Li, Jinkun Xu, Jingying Ye, Shi-Ming Yang
CONCLUSION: Unusual primary tumors of the facial nerve should be considered in patients with progressive facial paralysis, especially if this is accompanied by hearing loss or vertigo. Misdiagnosis could increase the difficulties of operation, diminish the chance of facial nerve reconstruction, and increase the likelihood of poor reconstructive outcomes. OBJECTIVE: This paper was to determine the characteristics of facial nerve primary tumors misdiagnosed as tumor-free conditions many years prior, and to describe appropriate treatments...
January 12, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28079242/application-of-baros-questionnaire-in-obese-patients-undergoing-bariatric-surgery-with-2-years-of-evolution
#14
Caetano de Queiroz, José Afonso Sallet, Pedro Gabriel Melo DE Barros E Silva, Luzia da Gloria Pereira de Sousa Queiroz, Jélis Arenas Pimentel, Paulo Clemente Sallet
BACKGROUND: -In recent decades, the high prevalence of obesity in the general population has brought serious concerns in terms of public health. Contrarily to conventional treatment involving dieting and physical exercising, often ineffective in generating long term results, bariatric opera-tions have been an effective method for sustained weight loss in morbidly obese individuals. The Bariatric Analysis and Reporting Outcome System (BAROS) is an objective and recognized system in the overall evaluation of results after bariatric surgery...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28078617/changes-in-the-first-postoperative-night-bispectral-index-of-patients-after-thyroidectomy-with-different-types-of-primary-anesthetic-management-a-randomized-controlled-trial
#15
Wen-Fei Tan, Zhi-Lin Wang, Hong Ma, Feng Jin, Huang-Wei Lu
Despite major advances in anesthesia management and developments in anesthetic agents, postoperative sleep disturbances remain dissatisfactory for many patients. We hypothesized that propofol might have a subtle influence on sleep after thyroidectomy compared to sevoflurane. A randomized, single-blinded, controlled trial was conducted at the First Hospital of China Medical University from October 2014 to October 2015. One hundred and twenty-four patients undergoing thyroidectomy were enrolled and received sevoflurane (sevoflurane group) or propofol (propofol group) as anesthesia maintenance...
January 12, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28078474/clinical-audit-effectively-bridges-the-evidence-practice-gap-in-chronic-subdural-haematoma-management
#16
Jignesh Tailor, D Fernando, Z Sidhu, R Foley, K D Abeysinghe, D C Walsh
BACKGROUND: Placement of a subdural drain after drainage of chronic subdural haematoma (CSDH) has been shown to reduce the rate of recurrence in several randomised controlled trials (RCT). The most recently published RCT was from Cambridge, UK, in 2009. Despite class I evidence for the use of subdural drains, it is unclear whether these results have been translated into clinical practice. In this clinical audit we review the use of subdural drains in our institution before and after the publication of the 2009 RCT results...
January 11, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28078463/endoscopic-vacuum-therapy-for-various-defects-of-the-upper-gastrointestinal-tract
#17
Florian Kuehn, Gunnar Loske, Leif Schiffmann, Michael Gock, Ernst Klar
BACKGROUND: Postoperative, iatrogenic or spontaneous upper gastrointestinal defects result in significant morbidity and mortality of the patients. In the last few years, endoscopic vacuum therapy (EVT) has been recognized as a new promising method for repairing upper gastrointestinal defects of different etiology. However, probably due to insufficient data and no commercially available system for EVT of the upper gastrointestinal tract, until the end of 2014, covering of esophageal defects with self-expanding metal stents (SEMS) were still the mainstay of endoscopic therapy...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078131/a-novel-management-of-post-oesophagectomy-gastro-pleural-fistula
#18
Javaid Ishtiaq, Jonathan Sutton, Waqar Ahmed
Oesophageal anastomotic leak and fistula are major and life-threatening complications of oesophagectomy with resultant increased mortality. Non-operative approach of such cases should be the initial strategy. Re-operative surgery and/or stent insertion are considered if conservative measures failed. Although oesophageal stenting is a safe option for the leaks, stent migration and failure to completely cover large anastomotic leaks are the main complications and pitfalls of the procedure. These can be overcome by using multiple or larger stents...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28078125/changing-paradigm-in-pancreatic-cancer-from-adjuvant-to-neoadjuvant-chemoradiation
#19
Justin D Anderson, Wen Wan, Brian J Kaplan, Jennifer Myers, Emma C Fields
BACKGROUND: Historically, management of pancreatic cancer has been determined based on whether the tumor was amenable to resection and all patients deemed resectable received curative intent surgery followed by adjuvant therapy with chemotherapy (CT) ± RT. However, patients who undergo resection with microscopic (R1) positive margins have inferior rates of survival. The purpose of this study is to identify patients who have undergone pancreatectomy for pancreatic cancer, determine the surgical margins, types of adjuvant therapies given and patterns of failure...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28078119/surgical-outcomes-of-post-chemoradiotherapy-unresectable-locally-advanced-rectal-cancers-improve-with-interim-chemotherapy-is-folfirinox-better-than-capox
#20
Vikas Ostwal, Reena Engineer, Anant Ramaswamy, Arvind Sahu, Saurabh Zanwar, Suprita Arya, Supriya Chopra, Munita Bal, Prachi Patil, Ashwin Desouza, Avanish Saklani
BACKGROUND: Role of chemotherapy in patients who continue to have unresectable disease after pre-operative chemo-radiotherapy (CRT) remains largely unaddressed. METHODS: Patients with LA rectal cancer from January 2013 to June 2015 were evaluated. Post-CRT, patients, who were deemed unresectable, were considered for further interim chemotherapy (i-CT). RESULTS: Seventy six patients (15%) with median age of 38.5 years received i-CT after CRT...
December 2016: Journal of Gastrointestinal Oncology
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