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https://www.readbyqxmd.com/read/29933484/-modern-management-of-pancoast-tumour
#1
Alessandro Marra
Pancoast or superior pulmonary sulcus tumour is a subset of lung carcinoma that invades the structures of the thoracic inlet - first ribs, distal roots of the brachial plexus, stellate ganglion, vertebrae, and subclavian vessels. The first symptom is usually shoulder pain; consequently, most patients are initially treated for osteoarthritis. Late diagnosis is common. Success of therapy depends on an accurate staging: standard imaging with CT scan of the chest, PET-CT scan, brain MRI are needed to rule out distant metastases, endobronchial ultrasound-guided needle biopsy (EBUS-TBNA) or mediastinoscopy are mandatory for reliable nodal staging...
June 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29933231/a-case-of-large-deep-fibrolipoma-in-the-left-subclavicular-region-that-compromised-the-branchial-plexus-and-thoracic-duct-a-case-report
#2
Jumana Hussain, Hussein Ali AlZamel, Imtiyaz Nawaz, Abdulmohsen Al Bader
INTRODUCTION: A fibrolipoma of the left subclavicular region, a neoplasm rarely encountered in this region, was compromising the branchial plexus and thoracic duct, causing thoracic outlet syndrome in a symptomatic patient. CASE PRESENTATION: A 41-year-old Asian woman was brought to our ENT (ear-nose-throat) clinic because of slowly progressive swelling of the left subclavicular region since 10 years before, which became painful with time, associated with increasing subpectoral and shoulder pains, left arm swelling, and left forearm paresthesias...
June 7, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29926110/skin-to-epidural-distance-in-the-southeast-asian-paediatric-population-multiethnic-morphometrics-and-international-comparisons
#3
Jolin Wong, Serene Siu Tin Lim
INTRODUCTION: Paediatric epidurals can present technical challenges due to wide variations in age and weight among children, ranging from neonates to teenagers. This study evaluated the skin-to-epidural distance in the thoracic and lumbar regions to determine the relationship between age, weight and ethnicity and depth to the epidural space in our Singapore paediatric population. METHODS: Data from the Acute Pain Service was prospectively collected over 16 years...
June 21, 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/29925724/influence-of-regional-anesthesia-on-the-rate-of-chronic-postthoracotomy-pain-syndrome-in-lung-cancer-patients
#4
Victoria Khoronenko, Danil Baskakov, Marc Leone, Anna Malanova, Andrey Ryabov, Oleg Pikin, Maksim Golovashchenko
PURPOSE: Our study aimed to assess whether the type of regional anesthesia influenced the incidence of chronic postthoracotomy pain syndrome (CPTPS). METHODS: This was a prospective, randomized study that included 300 patients undergoing lung cancer resection using thoracotomy. They were randomized into three groups: paravertebral nerve block (PVB), thoracic epidural anesthesia (TEA), and intercostal nerve block (INB). General anesthesia was similar in the groups...
June 20, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29925093/use-of-synthetic-osteochondral-implants-to-treat-bilateral-shoulder-osteochondritis-dissecans-in-a-dog
#5
Alan Danielski, Michael Farrell
CASE DESCRIPTION:  An 8-month-old American Bulldog was presented for assessment of bilateral thoracic limb lameness. Computed tomographic imaging revealed large, deep osteochondritis dissecans lesions in both humeral heads. TREATMENT AND OUTCOME:  The osteochondritis dissecans lesions were debrided and the exposed subchondral defects were prepared to receive synthetic grafts. Circular implants consisting of a surface layer of polycarbonate urethane and a deep layer of lattice-type titanium were implanted into the osteochondral defects to reconstruct the articular surface topography...
June 20, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29921751/thoracic-outlet-syndrome-biomechanical-and-exercise-considerations
#6
REVIEW
Nicholas A Levine, Brandon R Rigby
Thoracic outlet syndrome (TOS) describes a group of disorders that are due to a dynamic compression of blood vessels or nerves, between the clavicle and first rib or cervical vertebral nerve roots. Individuals with TOS typically experience upper limb pain, numbness, tingling, or weakness that is exacerbated by shoulder or neck movement. The causes of TOS vary, and can include abrupt movements, hypertrophy of the neck musculature, and anatomical variations in which the brachial plexus roots pass through this musculature, edema, pregnancy, repeated overhead motions, the blockage of an artery or vein, or abnormal posture...
June 19, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29920605/extended-asymmetrical-pedicle-subtraction-osteotomy-for-adult-spinal-deformity-2-dimensional-operative-video
#7
Thomas J Buell, Avery L Buchholz, John C Quinn, Jeffrey P Mullin, Juanita Garces, Marcus D Mazur, Mark E Shaffrey, Chun-Po Yen, Christopher I Shaffrey, Justin S Smith
Pedicle subtraction osteotomy (PSO) is an effective technique to correct fixed sagittal malalignment. A variation of this technique, the "trans-discal" or "extended" PSO (Schwab grade IV osteotomy), involves extending the posterior wedge resection of the index vertebra to include the superior adjacent disc for radical discectomy. The posterior wedge may be resected in asymmetric fashion to correct concurrent global coronal malalignment.This video illustrates the technical nuances of an extended asymmetrical lumbar PSO for adult spinal deformity...
June 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29913936/a-systematic-review-of-comparative-studies-indicates-that-paravertebral-block-is-neither-superior-nor-safer-than-epidural-analgesia-for-pain-after-thoracotomy
#8
Hilde M Norum, Harald Breivik
Background The "gold standard" for pain relief after thoracotomy has been thoracic epidural analgesia (TEA). The studies comparing TEA with paravertebral block (PVB) and recent reviews recommend PVB as a novel, safer method than TEA. Methods A systematic search of the Cochrane and PubMed databases for prospective, randomized trials (RCTs) comparing TEA and PVB for post-thoracotomy analgesia was done. We assessed how TEA and PVB were performed, methods of randomization, assessment of pain relief, and complications...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913844/systematic-review-of-neuropathic-component-in-persistent-post-surgical-pain
#9
S Haroutiunian, L Nikolajsen, N B Finnerup, T S Jensen
Background/aim The aim of the current study was to assess the neuropathic component of persistent post-surgical pain (PPSP) following eleven types of surgery. Methods We performed a systematic PubMed, CENTRAL and EMBASE search to identify studies on PPSP following (i) thoracic surgery, (ii) breast surgery, (iii) groin hernia repair, (iv) prostatectomy, (v) major abdominal surgery, (vi) gynecologic surgery, (vii) iliac crest bone harvest, (viii) total hip arthroplasty (THA) or knee arthroplasty (TKA), (ix) varicose vein stripping or ablation, (x) mandibular sagittal split osteotomy and (xi) donor nephrectomy, and assessed the prevalence of Probable/Definite neuropathic pain using the recently published neuropathic pain probability grading criteria [1]...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913812/chronic-thoracic-pain-in-children-after-cardiac-surgery
#10
Anders Due Kristensen, Mette Høj Lauridsen, Vibeke E Hjortdal, Troels S Jensen, Lone Nikolajsen
Background Chronic pain after surgical procedures in children has gained limited attention. Chronic thoracic pain after cardiac surgery is common, and has a significant impact on daily life in adults. The study aim was to investigate the prevalence and etiology of chronic pain after cardiac surgery via sternotomy in children. Methods The study included a prospective clinical examination with quantitative sensory testing 3 months after surgery, and a retrospective survey of children, who underwent cardiac surgery 10-60 months earlier...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913775/epidural-pain-management-after-open-lateral-thoracotomy-female-patients-have-better-pain-relief-and-need-smaller-amounts-of-analgesics-than-males
#11
Gísli Vigfússon, Gísli H Sigurðsson
Background and aims There is an ongoing dispute whether or not there is a gender difference in epidural drug requirements. The objective of this study was to compare the effects of a triple drug epidural mixture used for postoperative pain relief on male and female patients undergoing major surgery. Materials and methods To avoid possible influence of different age and type of surgery only 50-70 year old patients undergoing open lateral thoracotomy were included. 253 patients were enrolled: 116 males and 137 females...
December 29, 2017: Scandinavian Journal of Pain
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
#12
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...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29910637/combined-microwave-ablation-and-minimally-invasive-open-decompression-for-the-management-of-thoracic-metastasis-in-breast-cancer
#13
Bin Liu, Zhenchao Yuan, Chang Yuan Wei
Objective: The incidence rate of thoracic metastasis from breast cancer is increasing. Microwave ablation is one type of clinical therapy used to treat metastatic spine disease, although it can cause protein denaturation and immediate cell death, and coagulative necrosis can occur. Minimally invasive open decompression is associated with lower rates of surgical complications in comparison to traditional open surgery. Therefore, it is an alternative therapeutic option for spinal metastases...
2018: Cancer Management and Research
https://www.readbyqxmd.com/read/29907900/-anesthesia-ventilation-and-pain-treatment-in-thoracic-trauma
#14
REVIEW
M Weigeldt, M Paul, S Schulz-Drost, M D Schmittner
The management of anesthesia plays a central role in the treatment of thoracic trauma, both in the initial phase when safeguarding the difficult airway and in the intensive care unit. A rapid transfer to a trauma center should be considered in order to recognize and treat organ dysfunction in time. Development of atelectasis, pneumonia and acute lung failure are common pulmonary complications. Non-invasive ventilation combined with physiotherapy and respiratory training can help to minimize these pulmonary complications...
June 15, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29904975/the-eyes-don-t-see-what-the-mind-doesn-t-know-pleural-endometriosis-on-effusion-cytology
#15
Parikshaa Gupta, Nalini Gupta, Amanjit Bal, Inderpaul Singh Sehgal, Valliappan Muthu, Arvind Rajwanshi
Thoracic endometriosis is the presence of endometrial tissue in the pleura, lung parenchyma and/or airways. It is an extremely rare occurence and is challenging to diagnose clinically due to variable clinical presentations. A high index of clinical suspicion and recognition of the association of the clinical symptoms with menstruation is important to establish a clinical diagnosis of pleural endometriosis. The definitive diagnosis requires tissue diagnosis, demonstrating the presence of endometrial tissue in pleura, either by cytological or histopathological examination...
June 14, 2018: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/29904418/acquired-hypophosphatemic-osteomalacia-is-easily-misdiagnosed-or-neglected-by-rheumatologists-a-report-of-9-cases
#16
Ling Li, Shu-Xia Wang, Hong-Mei Wu, Dong-Lan Luo, Guang-Fu Dong, Yuan Feng, Xiao Zhang
The aim of the present study was to assist rheumatologists in differentiating hypophosphatemic osteomalacia (HO) from mimic rheumatology diseases. Clinical data was obtained from 9 patients with acquired HO, initially misdiagnosed as mimic rheumatologic diseases. The data were retrospectively analyzed and a literature review was performed. The etiology of the cases was as follows: Adefovir dipivoxil-induced Fanconi syndrome was present in 6 of the cases, 2 were tumors and 1 case was chronic nephropathy. The chief complaint was thoracic or back pain and arthralgia, followed by progressive muscle weakness and dramatic movement limitation...
June 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29901652/the-effects-of-preoperative-single-dose-thoracic-paravertebral-block-on-acute-and-chronic-pain-after-thoracotomy-a-randomized-controlled-double-blind-trial
#17
Xiu-Liang Li, Ye Zhang, Tian Dai, Lei Wan, Guan-Nan Ding
BACKGROUND: Patients undergoing thoracotomy frequently experience acute pain and chronic post-thoracotomy pain (CPTP). There are few articles relating to the investigations on the effects of preoperative single-dose thoracic paravertebral block (PSTPVB) on acute pain and CPTP. We tested the hypothesis that adding PSTPVB to intravenous (IV) patient-controlled analgesia (PCA) would reduce acute pain scores and decrease the incidence and intensity of CPTP. METHODS: Fifty-six patients undergoing elective thoracotomy were randomized to receive PSTPVB in addition to IV PCA (group T) or IV PCA alone (group C)...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901638/multiple-penetrating-aortic-ulcers-and-rupture-of-superior-mesenteric-artery-branch-presenting-with-symptoms-similar-to-unstable-angina-a-case-report
#18
Suqiao Zhang, Rui Lian, Guoqiang Zhang
RATINALE: Penetrating aortic ulcer (PAU) and rupture of a superior mesenteric artery branch is a rare but potentially life-threatening condition. PATIENT CONCERNS: We describe a case of 73-year-old man was brought to our Emergency Department for intermittent back pain. DIAGNOSES: The final diagnoses are PAU (Stanford B) and rupture of a branch of the superior mesenteric artery. INTERVENTIONS: Two covered stents were placed in the thoracic aorta and the right external iliac artery, and the superior mesenteric artery branch was embolized...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29892929/effect-of-early-mobilization-on-postoperative-pulmonary-complications-in-patients-undergoing-video-assisted-thoracoscopic-surgery-on-the-esophagus
#19
Masatoshi Hanada, Kengo Kanetaka, Shigekazu Hidaka, Ken Taniguchi, Masato Oikawa, Shuntaro Sato, Susumu Eguchi, Ryo Kozu
BACKGROUND: Esophagectomy performed via thoracotomy is associated with a high rate of postoperative pulmonary complications. Video-assisted thoracoscopic surgery at the esophagus (VATS-E) can reduce the rate of postoperative pulmonary complications. VATS-E is being increasingly implemented owing to its benefits. This procedure makes early patient mobilization possible, because there is minimal thoracic wall invasion, and thus, less postoperative pain. This study aimed to identify the efficacy of early mobilization in patients undergoing VATS-E...
April 2018: Esophagus: Official Journal of the Japan Esophageal Society
https://www.readbyqxmd.com/read/29890538/langerhans-cell-histiocytosis-of-the-adult-cervical-spine-a-case-report-and-literature-review
#20
Ralph T Schär, Ekkehard Hewer, Christian T Ulrich
A 36-year-old man was diagnosed with Langerhans cell histiocytosis (LCH) of the cervical spine with a unifocal expansive osteolytic lesion of C4. The surgical management with a 2-year follow-up and a review of the literature on LCH of the cervical spine are presented. Although a rare condition, LCH is an important differential diagnosis of any osteolytic lesion in the cervical spine with localized pain in a young adult patient. Review of the literature suggests a higher prevalence of LCH lesions affecting the cervical spine as compared with the thoracic or lumbar spine than historically reported...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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