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https://www.readbyqxmd.com/read/28729377/abundant-dystrophic-calcifications-mimicking-aortic-valve-abscess-in-a-patient-undergoing-elective-aortic-valve-replacement
#1
Adam L Booth, Christine Q Li, Ghannam Ayed Al-Dossari, Heather L Stevenson
Dystrophic calcifications of the aortic valve may cause symptomatic aortic stenosis and account for a significant portion of patients who undergo elective valve replacement. Calcifications appearing grossly as a cloudy fluid surrounding the aortic valve leaflets are an uncommon finding. Normally, calcified aortic valves are characterised by large, nodular masses within the aortic cusps. We report a case of dystrophic calcifications on a stenotic aortic valve encountered intraoperatively, which was suggestive of infective endocarditis and abscess formation...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#2
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28718350/tourniquet-deflation-prior-to-20-minutes-in-upper-extremity-intravenous-regional-anesthesia
#3
Richard W Gurich, Justin W Langan, Robert J Teasdall, Stephanie L Tanner, John L Sanders
BACKGROUND: Bier blocks, or intravenous regional anesthesia (IVRA), are a method of anesthesia for upper extremity surgeries. This study reports our experience with tourniquet deflation prior to 20 minutes with upper extremity IVRA. METHODS: This study was designed as a retrospective cohort analysis. Records, including intraoperative and immediate postoperative anesthesia notes, of 430 patients who underwent IVRA with an upper extremity Bier block and a corresponding tourniquet time of less than 20 minutes were reviewed...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#4
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28707534/fosbury-flop-tear-of-the-rotator-cuff-diagnostic-assessment-with-magnetic-resonance-arthrography
#5
Frank C Kolo, Adrien Jean-Pierre Schwitzguebel, Abed Kourhani, Patrick J Denard, Caecilia Charbonnier, Alexandre Ladermann
OBJECTIVES: The aim was to assess the diagnostic performance of magnetic resonance arthrography (MRA) of the shoulder for the detection of "Fosbury flop" tears. METHODS: All patients undergoing arthroscopic rotator cuff repair were considered as potentially eligible for inclusion in this prospective case series. Preoperative MRAs were consecutively performed and compared with intraoperative findings being the gold standard control. Two experienced musculoskeletal radiologists, blinded to the arthroscopic findings, independently analyzed all MRAs for the presence of typical signs of Fosbury flop tears...
July 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28702167/clostridium-perfringens-s-necrotizing-acute-pancreatitis-a-case-of-success
#6
Rita Castro, Joana Mendes, Luís Amaral, Rui Quintanilha, Tiago Rama, António Melo
The authors report a case of a 62-year-old man with upper abdominal pain with few hours of onset and vomits. The initial serum amylase was 2306 U/L. The first CT showed signs of a non-complicated acute pancreatitis. He suffered clinical deterioration and for this reason he was admitted on the intensive care unit where he progressed to multiple organ failure in <24 h. A new CT scan was performed that showed pneumoperitoneum and pneumoretroperitoneum. He underwent an exploratory laparotomy and pancreatic necrosectomy and vacuum pack laparostomy were performed...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28692739/analysis-of-retinal-architectural-changes-using-intraoperative-oct-following-surgical-manipulations-with-membrane-flex-loop-in-the-discover-study
#7
Atsuro Uchida, Sunil K Srivastava, Justis P Ehlers
Purpose: We investigate acute retinal alterations identified on intraoperative optical coherence tomography (iOCT) immediately following surgical intervention with the Finesse Flex Loop for vitreoretinal interface disorders. Methods: The Determination of feasibility of Intraoperative Spectral domain microscope Combined/integrated OCT Visualization during En face Retinal and ophthalmic surgery (DISCOVER) study is a prospective multisurgeon intraoperative OCT clinical study...
July 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28685071/development-of-video-assisted-breast-cancer-surgery-initial-experience-with-a-novel-method-for-creating-working-space-without-prior-liposuction
#8
Qian-Fu Wu, Ying-Hua Yu, Xiao Zhu, Ying Cui, Qin-Guo Mo, Chang-Yuan Wei, Xue-Juan Lin, Xue-Ying Liu, Wei-Kang Xie, Shui Gan, Wei Lei
Endoscopic techniques are promising in breast surgery. In order to create working space, liposuction is widely used in video-assisted breast surgery (VABS). However, the use of liposuction is likely associated with side effects that may partly limit the application of VABS. Therefore, a new technique of endoscopic axillary lymphadenectomy without prior liposuction was developed by our group. A total of 106 female patients underwent VABS, with special adaptation of the video-assisted surgical procedures previously described...
July 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28684150/sandwich-technique-using-fibrin-coated-collagen-fleece-for-sellar-reconstruction-in-large-dural-defects-during-transsphenoidal-surgery
#9
Jaeyoung So, Hunho Park, Kyeong-Soo Sung, Kyu Sung Lee, Chang-Ki Hong
PURPOSE: Various surgical methods to prevent intraoperative and postoperative cerebrospinal fluid (CSF) leaks during transsphenoidal approach (TSA) surgeries have been reported, but surgical techniques to address large dural defects have been less thoroughly investigated in the literature. The authors retrospectively evaluated the usefulness of the sandwich technique using fibrin-coated collagen fleece (TachoSil) to prevent intraoperative CSF leakage from large dural defects in TSA surgery...
July 3, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28683817/the-effects-of-intravenous-lignocaine-on-depth-of-anaesthesia-and-intraoperative-haemodynamics-during-open-radical-prostatectomy
#10
Laurence Weinberg, Jae Jang, Clive Rachbuch, Chong Tan, Raymond Hu, Larry McNicol
BACKGROUND: Lignocaine is a local anaesthetic agent, which is also commonly used as a perioperative analgesic adjunct to accelerate rehabilitation and enhance recovery after surgery. Lignocaine's systemic effects on intraoperative haemodynamics and volatile anaesthetic requirements are not well explored. Therefore, we evaluated the effects of intravenous lignocaine on intraoperative volatile agent requirements and haemodynamics in patients undergoing major abdominal surgery. METHODS: We performed an analysis of 76 participants who underwent elective open radical retropubic prostatectomy...
July 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28682955/ringer-s-lactate-versus-normal-saline-in-urgent-cesarean-delivery-in-a-resource-limited-setting-a-pragmatic-clinical-trial
#11
Emmanuel Timarwa Ayebale, Arthur Kwizera, Cephas Mijumbi, Samuel Kizito, Anthony Michael Roche
BACKGROUND: Crystalloids are used routinely for perioperative fluid management in cesarean delivery. Few studies have determined the crystalloid of choice in obstetric anesthesia. We compared the effects of Ringer's lactate (RL) versus 0.9% normal saline (NS) on maternal and neonatal blood pH and 24-hour postoperative morbidity in urgent cesarean delivery in a low-resource setting. Our hypothesis was that RL would result in 30% less acidosis than NS. METHODS: This was a pragmatic prospective double-blind randomized controlled trial in the Mulago National Referral Hospital Labor Ward Theater from September 2011 to May 2012...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28680389/post-mortem-validation-of-mri-identified-veins-on-the-surface-of-the-cerebral-cortex-as-potential-landmarks-for-neurosurgery
#12
Günther Grabner, Thomas Haider, Mark Glassner, Alexander Rauscher, Hannes Traxler, Siegfried Trattnig, Simon D Robinson
Background and Objective: Image-guided neurosurgery uses information from a wide spectrum of methods to inform the neurosurgeon's judgement about which tissue to resect and which to spare. Imaging data are registered to the patient's skull so that they correspond to the intraoperative macro- and microscopic view. The correspondence between imaging and optical systems breaks down during surgery, however, as a result of cerebro-spinal fluid drain age, tissue resection, and gravity-based brain shift. In this work we investigate whether a map of surface veins, automatically segmented from MRI, could serve as additional reference system...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28678111/effectiveness-and-safety-of-batroxobin-tranexamic-acid-and-a-combination-in-reduction-of-blood-loss-in-lumbar-spinal-fusion-surgery
#13
Roopa Mn, Ajoy Prasad Shetty, Srikanth Reddy Dumpa, Balavenkat Subarmaniam, Rishi Mugesh Kanna, Rajasekeran Shanmuganathan
STUDY DESIGN: A prospective randomized double blind placebo controlled trail OBJECTIVE.: To evaluate and compare the efficacy and safety of Batroxobin (botropase),Tranexamic acid(TXA) and their combination in reduction of perioperative blood loss in lumbar spine single level fusion surgeries. SUMMARY OF BACKGROUND DATA: Spinal surgeries are associated with significant blood loss leading to perioperative anaemia and increased need for allogenic transfusion. TXA competitively inhibits plasmin and batroxobin converts fibrinogen to fibrin and theoretically their combination is synergistic ...
July 3, 2017: Spine
https://www.readbyqxmd.com/read/28676821/intraoperative-imaging-modalities-and-compensation-for-brain-shift-in-tumor-resection-surgery
#14
REVIEW
Siming Bayer, Andreas Maier, Martin Ostermeier, Rebecca Fahrig
Intraoperative brain shift during neurosurgical procedures is a well-known phenomenon caused by gravity, tissue manipulation, tumor size, loss of cerebrospinal fluid (CSF), and use of medication. For the use of image-guided systems, this phenomenon greatly affects the accuracy of the guidance. During the last several decades, researchers have investigated how to overcome this problem. The purpose of this paper is to present a review of publications concerning different aspects of intraoperative brain shift especially in a tumor resection surgery such as intraoperative imaging systems, quantification, measurement, modeling, and registration techniques...
2017: International Journal of Biomedical Imaging
https://www.readbyqxmd.com/read/28673220/anaesthetic-management-of-patients-undergoing-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy-for-pseudomyxoma-peritonei-a-retrospective-audit
#15
S P Shiralkar, P Kerr, J Scott, P Sivalingam
Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to improve quality of life and survival rates in patients suffering from pseudomyxoma peritonei. The procedure is long and associated with significant intraoperative blood loss. As such, the anaesthetic management of patients undergoing this procedure can be challenging. The aim of this paper is to describe our perioperative management of pseudomyxoma peritonei patients who received CRS and to report a retrospective audit of our outcomes and complications over a six-year period at a large tertiary centre...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28665386/-modern-diagnosis-and-treatment-in-children-with-congenital-basal-encephalocele
#16
A V Sakharov, V V Roginskiy, D N Kapitanov, A L Ivanov, E V Shelesko, S K Gorelyshev, A A Evteev, N V Lemeneva, D N Zinkevich, Yu A Kochkin, V I Ozerova, L A Satanin
Basal encephalocele is a rare disease that predominantly occurs in children. Its most common symptoms include nasal liquorrhea, difficulty in nasal breathing, and deformity of the naso-orbital region. MATERIAL AND METHODS: The study group included 19 patients with basal encephalocele, aged 2 months to 18 years. Ten (59%) patients were operated on through a transnasal endoscopic approach; 3 (17.5%) patients were operated on through a transcranial approach; 4 (23.5%) patients were operated on using a combined approach: the patients underwent simultaneous elimination of a cranio-orbital region deformity using the basal transcranial approach as well as hernial sac resection and hernioplasty using the transnasal endoscopic approach...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28659243/the-impact-of-using-an-intraoperative-goal-directed-fluid-therapy-protocol-on-clinical-outcomes-in-patients-undergoing-total-pancreatectomy-and-islet-cell-autotransplantation
#17
Matthew K Wagar, Josh Magnuson, Patty T Liu, Varvara Kirchner, Joshua J Wilhelm, Martin L Freeman, Melena D Bellin, Timothy L Pruett, Gregory J Beilman, Ty B Dunn
BACKGROUND: Patients undergoing total pancreatectomy and islet cell autotransplant (TPIAT) for treatment of pancreatitis are at risk for complications of over and under resuscitation. We hypothesized that using a goal directed fluid therapy (GDFT) protocol might impact clinical outcomes. MATERIALS AND METHODS: A consecutive series of adult patients undergoing TPIAT were managed intraoperatively using either standard fluid therapy (SFT, n = 44) or GDFT (n = 23) as part of a pilot study between January 2013 and May 2015...
June 23, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28650680/transurethral-resection-of-prostate-and-bleeding-a-prospective-randomized-double-blind-placebo-controlled-trial-to-see-the-efficacy-of-short-term-use-of-finasteride-and-dutasteride-on-operative-blood-loss-and-prostatic-microvessel-density
#18
Ankur Bansal, Aditi Arora
OBJECTIVE: The aim of this study was to determine the efficacy of short-duration use of finasteride and dutasteride before transurethral resection of the prostate (TURP) on intraoperative blood loss and microvessel density (MVD) of prostate stroma and suburethral tissues in benign prostatic hyperplasia (BPH). METHODS: This study includes 450 patients who were planned for TURP. They were prospectively randomized into three groups (150 patients each). Group 1 received placebo, group 2 received finasteride, 5 mg per day, and group 3 patients received dutasteride, 0...
June 26, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28648840/reducing-fluid-related-complications-during-operative-hysteroscopy-the-use-of-a-new-mandatory-fluid-balance-form
#19
Heli Alkaslassy, Raz Bahar, Hillel Henry Chill, Gilad Karavani, Orna Ben-Yosseff, Asher Shushan
STUDY OBJECTIVE: To examine whether our new reporting system and mandatory fluid-balance form could improve the communication and awareness within the surgical team and therefore the safety of hysteroscopic operations. DESIGN: A case-control study DESIGN: classification: II-2 SETTING: An endoscopic gynecology unit at a tertiary-care university hospital. PATIENTS: Women aged 17-88 (median 43.9) years, who underwent operative hysteroscopy to treat uterine pathology...
June 22, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28648412/renal-outcome-after-radical-cystectomy-and-urinary-diversion-performed-with-restrictive-hydration-and-vasopressor-administration-in-the-frame-of-an-enhanced-recovery-program-a-follow-up-study-of-a-randomized-clinical-trial
#20
Fiona Mei Wen Wu, Fiona Burkhard, Filippo Turri, Marc Furrer, Lukas Loeffel, George Thalmann, Patrick Wuethrich
OBJECTIVE: To determine whether a restrictive perioperative fluid management in the context of an enhanced recovery after surgery program for radical cystectomy and urinary diversion affects renal function, as fluid restriction and the use of vasopressors have been linked to impaired tissue perfusion, potentially resulting in renal dysfunction. METHODS: We followed 166 patients initially included in a randomized clinical trial and equally allocated to receive a continuous norepinephrine administration combined with 1ml/kg/h initially, and after cystectomy 3ml/kg/h crystalloid infusion (intervention group, n = 83), or a standard crystalloid infusion of 6ml/kg/h throughout surgery (control group, n = 83)...
June 22, 2017: Urologic Oncology
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