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https://www.readbyqxmd.com/read/29789815/challenging-case-robot-assisted-laparoscopic-prostatectomy-after-prior-suprapubic-open-prostatectomy
#1
Shirin Razdan, Sanjay Razdan
Introduction: Given the ubiquity of robot-assisted laparoscopic prostatectomy (RALP) for treatment of localized prostate cancer, more surgeons are encountering challenging cases, either secondary to difficult anatomy, prior abdominal surgery, or prior radiation therapy. Our case is of RALP in a patient after prior suprapubic prostatectomy. Case Presentation: A 61-year-old otherwise healthy Hispanic gentleman presented for consultation after being found to have Gleason 4 + 4 = 8 prostate cancer on transrectal ultrasound-guided biopsy by an outside provider in July 2017...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29770303/cooled-tip-radiofrequency-ablation-of-benign-thyroid-nodules-preliminary-experience-with-two-different-devices
#2
Francesco Morelli, Anna Maria Ierardi, Giovanni Pompili, Andrea Sacrini, Pierpaolo Biondetti, Salvatore Alessio Angileri, Giovanni Montesano, Mario Petrillo, Roberta Giacchero, Gianlorenzo Dionigi, Gianpaolo Carrafiello
Background: Thyroid nodules are very common in general population. Even if benign, they may require a treatment in case of symptoms or cosmetic concerns. In the last years, minimally invasive treatments alternative to surgery have been developed, in particular ultrasound (US) guided radiofrequency ablation (RFA). Methods: Twenty-four patients (9 males; 15 females; mean age 57.9 years) were treated and divided in two groups (A and B) according to the RFA needle used (18 gauge needle, AMICA; 17 gauge needle, COVIDIEN)...
April 2018: Gland Surgery
https://www.readbyqxmd.com/read/29753185/us-guided-diffuse-optical-tomography-clinicopathological-features-affect-total-hemoglobin-concentration-in-breast-cancer
#3
Wenxiang Zhi, Yu Wang, Cai Chang, Fen Wang, Yaling Chen, Na Hu, Xiaoli Zhu, Li Xie
PURPOSE: To investigate breast cancers total hemoglobin concentration (THC) characteristics and its association with clinical pathologic findings. MATERIALS AND METHODS: The study was approved by the institutional review board and all patients provided written informed consent. 447 breast cancer patients, totally 455 lesions were included in our study. The size and THC of breast lesions were measured by conventional ultrasound (US) and US-guided Diffuse Optical Tomography (DOT) 1-2 days before surgery...
May 9, 2018: Translational Oncology
https://www.readbyqxmd.com/read/29750695/proximal-versus-distal-continuous-adductor-canal-blocks-does-varying-perineural-catheter-location-influence-analgesia-a-randomized-subject-masked-controlled-clinical-trial
#4
Jacklynn F Sztain, Bahareh Khatibi, Amanda M Monahan, Engy T Said, Wendy B Abramson, Rodney A Gabriel, John J Finneran, Richard H Bellars, Patrick L Nguyen, Scott T Ball, Francis B Gonzales, Sonya S Ahmed, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
BACKGROUND: A continuous adductor canal block provides analgesia after surgical procedures of the knee. Recent neuroanatomic descriptions of the thigh and knee led us to speculate that local anesthetic deposited in the distal thigh close to the adductor hiatus would provide superior analgesia compared to a more proximal catheter location. We therefore tested the hypothesis that during a continuous adductor canal nerve block, postoperative analgesia would be improved by placing the perineural catheter tip 2-3 cm cephalad to where the femoral artery descends posteriorly to the adductor hiatus (distal location) compared to a more proximal location at the midpoint between the anterior superior iliac spine and the superior border of the patella (proximal location)...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#5
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29723587/duplex-ultrasound-guided-direct-percutaneous-management-of-pseudoaneurysm-of-branch-of-segmental-renal-artery-technique-and-its-outcome
#6
Kumar Manoj, Gaurav Garg, Deepak Nagathan, Sanjeev Kumar Verma, Neera Kohli, Santosh Kumar, Sant Kumar Pandey, Satya Narayan Sankhwar
OBJECTIVE: To describe the role of Duplex-Ultrasound Imaging (DUI) in prompt diagnosis of pseudoaneurysm (PSA) of a branch of the segmental renal artery (b-SRA) and evaluate outcomes of DUI directed percutaneous embolization. METHODS: Forty-five patients were referred to us for the management of intractable renal hematuria. 20 cases (44.44%) had developed PSA after nephrolithotomy. 12 cases (12.66%) had developed PSA after guided renal biopsies. 6 cases (13.33%) had developed PSA following road side trauma...
April 30, 2018: Urology
https://www.readbyqxmd.com/read/29712519/systematic-review-of-health-economic-studies-in-cranial-neurosurgery
#7
Won Hyung A Ryu, Michael M H Yang, Sandeep Muram, W Bradley Jacobs, Steven Casha, Jay Riva-Cambrin
OBJECTIVE As the cost of health care continues to increase, there is a growing emphasis on evaluating the relative economic value of treatment options to guide resource allocation. The objective of this systematic review was to evaluate the current evidence regarding the cost-effectiveness of cranial neurosurgery procedures. METHODS The authors performed a systematic review of the literature using PubMed, EMBASE, and the Cochrane Library, focusing on themes of economic evaluation and cranial neurosurgery following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29709272/value-of-ultrasound-guided-fine-needle-aspiration-in-diagnosing-axillary-lymph-node-recurrence-after-breast-cancer-surgery
#8
Vivian Youngjean Park, Eun-Kyung Kim, Hee Jung Moon, Jung Hyun Yoon, Min Jung Kim
BACKGROUND: This article aims to assess the diagnostic performance of ultrasound-guided fine needle aspiration (US-FNA) in diagnosing axillary lymph node (ALN) recurrence in patients with a history of breast cancer. METHODS: From January 2005 to June 2015, 231 US-FNA examinations performed for suspicious axillary lesions in 218 patients with a history of breast cancer were included. Diagnostic performance of US-FNA for ALN recurrence were evaluated. RESULTS: Of the 231 US-FNA examinations, 172 (74...
April 21, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29695370/effects-of-a-12-week-digital-care-program-for-chronic-knee-pain-on-pain-mobility-and-surgery-risk-randomized-controlled-trial
#9
Gabriel Mecklenburg, Peter Smittenaar, Jennifer C Erhart-Hledik, Daniel A Perez, Simon Hunter
BACKGROUND: Chronic knee pain, most commonly caused by knee osteoarthritis, is a prevalent condition which in most cases can be effectively treated through conservative, non-surgical care involving exercise therapy, education, psychosocial support, and weight loss. However, most people living with chronic knee pain do not receive adequate care, leading to unnecessary use of opiates and surgical procedures. OBJECTIVE: Assess the efficacy of a remotely delivered digital care program for chronic knee pain...
April 25, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29685086/preoperative-localization-of-recurrence-in-the-thyroidectomy-bed-using-a-radioactive-iodine-125-seed
#10
Hillary W Garner, Ricardo Paz-Fumagalli, Geoffrey D Young
Intraoperative localization of nonpalpable recurrent thyroid cancer has been reported using needle localization, intraoperative ultrasound (US), dye injection, and radio-guided surgery. We describe the alternative technique of radioactive seed localization (RSL) in 3 patients with residual or recurrent papillary thyroid cancer. This technique has been used for many years in the setting of nonpalpable breast cancer, where it has been shown to be safe and has been associated with greater surgeon satisfaction as well as improved patient tolerability, cosmesis, and outcomes compared to needle localization...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29672327/the-affordable-care-act-decreased-the-proportion-of-uninsured-patients-in-a-safety-net-orthopaedic-clinic
#11
Joseph A Gil, Avi D Goodman, Justin Kleiner, Robin N Kamal, Laurence C Baker, Edward Akelman
BACKGROUND: The Patient Protection and Affordable Care Act (ACA) was approved in 2010, substantially altering the economics of providing and receiving healthcare services in the United States. One of the primary goals of this legislation was to expand insurance coverage for under- and uninsured residents. Our objective was to examine the effect of the ACA on the insurance status of patients at a safety net clinic. Our institution houses a safety net clinic that provides the dominant majority of orthopaedic care for uninsured patients in our state...
May 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29667115/biopsy-feasibility-trial-for-breast-cancer-pathologic-complete-response-detection-after-neoadjuvant-chemotherapy-imaging-assessment-and-correlation-endpoints
#12
Gaiane M Rauch, Henry M Kuerer, Beatriz Adrada, Lumarie Santiago, Tanya Moseley, Rosalind P Candelaria, Elsa Arribas, Jia Sun, Jessica W T Leung, Savitri Krishnamurthy, Wei T Yang
PURPOSE: This study was designed to present the secondary imaging endpoints of the trial for evaluating mammogram (MMG), ultrasound (US) and image guided biopsy (IGBx) assessment of pathologic complete response (pCR) in breast cancer (BC) patients undergoing neoadjuvant chemotherapy (NAC). METHODS: Patients with T1-3, N0-3, M0 triple-negative or HER2-positive BC who received NAC were enrolled in an Institutional Review Board-approved prospective, clinical trial...
April 17, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29630033/a-randomized-comparison-between-interscalene-and-small-volume-supraclavicular-blocks-for-arthroscopic-shoulder-surgery
#13
Julián Aliste, Daniela Bravo, Diego Fernández, Sebastián Layera, Roderick J Finlayson, De Q Tran
BACKGROUND AND OBJECTIVES: This randomized trial compared ultrasound (US)-guided interscalene block (ISB) and small-volume supraclavicular block (SCB) for arthroscopic shoulder surgery. We hypothesized that SCB would provide equivalent analgesia to ISB 30 minutes after surgery without the risk of hemidiaphragmatic paralysis (HDP). METHODS: All patients received an US-guided intermediate cervical plexus block. In the ISB group, US-guided ISB was performed with 20 mL of levobupivacaine 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29619521/us-guided-percutaneous-release-of-the-first-extensor-tendon-compartment-using-a-21-gauge-needle-in-de-quervain-s-disease-a-prospective-study-of-35-cases
#14
Franck Lapègue, Aymeric André, Etienne Pasquier Bernachot, Ezin Jocelyn Akakpo, Pierre Laumonerie, Hélène Chiavassa-Gandois, Omar Lasfar, Christophe Borel, Marine Brunet, Olivia Constans, Hubert Basselerie, Nicolas Sans, Marie Faruch-Bilfeld
PURPOSE: To evaluate the efficacy of ultrasonography-guided percutaneous treatment of de Quervain tenosynovitis with the combination of a corticosteroid injection and release of the retinaculum of the first extensor compartment tendons with a 21-gauge needle. MATERIALS AND METHODS: The first part of our study consisted of ten procedures on cadaver wrists followed by dissection to analyse the effectiveness of the retinaculum release and detect any collateral damage...
April 4, 2018: European Radiology
https://www.readbyqxmd.com/read/29616168/personalized-3d-printed-surgical-tool-for-guiding-the-chisel-during-hump-reduction-in-rhinoplasty
#15
Hugo Herrero Antón de Vez, Javier Herrero Jover, Claudio Silva-Vergara
The authors aimed to present an introduction of patient-specific model in rhinoplasty by introducing a 3D printed surgical guide designed and adapted in an individualized manner for guiding dorsal hump reduction. To introduce the tool, we have designed a six step workflow. First, we obtain a digital 3D model of patient anatomy using computed tomography (CT) images. Second, we conduct a surgical preoperative planning of the rhinoplasty on the mentioned model. Third step consists of designing the guide, while taking into account nasal anthropometries and resection objectives...
February 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29608439/quantitative-analysis-of-the-benefits-and-risk-of-thyroid-nodule-evaluation-in-patients-%C3%A2-70-years-old
#16
Zhihong Wang, Chirag M Vyas, Olivia Van Benschoten, Matt A Nehs, Francis D Moore, Ellen Marqusee, Jeffrey F Krane, Matthew I Kim, Howard T Heller, Atul A Gawande, Mary C Frates, Peter M Doubilet, Gerard M Doherty, Nancy L Cho, Edmund S Cibas, Carol B Benson, Justine A Barletta, Ann Marie Zavacki, P Reed Larsen, Erik K Alexander, Trevor E Angell
BACKGROUND: In older patients, thyroid nodules are frequently detected and referred for evaluation, though usually prove to be benign disease or low-risk cancer. Therefore, management should be guided not solely by malignancy risk, but also by the relative risks of any intervention. Unfortunately, few such data are available for patients ≥70 years old. METHODS: All consecutive patients ≥70 years old assessed by ultrasound (US) and fine-needle aspiration (FNA) between 1995 and 2015 were analyzed...
April 2, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29582053/adeno-associated-viral-vector-serotype-2-nerve-growth-factor-for-patients-with-alzheimer-disease-a-randomized-clinical-trial
#17
Michael S Rafii, Mark H Tuszynski, Ronald G Thomas, David Barba, James B Brewer, Robert A Rissman, Joao Siffert, Paul S Aisen
Importance: Nerve growth factor (NGF) is an endogenous neurotrophic factor that prevents the death and augments the functional state of cholinergic neurons of the basal forebrain, a cell population that undergoes extensive degeneration in Alzheimer disease (AD). Objective: To determine whether stereotactically guided intracerebral injections of adeno-associated viral vector (serotype 2)-nerve growth factor (AAV2-NGF) are well tolerated and exhibit preliminary evidence of impact on cognitive decline in mild to moderate AD-associated dementia...
March 26, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29579018/utilizing-black-bone-mri-in-craniofacial-virtual-surgical-planning-a-comparative-cadaver-study
#18
Marissa A Suchyta, Waleed Gibreel, Christopher H Hunt, Krzysztof R Gorny, Matthew A Bernstein, Samir Mardini
BACKGROUND: The use of MRI for virtual surgical planning has not yet been described. In the US, over 600,000 CT scans are performed on children annually, who are at higher risk for developing cancer caused by ionizing radiation compared to adults. The aim of this study is to demonstrate that 3D printed craniofacial surgical guides created from Black Bone MRI are comparable in accuracy to those created from CT scans. METHODS: A mock craniosynostosis surgery translocating four calvarial segments was virtually planned and performed in ten cadavers...
March 19, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29558507/clinical-and-ultrasonographic-features-of-male-breast-tumors-a-retrospective-analysis
#19
Wei-Hsin Yuan, Anna Fen-Yau Li, Yi-Hong Chou, Hui-Chen Hsu, Ying-Yuan Chen
OBJECTIVE: The purpose of this study was to determine clinical and ultrasonographic characteristics of male breast tumors. METHODS: The medical records of male patients with breast lesions were retrieved from an electronic medical record database and a pathology database and retrospectively reviewed. A total of 112 men (125 breast masses) with preoperative breast ultrasonography (US) were included (median age, 59.50 years; age range, 15-96 years). Data extracted included patient age, if the lesions were bilateral, palpable, and tender, and the presence of nipple discharge...
2018: PloS One
https://www.readbyqxmd.com/read/29528160/presurgical-language-fmri-clinical-practices-and-patient-outcomes-in-epilepsy-surgical-planning
#20
Christopher F A Benjamin, Alexa X Li, Hal Blumenfeld, R Todd Constable, Rafeed Alkawadri, Stephan Bickel, Christoph Helmstaedter, Stefano Meletti, Richard Bronen, Simon K Warfield, Jurriaan M Peters, David Reutens, Monika Połczyńska, Dennis D Spencer, Lawrence J Hirsch
The goal of this study was to document current clinical practice and report patient outcomes in presurgical language functional MRI (fMRI) for epilepsy surgery. Epilepsy surgical programs worldwide were surveyed as to the utility, implementation, and efficacy of language fMRI in the clinic; 82 programs responded. Respondents were predominantly US (61%) academic programs (85%), and evaluated adults (44%), adults and children (40%), or children only (16%). Nearly all (96%) reported using language fMRI. Surprisingly, fMRI is used to guide surgical margins (44% of programs) as well as lateralize language (100%)...
March 12, 2018: Human Brain Mapping
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