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https://www.readbyqxmd.com/read/28719712/post-tonsillectomy-hemorrhage-rates-in-children-compared-by-surgical-technique
#1
Nicole M Reusser, Robert W Bender, Nikhil A Agrawal, James T Albright, Newton O Duncan, Joseph L Edmonds
Despite the sheer number of pediatric tonsillectomies performed in the United States annually, there is no clear consensus as to which surgical technique is superior. One way to compare surgical techniques is to study the morbidity associated with each. We report postoperative hemorrhage rates, one of the frequently encountered major adverse events, as part of a retrospective chart review across four different surgical techniques. These surgeries involved either (1) Coblation, (2) Co-blation with partial suture closure of the tonsillar fossa, (3) diathermy, or (4) partial intracapsular tonsillectomy (PIT)...
July 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28719609/renal-function-following-xenon-anesthesia-for-partial-nephrectomy-an-explorative-analysis-of-a-randomized-controlled-study
#2
Ana Stevanovic, Patrick Schaefer, Mark Coburn, Rolf Rossaint, Christian Stoppe, Peter Boor, David Pfister, Axel Heidenreich, Hildegard Christ, Martin Hellmich, Astrid V Fahlenkamp
BACKGROUND: Perioperative preservation of renal function has a significant impact on morbidity and mortality in kidney surgery. Nephroprotective effects of the anesthetic xenon on ischemia-reperfusion injury were found in several experimental studies. OBJECTIVE: We aimed to explore whether xenon anesthesia can reduce renal damage in humans undergoing partial nephrectomy and to gather pilot data of possible nephroprotection in these patients. DESIGN: A prospective randomized, single-blinded, controlled study...
2017: PloS One
https://www.readbyqxmd.com/read/28719527/pupillometry-guided-intraoperative-remifentanil-administration-versus-standard-practice-influences-opioid-use-a-randomized-study
#3
Nada Sabourdin, Jérôme Barrois, Nicolas Louvet, Agnès Rigouzzo, Marie-Laurence Guye, Christophe Dadure, Isabelle Constant
BACKGROUND: Pupillometry has shown promising results for assessing nociception in anesthetized patients. However, its benefits in clinical practice are not demonstrated. The aim of this prospective randomized study was to evaluate the impact of intraoperative pupillometry monitoring on perioperative opioid consumption in major gynecologic surgery. METHODS: After receiving ethics committee approval and written consent of patients, American Society of Anesthesiologists status I to II women undergoing gynecologic surgery were included in this single-blinded, prospective, parallel-arm randomized study...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28719091/multimodal-analgesia-as-an-alternative-to-the-risks-of-opioid-monotherapy-in-surgical-pain-management
#4
John J Savarese, Norman G Tabler
Clinicians have long been aware of the danger of overreliance on opioids to manage acute pain, such as the pain accompanying surgery. The risk of adverse drug events is higher with opioids than with any other common class of drugs. Overreliance on opioids increases length of stay and hospital costs, while decreasing patient satisfaction. Opioids can lead to problems that continue well after discharge, including chronic pain, abuse and addiction, and even death. Increasingly, prescribed opioids have proved to lead to heroin addiction...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28718878/deep-brain-and-cortical-stimulation-for-epilepsy
#5
REVIEW
Mathieu Sprengers, Kristl Vonck, Evelien Carrette, Anthony G Marson, Paul Boon
BACKGROUND: Despite optimal medical treatment, including epilepsy surgery, many epilepsy patients have uncontrolled seizures. Since the 1970s interest has grown in invasive intracranial neurostimulation as a treatment for these patients. Intracranial stimulation includes both deep brain stimulation (DBS) (stimulation through depth electrodes) and cortical stimulation (subdural electrodes). This is an updated version of a previous Cochrane review published in 2014. OBJECTIVES: To assess the efficacy, safety and tolerability of DBS and cortical stimulation for refractory epilepsy based on randomized controlled trials (RCTs)...
July 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28717055/incidence-of-anaphylactic-reactions-after-propofol-administration-in-dogs
#6
Mamoru Onuma, Misao Terada, Sadaharu Ono, Akiyoshi Murakami, Tomoko Ishida, Tadashi Sano
Propofol is an anesthetic agent suspended in an emulsion system that includes egg yolk lecithin and soybean oil, because of which, there is concern about the use of propofol in patients allergic to these substances. We examined the association between propofol administration and incidence of adverse events in dogs with allergy to egg yolk lecithin and soybean oil. On the basis of the findings of an allergen-specific immunoglobulin E (IgE) test, 14 dogs with high levels (high-IgE group) and 7 dogs with low levels (normal-IgE group) of IgE were selected...
July 14, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28716404/partial-jejunal-diversion-using-an-incisionless-magnetic-anastomosis-system-1-year-interim-results-in-subjects-with-obesity-and-diabetes
#7
Evžen Machytka, Marek Bužga, Pavel Zonca, David B Lautz, Marvin Ryou, Donald C Simonson, Christopher C Thompson
BACKGROUND AND AIMS: The majority of patients with type 2 diabetes mellitus (T2DM) have obesity. Studies show that bariatric surgery is superior to medical treatment for remission of T2DM. Nevertheless, very few patients undergo surgery, and a less-invasive endoscopic alternative is desirable. METHODS: This was a single-arm first-in-human pilot study, designed to evaluate the technical feasibility, safety, and clinical performance of the incisionless magnetic anastomosis system (IMAS) in creation of a partial jejunal diversion (PJD)...
July 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28715092/the-origins-of-oral-medicine-in-the-hippocratic-collected-works
#8
REVIEW
Helen Askitopoulou, Vasileia Nyktari, Alexandra Papaioannou, Georgios Stefanakis, Elina Konsolaki
The collected works of Hippocrates describe for the first time in a systematic way a large number of oral diseases, such as ulcers, inflammations, abscesses and tumours from the epiglottis, mouth, tongue, palate, uvula and the sublingual area. Several of these case reports are remarkable for the accurate observation of clinical symptoms and signs, the aetiology, the pathogenesis and their therapeutic approach in relation to prognosis. The Hippocratic authors report cases of 'aphthae' as part of a polysystemic disease, described many centuries later by Behçet and Adamantiades, while they associate features of splenomegaly from endemic malaria with gingivitis ('ulitis')...
July 17, 2017: Journal of Oral Pathology & Medicine
https://www.readbyqxmd.com/read/28715063/peripehral-artery-atherosclerotic-disease-and-sleep-disordered-breathing-paradise-trial-protocol-for-an-observational-cohort-study
#9
Filip M Szymański, Zbigniew Gałązka, Anna E Płatek, Dariusz Górko, Tomasz Ostrowski, Karolina Adamkiewicz, Paweł Łęgosz, Anna Ryś, Karolina Semczuk, Krzysztof Celejewski, Krzysztof J Filipiak
BACKGROUND: Peripheral arterial disease (PAD) is in fact a group of disease entities with different symptoms and course but a common underlying cause that is atherosclerosis. Atherosclerosis is known to be aggravated by several cardiovascular risk factors, including obstructive sleep apnea (OSA). AIM: Following paper is a protocol for Peripehral ARtery Atherosclerotic DIsease and SlEep disordered breathing (PARADISE) trial, which aims to describe the prevalence of OSA in PAD patients scheduled for revascularization and to determine the effect of OSA on the procedure outcomes...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28713063/radiofrequency-ablation-for-the-treatment-of-weight-regain-after-roux-en-y-gastric-bypass-surgery
#10
Julian A Abrams, Sri Komanduri, Nicholas J Shaheen, Zengri Wang, Richard I Rothstein
BACKGROUND AND AIMS: Roux-en-Y gastric bypass (RYGB) surgery is an established modality for the treatment of morbid obesity. However, approximately one-quarter of patients experience weight regain after initially successful weight loss. Endoscopic therapy targeting the gastric remnant pouch represents a novel potential strategy to re-induce weight loss in this population. We performed a pilot trial of radiofrequency ablation (RFA) of the gastric remnant pouch after RYGB to determine feasibility, safety and efficacy for weight loss...
July 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28713061/the-extent-of-unnecessary-surgery-for-benign-rectal-polyps-in-the-netherlands
#11
L Laurien J van Nimwegen, L Leon M G Moons, J Joost M J Geesing, L Rene Arensman, M M Miangela Laclé, I Ivo A M J Broeders, P Peter P Viergever, J John N Groen, K Koen Kessels, M Thijs P Schwartz
BACKGROUND AND AIMS: Minimally invasive techniques are available to safely and efficaciously remove even the largest rectal polyps. This study aimed to investigate the magnitude of cases still referred for radical rectal surgery, the reasons for theses referrals, and to perform a re-evaluation of cases potentially suitable for endoscopic therapy. METHODS: A retrospective analysis of data from the Dutch Pathology Registry (PALGA) was performed using the records of patients who underwent major surgical treatment for a histologically proven benign rectal polyp between 2005 to 2014 in the Netherlands...
July 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28713035/intracerebral-gene-therapy-in-children-with-mucopolysaccharidosis-type-iiib-syndrome-an-uncontrolled-phase-1-2-clinical-trial
#12
Marc Tardieu, Michel Zérah, Marie-Lise Gougeon, Jérome Ausseil, Stéphanie de Bournonville, Béatrice Husson, Dimitrios Zafeiriou, Giancarlo Parenti, Philippe Bourget, Béatrice Poirier, Valérie Furlan, Cécile Artaud, Thomas Baugnon, Thomas Roujeau, Ronald G Crystal, Christian Meyer, Kumaran Deiva, Jean-Michel Heard
BACKGROUND: Mucopolysaccharidosis type IIIB syndrome (also known as Sanfilippo type B syndrome) is a lysosomal storage disease resulting in progressive deterioration of cognitive acquisition after age 2-4 years. No treatment is available for the neurological manifestations of the disease. We sought to assess the safety and efficacy of a novel intracerebral gene therapy. METHODS: Local regulatory authorities in France allowed inclusion of up to four children in this phase 1/2 study...
July 13, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28712537/efficacy-and-safety-of-voretigene-neparvovec-aav2-hrpe65v2-in-patients-with-rpe65-mediated-inherited-retinal-dystrophy-a-randomised-controlled-open-label-phase-3-trial
#13
Stephen Russell, Jean Bennett, Jennifer A Wellman, Daniel C Chung, Zi-Fan Yu, Amy Tillman, Janet Wittes, Julie Pappas, Okan Elci, Sarah McCague, Dominique Cross, Kathleen A Marshall, Jean Walshire, Taylor L Kehoe, Hannah Reichert, Maria Davis, Leslie Raffini, Lindsey A George, F Parker Hudson, Laura Dingfield, Xiaosong Zhu, Julia A Haller, Elliott H Sohn, Vinit B Mahajan, Wanda Pfeifer, Michelle Weckmann, Chris Johnson, Dina Gewaily, Arlene Drack, Edwin Stone, Katie Wachtel, Francesca Simonelli, Bart P Leroy, J Fraser Wright, Katherine A High, Albert M Maguire
BACKGROUND: Phase 1 studies have shown potential benefit of gene replacement in RPE65-mediated inherited retinal dystrophy. This phase 3 study assessed the efficacy and safety of voretigene neparvovec in participants whose inherited retinal dystrophy would otherwise progress to complete blindness. METHODS: In this open-label, randomised, controlled phase 3 trial done at two sites in the USA, individuals aged 3 years or older with, in each eye, best corrected visual acuity of 20/60 or worse, or visual field less than 20 degrees in any meridian, or both, with confirmed genetic diagnosis of biallelic RPE65 mutations, sufficient viable retina, and ability to perform standardised multi-luminance mobility testing (MLMT) within the luminance range evaluated, were eligible...
July 13, 2017: Lancet
https://www.readbyqxmd.com/read/28712185/effect-of-midazolam-premedication-on-doses-of-propofol-for-laryngeal-mask-airway-insertion-in-children
#14
Muhammad Adnan, Aamir Furqan, Muhammad Kaleem Sattar
BACKGROUND: Propofol is a widely-accepted medication for the successful insertion of laryngeal mask airway (LMA). When propofol is used alone, larger doses are required which can lead to cardiorespiratory distress resulting in hypotension and prolonged apnoea. The objective of this study was to evaluate the effect of premedication of midazolam on different doses of propofol for LMA insertion. METHODS: In this randomized clinical trial, eighty-six (86) patients who were scheduled to undergo elective surgery is supine position not requiring the need for tracheal intubation from September 2015 to 6 March 2016 were included...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28711761/laparoscopic-vs-open-hysterectomy-for-benign-disease-in-uteri-weighing-1-kg-a-retrospective-analysis-on-258-patients
#15
Stefano Uccella, Chiara Morosi, Nicola Marconi, Anna Arrigo, Baldo Gisone, Jvan Casarin, Ciro Pinelli, Camilla Borghi, Fabio Ghezzi
OBJECTIVE: To present a large single-center series of hysterectomies for uteri≥ 1 kilogram and to compare laparoscopic and open abdominal approach in terms of peri-operative outcomes and complications. DESIGN: Retrospective analysis of prospectively-collected data (Canadian Task Force II-2). SETTING: Academic research center. PATIENTS: Consecutive women who underwent hysterectomy for uteri ≥ 1 kilogram in the period between January 2000 and December 2016...
July 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28711737/subthalamic-deep-brain-stimulation-sweet-spots-and-hyperdirect-cortical-connectivity-in-parkinson-s-disease
#16
Harith Akram, Stamatios N Sotiropoulos, Saad Jbabdi, Dejan Georgiev, Philipp Mahlknecht, Jonathan Hyam, Thomas Foltynie, Patricia Limousin, Enrico De Vita, Marjan Jahanshahi, Marwan Hariz, John Ashburner, Tim Behrens, Ludvic Zrinzo
OBJECTIVES: Firstly, to identify subthalamic region stimulation clusters that predict maximum improvement in rigidity, bradykinesia and tremor, or emergence of side-effects; and secondly, to map-out the cortical fingerprint, mediated by the hyperdirect pathways which predict maximum efficacy. METHODS: High angular resolution diffusion imaging in twenty patients with advanced Parkinson's disease was acquired prior to bilateral subthalamic nucleus deep brain stimulation...
July 12, 2017: NeuroImage
https://www.readbyqxmd.com/read/28711531/transdural-indocyanine-green-videography-for-sta-mca-bypass-technical-note
#17
Hiroshi Yokota, Taiji Yonezawa, Tomonori Yamada, Seisuke Miyamae, Taekyun Kim, Yoshiaki Takamura, Katsuya Masui, Shuta Aketa
BACKGROUND: Neurosurgical application of indocyanine green (ICG) videography prior to performing a dural opening has been reported as transdural ICG videography and used during surgery of meningiomas associated with venous sinuses, as well as cranial and spinal arteriovenous malformations. However, its use for a superficial temporal artery to middle cerebral artery (STA-MCA) bypass has not been reported. METHODS: We performed a retrospective analysis of medical records of patients who underwent a transdural ICG videography technique during STA-MCA bypass procedures performed between January 2012 and March 2015...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711400/thirty-day-outcomes-after-fenestrated-endovascular-repair-are-superior-to-open-repair-of-abdominal-aortic-aneurysms-involving-visceral-vessels
#18
Prateek K Gupta, Reshma Brahmbhatt, Kelly Kempe, Shaun M Stickley, Michael J Rohrer
OBJECTIVE: Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcomes after FEVAR vs OS for AAA-Vs. METHODS: Patients who underwent FEVAR (n = 535) and OS (n = 1207) for elective AAA-Vs were identified from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) 2008 to 2013 database...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28711368/the-safety-and-feasibility-of-early-discharge-following-ileostomy-reversal-a-national-surgical-quality-improvement-program-analysis
#19
Arash Azin, Emily Le Souder, David Urbach, Allan Okrainec, Sami A Chadi, Fayez Quereshy, Timothy D Jackson, Ahmad Elnahas
BACKGROUND: This study aimed to compare 30-day clinical outcomes following routine ileostomy reversal between patients that underwent early discharge (<24 h) and standard discharge (postoperative day [POD] 2 or 3). METHODS: A retrospective cohort analysis was conducted between 2005 and 2014 using the American College of Surgeons National Surgical Quality Improvement Program data set. All patients undergoing ileostomy reversal who were discharged on POD 0 or 1 (early discharge group [EDG]) versus POD 2 or 3 (standard discharge group [SDG]) were identified...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28710540/home-based-exercise-during-preoperative-therapy-for-pancreatic-cancer
#20
An Ngo-Huang, Nathan H Parker, Xuemei Wang, Maria Q B Petzel, David Fogelman, Keri L Schadler, Eduardo Bruera, Jason B Fleming, Jeffrey E Lee, Matthew H G Katz
PURPOSE: Exercise concurrent with neoadjuvant chemotherapy and/or chemoradiation for pancreatic adenocarcinoma (PDAC) may mitigate the decline in function that may occur as a result of the disease or its treatment in the preoperative period. The primary objective of this single-arm prospective trial was to determine adherence to a home-based exercise program administered during preoperative therapy. METHODS: Twenty patients from a quaternary cancer center with potentially resectable PDAC were enrolled...
July 15, 2017: Langenbeck's Archives of Surgery
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