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https://www.readbyqxmd.com/read/28746702/identifying-an-optimal-adjuvant-radiotherapy-dose-for-extremity-and-trunk-merkel-cell-carcinoma-following-resection-an-analysis-of-the-national-cancer-database
#1
Sagar A Patel, Muhammad M Qureshi, Debjani Sahni, Minh Tam Truong
Importance: Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine neoplasm with a high risk of recurrence following resection. Despite a rising incidence over the past 3 decades, there is a paucity of prospective data owing to the rarity of this disease. Objective: To determine the optimal adjuvant radiation therapy (RT) dose following resection of localized MCC of the extremities or trunk. Design, Setting, and Participants: Using the National Cancer Database, a large national database consisting of a heterogeneous population and treatment settings, we retrospectively analyzed a cohort of 2093 patients 18 years or older with stage I to III MCC of the extremities and/or trunk treated with definitive surgery and adjuvant RT between 1998 and 2011...
July 26, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28746083/novel-cardiac-coordinate-modeling-system-for-three-dimensional-quantification-of-inflow-cannula-malposition-of-heartmate-ii-lvads
#2
Brian Lima, Onur Dur, Joyce Chuang, Themistokles Chamogeorgakis, David J Farrar, Kartik S Sundareswaran, Joost Felius, Susan M Joseph, Shelley A Hall, Gonzalo V Gonzalez-Stawinski
Optimal function of left ventricular assist devices (LVADs) depends on proper alignment of the inflow cannula (IC). Quantitative guidelines for IC angulation are lacking because of variation in cardiac geometry and difficulty in analyzing three-dimensional (3D) cannula orientation relative to the left ventricle (LV). Based on contrast-enhanced computed tomography images from five normal and five clinically malpositioned IC cases in patients with HeartMate II LVADs, we developed a method for 3D quantification of IC malpositioning...
July 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28744807/the-effectiveness-of-low-dose-and-high-dose-tranexamic-acid-in-posterior-lumbar-interbody-fusion-a-double-blinded-placebo-controlled-randomized-study
#3
Ki-Tack Kim, Cheung-Kue Kim, Yong-Chan Kim, Hyung-Suk Juh, Hyo-Jong Kim, Hyeon-Soo Kim, Se Jung Hong, Hwee Weng Dennis Hey
PURPOSE: Tranexamic acid is a proven drug used for reduction of intraoperative blood loss in spinal surgery. However, optimal dosing considering risk/benefits is not well established owing to the heterogeneity in patient selection and surgical procedures of previous studies. This study aimed to evaluate the effectiveness and safety of various tranexamic acid regimens in reducing perioperative blood loss in single-level posterior lumbar interbody fusion (PLIF). METHODS: Patients were randomly grouped into three different interventions: low-dose tranexamic acid (LD), high-dose tranexamic acid (HD), and placebo-controlled (PC) groups...
July 25, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28743150/-anesthesiology-and-outcome-impact-of-the-perioperative-process
#4
Jörg Zieger, Helene A Häberle
In recent years, the role of the anesthesiologist has turned tremendously from the "anaesthesia doctor" into a perioperative physician and risk specialist. Patients are older, multimorbid, and are called up for more and more extensive surgery and interventions. Socioeconomic aspects have grown in importance. The anesthesiologist, paving the way for a good outcome, is involved in nearly all perioperative processes: preoperative evaluation, definition and optimization of preoperative and intraoperative conditions, management of modern intraoperative anesthesia as well as postoperative medically indicated, effective and efficient treatment of partially highly complex patients...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#5
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742730/predictive-model-for-neoplastic-potential-of-gallbladder-polyp
#6
Ju-Il Yang, Jong Kyun Lee, Dae Geon Ahn, Joo Kyung Park, Kwang Hyuck Lee, Kyu Taek Lee, Sang Ah Chi, Sin-Ho Jung
GOAL: To provide the statistical predictive model for neoplastic potential of gallbladder polyp (GBP). BACKGROUND: Many studies have attempted to define the risk factors for neoplastic potential of GBP. It remains difficult to precisely adapt the reported risk factors for the decision of surgery. Estimating the probability for neoplastic potential of GBP using a combination of several risk factors before surgical resection would be useful in patient consultation...
July 24, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28740781/direct-to-implant-reconstruction-in-nipple-sparing-mastectomy-patient-selection-by-preoperative-digital-mammogram
#7
Alberto O Rancati, Claudio H Angrigiani, Dennis C Hammond, Maurizio B Nava, Eduardo G Gonzalez, Julio C Dorr, Gustavo F Gercovich, Nicola Rocco, Roman L Rostagno
BACKGROUND: Digital mammography clearly distinguishes gland tissue density from the overlying nonglandular breast tissue coverage, which corresponds to the existing tissue between the skin and the superficial layer of the fascia superficialis surrounding the gland (i.e., dermis and subcutaneous fat). Preoperative digital imaging can determine the thickness of this breast tissue coverage, thus facilitating planning and reducing the rate of necrotic complications after direct to implant (DTI) reconstruction in nipple sparing mastectomy (NSM)...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740773/botulinum-toxin-a-as-an-adjunct-to-abdominal-wall-reconstruction-for-incisional-hernia
#8
Sinor Soltanizadeh, Frederik Helgstrand, Lars N Jorgensen
BACKGROUND: Repair of large incisional hernias remains a surgical and costly challenge. Temporary paralysis of the lateral abdominal wall muscles with topical administration of botulinum toxin A (BTA) is a new therapeutic concept, which may obviate the need for component separation technique (CST) for repair of large incisional hernias. Current literature on the administration of BTA as adjunct to surgical repair of abdominal incisional hernias was investigated. METHODS: The electronic databases PubMed and Embase were searched for eligible studies...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740766/early-cleft-lip-repair-revisited-a-safe-and-effective-approach-utilizing-a-multidisciplinary-protocol
#9
Jeff A Hammoudeh, Thomas A Imahiyerobo, Fan Liang, Artur Fahradyan, Leo Urbinelli, Jennifer Lau, Marla Matar, William Magee, Mark Urata
BACKGROUND: The optimal timing for cleft lip repair has yet to be established. Advances in neonatal anesthesia, along with a growing body of literature, suggesting benefits of earlier cleft lip and nasal repair, have set the stage for a reexamination of current practices. METHODS: In this prospective study, cleft lip and nasal repair occurred on average at 34.8 days (13-69 days). Nasal correction was achieved primarily through molding the nasal cartilage without the placement of nasal sutures at the time of repair...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740665/decrease-in-performance-status-after-lobectomy-mean-poor-prognosis-in-elderly-lung-cancer-patients
#10
Yo Kawaguchi, Jun Hanaoka, Yasuhiko Oshio, Masayuki Hashimoto, Tomoyuki Igarashi, Yoko Kataoka, Ryosuke Kaku, Yuki Namura, Akira Akazawa
BACKGROUND: Surgery remains the best treatment for obtaining cure in patients with resectable lung cancer, regardless of age. In elderly patients, however, the presumed fear of decreased performance status (PS) after lobectomy has resulted in the delivery of sub-optimal cancer surgery. Surgical decision making for such patients would become easier if post-lobectomy survival benefits and changes in PS were well defined. METHODS: We reviewed patients aged 75 years or older who received lobectomy for non-small cell lung cancer (NSCLC) at our hospital between January 2004 and December 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740422/preoperative-intravenous-ibuprofen-does-not-influence-postoperative-narcotic-use-in-patients-undergoing-elective-hernia-repair-a-randomized-double-blind-placebo-controlled-prospective-trial
#11
Lauren S Sparber, Christine Sm Lau, Tanya S Vialet, Ronald S Chamberlain
INTRODUCTION: Inguinal and umbilical hernia repairs are among the most common surgical procedures performed in the US. Optimal perioperative pain control regimens remain challenging and opioid analgesics are commonly used. Preoperative nonsteroidal anti-inflammatory drug (NSAID) administration has been shown to reduce postoperative narcotic requirements. This study sought to evaluate the efficacy of perioperative intravenous (IV) ibuprofen on postoperative pain level and narcotic use in patients undergoing open or laparoscopic inguinal and/or umbilical hernia repair...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28739154/prostaglandin-e2-a-pancreatic-fluid-biomarker-of-intraductal-papillary-mucinous-neoplasm-dysplasia
#12
Michele T Yip-Schneider, Rosalie A Carr, Huangbing Wu, C Max Schmidt
BACKGROUND: With the increased frequency of diagnostic imaging, pancreatic cysts are now detected in >3% of American adults. Most of these are intraductal papillary mucinous neoplasm (IPMN) with well-established but variable malignant potential. A biomarker that predicts malignant potential or dysplastic grade would help determine which IPMN require removal or can be safely observed. We previously reported that pancreatic fluid prostaglandin E2 (PGE2) levels may have promise as a predictor of IPMN dysplasia and seek to validate these results in the current study...
July 21, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28739094/automatic-repositioning-of-jaw-segments-for-three-dimensional-virtual-treatment-planning-of-orthognathic-surgery
#13
Rodrigo Mologni Gonçalves Dos Santos, José Mario De Martino, Luis Augusto Passeri, Romis Ribeiro de Faissol Attux, Francisco Haiter Neto
PURPOSE: To develop a computer-based method for automating the repositioning of jaw segments in the skull during three-dimensional virtual treatment planning of orthognathic surgery. The method speeds up the planning phase of the orthognathic procedure, releasing surgeons from laborious and time-consuming tasks. MATERIALS AND METHODS: The method finds the optimal positions for the maxilla, mandibular body, and bony chin in the skull. Minimization of cephalometric differences between measured and standard values is considered...
July 4, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28736345/preoperative-frailty-score-predicts-30-day-morbidity-and-mortality-following-cranial-neurosurgery
#14
Samuel B Tomlinson, Keaton Piper, Kristopher T Kimmell, Edward Vates
BACKGROUND: Evaluating preoperative frailty is critical for guiding shared surgical decision-making. The purpose of this study was to develop a novel preoperative frailty index for prediction of adverse outcomes following cranial neurosurgery procedures. METHODS: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried for all cranial neurosurgery cases from 2006-2014. Sequential univariate and multivariate testing was used to identify significant independent predictors of 30-day mortality...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735986/challenges-for-the-travelling-donor-variability-between-donor-workup-and-donor-surgery-in-the-canadian-kidney-paired-exchange-program
#15
B A Reikie, T Kroczak, T B McGregor
BACKGROUND: A primary obstacle to providing renal transplantation is limited access to donated kidneys. The living-donor pool for renal allografts was greatly expanded through implementation of a kidney paired donation program. Whereas some programs ship donor kidneys to the site of renal transplantation, others send the donor to the site of transplantation. Performing the nephrectomy and transplantation at the same location may optimize functional renal outcomes, but preferred surgical approaches may differ between surgical teams performing the donor workup and donor surgery...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735015/preliminary-experience-of-non-transecting-urethroplasty-for-pelvic-fracture-related-urethral-injury
#16
Hong Xie, Chao Li, Yue-Min Xu, Chao Feng, Xiang-Guo Lv, Lei Chen, Hong-Bin Li, Jing-Dong Xue
OBJECTIVE: To evaluate the urinary outcomes and preservation of erectile function in patients with pelvic fracture related urethral injury (PFUI) after non-transecting spongiosum anastomotic urethroplasty (NTSAU). METHODS: Fifty-nine male patients with PFUI following traumatic pelvic fracture underwent NTSAU. Inclusion criteria were age 18 to 60 years, posterior urethral stenosis < 2.5 cm without previous urethroplasty, and intact erectile function. Exclusion criteria were previous history of open urethroplasty, long segment posterior urethral stenosis (>2...
July 19, 2017: Urology
https://www.readbyqxmd.com/read/28733301/a-3d-navigation-template-for-guiding-a-unilateral-lumbar-pedicle-screw-with-contralateral-translaminar-facet-screw-fixation-a-study-protocol-for-multicentre-randomised-controlled-trials
#17
Zhen-Xuan Shao, Wei He, Shao-Qi He, Sheng-Lei Lin, Zhe-Yu Huang, Hong-Chao Tang, Wen-Fei Ni, Xiang-Yang Wang, Ai-Min Wu
INTRODUCTION: The incidence of lumbar disc degeneration disease has increased in recent years. Lumbar interbody fusion using two unilateral pedicle screws and a translaminar facet screw fixation has advantages of minimal invasiveness and lower costs compared with the traditional methods. Moreover, a method guided by a three-dimensional (3D) navigation template may help us improve the surgical accuracy and the success rate. This is the first randomised study using a 3D navigation template to guide a unilateral lumbar pedicle screw with contralateral translaminar facet screw fixation...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28732300/complete-torsion-of-gallbladder-following-laparoscopic-cholecystectomy-a-case-study
#18
Tomoaki Bekki, Tomoyuki Abe, Hironobu Amano, Nobuaki Fujikuni, Hiroshi Okuda, Tatsunari Sasada, Minoru Yamaki, Tsuyoshi Kobayashi, Toshio Noriyuki, Masahiro Nakahara
INTRODUCTION: Gallbladder torsion is mainly associated with a floating gallbladder. From an anatomical perspective, laparoscopic cholecystectomy is a more optimal treatment than open cholecystectomy. PRESENTATION OF CASE: An 84-year-old woman visited the Onomichi General Hospital because of progressive pain in the right upper quadrant of her abdomen. Physical examination revealed a positive Murphy sign and peritoneal irritation. Laboratory data demonstrated that inflammatory marker levels were increased...
June 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28732252/update-on-medical-treatment-of-uterine-fibroids
#19
REVIEW
Fátima Faustino, Margarida Martinho, José Reis, Fernanda Águas
OBJECTIVES: In this review paper, the pros and cons of the available pharmacological options for the treatment of uterine fibroids are explored, including oral progestogens, levonorgestrel intra-uterine device, gonadotropin-releasing hormone analogs and progesterone receptor modulators with an emphasis on ulipristal acetate. STUDY DESIGN: The choice of the appropriate therapeutic approach for uterine fibroids depends on several factors, including women's age, parity, childbearing aspirations and wish to preserve fertility, extent and severity of symptoms, size, number and location of myomas, risk of malignancy and proximity to menopause...
July 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28732141/intraoperative-ultrasound-for-prediction-of-hepatocellular-carcinoma-biological-behavior-prospective-comparison-with-pathology
#20
Roberto Santambrogio, Claudia Cigala, Matteo Barabino, Marco Maggioni, Giovanna Scifo, Savino Bruno, Emanuela Bertolini, Enrico Opocher, Gaetano Bulfamante
BACKGROUND AND AIMS: Preoperative prediction of both microinvasive hepatocellular carcinoma and histological grade of hepatocellular carcinoma is pivotal to treatment planning and prognostication. Aim of the study was to evaluate whether some intraoperative ultrasound features correlate with both the presence of same histological patterns and differentiation grade of hepatocellular carcinoma on the histologic features of the primary resected tumor. METHODS: All patients with single, small hepatocellular carcinoma that underwent hepatic resection were included in this prospective double-blind study: the intraoperative ultrasound patterns of nodule were registered and compared with similar histological features...
July 21, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
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