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https://www.readbyqxmd.com/read/28445357/the-challenges-of-augmentation-mastopexy-in-the-massive-weight-loss-patient-technical-considerations
#1
Demetrius M Coombs, Udayan Srivastava, Dalit Amar, J Peter Rubin, Jeffrey A Gusenoff
BACKGROUND: Augmentation mastopexy in the massive weight loss population is challenging because of poor skin elasticity and lack of inframammary support. Despite several large studies of augmentation mastopexy in the literature, few data exist regarding this unique patient population. The authors examine early postoperative ptosis, implant malposition, and strategies to optimize outcomes. METHODS: A retrospective review of massive weight loss patients who underwent augmentation mastopexy from 2003 to 2011 was performed to record age, body mass index, implant characteristics, postoperative ptosis, and implant malposition...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28445352/consensus-review-of-optimal-perioperative-care-in-breast-reconstruction-enhanced-recovery-after-surgery-eras-society-recommendations
#2
Claire Temple-Oberle, Melissa A Shea-Budgell, Mark Tan, John L Semple, Christiaan Schrag, Marcio Barreto, Phillip Blondeel, Jeremy Hamming, Joseph Dayan, Olle Ljungqvist
BACKGROUND: Enhanced recovery following surgery can be achieved through the introduction of evidence-based perioperative maneuvers. This review aims to present a consensus for optimal perioperative management of patients undergoing breast reconstructive surgery and to provide evidence-based recommendations for an enhanced perioperative protocol. METHODS: A systematic review of meta-analyses, randomized controlled trials, and large prospective cohorts was conducted for each protocol element...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28442185/modified-frailty-index-is-an-effective-risk-assessment-tool-in-primary-total-knee-arthroplasty
#3
Robert P Runner, Jaime L Bellamy, CatPhuong Cathy L Vu, Greg A Erens, Mara L Schenker, George N Guild
BACKGROUND: "Frailty" is a marker of physiological decline of multiple organ systems, and the frailty index identifies patients who are more susceptible to postoperative complications. The purpose of this study is to validate the modified frailty index (MFI) as a predictor of postoperative complications, reoperations, and readmissions in patients who underwent primary total knee arthroplasty (TKA). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2014 was queried by the Current Procedural Terminology code for primary TKA (27447)...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28441686/surgical-and-functional-outcomes-after-multilevel-cervical-fusion-for-degenerative-disc-disease-compared-with-fusion-for-radiculopathy-a-study-of-workers-compensation-population
#4
Mhamad Faour, Joshua T Anderson, Arnold R Haas, Rick Percy, Stephen T Woods, Uri M Ahn, Nicholas U Ahn
STUDY DESIGN: Retrospective cohort comparative study. OBJECTIVE: To evaluate presurgical and surgical factors that affect return to work (RTW) status after multilevel cervical fusion, and to compare outcomes after multilevel cervical fusion for degenerative disc disease (DDD) versus radiculopathy. SUMMARY OF BACKGROUND DATA: Cervical fusion provides more than 90% of symptomatic relief for radiculopathy and myelopathy. However, cervical fusion for DDD without radiculopathy is considered controversial...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28439612/-imaging-of-the-paranasal-sinuses-and-anterior-skull-base
#5
S Greschus, F Albert, K W G Eichhorn
Due to the complex anatomy of the anterior skull base and paranasal sinuses, radiologic diagnostics in this area are challenging. Magnetic resonance imaging (MRI) and computed tomography (CT) are the primary indicated modalities. Guidelines helping to select the appropriate modality have been published by the German Society of Head and Neck Radiology and the Society of Otorhinolaryngology. The present article presents an overview of the current radiologic procedures and their optimized implementation using clinical examples...
April 21, 2017: HNO
https://www.readbyqxmd.com/read/28439352/preoperative-practice-paired-with-instructor-feedback-may-not-improve-obstetrics-gynecology-residents-operative-performance
#6
Jamie Kroft, Michael Ordon, Leslie Po, Nora Zwingerman, Katie Waters, Jason Y Lee, Richard Pittini
BACKGROUND: There is evidence that preoperative practice prior to surgery can improve trainee performance, but the optimal approach has not been studied. OBJECTIVE: We sought to determine if preoperative practice by surgical trainees paired with instructor feedback improved surgical technique, compared to preoperative practice or feedback alone. METHODS: We conducted a randomized controlled trial of obstetrics-gynecology trainees, stratified on a simulator-assessed surgical skill...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439322/susceptibility-imaging-in-glial-tumor-grading-using-3-tesla-magnetic-resonance-mr-system-and-32-channel-head-coil
#7
Omer Aydin, Ramazan Buyukkaya, Bahattin Hakyemez
BACKGROUND: Susceptibility weighted imaging (SWI) is a velocity compensated, high-resolution three-dimensional (3D) spoiled gradient-echo sequence that uses magnitude and filtered-phase data. SWI seems to be a valuable tool for non-invasive evaluation of central nervous system gliomas. Relative cerebral blood volume (rCBV) ratio is one of the best noninvasive methods for glioma grading. Degree of intratumoral susceptibility signal (ITSS) on SWI correlates with rCBV ratio and histopathological grade...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28438449/ankylosing-spondylitis-increases-perioperative-and-postoperative-complications-after-total-hip-arthroplasty
#8
Daniel J Blizzard, Colin T Penrose, Charles Z Sheets, Thorsten M Seyler, Michael P Bolognesi, Christopher R Brown
BACKGROUND: Ankylosing spondylitis (AS) is a chronic autoimmune spondyloarthropathy that primarily affects the axial spine and hips. Progressive disease leads to pronounced spinal kyphosis, positive sagittal balance, and altered biomechanics. The purpose of this study is to determine the complication profile of patients with AS undergoing total hip arthroplasty (THA). METHODS: The Medicare sample was searched from 2005 to 2012 yielding 1006 patients with AS who subsequently underwent THA...
March 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28437811/symptomatic-outcome-after-bone-only-suboccipital-decompression-in-adult-patients-with-chiari-type-i-malformations-in-the-absence-of-hydromyelia-or-hydrocephalus
#9
Nicolas Olmo Koechlin, Hazem J Abuhusain, Manuri Gunawardena, Tyler S Auschwitz, Charles Teo
Background Type I Chiari malformation presents without an associated hydromyelia in 30 to 70% of cases, yet there is no agreement regarding the optimal surgical treatment for these patients. We review our experience for treating symptomatic adult type I Chiari malformation without hydromyelia using a suboccipital bone decompression of the hindbrain and no duraplasty in 12 adult patients. Outcome was measured according to the Chicago Chiari Outcome Scale (CCOS). Results Nine of 12 patients were female; average age at surgery was 34...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#10
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437619/management-of-posterior-cruciate-ligament-tibial-avulsion-injuries-a-systematic-review
#11
Perry O Hooper, Chris Silko, Tennison L Malcolm, Lutul D Farrow
BACKGROUND: Tibial-sided avulsion injuries of the posterior cruciate ligament (PCL) generally require surgical intervention. No consensus exists concerning the optimal surgical treatment approach for these injuries. PURPOSE: To perform a systematic review investigating the open and arthroscopic surgical treatment modalities, outcomes, and complications of PCL tibial-sided bony avulsions. STUDY DESIGN: Systematic review; Level of evidence, 4...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28437349/a-new-navigational-tool-for-pedicle-screw-placement-in-patients-with-severe-scoliosis-a-pilot-study-to-prove-feasibility-accuracy-and-identify-operative-challenges
#12
Michael Putzier, Patrick Strube, Riccardo Cecchinato, Claudio Lamartina, Eike K Hoff
STUDY DESIGN: Pilot study. OBJECTIVE: To develop and validate the feasibility and accuracy of a newly designed navigational spinal instrument guiding tool for patient-matched thoracic and lumbar pedicle screw placement in patients with severe scoliosis, and to identify intraoperative challenges that may be relevant. SUMMARY OF BACKGROUND DATA: Pedicle screw placement is challenging in severely rotated scoliotic spine with small diameters and asymmetrical shape of the pedicles and vertebrae...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28436628/-monitoring-time-of-interictal-epileptiform-discharges-by-long-term-video-eeg-in-patients-with-epilepsy
#13
Han Wu, Zhongjin Wang, Wenjie Ming, Shuang Wang, Meiping Ding
Objective: To optimize the monitoring time of interictal epileptiform discharges (IED) in patients with epilepsy by long-term video electroencephalogram (VEEG). Methods: The cumulative percentages of IED detected by VEEG in 346 epilepsy patients (349 times) with different purposes, different waking sleep states and different MRI findings were retrospectively analyzed. According to the purposes, there were 164 patients (165 times) for clarifying diagnosis, 124 patients (124 times) for preoperative evaluation and 58 patients (60 times) for adjustment of medications...
January 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28436411/benign-mixed-epithelial-and-stromal-tumor-of-the-kidney-with-inferior-vena-cava-tumor-thrombus-a-rare-case-report-and-review-of%C3%A2-literature
#14
Chi Zhang, Xiaofei Li, Chengqiang Mo, Zhenpeng Peng, Ruilin Yang, Yiming Tang, Yuanyuan Zhang, Rongpei Wu
Mixed epithelial and stromal tumor of the kidney (MESTK) is a rare renal tumor composed of epithelial and stromal cells. In this study, we report a rare case of MESTK, which was pathologically benign but complicated with renal vein and inferior vena cava tumor thrombus. The 50-year-old female patient was admitted to hospital for a mass on the left kidney. Computed tomography showed a 32 mm×18 mm mass with slight delayed enhancement in the left renal sinus, and neoplastic thrombus was detected in left renal vein and inferior vena cava...
April 18, 2017: Journal of X-ray Science and Technology
https://www.readbyqxmd.com/read/28436355/quantification-of-risk-factors-in-500-patients-with-postoperative-urinary-retention
#15
Peter N Tsambarlis, Benjamin A Sherer, Karl F Godlewski, Rebecca M Deal, Jonathan A Myers, Leslie A Deane
INTRODUCTION: An Institutional Quality and Safety Initiative to reduce postoperative urinary retention (POUR) and improve patient safety indicators (PSIs) was undertaken after a nurse driven protocol for catheter removal lead to an increase in POUR. The aim of this study was to identify the number of risk factors present in patients with POUR while examining the prevalence of those risk factors individually. MATERIALS AND METHODS: A retrospective review of our institution's surgical database was performed to identify 500 consecutive cases of POUR between July 1, 2013 and July 1, 2014...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28435118/transoral-intracranial-injury-via-middle-skull-base-by-a-blunt-chopstick-in-a-child
#16
Thiti Samuthrat, Ke Ye, Ying Tong
BACKGROUND: Transoral penetrating injury from a blunt-tipped chopstick is unusual and should be promptly dealt with since it is associated with high morbidity and mortality. CASE DESCRIPTION: We report a peculiar case of a 2-year-old girl who suffered from a transoral penetrating brain injury after falling onto a bamboo chopstick, which penetrated through the hard palate and eventually led to middle skull base fracture as well as temporal lobe laceration and contusion...
April 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28433427/do-medial-pivot-kinematics-correlate-with-patient-reported-outcomes-after-total-knee-arthroplasty
#17
Lucian C Warth, Marshall K Ishmael, Evan R Deckard, Mary Ziemba-Davis, R Michael Meneghini
BACKGROUND: Many total knee arthroplasty (TKA) implants are designed to facilitate a medial pivot kinematic pattern. The purpose of this study was to determine whether intraoperative medial pivot kinematic patterns are associated with improved patient outcomes. METHODS: A retrospective review of consecutive primary TKAs was performed. Sensor-embedded tibial trials determined kinematic patterns intraoperatively. The center of rotation (COR) was identified from 0° to 90° and from 0° to terminal flexion, and designated medial-pivot or non-medial pivot based on accepted criteria...
March 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28432531/effectiveness-of-nanoencapsulated-methotrexate-against-osteosarcoma-cells-in-vitro-cytotoxicity-under-dynamic-conditions
#18
O Mitxelena-Iribarren, C L Hisey, M Errazquin-Irigoyen, Y González-Fernández, E Imbuluzqueta, M Mujika, M J Blanco-Prieto, S Arana
Cancer is a leading cause of mortality in the world, with osteosarcoma being one of the most common types among children between 1 and 14 years old. Current treatments including preoperative chemotherapy, surgery and postoperative chemotherapy produce several side effects with limited effectiveness. The use of lipid nanoparticles as biodegradable shells for controlled drug delivery shows promise as a more effective and targeted tumor treatment. However, in vitro validation of these vehicles is limited due to fluid stagnation in current techniques, in which nanoparticles sediment onto the bottom of the wells killing the cells by asphyxiation...
June 2017: Biomedical Microdevices
https://www.readbyqxmd.com/read/28431952/evaluation-of-patient-preparedness-for-surgery-a-randomized-controlled-trial
#19
Kristie A Greene, Allison M Wyman, Lauren A Scott, Stuart Hart, Lennox Hoyte, Renee Bassaly
BACKGROUND: Patient preparedness for pelvic reconstructive surgery has important implications for patient satisfaction and perception of improvement after surgery. The ideal method in which to optimally prepare patients for surgery has not been determined. OBJECTIVE: To evaluate the impact of a preoperative patient education video on patient preparedness prior to sacrocolpopexy as measured by a preoperative preparedness questionnaire (PPQ). STUDY DESIGN: We performed a single-blind, randomized stratified clinical trial at a single academic center evaluating the use of a preoperative patient education video as an adjunct to preoperative counseling on patient preparedness...
April 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28431566/the-prognostic-value-of-the-preoperative-c-reactive-protein-albumin-ratio-in-ovarian-cancer
#20
Yubo Liu, Shengfu Chen, Chengyu Zheng, Miao Ding, Lan Zhang, Liangan Wang, Meiqing Xie, Jianhua Zhou
BACKGROUND: Inflammation plays an important role in the pathogenesis of ovarian cancer. This study sought to investigate the association between the preoperative c-reactive protein/albumin ratio (CRP/Alb) and oncological outcomes in ovarian cancer patients. METHODS: Two hundred patients with histologically verified ovarian cancer between June 2006 and July 2012 were retrospectively reviewed. Overall survival was evaluated by the Kaplan-Meier method and log-rank test...
April 21, 2017: BMC Cancer
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