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https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#1
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28642181/surgery-outcome-of-growth-hormone-secreting-pituitary-adenoma-with-empty-sella-using-a-new-classification
#2
Qiang Wang, Xiaopeng Guo, Lu Gao, Zihao Wang, Kan Deng, Wei Lian, Renzhi Wang, Huijuan Zhu, Bing Xing
OBJECTIVE: To investigate the outcomes and identified risk factors for a cure and intraoperative cerebrospinal fluid leak following transsphenoidal surgery using a new classification for growth hormone-secreting pituitary adenoma associated with "empty sella". METHODS: This retrospective cohort study included 51 patients enrolled from January 2010 to June 2016. All subjects were categorized into three groups using a new classification scheme: Grade A, whole tumor occupation area beneath a horizontal line drawn along the lowest level of ES; Grade B, tumor occupation area that crossed the horizontal line on one side; and Grade C, tumor occupation area that crossed the horizontal line on two sides...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28642125/safety-and-efficacy-of-dual-lead-thalamic-deep-brain-stimulation-for-patients-with-treatment-refractory-multiple-sclerosis-tremor-a-single-centre-randomised-single-blind-pilot-trial
#3
Seth F Oliveria, Ramon L Rodriguez, Dawn Bowers, Daniel Kantor, Justin D Hilliard, Erin H Monari, Bonnie M Scott, Michael S Okun, Kelly D Foote
BACKGROUND: Efficacy in previous studies of surgical treatments of refractory multiple sclerosis tremor using lesioning or deep brain stimulation (DBS) has been variable. The aim of this study was to investigate the safety and efficacy of dual-lead thalamic DBS (one targeting the ventralis intermedius-ventralis oralis posterior nucleus border [the VIM lead] and one targeting the ventralis oralis anterior-ventralis oralis posterior border [the VO lead]) for the treatment of multiple sclerosis tremor...
June 19, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28641693/-evidence-and-practice-of-enhanced-lung-recovery-after-surgery-%C3%A2-in-patients-undergoing-lung-surgery
#4
Guowei Che
The clinic application pathway is a variant of the enhanced recovery after surgery (ERAS), which based disease and team. What are the published evidence is conducive to enhanced lung recovery after surgery (ELRAS) in clinical implementation. This article mainly from the perioperative management can adopt the measures and methods were retrospectively analyzed. The measures of education and assessment of the risk factors and prevention is emphasized in preoperative. The minimally invasive surgery and process optimization is adopted by surgeon...
June 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/28640786/a-standardized-approach-for-transfusion-medicine-support-in-patients-with-morbidly-adherent-placenta
#5
Anil K Panigrahi, Amanda Yeaton-Massey, Sara Bakhtary, Jennifer Andrews, Deirdre J Lyell, Alexander J Butwick, Lawrence Tim Goodnough
BACKGROUND: The incidence of placenta accreta (PA) has increased from 0.8 to 3.0 in 1000 pregnancies, driven by increased rates of cesarean deliveries (32.2% in 2014) of births in the United States. The average blood loss for a delivery complicated by PA ranges from 2000 to 5000 mL, frequently requiring substantial transfusion medicine support. We report our own institutional multidisciplinary approach for managing such patients, along with transfusion medicine outcomes, in this setting over a 5-year period...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28640694/assessment-of-rectal-tumors-with-shear-wave-elastography-before-surgery-comparison-with-endorectal-us
#6
Li-Da Chen, Wei Wang, Jian-Bo Xu, Jian-Hui Chen, Xin-Hua Zhang, Hui Wu, Jin-Ning Ye, Jin-Ya Liu, Zhi-Qiang Nie, Ming-De Lu, Xiao-Yan Xie
Purpose To compare the value of endorectal ultrasonography (US) with shear-wave elastography (SWE) in staging rectal tumors before surgery. Materials and Methods This prospective study was approved by the institutional review board and written informed consent was obtained. In a pilot cohort from April 2015 to January 2016, 70 patients with rectal adenocarcinomas and/or adenomas confirmed with histopathologic examination underwent both endorectal US and SWE. Tumor stiffness and three regions of reference backgrounds, as well as tumor stiffness ratios (SRs) versus these backgrounds, were analyzed...
June 21, 2017: Radiology
https://www.readbyqxmd.com/read/28640538/whole-lesion-histogram-analysis-of-the-apparent-diffusion-coefficient-evaluation-of-the-correlation-with-subtypes-of-mucinous-breast-carcinoma
#7
Yuan Guo, Qing-Cong Kong, Ye-Qing Zhu, Zhen-Zhen Liu, Ling-Rong Peng, Wen-Jie Tang, Rui-Meng Yang, Jia-Jun Xie, Chun-Ling Liu
PURPOSE: To evaluate the utility of the whole-lesion histogram apparent diffusion coefficient (ADC) for characterizing the heterogeneity of mucinous breast carcinoma (MBC) and to determine which ADC metrics may help to best differentiate subtypes of MBC. MATERIALS AND METHODS: This retrospective study involved 52 MBC patients, including 37 pure MBC (PMBC) and 15 mixed MBC (MMBC). The PMBC patients were subtyped into PMBC-A (20 cases) and PMBC-B (17 cases) groups...
June 22, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28639069/the-application-of-3d-printing-technology-for-simultaneous-orthognathic-surgery-and-mandibular-contour-osteoplasty-in-the-treatment-of-craniofacial-deformities
#8
Yanju Xiao, Xiumei Sun, Lin Wang, Yaoyao Zhang, Kai Chen, Guomin Wu
BACKGROUND: Because of the limitation of specific preoperative design and surgical templates, orthognathic surgery and mandibular contour osteoplasty are generally performed in two stages. Three-dimensional printing technology has improved the accuracy of the surgery and results in good surgical predictability easily. This study aims to confirm the effectiveness, feasibility and precision of simultaneous mandibular contour osteoplasty and orthognathic surgery with the assistance of 3D printing technology...
June 21, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28637368/emergency-ureteral-stone-treatment-eust-score-predicts-outcomes-of-ureteroscopic-intervention-in-acute-obstructive-uropathy-secondary-to-urolithiasis
#9
Timothy Y Tran, Natalia Hernandez Bustos, Avinash Kambadakone, Brian H Eisner, Gyan Pareek
INTRODUCTION:  Immediate ureteroscopic treatment for patients presenting to the emergency room with symptomatic ureterolithiasis is more commonly being utilized. Recent reports demonstrate good efficacy for emergency URS, however preoperative predictors of treatment success have not been described. Here, we report our multi-center experience with emergency URS and identify predictors of successful treatment. We also describe the Emergency Ureteral Stone Treatment (EUST) Score, which integrates these predictors and stratifies patients into those that are likely and unlikely to have successful treatment...
June 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28634542/angioedema-perioperative-management
#10
Andrew A Maynard, Christina F Burger, Joseph J Schlesinger
OBJECTIVE: To describe the perioperative management of a patient with acquired angioedema (AAE). METHODS: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor-related intractable urticaria and mastocytosis. He was admitted for urgent laparoscopic partial gastrectomy, secondary to gastric outlet obstruction symptomatology. Previous combined attacks were characterized by a widespread rash, abdominal pain and respiratory distress resulting in hospitalization...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28631129/optimizing-the-deep-brain-stimulation-care-pathway-in-patients-with-parkinson-s-disease
#11
N J Thomas, P Mertens, T Danaila, G Polo, H Klinger, E Broussolle, S Thobois
Management of Parkinson's disease (PD) using deep brain stimulation (DBS) requires complex care in specialized, multidisciplinary centers. A well-organized, efficient patient flow is crucial to ensure that eligible patients can quickly access DBS. Delays or inefficiencies in patient care may impact a center's ability to meet demand, creating a capacity bottleneck. Analysis of the current practices within a center may help identify areas for improvement. After external audit of the DBS workflow of the Lyon Neurological Hospital and comparison with other European centers, manageable steps were suggested to restructure the care pathway...
June 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28630764/impact-of-b-scan-averaging-on-spectralis-optical-coherence-tomography-image-quality-before-and-after-cataract-surgery
#12
Dominika Podkowinski, Ehsan Sharian Varnousfaderani, Christian Simader, Hrvoje Bogunovic, Ana-Maria Philip, Bianca S Gerendas, Ursula Schmidt-Erfurth, Sebastian M Waldstein
BACKGROUND AND OBJECTIVE: To determine optimal image averaging settings for Spectralis optical coherence tomography (OCT) in patients with and without cataract. STUDY DESIGN/MATERIAL AND METHODS: In a prospective study, the eyes were imaged before and after cataract surgery using seven different image averaging settings. Image quality was quantitatively evaluated using signal-to-noise ratio, distinction between retinal layer image intensity distributions, and retinal layer segmentation performance...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28629433/smoking-and-timing-of-cessation-on-postoperative-pulmonary-complications-after-curative-intent-lung-cancer-surgery
#13
Sebastian T Lugg, Theofano Tikka, Paula J Agostini, Amy Kerr, Kerry Adams, Maninder S Kalkat, Richard S Steyn, Pala B Rajesh, Ehab Bishay, David R Thickett, Babu Naidu
BACKGROUND: Smoking is a risk factor for postoperative pulmonary complications (PPC) following non-small cell lung cancer (NSCLC) surgery. The optimal timing for preoperative smoking cessation has not been identified. Our study aimed to observe the impact of preoperative smoking cessation on PPC incidence and other postoperative outcomes including long-term survival. METHODS: A prospective study included consecutive patients following resection for NSCLC in a regional thoracic centre over a 4-year period (2010-2014)...
June 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28626254/the-maximum-standardized-uptake-value-increment-calculated-by-dual-time-point-18-f-fluorodeoxyglucose-positron-emission-tomography-predicts-survival-in-patients-with-oral-tongue-squamous-cell-carcinoma
#14
Natsuki Yonezawa, Tsutomu Minamikawa, Kazuhiro Kitajima, Yusuke Takahashi, Ryohei Sasaki, Ken-Ichi Nibu, Takahide Komori
The aim of this study was to investigate the prognostic value of dual-time-point (DTP) (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) imaging in primary oral tongue squamous cell carcinoma (OTSCC). The study included 52 patients who underwent preoperative (18)F-FDG PET scans at two time points, namely 1 h and 2 h after injection. The following PET parameters were calculated: maximum standardized uptake value (SUVmax) for both time points (SUV early, SUV delayed); retention index (RI); and SUVmax increment (ΔSUVmax)...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28624841/the-neutrophil-to-lymphocyte-ratio-as-a-marker-of-recovery-status-in-patients-with-severe-dental-infection
#15
F Dogruel, Z-B Gonen, D Gunay-Canpolat, G Zararsiz, A Alkan
BACKGROUND: The aim of the study was to assess the value of pretreatment neutrophil/lymphocyte (N/L) ratio and mean platelet volume (MPV) and the correlation between these markers with progression in patients with severe odontogenic infection. MATERIAL AND METHODS: A cohort of 100 patients with severe odontogenic infection were divided into 2 groups according to their length of hospital stay. The N/L ratio and MPV was measured in all patients. The correlation in all patients between preoperative fever, preoperative antibiotic doses, postoperative antibiotic doses, total antibiotic doses and hospital stay with N/L ratio and MPV were analyzed...
June 18, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/28624798/selection-of-optimal-molecular-targets-for-tumor-specific-imaging-in-pancreatic-ductal-adenocarcinoma
#16
Willemieke Tummers, Arantza Farina Sarasqueta, Martin Boonstra, Hendrica Prevoo, Cornelis Sier, Sven Mieog, Johannes Morreau, Casper van Eijck, Peter Kuppen, Cornelis van de Velde, Bert Bonsing, Alexander Vahrmeijer, Rutger-Jan Swijnenburg
Discrimination of pancreatic ductal adenocarcinoma (PDAC) from chronic pancreatitis (CP) or peritumoral inflammation is challenging, both at preoperative imaging and during surgery, but it is crucial for proper therapy selection. Tumor-specific molecular imaging aims to enhance this discrimination and to help select and stratify patients for resection. We evaluated various biomarkers for the specific identification of PDAC and associated lymph node metastases. Using immunohistochemistry (IHC), expression levels and patterns were investigated of integrin αvβ6, carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5), Cathepsin E (Cath E), epidermal growth factor receptor (EGFR), hepatocyte growth factor receptor (c-MET), thymocyte differentiation antigen 1 (Thy1), and urokinase-type plasminogen activator receptor (uPAR)...
May 26, 2017: Oncotarget
https://www.readbyqxmd.com/read/28623758/a-massive-hepatic-tumor-demonstrating-hepatocellular-cholangiocarcinoma-and-neuroendocrine-lineages-a-case-report-and-review-of-the-literature
#17
Rachel E Beard, Sydney D Finkelstein, Amir A Borhani, Marta I Minervini, J Wallis Marsh
INTRODUCTION: Mixed hepatocellular and cholangiocarcinoma tumors (MHCC) are described in the literature, as are the more rare mixed adenoneuroendocrine carcinomas (MANC) of hepatobiliary origin. Only two cases of tumors with characteristics of all three histologies/phenotypes have been previously described in one Chinese study. PRESENTATION OF CASE: Herein we report clinical, microscopic and molecular features of a 25cm mixed hepatic tumor with hepatocellular, cholangiocarcinoma and neuroendocrine differentiation arising in an otherwise healthy 19-year-old North American Caucasian male without any identifiable risk factors...
June 7, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28622969/probability-of-undiagnosed-obstructive-sleep-apnea-does-not-correlate-with-adverse-pulmonary-events-nor-length-of-stay-in-hip-and-knee-arthroplasty-using-intrathecal-opioid
#18
Matthew J Thompson, Bryce N Clinger, Robert M Simonds, Camille J Hochheimer, Laura A Lahaye, Gregory J Golladay
BACKGROUND: Recent emphasis on bundled payments and outcomes tracking has increased the focus on preoperative optimization in patients undergoing elective lower extremity arthroplasty. Since patients with obstructive sleep apnea (OSA) have an increased risk of adverse perioperative pulmonary events, screening for undiagnosed OSA is sometimes included as part of preoperative risk assessment. However, there are limited data regarding quantification of OSA risk in lower extremity arthroplasty patients, and little is known about the utility of quantitative OSA screening and the risk of pulmonary complications in hip and knee arthroplasty patients who receive intrathecal morphine anesthetic...
April 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28622188/differences-in-fundamental-sagittal-pelvic-parameters-based-on-age-sex-and-race
#19
Robert K Merrill, Jun S Kim, Dante M Leven, Joung Heon Kim, Joshua J Meaike, Rachel S Bronheim, Kelly I Suchman, Doug Nowacki, Sunder S Gidumal, Samuel K Cho
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To determine whether age, sex, and race have independent effects on sagittal pelvic parameters. SUMMARY OF BACKGROUND DATA: Pelvic parameters and sagittal balance correlate with health-related quality of life and are important for patient assessment and surgical planning. Age, sex, and race are 3 unalterable patient factors that may influence pelvic morphology. METHODS: We conducted a retrospective review of consecutive adult patients who presented to our radiology practice between 2010 and 2015 and had a standing, lateral lumbosacral radiograph...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28622150/intraoperative-hyperkalemia-and-ventricular-arrhythmia-during-parathyroidectomy-a-case-report
#20
Daniel J Rosenkrans, Lavinia M Kolarczyk
We present a case of acute hyperkalemia and ventricular arrhythmia during parathyroidectomy in a patient with end-stage renal disease. This case highlights the under-recognized alterations in potassium homeostasis associated with parathyroidectomy and underscores the importance of preoperative optimization.
June 15, 2017: A & A Case Reports
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