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https://www.readbyqxmd.com/read/29133164/pre-incision-urethral-plate-width-does-not-impact-short-term-tubularized-incised-plate-urethroplasty-outcomes
#1
N C Bush, W Snodgrass
INTRODUCTION: Two reports have found that urethral plate (UP) widths <8 mm before tubularized incised plate (TIP) incision increased urethroplasty complications. The present study measured pre-incision UP width in consecutive boys undergoing TIP to determine if it affected outcomes. METHODS: The present study followed the method previously used by Holland and Smith, and Sarhan et al. to measure UP width before creating glans wings or performing midline plate incision in consecutive patients with primary hypospadias and ventral curvature <30°, who all underwent TIP repair (Summary Fig...
June 19, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29046095/surgical-placement-of-rectus-sheath-catheters-in-a-cadaveric-cystectomy-model
#2
Ecp Chedgy, G Lowe, R Tang, C Krebs, A Sawka, H Vaghadia, M E Gleave, A I So
Introduction Surgically inserted rectus sheath catheters (RSCs) are used increasingly for analgesia after cystectomy and other abdominal surgery. Currently, there is little information on the optimal positioning of RSCs to allow maximal spread of local anaesthetic. This study sought to assess the spread of dye injected via RSCs and to highlight the extent of its coverage in a fresh unembalmed cadaveric cystectomy model in order to confirm the nerve endings that are likely to be anaesthetised with RSCs. Methods Four cadavers underwent lower midline incision with limited bladder mobilisation...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28965156/decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-including-patients-with-additional-involvement-of-the-anterior-and-or-posterior-cerebral-artery-territory-outcome-analysis-and-definition-of-prognostic-factors
#3
Sven Kürten, Christopher Munoz, Kerim Beseoglu, Igor Fischer, Jason Perrin, Hans-Jakob Steiger
BACKGROUND: According to current evidence, adding decompressive craniectomy (DC) to best medical therapy reduces case fatality rate of malignant middle cerebral artery infarction by 50-75%. There is currently little information available regarding the outcome of subgroups, in particular of patients with extensive infarctions exceeding the territory of the middle cerebral artery. METHODS: The records of 101 patients with large hemispheric infarctions undergoing DC were retrospectively reviewed...
September 30, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28904900/advance-male-sling
#4
REVIEW
Amanda S J Chung, Oscar A Suarez, Kurt A McCammon
The AdVance sling (American Medical Systems, Minnetonka, MN, United States of America) is a synthetic transobturator sling, which is a safe and effective minimally invasive treatment for mild to moderate stress urinary incontinence (SUI) in male patients. This article provides a step-by-step description of our technique for placement of the AdVance male sling, including details and nuances gained from surgical experience, advice for avoidance of complications and discussion on management of complications and sling failures...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28856110/the-analgesic-efficiency-of-ultrasound-guided-rectus-sheath-analgesia-compared-with-low-thoracic-epidural-analgesia-after-elective-abdominal-surgery-with-a-midline-incision-a-prospective-randomized-controlled-trial
#5
Hany Mahmoud Yassin, Ahmed Tohamy Abd Elmoneim, Hatem El Moutaz
BACKGROUND: Ultrasound-guided rectus sheath blockade has been described to provide analgesia for midline abdominal incisions. We aimed to compare thoracic epidural analgesia (TEA) and rectus sheath analgesia (RSA) with respect to safety and efficacy. METHODS: Sixty patients who underwent elective laparotomies through a midline incision were assigned randomly to receive either continuous TEA (TEA group, n = 31) or intermittent RSA (RSA group, n = 29). The number of patients who required analgesia, the time to first request analgesia, the interval and the cumulative morphine doses consumption during 72 hours postoperatively, and pain intensity using visual analog score (VAS) at rest and upon coughing were reported in addition to any side effects related to both techniques or administered drugs...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28838107/contralateral-anterior-interhemispheric-approach-to-medial-frontal-arteriovenous-malformations-surgical-technique-and-results
#6
Ahmad Hafez, Kunal P Raygor, Michael T Lawton
BACKGROUND: Medial frontal arteriovenous malformations (AVMs) require opening the interhemispheric fissure and are traditionally accessed through an ipsilateral anterior interhemispheric approach (IAIA). The contralateral anterior interhemispheric approach (CAIA) flips the positioning with the midline still positioned horizontally for gravity retraction, but with the AVM on the upside and the approach from the contralateral, dependent side. OBJECTIVE: To determine whether the perpendicular angle of attack associated with the IAIA converts to a more favorable parallel angle of attack with the CAIA...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28767523/respiratory-mechanical-and-cardiorespiratory-consequences-of-cycling-with-aerobars
#7
Jesse M Charlton, Andrew H Ramsook, Reid A Mitchell, Michael A Hunt, Joseph H Puyat, Jordan A Guenette
PURPOSE: Aerobars place a cyclist in a position where the trunk is flexed forward and the elbows are close to the midline of the body. This position is known to improve cycling aerodynamics and time trial race performance compared with upright cycling positions. However, the aggressive nature of this position may have important cardiorespiratory and metabolic consequences. The purpose of this investigation was to examine the respiratory mechanical, ventilatory, metabolic, and sensory consequences of cycling while using aerobars during laboratory-based cycling...
December 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28731396/contralateral-posterior-interhemispheric-approach-to-deep-medial-parietooccipital-vascular-malformations-surgical-technique-and-results
#8
Jan-Karl Burkhardt, Ethan A Winkler, Michael T Lawton
OBJECTIVE Deep medial parietooccipital arteriovenous malformations (AVMs) and cerebral cavernous malformations (CCMs) are traditionally resected through an ipsilateral posterior interhemispheric approach (IPIA), which creates a deep, perpendicular perspective with limited access to the lateral margins of the lesion. The contralateral posterior interhemispheric approach (CPIA) flips the positioning, with the midline positioned horizontally for retraction due to gravity, but with the AVM on the upper side and the approach from the contralateral, lower side...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28688033/first-case-of-robotic-laparoendoscopic-single-site-radical-prostatectomy-with-single-site-vespa-platform
#9
D Mattevi, L G Luciani, V Vattovani, S Chiodini, M Puglisi, G Malossini
This study aimed at reporting our first experience with robotic laparoendoscopic single-site radical prostatectomy (R-LESS-RP) with single-site VesPa platform (Intuitive Surgical Inc.). A 68-year-old-man presenting with a cT1c adenocarcinoma Gleason Score 3 + 4 = 7 in 4/12 bilateral cores underwent a transperitoneal robotic LESS-RP with a single-site Vespa platform. Initial PSA, prostate weight, and body mass index (BMI) were 4.4 ng/ml, 45 g, and 25, respectively. Instruments and camera cross within the Single-Site port; the da Vinci System software detects and reassigns the user's hands with the instruments position...
July 7, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28673214/randomised-comparison-of-three-types-of-continuous-anterior-abdominal-wall-block-after-midline-laparotomy-for-gynaecological-oncology-surgery
#10
RANDOMIZED CONTROLLED TRIAL
P J Cowlishaw, P J Kotze, L Gleeson, N Chetty, L E Stanbury, P J Harms
Effective analgesia after midline laparotomy surgery is essential for enhanced recovery programs. We compared three types of continuous abdominal wall block for analgesia after midline laparotomy for gynaecological oncology surgery. We conducted a single-centre, double-blind randomised controlled trial. Ninety-four patients were randomised into three groups to receive two days of programmed intermittent boluses of ropivacaine (18 ml 0.5% ropivacaine every four hours) via either a transversus abdominis plane (TAP) catheter, posterior rectus sheath (PRS) catheter, or a subcutaneous (SC) catheter...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28615428/increased-rate-of-venous-thrombosis-may-be-associated-with-inpatient-dihydroergotamine-treatment
#11
COMPARATIVE STUDY
Amy R Tso, Irene R Patniyot, Amy A Gelfand, Peter J Goadsby
OBJECTIVE: To review whether the incidence of catheter-associated venous thromboses was higher in patients receiving IV dihydroergotamine compared to lidocaine. METHODS: We retrospectively reviewed all admissions at the University of California, San Francisco Headache Center from February 25, 2008, through October 31, 2014, for age, sex, diagnosis, aura, treatment dose, type of IV line used, days with line, superficial (SVT) or deep venous thrombosis (DVT), and pulmonary embolism (PE)...
July 18, 2017: Neurology
https://www.readbyqxmd.com/read/28528738/our-initial-experience-with-ventriculo-epiplooic-shunt-in-treatment-of-hydrocephalus-in-two-centers
#12
Valentin Titus Grigorean, Aurelia Mihaela Sandu, Mihai Popescu, Ioan Stefan Florian, Cristian Dumitru Lupascu, Corina Lupascu Ursulescu
INTRODUCTION: Hydrocephalus represents impairment in cerebrospinal fluid (CSF) dynamics. If the treatment of hydrocephalus is considered difficult, the repeated revisions of ventriculo-peritoneal (VP) shunts are even more challenging. OBJECTIVE: The aim of this article is to evaluate the efficiency of ventriculo-epiplooic (VEp) shunt as a feasible alternative in hydrocephalic patients. MATERIAL AND METHODS: A technical modification regarding the insertion of peritoneal catheter was imagined: midline laparotomy 8-10cm long was performed in order to open the peritoneal cavity; the great omentum was dissected between its two layers; we placed the distal end of the catheter between the two epiplooic layers; a fenestration of 4cm in diameter into the visceral layer was also performed...
July 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28524798/revisiting-the-rules-for-freehand-ventriculostomy-a-virtual-reality-analysis
#13
Clemens Raabe, Jens Fichtner, Jürgen Beck, Jan Gralla, Andreas Raabe
OBJECTIVE Frontal ventriculostomy is one of the most frequent and standardized procedures in neurosurgery. However, many first and subsequent punctures miss the target, and suboptimal placement or misplacement of the catheter is common. The authors therefore reexamined the landmarks and rules to determine the entry point and trajectory with the best hit rate (HtR). METHODS The authors randomly selected CT scans from their institution's DICOM pool that had been obtained in 50 patients with normal ventricular and skull anatomy and without ventricular puncture...
May 19, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28353459/first-report-of-kocuria-marina-bloodstream-infection-unrelated-to-a-central-venous-catheter-a-mini-review-on-an-emerging-and-under-recognized-opportunistic-pathogen
#14
Giovanna Pulcrano, Michela Balzaretti, Alessia Grosini, Vincenzo Piacentini, Dimitri Poddighe
We report a case of sepsis by Kocuria marina in a 45-year-old woman carrying a midline venous catheter to provide total parenteral nutrition. Despite the finding of K. marina bacteraemia, no bacteria grew from the culture of the catheter tip. As the patient was affected with severe leg ulcers, K. marina bloodstream infection from a skin breakage other than CVC was supposed. K. marina is an emerging opportunistic agent deserving attention and probably under-recognized, as it can be misdiagnosed as Staphylococcus if only conventional microbiological analyses are performed for bacterial identification...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28321158/porcine-model-characterizing-various-parameters-assessing-the-outcome-after-acetaminophen-intoxication-induced-acute-liver-failure
#15
Karolin Thiel, Wilfried Klingert, Kathrin Klingert, Matthias H Morgalla, Martin U Schuhmann, Pamela Leckie, Yalda Sharifi, Nathan A Davies, Rajiv Jalan, Andreas Peter, Christian Grasshoff, Alfred Königsrainer, Martin Schenk, Christian Thiel
AIM: To investigate the changes of hemodynamic and laboratory parameters during the course of acute liver failure following acetaminophen overdose. METHODS: Eight pigs underwent a midline laparotomy following jejunal catheter placement for further acetaminophen intoxication and positioning of a portal vein Doppler flow-probe. Acute liver failure was realized by intrajejunal acetaminophen administration in six animals, two animals were sham operated. All animals were invasively monitored and received standardized intensive care support throughout the study...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28306331/intraoperative-radiographic-determination-of-ureteral-length-as-a-method-of-determining-ideal-stent-length
#16
Keith Barrett, Daniela Ghiculete, Robert J Sowerby, Monica Farcas, Kenneth T Pace, Richardson John D'Arcy Honey
INTRODUCTION: Accurate determination of ureteral length (UL) and appropriate stent length remains a challenge. The objective of this study was to describe an intraoperative technique to measure UL and determine appropriate stent length, and to compare this technique with other methods of determining appropriate stent length. METHODS: Patients undergoing ureteroscopy requiring postoperative stenting and who had a preoperative CT were prospectively identified. Gender, age, height, body mass index, L1 to L5 lumbar height on CT, and surgeon's estimate of UL were recorded...
April 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28260150/importance-of-multidisciplinary-management-for-pulmonary-atresia-ventricular-septal-defect-major-aorto-pulmonary-collateral-arteries-and-completely-absent-central-pulmonary-arteries
#17
COMPARATIVE STUDY
Takaya Hoashi, Satoshi Yazaki, Koji Kagisaki, Masataka Kitano, Masatoshi Shimada, Isao Shiraishi, Hajime Ichikawa
BACKGROUND: To review long-term clinical outcomes for pulmonary atresia, ventricular septal defect (PA/VSD), major aorto-pulmonary collateral arteries (MAPCAs) and completely absent central pulmonary arteries (cPAs). METHODS: Of all 120 surgically treated patients with PA/VSD, MAPCAs between 1981 and 2011, 15 patients (12.5%) with completely absent cPAs were enrolled. The median age at initial surgery was 3.8 ± 4.9 years old (range 0.1-17.6) and 3.5 (2-6)...
June 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28250281/why-a-catheter-can-be-correctly-placed-in-the-anterior-horn-of-lateral-ventricle-by-inserting-perpendicular-to-the-frontal-bone-on-the-ventricular-drainage-demonstration-of-the-accuracy-of-an-inserting-path-by-computed-tomographic-image-study-and-clinical-practices
#18
Kiyonobu Ikeda, Takashi Asahi, Takaaki Iida, Jiro Yamamoto, Tsuyoshi Tsukada, Nobutaka Yamamoto, Fumihiko Takeuchi, Shigeru Munemoto, Shu-Ji Sato, Shuichi Akaike, Katsuo Shoin
Why a catheter can be correctly placed in the ventricle by inserting perpendicular to the frontal bone on the ventricular drainage? We performed a study on the accuracy of a path perpendicular to the skull surface into the anterior horn using computed tomography (CT), and a clinical study. Twenty patients were studied on CT images. Using the curved multi-planar reconstruction method, the curved frontal skull and brain were reconstructed to flat structures, and perpendicular lines were drawn from the flat surface to the foramen of Monro on the reconstructed images...
May 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28245342/assessment-of-the-extravascular-implantable-defibrillator-feasibility-of-substernal-ventricular-pacing
#19
Tom F Brouwer, Lonneke Smeding, Wouter R Berger, Antoine H G Driessen, Joris R DE Groot, Arthur A M Wilde, Reinoud E Knops
INTRODUCTION: The objective of this study was to assess feasibility of ventricular pacing and thresholds from within the substernal space to examine a new extravascular ICD configuration with pacing capabilities. METHODS: In patients undergoing midline sternotomy, a duodecapolar diagnostic pacing catheter was positioned in the substernal space anterior to the pericardium, and a cutaneous patch in left lateral position. Different unipolar and bipolar pacing configurations were assessed...
June 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28217056/preprocedural-ultrasound-examination-versus-manual-palpation-for-thoracic-epidural-catheter-insertion
#20
Ahmed M Hasanin, Ali M Mokhtar, Shereen M Amin, Ahmed A Sayed
BACKGROUND AND AIMS: Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal operations. SUBJECTS AND METHODS: Forty-eight patients scheduled to midline laparotomy under combined general anesthesia with thoracic epidural analgesia were included in the study...
January 2017: Saudi Journal of Anaesthesia
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