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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
#1
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/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#2
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
April 24, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28437759/correlation-of-technical-surgical-goals-to-the-gdi-and-investigation-of-post-operative-gdi-change-in-children-with-cerebral-palsy
#3
Christina Bickley, Judi Linton, Nancy Scarborough, Elroy Sullivan, Katy Mitchell, Douglas Barnes
AIM: The purpose of this study was to introduce a standardized set of surgical technical achievement goals (TAGs) as part of a comprehensive outcome assessment model for children with spastic cerebral palsy (CP) undergoing orthopaedic surgical intervention to improve gait. Examination of relationships of these surgical goals to the Gait Deviation Index (GDI) and use of two assessments in tandem provided a thorough picture of technical surgical outcomes. This study also investigated changes in GDI in children with spastic CP after surgery...
April 13, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28437737/changes-in-regulatory-t-cells-in-patients-with-ovarian-cancer-undergoing-surgery-preliminary-results
#4
Meng Wu, Xian Chen, Jianfang Lou, Shuping Zhang, Xiaojie Zhang, Lei Huang, Ruihong Sun, Peijun Huang, Shiyang Pan, Fang Wang
Regulatory T cells (Treg) suppress immune responses in patients with cancer. Surgery is the most effective therapeutic strategy for ovarian cancer (OC). However, the interplay between the Treg population and surgical resection remains unclear. 61 patients with OC who received no prior treatment were enrolled in the study. Treg percentages were characterized from peripheral blood mononuclear cells. We investigated CD4(+)CD25(+), CD4(+)CD25(+)Foxp3(+), CD8(+)CD28(-), and CD8(+)Foxp3(+) Tregs in OC patients and their postoperative changes using flow cytometry...
April 21, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28437679/nodal-recurrence-after-stereotactic-body-radiotherapy-for-early-stage-non-small-cell-lung-cancer-incidence-and-proposed-risk-factors
#5
REVIEW
Krista C J Wink, Angela van Baardwijk, Esther G C Troost, Dirk De Ruysscher
Stereotactic body radiotherapy (SBRT) is an alternative to surgery for patients with early stage non-small cell lung cancer (NSCLC) who are inoperable due to comorbid disease or who refuse surgery. SBRT results in an excellent local control rate of more than 90%, which is comparable to surgery, while short and long-term overall toxicity is low. Surgically treated patients are often more extensively staged pre-operatively, e.g. with endobronchial ultrasound and/or mediastinoscopy, and typically undergo intra-operative lymph node dissection or sampling...
April 12, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28437673/successful-primary-repair-of-late-diagnosed-spontaneous-esophageal-rupture-a-case-report
#6
Diana Y Kircheva, Wickii T Vigneswaran
INTRODUCTION: Spontaneous esophageal rupture is rare, roughly 300 cases reported annually. Diagnosis is often delayed or missed. Overall mortality is about 20%. This feared high mortality rate has led to the misconception that primary esophageal repair should be avoided in late diagnosed patients. We report a successful primary repair of spontaneous esophageal rupture which was delayed for more than two weeks. METHODS: A 53 year-old male presented to our medical service after falsely having been treated for pneumonia at an outside hospital...
April 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28437672/eosinophilic-funiculitis-initially-diagnosed-as-irreducible-inguinal-hernia-a-case-report
#7
Kohei Yamada, Akashi Ikubo, Shota Ikeda, Satoko Koga, Yasuhiro Tsuru, Hideo Kuroki, Naohiko Koya, Ryuichiro Samejima, Masashi Sakai, Masanobu Tabuchi, Seiji Yunotani, Shinichi Kido, Kazushige Nishimura, Hiroyuki Meiri
BACKGROUND: Most groin masses are first suspected to be groin hernias. More than 80% of bulging groin lesions are reportedly diagnosed as hernias by ultrasonography. Establishment of the correct diagnosis of hernia among all differential diagnoses is not easy. We herein describe a very rare case of groin eosinophilic funiculitis that presented as an irreducible groin hernia. CASE PRESENTATION: A 59-year-old man presented to our hospital with suspicion of a right groin hernia...
April 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28437670/a-case-report-of-invasive-candidiasis-and-fungal-osteomyelitis-mimicking-oropharyngeal-carcinoma-recurrence-in-an-immunocompetent-patient-following-transoral-robotic-surgery
#8
Hong Yu Tan, Jenny Guek-Hong Low, Elizabeth Roche, Hiang Khoon Tan
INTRODUCTION: Transoral robotic surgery(TORS) for the excision of oropharyngeal tumour is increasingly considered for its lower rates of postoperative complications and better functional outcomes. However, we report a case of invasive candidiasis in an immunocompetent patient with previous radiation therapy years ago who underwent TORS recently. CASE PRESENTATION: A 55year old Chinese female with previous radiation therapy for nasopharyngeal carcinoma diagnosed in 1986 underwent wide excision of a newly diagnosed oropharyngeal carcinoma with TORS...
April 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28437619/management-of-posterior-cruciate-ligament-tibial-avulsion-injuries-a-systematic-review
#9
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/28437582/modified-frailty-index-predicts-postoperative-outcomes-in-older-gastrointestinal-cancer-patients
#10
Sarah A Vermillion, Fang-Chi Hsu, Robert D Dorrell, Perry Shen, Clancy J Clark
BACKGROUND AND OBJECTIVES: Frailty disproportionately impacts older patients with gastrointestinal cancer, rendering them at increased risk for poor outcomes. A frailty index may aid in preoperative risk stratification. We hypothesized that high modified frailty index (mFI) scores are associated with adverse outcomes after tumor resection in older, gastrointestinal cancer patients. METHODS: Patients (60-90 years old) who underwent gastrointestinal tumor resection were identified in the 2005-2012 NSQIP Participant Use File...
April 24, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28437546/root-cause-analysis-and-actions-for-the-prevention-of-medical-errors-quality-improvement-and-resident-education
#11
Ryan Charles, Brandon Hood, Joseph M DeRosier, John W Gosbee, James P Bagian, Ying Li, Michelle S Caird, J Sybil Biermann, Mark E Hake
The quality of care delivered by orthopedic surgeons continues to grow in importance. Multiple orthopedic programs, organizations, and committees have been created to measure the quality of surgical care and reduce the incidence of medical adverse events. Structured root cause analysis and actions (RCA2) has become an area of interest. If performed thoroughly, RCA2 has been shown to reduce surgical errors across many subspecialties. The Accreditation Council for Graduate Medical Education has a new mandate for programs to involve residents in quality improvement processes...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28437516/a-rare-case-of-misdiagnosed-silent-lung-cancer-with-solitary-metastasis-to-the-temporomandibular-joint-condyle
#12
Luca Guarda-Nardini, Edoardo Stellini, Adolfo Di Fiore, Daniele Manfredini
This article describes the case history of a 59-year-old female patient who sought advice for temporomandibular joint (TMJ) pain and sounds but who was actually diagnosed with a primary lung cancer with metastasis to the TMJ. The patient had a history of TMJ pain and deflection in jaw movement that progressively worsened over a few months and did not improve with the usual standard of care treatment provided by an orofacial pain practitioner. Magnetic resonance and computed tomography (CT) prescribed at a tertiary clinic showed an osteolytic bone mass within the right TMJ condyle...
April 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28437505/guidelines-for-treatment-of-lateral-patella-dislocations-in-skeletally-mature-patients
#13
Michael C Liebensteiner, Florian Dirisamer, Peter Balcarek, Philip Schoettle
The incidence of lateral patella dislocations is high, particularly in young females. Beside traumatic cases, many patients present with specific anatomical factors that predispose to lateral patella dislocations (torsional abnormalities of the femur or the tibia, trochlea dysplasia, patella alta, etc). It is of utmost importance to correct those pathologic factors during concomitant procedures as isolated reconstructions of the medial patellofemoral ligament would fail in the presence of severe anatomic risk factors...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437499/systemic-hypothermia-as-treatment-for-an-acute-cervical-spinal-cord-injury-in-a-professional-football-player-9-year-follow-up
#14
Andrew Cappuccino, Leslie J Bisson, Bud Carpenter, Ken Snyder, Helen Cappuccino
The following report provides clinical follow-up on a National Football League player who sustained a complete cervical spinal cord injury (SCI) while tackling an opposing player in 2007. He received prompt medical and surgical care based on then-current recommendations, but was also treated with systemic hypothermia soon after his injury, which was controversial at the time. Since then, smaller randomized human studies have described the tolerable safety profile, efficacy, and potential benefits of this intervention in acute SCI in humans...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437497/a-rare-case-of-spontaneous-fusion-of-the-knee
#15
Ola S Ahmed, James P Cashman
To our knowledge, this article is the first report of a case of spontaneous and progressive bony fusion of a knee joint without a prior diagnosis of inflammatory or septic arthritis or surgical arthrodesis.
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437496/novel-solution-for-massive-glenoid-defects-in-shoulder-arthroplasty-a-patient-specific-glenoid-vault-reconstruction-system
#16
David M Dines, Lawrence Gulotta, Edward V Craig, Joshua S Dines
Complex glenoid deformities present the most difficult challenges in shoulder arthroplasty. These deformities may be caused by severe degenerative or congenital deformity, posttraumatic anatomy, tumor, or, in most cases, bone loss after glenoid failure in anatomical total shoulder arthroplasty. Methods of treating severe bone loss have included inlay and onlay bone-graft options with augmented fixation and, in severe cases, salvage hemiarthroplasty with limited goal expectations. Unfortunately, none of these methods has provided consistently satisfactory reproducible results...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437494/patellofemoral-pain-an-enigma-explained-by-homeostasis-and-common-sense
#17
William R Post, Scott F Dye
We present a rational, scientific, low-risk approach to patellofemoral pain (anterior knee pain) based on an understanding of tissue homeostasis. Loss of tissue homeostasis from overload and/or injury produces pain. Bone overload and synovial inflammation are common sources of such pain. Chondromalacia and malalignment are findings that almost always do not need to be "corrected" to relieve pain. Patience and persistence in nonoperative care results in consistent success. Surgery should be rare and done only after extensive nonoperative management and in the setting of clearly defined pathology...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437441/fluorescence-imaging-topography-scanning-system-for-intraoperative-multimodal-imaging
#18
Tri T Quang, Hye-Yeong Kim, Forrest Sheng Bao, Francis A Papay, W Barry Edwards, Yang Liu
Fluorescence imaging is a powerful technique with diverse applications in intraoperative settings. Visualization of three dimensional (3D) structures and depth assessment of lesions, however, are oftentimes limited in planar fluorescence imaging systems. In this study, a novel Fluorescence Imaging Topography Scanning (FITS) system has been developed, which offers color reflectance imaging, fluorescence imaging and surface topography scanning capabilities. The system is compact and portable, and thus suitable for deployment in the operating room without disturbing the surgical flow...
2017: PloS One
https://www.readbyqxmd.com/read/28437376/organizational-issues-structure-and-processes-of-care-in-257-icus-in-latin-america-a-study-from-the-latin-america-intensive-care-network
#19
Elisa Estenssoro, Leyla Alegría, Gastón Murias, Gilberto Friedman, Ricardo Castro, Nicolas Nin Vaeza, Cecilia Loudet, Alejandro Bruhn, Manuel Jibaja, Gustavo Ospina-Tascon, Fernando Ríos, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, F Javier Hurtado, Arturo Briva, Carlos Romero, Guillermo Bugedo, Jan Bakker, Maurizio Cecconi, Luciano Azevedo, Glenn Hernandez
OBJECTIVE: Latin America bears an important burden of critical care disease, yet the information about it is scarce. Our objective was to describe structure, organization, processes of care, and research activities in Latin-American ICUs. DESIGN: Web-based survey submitted to ICU directors. SETTINGS: ICUs located in nine Latin-American countries. SUBJECTS: Individual ICUs. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred fifty-seven of 498 (52%) of submitted surveys responded: 51% from Brazil, 17% Chile, 13% Argentina, 6% Ecuador, 5% Uruguay, 3% Colombia, and 5% between Mexico, Peru, and Paraguay...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437375/both-positive-and-negative-fluid-balance-may-be-associated-with-reduced-long-term-survival-in-the-critically-ill
#20
Vikram Balakumar, Raghavan Murugan, Florentina E Sileanu, Paul Palevsky, Gilles Clermont, John A Kellum
OBJECTIVES: Among critically ill patients with acute kidney injury, exposure to positive fluid balance, compared with negative fluid balance, has been associated with mortality and impaired renal recovery. However, it is unclear whether positive and negative fluid balances are associated with poor outcome compared to patients with even fluid balance (euvolemia). In this study, we examined the association between exposure to positive or negative fluid balance, compared with even fluid balance, on 1-year mortality and renal recovery...
April 21, 2017: Critical Care Medicine
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