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https://www.readbyqxmd.com/read/28340493/conservative-treatment-with-octreotide-to-provide-early-recovery-of-children-with-esophageal-perforation
#1
Ramazan Karabulut, Zafer Turkyilmaz, Kaan Sonmez, Abdullah Can Basaklar
Background The effectiveness of nonoperative treatment of esophageal perforation (EP) in children with octreotide is highlighted. Methods Records of nine patients (seven boys and two girls with an average age of 5.83 ± 5.35 years) with EP were reviewed. Results EP developed in six patients during dilation of esophageal stenosis (five of six caused by caustic burns). In the other three patients, EP developed after nasogastric placement, after endotracheal intubation, and during endoscopy for foreign body...
March 24, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28333840/primary-versus-preoperative-radiation-for-locally-advanced-vulvar-cancer
#2
Divya Natesan, Julian C Hong, Jonathan Foote, Julie A Sosa, Laura Havrilesky, Junzo Chino
OBJECTIVES: The objective of this study was to evaluate patterns of care and the survival impact of primary radiation and preoperative radiation therapy with surgery in women with locally advanced vulvar cancer using a large national cohort. METHODS AND MATERIALS: Women with vulvar cancer, diagnosed from 2004 to 2012, who received primary or preoperative radiation therapy were identified in the National Cancer Database. Patient characteristics, such as age, race, American Joint Committee on Cancer stage, and comorbidity score, were compared between those that received primary radiation only and those that received preoperative radiation with surgery using the χ, Fisher exact, and Mann-Whitney tests as appropriate...
March 23, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28327997/lumbar-fusion-for-degenerative-disease-a-systematic-review-and-meta-analysis
#3
Daniel Yavin, Steven Casha, Samuel Wiebe, Thomas E Feasby, Callie Clark, Albert Isaacs, Jayna Holroyd-Leduc, R John Hurlbert, Hude Quan, Andrew Nataraj, Garnette R Sutherland, Nathalie Jette
BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016)...
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326411/medial-tibial-spackling-to-lessen-chronic-medial-tibial-soft-tissue-irritation
#4
J Ryan Martin, Tyler Steven Watters, Daniel L Levy, Jason M Jennings, James P Boyle, Douglas A Dennis
We describe a unique, utilitarian reconstructive treatment option known as tibial "spackling" for chronic, localized medial joint line pain corresponding with progressive radiographic peripheral medial tibial bone loss beneath a well-fixed revision total knee arthroplasty tibial baseplate. It is believed that this localized pain is due to chronic irritation of the medial capsule and collateral ligament from the prominent medial edge of the tibial component. In the setting of failed nonoperative treatment, our experience with utilizing bone cement to reconstruct the medial tibial bone defect and create a smooth medial tibial surface has been successful in eliminating chronic medial soft tissue irritation...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28321428/high-grade-partial-and-retracted-2-cm-proximal-hamstring-ruptures-nonsurgical-treatment-revisited
#5
Jonathan R Piposar, Amrit V Vinod, Joshua R Olsen, Edward Lacerte, Suzanne L Miller
BACKGROUND: High-grade partial proximal hamstring tears and complete tears with retraction less than 2 cm are a subset of proximal hamstring injuries where, historically, treatment has been nonoperative. It is unknown how nonoperative treatment compares with operative treatment. HYPOTHESIS: The clinical and functional outcomes of nonoperative and operative treatment of partial/complete proximal hamstring tears were compared. We hypothesize that operative treatment of these tears leads to better clinical and functional results...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28316316/colonic-diverticulosis-and-diverticulitis-in-renal-transplant-recipients-management-and-long-term-outcomes
#6
Ahmet Rencuzogullari, Gokhan Ozuner, Sinan Binboga, Erman Aytac, Venkatesh Krishnamurthi, Emre Gorgun
Data regarding management of colonic diverticulitis in renal transplant recipients (RTRs) are limited. This study aims to identify prevalence, risk factors, and outcomes in RTRs with colonic diverticulosis and diverticulitis. Between January 2004 and December 2013, all patients who underwent kidney transplantation were analyzed. Among all RTSs, patients who had a pretransplant colonoscopic diagnosis of diverticulosis and patients with a proven attack of diverticulitis were included in our analysis. There were 1578 RTRs with a mean age of 50 ± 14 years at the time of transplantation...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28306630/nonoperative-management-of-appendicitis-in-children
#7
Joseph J López, Katherine J Deans, Peter C Minneci
PURPOSE OF REVIEW: The aim of this review is to summarize the recent literature investigating nonoperative management of uncomplicated and complicated appendicitis and highlight recent data establishing its safety and efficacy. RECENT FINDINGS: Recent studies and clinical trials have demonstrated the efficacy of nonoperative treatment of both uncomplicated and complicated appendicitis, defined as perforated appendicitis with or without formed abscess or phlegmon...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28296515/risk-preferences-and-attitudes-to-surgery-in-decision-making
#8
Andreas Meunier, Kinga Posadzy, Gustav Tinghög, Per Aspenberg
Background and purpose - There is increasing evidence that several commonly performed surgical procedures provide little advantage over nonoperative treatment, suggesting that doctors may sometimes be inappropriately optimistic about surgical benefit when suggesting treatment for individual patients. We investigated whether attitudes to risk influenced the choice of operative treatment and nonoperative treatment. Methods - 946 Swedish orthopedic surgeons were invited to participate in an online survey. A radiograph of a 4-fragment proximal humeral fracture was presented together with 5 different patient characteristics, and the surgeons could choose between 3 different operative treatments and 1 nonoperative treatment...
March 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#9
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28282004/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#10
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28280961/failure-of-conservative-treatment-with-gastrografin%C3%A2-for-adhesive-small-bowel-obstruction-after-colorectal-surgery
#11
Jordi Miquel, Sebastiano Biondo, Esther Kreisler, Catalina Uribe, Loris Trenti
PURPOSE: The aim of this study was to identify risk factors related with failure of conservative management of adhesive small bowel obstruction (ASBO) in patients with previous colorectal surgery. METHODS: Patients admitted with the diagnosis of ASBO after previous colorectal resection, were included. All patients underwent administration of Gastrografin®. Abdominal radiography was done after 24 h, to confirm the presence of contrast in colon (incomplete obstruction) or not (complete obstruction)...
March 10, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28278379/tibial-tuberosity-anteromedialization-for-patellofemoral-chondral-disease
#12
Federica Rosso, Roberto Rossi, Giorgio Governale, Antongiulio Marmotti, Valeria Cherubini, Umberto Cottino, Davide Edoardo Bonasia
BACKGROUND: Tibial tuberosity anteromedialization (TTA) is a well-established treatment option for patellofemoral chondral disease that is resistant to nonoperative treatment. However, the prognostic factors of this procedure are unknown. PURPOSE: To analyze the prognostic factors correlated with the midterm outcomes of TTA for patellofemoral chondral disease and determine the survivorship. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Indications of TTA for chondral disease included skeletal maturity, age <65 years, <grade 3 Kellgren-Lawrence degeneration, and isolated patellofemoral pain for ≥6 months despite nonoperative treatment...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28268146/comparative-effectiveness-of-imaging-modalities-for-the-diagnosis-and-treatment-of-intussusception-a-critically-appraised-topic
#13
Anne G Carroll, Richard G Kavanagh, Caoilfhionn Ni Leidhin, Noelle M Cullinan, Lisa P Lavelle, Dermot E Malone
RATIONALE AND OBJECTIVES: The purpose of this study was to critically appraise and compare the diagnostic performance of imaging modalities that are used for the diagnosis of intussusception and methods used in the treatment of ileocolic intussusception. METHODS: A focused clinical question was constructed and the literature was searched using the patient, intervention, comparison, outcome (PICO) method comparing radiography, ultrasound, and computed tomography in the detection of intussusception...
March 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28262280/shared-decision-making-in-the-management-of-midshaft-clavicular-fractures-nonoperative-treatment-or-plate-fixation
#14
Sarah Woltz, Pieta Krijnen, Sven A G Meylaerts, Arwen H Pieterse, Inger B Schipper
INTRODUCTION: Most patients with a displaced midshaft clavicular fracture can be treated either operatively or nonoperatively, with similar long-term outcomes. The treatment choice depends on individual preferences, and is therefore suited for a shared decision making (SDM) approach. However, little is known about SDM in fracture treatment. The purpose of this study was to evaluate the current daily practice of shared decisional behaviour in clavicular fracture treatment, in order to assess the need for improvement and set a baseline level for future research...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28257674/insertional-achilles-tendinopathy
#15
REVIEW
Gage M Caudell
Posterior heel pain is a common condition of the foot and ankle and is seen in a variety of foot types. Nonoperative treatment methods consisting of shoes inserts, heel lifts, stretching, physical therapy, nonsteroidal antiinflammatory drugs, eccentric strength training, and other modalities have been shown to have mixed results. When indicated, surgical repair can produce good long-term results. Complications, although uncommon, most commonly result from wound healing complications.
April 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28257673/midsubstance-tendinopathy-surgical-management
#16
REVIEW
William T DeCarbo, Mark J Bullock
Noninsertional Achilles tendinopathy often responds to nonoperative treatment. When nonoperative treatment fails, the clinician must distinguish between paratendinopathy and noninsertional tendinopathy. In paratendinopathy, myofibroblasts synthesize collagen, causing adhesions, and the paratenon may be released or excised. If a core area of tendinopathy is identified on MRI, the area is excised longitudinally and repaired with a side-to-side suture. If greater than 50% of the tendon diameter is excised, the authors recommend a short flexor hallucis longus tendon transfer with an interference screw...
April 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28255931/scary-gas-intravascular-intracranial-and-intraspinal-ectopic-gas-part-iii
#17
Claire K Sandstrom, Sherif F Osman, Ken F Linnau
While ectopic gas can be a sign of dangerous disease requiring immediate medical or surgical intervention, it can also be an incidental and benign finding. Intravenous gas and spinal vacuum gas are common and almost always benign. Intravascular gas is most often related to instrumentation and, if intraarticular, can cause end-organ ischemia; however, treatment is usually supportive. Pneumocephalus arises from a communication with paranasal sinuses or mastoids more often than from meningeal infection and can usually be managed nonoperatively...
March 2, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28255503/outcome-and-2-year-survival-rate-in-elderly-patients-with-lateral-compression-fractures-of-the-pelvis
#18
Andreas Höch, Orkun Özkurtul, Philipp Pieroh, Christoph Josten, Jörg Böhme
INTRODUCTION: Osteoporotic pelvic ring fractures are a rising problem for surgeons in industrialized countries. There is no evidence-based treatment strategy especially for lateral compression (LC) fractures involving the sacrum. The aim of this study was to evaluate and compare outcome and survival rate of nonoperative and operative treatment strategies for lateral compression fractures. PATIENTS AND METHODS: In a retrospective study, 128 patients (aged ≥65 years) with an Orthopedic Trauma Association (OTA) types B2...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28245853/a-neuromuscular-exercise-programme-versus-standard-care-for-patients-with-traumatic-anterior-shoulder-instability-study-protocol-for-a-randomised-controlled-trial-the-sinex-study
#19
Henrik Eshoj, Sten Rasmussen, Lars Henrik Frich, Inge Hvass, Robin Christensen, Steen Lund Jensen, Jens Søndergaard, Karen Søgaard, Birgit Juul-Kristensen
BACKGROUND: Anterior shoulder dislocation is a common injury and may have considerable impact on shoulder-related quality of life (QoL). If not warranted for initial stabilising surgery, patients are mostly left with little to no post-traumatic rehabilitation. This may be due to lack of evidence-based exercise programmes. In similar, high-impact injuries (e.g. anterior cruciate ligament tears in the knee) neuromuscular exercise has shown large success in improving physical function and QoL...
February 28, 2017: Trials
https://www.readbyqxmd.com/read/28245852/reverse-shoulder-arthroplasty-for-the-treatment-of-proximal-humeral-fractures-in-the-elderly-reshape-trial-study-protocol-for-a-multicentre-combined-randomised-controlled-and-observational-trial
#20
Geoffrey C S Smith, Ed Bateman, Ben Cass, Maurizio Damiani, Wade Harper, Hugh Jones, David Lieu, Jeff Petchell, Minas Petrelis, Kalman Piper, Doron Sher, Christopher J Smithers, John Trantalis, Sindy Vrancic, Ian A Harris
BACKGROUND: Proximal humeral fractures are common in older patients. The majority are minimally displaced and are associated with good outcomes after nonoperative treatment. Poorer outcomes are associated with displaced, multipart fractures. There is no clear benefit from surgical fracture fixation compared to nonoperative treatment. Replacement of the fractured humeral head with a hemiarthroplasty is another treatment option, but has not been shown to be clearly superior to nonoperative treatment or internal fixation...
February 28, 2017: Trials
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