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https://www.readbyqxmd.com/read/27919452/imaging-gently-higher-rates-of-computed-tomography-imaging-for-pediatric-appendicitis-in-non-children-s-hospitals
#1
K Tinsley Anderson, Luke R Putnam, Kelly M Caldwell, Michael B Diffley, Aubrey A Hildebrandt, Sarah E Covey, Mary T Austin, Akemi L Kawaguchi, Kevin P Lally, KuoJen Tsao
BACKGROUND: Growing concerns regarding radiation exposure in children have led to recommendations to minimize computed tomography imaging for appendicitis. We hypothesized that within a metropolitan hospital system (1 children's hospital and 8 non-children's hospitals), use of preoperative computed tomography is much greater in non-children's hospitals. METHODS: We conducted a retrospective study of patients <18 years of age undergoing appendectomy for acute appendicitis from April 2012 to April 2015...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27910800/routine-x-ray-of-the-chest-is-not-justified-in-staging-of-cutaneous-melanoma-patients
#2
Caroline Asirvatham Gjørup, Helle Westergren Hendel, Rita Kaae Pilegaard, Cecilie Balslev Willert, Lisbet Rosenkrantz Hölmich
INTRODUCTION: The incidence of cutaneous melanoma is increasing in Denmark and worldwide. However, the prevalence of distant metastases at the time of diagnosis has decreased to 1%. We therefore questioned the value of routine preoperative chest X-ray (CXR) for staging asymptomatic melanoma patients and hypothesised that routine CXR is not justified. METHODS: A retrospective study was conducted on patients undergoing wide local excision and sentinel lymph node biopsy for cutaneous melanoma in the period from 2010 to 2014...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#3
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27905053/seom-clinical-guideline-of-localized-rectal-cancer-2016
#4
E González-Flores, F Losa, C Pericay, E Polo, S Roselló, M J Safont, R Vera, J Aparicio, M T Cano, C Fernández-Martos
Localized rectal adenocarcinoma is a heterogeneous disease and current treatment recommendations are based on a preoperative multidisciplinary evaluation. High-resolution magnetic resonance imaging and endoscopic ultrasound are complementary to do a locoregional accurate staging. Surgery remains the mainstay of treatment and preoperative therapies with chemoradiation (CRT) or short-course radiation (SCRT) must be considered in more locally advanced cases. Novel strategies with induction chemotherapy alone or preceding or after CRT (SCRT) and surgery are in development...
December 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27901596/magnetic-resonance-imaging-in-the-pre-surgical-staging-of-breast-cancer-our-experience
#5
Paola Rabasco, Rocchina Caivano, Giuseppina Dinardo, Matilde Gioioso, Antonella Lotumolo, Giancarlo Iannelli, Antonio Villonio, Giuseppe La Torre, Stefano D'Errico, Luca Macarini, Giuseppe Guglielmi, Aldo Cammarota
PURPOSE: To investigate the clinical impact of magnetic resonance imaging (MRI) in the detection of multifocal-multicentric breast cancers, already identified by mammography and ultrasound, and analyzed histologically, to evaluate its role in preoperative staging. MATERIALS AND METHODS: From January 2012 to February 2014, 188 patients, aged 28 to 74 years, newly diagnosed with breast cancer on conventional imaging (mammography and ultrasound) were enrolled. They underwent preoperative contrast-enhanced 3T MRI...
November 30, 2016: Cancer Investigation
https://www.readbyqxmd.com/read/27896825/is-it-time-to-reconsider-lobectomy-in-low-risk-paediatric-thyroid-cancer
#6
Wouter P Kluijfhout, Jesse D Pasternak, Danielle van der Kaay, Menno R Vriens, Evan J Propst, Jonathan D Wasserman
OBJECTIVE: Current guidelines recommend total thyroidectomy for nearly all children with well-differentiated thyroid cancer (WDTC). These guidelines, however, derive from older data accrued prior to current high-resolution imaging. We speculate that there is a sub-population of children who may be adequately treated with lobectomy. DESIGN: Retrospective analysis of prospectively maintained database. PATIENTS: 73 children with WDTC treated between 2004 and 2015...
November 29, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27896677/results-of-database-studies-in-spine-surgery-can-be-influenced-by-missing-data
#7
Bryce A Basques, Ryan P McLynn, Michael P Fice, Andre M Samuel, Adam M Lukasiewicz, Daniel D Bohl, Junyoung Ahn, Kern Singh, Jonathan N Grauer
BACKGROUND: National databases are increasingly being used for research in spine surgery; however, one limitation of such databases that has received sparse mention is the frequency of missing data. Studies using these databases often do not emphasize the percentage of missing data for each variable used and do not specify how patients with missing data are incorporated into analyses. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to examine whether different treatments of missing data can influence the results of spine studies...
November 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27896181/the-correlation-between-the-orbital-volume-ratio-and-enophthalmos-in-unoperated-blowout-fractures
#8
Su Hyun Choi, Dong Hee Kang, Ja Hea Gu
BACKGROUND: Enophthalmos may not appear immediately after trauma due to periorbital swelling in a blowout fracture, and preoperative measurements of enophthalmos cannot be used as a reliable guideline. It is important to predict the eventual final extent of enophthalmos in order to determine whether to perform surgery, and there have been several attempts to predict the degree of late enophthalmos using preoperative orbital volume. The purpose of this study is to investigate the correlation between the orbital volume ratio (OVR) with final enophthalmos and the palpebral fissure, and to find the OVR that induced 2 mm of enophthalmos in unilateral unoperated blowout fractures...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27894155/increased-lower-extremity-venous-stasis-may-contribute-to-deep-venous-thrombosis-formation-after-microsurgical-breast-reconstruction-an-ultrasonographic-study
#9
Arash Momeni, Michael G Tecce, Michael A Lanni, Shagun Aggarwal, Christopher Pannucci, Stephen J Kovach, Suhail K Kanchwala, Liza C Wu, Joseph M Serletti
Background Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis. Methods An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27889306/return-to-sporting-activity-after-total-hip-arthroplasty-a-survey-of-members-of-the-british-hip-society
#10
Benjamin M Bradley, Stephen J Moul, Fintan J Doyle, Matthew J Wilson
BACKGROUND: Total hip arthroplasty is increasingly performed in younger, more active patients. Thirty-five percent of patients are involved in sports preoperatively, and a desire to return to sporting activity is now a major expectation. Sporting activity potentially risks premature failure of the implant, and there is no consensus or guidelines among British or European surgeons performing total hip arthroplasty in sporting patients. METHODS: The current practice of British Hip Society members was explored through a Web-based survey...
September 28, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27888671/sclerosing-polycystic-adenosis-of-the-parotid-gland-a-systematic-review-and-report-of-2-new-cases
#11
Carlos A Espinosa, Laura Rua, Héctor E Torres, Álvaro Fernández Del Valle, Rui P Fernandes, Juan C Devicente
PURPOSE: We sought to evaluate clinical-epidemiologic aspects, pathologic characteristics, and treatment of sclerosing polycystic adenosis (SPA) of the parotid gland and to report 2 new cases. MATERIALS AND METHODS: We conducted a systematic review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for studies published in or before June 2016. The inclusion criteria were as follows: final diagnosis of SPA affecting the parotid gland and articles published in Spanish or English...
November 2, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27883254/the-degree-of-extramural-spread-of-t3-rectal-cancer-an-appeal-to-the-ajcc
#12
R Zinicola, G Pedrazzi, N Haboubi, R J Nicholls
AIM: The T3 category of the TNM classification includes over 60% of all rectal tumours and encompasses the greatest variance in cancer specific end points than any other T category. The most recent edition of the cancer staging handbook of the American Joint Committee on Cancer (AJCC) (1) dated 2010 does not divide T3 tumours into subgroups which reflect cancer specific outcome more sensitively. The original aim of the present study was to review the literature to assess the influence of the degree of extramural extent of T3 rectal cancer on local recurrence and survival...
November 24, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27882420/the-clinical-indications-for-limited-surgery-of-intraductal-papillary-mucinous-neoplasms-of-the-pancreas
#13
Kenjiro Kimura, Ryosuke Amano, Sadaaki Ymazoe, Go Ohira, Kohei Nishio, Kosei Hirakawa, Masaichi Ohira
BACKGROUND: There are many reports about limited surgery for intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. However, there is no consensus on limited surgery for IPMNs. The primary objective of this study was to define the clinical indications for limited surgery for IPMNs. METHODS: The data of 98 patients who underwent curative resections for IPMN were retrospectively analyzed. IPMNs were classified into four different pathological grades: low-grade dysplasia (LGD), intermediate-grade dysplasia (IGD), high-grade dysplasia (HGD), and invasive carcinoma (Inv-IPMN)...
November 23, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27881294/comparison-of-outcomes-with-arthroscopic-repair-of-acute-on-chronic-within-6-months-and-chronic-rotator-cuff-tears
#14
Jeung Yeol Jeong, Seung Yeop Song, Jae Chul Yoo, Keun Min Park, Sang Min Lee
BACKGROUND: The purpose of this study was to define preoperative and intraoperative findings of acute-on-chronic rotator cuff tears (RCTs). This study also compared the functional and clinical outcomes with acute-on-chronic RCTs and chronic RCTs. METHODS: This study was conducted between December 2007 and December 2013. An acute-on-chronic full-thickness RCT was diagnosed with preoperative and intraoperative findings on arthroscopy. The study group consisted of 36 patients with preoperative and intraoperative findings (surgery performed within 6 months of trauma) indicative of an acute-on-chronic RCT...
November 21, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27879509/surgical-site-infections-following-the-transoral-approach-a-review-of-172-consecutive-cases
#15
QingShui Yin, Hong Xia, ZengHui Wu, XiangYang Ma, FuZhi Ai, Kai Zhang, JianHua Wang, Tao Zhang, ZhaoHui Bai, ZhiYun Wang
STUDY DESIGN: A retrospective review. OBJECTIVE: The aim of this study was to discuss the characteristics, treatment, and incidence of surgical site infection (SSI) following transoral approach surgery. SUMMARY OF BACKGROUND DATA: One of the primary risks associated with transoral approach surgery is postoperative SSI. Few reports exist detailing the specific circumstances, treatment options, and incidence of SSIs following transoral approach surgery in a large series of consecutive cases...
December 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27878044/a-comparative-study-of-radical-prostatectomy-and-permanent-seed-brachytherapy-for-low-and-intermediate-risk-prostate-cancer
#16
Daniel Taussky, Véronique Ouellet, Guila Delouya, Fred Saad
INTRODUCTION: We sought to compare the outcomes between radical prostatectomy (RP) and permanent seed prostate brachytherapy (PB) in patients with low- and low-intermediate-risk prostate cancer from a single tertiary care centre. METHODS: Patients were selected from our institute's internal database based on preoperative selection criteria from the National Comprehensive Cancer Network (NCCN) guidelines (2015) for low- and intermediate-risk patients. No patient had received any neo-adjuvant androgen-deprivation therapy...
August 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/27871597/variability-in-anesthesiologists-approach-to-the-preoperative-management-of-asthmatic-children
#17
Keren Armoni Domany, Guy Gut, Bat-El Yakir, Yakov Sivan
OBJECTIVE: No consensus guidelines exist for the preoperative treatment of asthmatic children referred for elective surgery. We investigated the attitude of pediatric anesthesiologists to this issue. DESIGN: A questionnaire survey was conducted. SETTING: National survey. SUBJECTS: Certified Israeli pediatric anesthesiologists from all 24 general hospitals in Israel. MEASUREMENT: Twenty-one questions regarding the approach to preoperative management of asthmatic children including 6 case scenarios with a variety of clinical situations and treatments of asthmatic children...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871580/c1-esterase-inhibitor-for-short-term-prophylaxis-in-a-patient-with-hereditary-angioedema-with-normal-c1-inhibitor-function
#18
Savio K H Yu, Jeannie Callum, Asim Alam
Hereditary angioedema with normal C1-esterase inhibitor (HAE-nC1INH) perioperative is a rare condition which could have potential disastrous ramifications for the anesthesiologist in the perioperative period. However, there is limited evidence and/or guidelines on the optimal way to manage these patients. We present the case of a patient with HAE-nC1INH who was successfully managed in the perioperative period with plasma derived C1-esterase inhibitor (pdC1INH). A 29-year-old woman with a diagnosis of HAE-nC1INH presented to the preoperative consultation in preparation for an upcoming total thyroidectomy...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871517/guidelines-for-preoperative-investigations-for-elective-surgery-at-queen-elizabeth-hospital-effects-on-practices-outcomes-and-costs
#19
Judith Nicholls, Pamela S Gaskin, Justin Ward, Yasodananda K Areti
STUDY OBJECTIVE: We endeavor to assess the impact of introduction of guidelines for preoperative investigations (PIs) on anesthetic practices and costs and compare their efficacy to current practices. DESIGN: A prospective study. SETTING: Queen Elizabeth Hospital, Barbados. PATIENTS: Participants comprised all patients undergoing general, epidural, spinal, and regional anesthesia, with the exception of emergency cases or instances where an anesthesiologist was not required...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871494/current-surgical-management-of-carotid-body-tumors
#20
Victor J Davila, James M Chang, William M Stone, Richard J Fowl, Thomas C Bower, Michael L Hinni, Samuel R Money
BACKGROUND: Carotid body tumors (CBTs) are rare. Management guidelines may include genetic testing for succinate dehydrogenase (SDH) mutations. We performed an institutional review of the surgical management of CBT. METHODS: A retrospective analysis (1994-2015) of CBT excisions at our institution was performed. Data obtained included demographics, genetic testing (if performed), intraoperative details, postoperative morbidity, and long-term outcomes. Data from the first CBT excision were included in patients with bilateral tumors...
December 2016: Journal of Vascular Surgery
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