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https://www.readbyqxmd.com/read/28215039/impact-of-surgical-experience-on-management-and-outcome-of-pancreatic-surgery-performed-in-high-and-low-volume-centers
#1
Marco Stella, Massimiliano Bissolati, Daniele Gentile, Alessandro Arriciati
Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume...
February 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28215029/an-introduction-to-the-pathophysiology-of-aneurysmal-subarachnoid-hemorrhage
#2
REVIEW
Jasper H van Lieshout, Maxine Dibué-Adjei, Jan F Cornelius, Philipp J Slotty, Toni Schneider, Tanja Restin, Hieronymus D Boogaarts, Hans-Jakob Steiger, Athanasios K Petridis, Marcel A Kamp
Pathophysiological processes following subarachnoid hemorrhage (SAH) present survivors of the initial bleeding with a high risk of morbidity and mortality during the course of the disease. As angiographic vasospasm is strongly associated with delayed cerebral ischemia (DCI) and clinical outcome, clinical trials in the last few decades focused on prevention of these angiographic spasms. Despite all efforts, no new pharmacological agents have shown to improve patient outcome. As such, it has become clear that our understanding of the pathophysiology of SAH is incomplete and we need to reevaluate our concepts on the complex pathophysiological process following SAH...
February 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28214832/the-burden-of-respiratory-disease-in-very-low-birth-weight-infants-changes-in-perinatal-care-and-outcomes-in-a-decade-in-spain
#3
Fermín García-Muñoz Rodrigo, Antonio Losada Martínez, María Dolores Elorza Fernández, Julio Moreno Hernando, Josep Figueras Aloy, Máximo Vento Torres
BACKGROUND: Advances in perinatal care have led to a significant reduction in morbidity and mortality among very-low-birth-weight (VLBW) infants. Much of this progress is related to the prevention and management of respiratory disease. OBJECTIVES: To evaluate changes in perinatal care and its influence on respiratory morbidity and mortality among VLBW infants in Spain in 2 consecutive periods (2002-2006 and 2007-2011). METHODS: This is a retrospective analysis of data prospectively collected of all VLBW infants included in the Spanish SEN1500 network...
February 18, 2017: Neonatology
https://www.readbyqxmd.com/read/28214641/posterior-reversible-encephalopathy-syndrome-causing-vision-loss-following-endoscopic-endonasal-resection-of-pituitary-adenoma-a-case-report
#4
Nicolas W Villelli, Daniel M Prevedello, Daniel S Ikeda, Alaa S Montaser, Bradley A Otto, Ricardo L Carrau
BACKGROUND: Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by headache, altered mental status, visual changes, and seizure combined with brain imaging consistent with cerebral edema without infarction. To the best of our knowledge, we report the first case of PRES following an endoscopic endonasal resection of a pituitary macroadenoma. CASE DESCRIPTION: A 59-year-old female was diagnosed with a pituitary macroadenoma, for which she underwent endoscopic endonasal extracapsular resection...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28214559/radiation-therapy-for-invasive-breast-cancer-increases-the-risk-of-second-primary-lung-cancer-a-nationwide-population-based-cohort-analysis
#5
Yi-Jhih Huang, Tsai-Wang Huang, Fu-Huang Lin, Chi-Hsiang Chung, Chang-Huei Tsao, Wu-Chien Chien
INTRODUCTION: Although the risk factors for lung cancer are well documented, it remains unclear if previous radiation therapy (RT) to treat breast cancer (BC) increases the incidence of second primary lung cancer. We determined the overall incidence of second primary lung cancer after previous RT for all clinical stages of BC. METHODS: After analyzing the Longitudinal Health Insurance Database, 986,713 individuals were randomly enrolled from 2000 to 2010 for cohort analysis...
January 31, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28214526/recent-advances-in-human-genetics-and-epigenetics-of-adiposity-pathway-to-precision-medicine
#6
Tove Fall, Michael Mendelson, Elizabeth K Speliotes
Obesity is a heritable trait that contributes to substantial global morbidity and mortality. Here, we summarize findings from the last decade of genetic and epigenetic research focused on unravelling the underpinnings of adiposity. More than 140 genetic regions are now known to influence adiposity traits. The genetics of general adiposity, as measured by body mass index, and that of abdominal obesity, as measured by waist to hip ratio, have distinct biological backgrounds. Expression of genes associated with general adiposity are enriched in the nervous system...
February 15, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28214525/-is-there-an-optimal-diet-for-weight-management-and-metabolic-health
#7
George Thom, Mike Lean
Individuals can lose body weight and improve health status on a wide range of energy (calorie) restricted dietary interventions. In this paper, we have reviewed the effectiveness of the most commonly utilized diets, including low-fat, low-carbohydrate and Mediterranean approaches in addition to commercial slimming programmes, meal replacements and newly-popularized intermittent fasting diets. We also consider the role of artificial sweeteners in weight management. Low-fat diets tend to improve LDL-cholesterol most, whilst lower-carbohydrate diets may preferentially improve triglycerides and HDL-cholesterol, however differences between diets are marginal...
February 15, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28214498/vasculitic-and-autoimmune-wounds
#8
REVIEW
Victoria K Shanmugam, Divya Angra, Hamza Rahimi, Sean McNish
OBJECTIVE: Chronic wounds are a major cause of morbidity and mortality. Approximately 20% to 23% of nonhealing wounds that are refractory to vascular intervention have other causes, including vasculitis, pyoderma gangrenosum, and other autoimmune diseases. The purpose of this article was to review the literature across medical and surgical specialties with regard to refractory chronic wounds associated with vasculitis and autoimmune diseases and to delineate clinical outcomes of these wounds in response to vascular and other interventions...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214486/robotic-inferior-vena-cava-surgery
#9
Victor J Davila, Cristine S Velazco, William M Stone, Richard J Fowl, Haidar M Abdul-Muhsin, Erik P Castle, Samuel R Money
OBJECTIVE: Inferior vena cava (IVC) surgery is uncommon and has traditionally been performed through open surgical approaches. Renal cell carcinoma with IVC extension generally requires vena cavotomy and reconstruction. Open removal of malpositioned IVC filters (IVCF) is occasionally required after endovascular retrieval attempts have failed. As our experience with robotic surgery has advanced, we have applied this technology to surgery of the IVC. We reviewed our institution's experience with robotic surgical procedures involving the IVC to determine its safety and efficacy...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214485/outcome-of-peripheral-venous-reconstructions-during-tumor-resection
#10
Philip Y Sun, Mark D Fleming, Kendall Stauffer, Manju Kalra, Gustavo Oderich, Thomas Bower, Peter Gloviczki, Randall R DeMartino
OBJECTIVE: Peripheral venous reconstruction surgery may be necessary for appropriate oncologic resection; however, the operative approach and surgical outcomes are not well described. We report our experience with these complex reconstructions to identify best practice. METHODS: We retrospectively reviewed all adult patients who underwent peripheral vein reconstruction for tumor resection at Mayo Clinic, Rochester (2000-2015). Patients were classified into three subgroups by the location: iliac (IL), lower extremity (LE), and upper extremity (UE)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214469/cost-benefit-analysis-of-chlamydia-trachomatis-screening-in-pregnant-women-in-a-high-burden-setting-in-the-united-states
#11
Jared Ditkowsky, Khushal H Shah, Margaret R Hammerschlag, Stephan Kohlhoff, Tamar A Smith-Norowitz
BACKGROUND: Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) in the United States (U.S.) [1] and remains a major public health problem. We determined the cost- benefit of screening all pregnant women aged 15-24 for Chlamydia trachomatis infection compared with no screening. METHODS: We developed a decision analysis model to estimate costs and health-related effects of screening pregnant women for C. trachomatis in a high burden setting (Brooklyn, NY)...
February 18, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28214396/totally-extra-peritoneal-repair-for-acute-incarcerated-femoral-hernia-with-intestinal-obstruction
#12
Guowei Kim, Jimmy Bok Yan So, Asim Shabbir
INTRODUCTION: Femoral hernias frequently present with incarceration, resulting in obstruction and strangulation. Laparoscopic groin hernia repairs have been shown in the elective setting to be an effective alternative to open repair. Acute incarceration of groin hernia with obstruction, though previously seen as a relative contraindication, has been increasingly repaired with minimally invasive techniques, with the potential benefit of avoiding the morbidity associated with a laparotomy...
January 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28214329/-p-clphse-2-reduces-hepatotoxicity-induced-by-monosodium-glutamate-by-improving-mitochondrial-function-in-rats
#13
Caroline B Quines, Pietro M Chagas, Diane Hartmann, Nélson R Carvalho, Félix A Soares, Cristina W Nogueira
It is has been demonstrated that mitochondrial dysfunction, oxidative stress and chronic inflammatory process are associated with progress of morbid obesity in human patients. For this reason, the searching for safe and effective antiobesity drugs has been the subject of intense research. In this context, the organic selenium compounds have attracted much attention due to their pharmacological properties, such as antihyperglycemic, antioxidant and anti-inflammatory. The aim of this study was to evaluate the hepatoprotective action of p-chloro-diphenyl diselenide (p-ClPhSe)2 , an organic selenium compound, in a model of obesity induced by monosodium glutamate (MSG) administration in rats...
February 18, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28214181/-adult-immunisation-general-points-hot-topics-and-perspectives
#14
P Loubet, O Launay
Vaccination in immunocompetent adult mainly concerns booster vaccination against diphtheria, tetanus, polio and pertussis. Some chronic diseases may also require the achievement of pneumococcal and influenza vaccines. In addition, from the age of 65, annual influenza vaccination as well as one dose of a live attenuated shingles vaccine between 64 and 75 years are recommended. Immunocompromised adults, due to the increased risk of serious infections responsible of significant morbidity and mortality, are particularly concerned by vaccination...
February 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28214166/sleeve-gastrectomy-in-the-elderly-a-case-control-study-with-long-term-follow-up-of-3-years
#15
Andrés Navarrete, Ricard Corcelles, Gabriel Diaz Del Gobbo, Sofía Perez, Josep Vidal, Antonio Lacy
BACKGROUND: Advanced age is considered to be a relative contraindication to bariatric surgery because of increased perioperative risk and suboptimal excess weight loss. OBJECTIVES: The aim of this study was to analyze the safety and effectiveness of the sleeve gastrectomy (SG) procedure in a cohort of elderly patients (aged≥60 yr) compared with younger patients (aged<60 yr). SETTING: Hospital clinic, Barcelona, Spain. METHODS: A retrospective analysis of all cases of SG in patients≥60 years old between January 2006 and December 2012 was performed...
December 14, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28214150/self-efficacy-for-deprescribing-a-survey-for-health-care-professionals-using-evidence-based-deprescribing-guidelines
#16
Barbara Farrell, Lisa Richardson, Lalitha Raman-Wilms, David de Launay, Mhd Wasem Alsabbagh, James Conklin
BACKGROUND: Although polypharmacy is associated with significant morbidity, deprescribing can be challenging. In particular, clinicians express difficulty with their ability to deprescribe (i.e. reduce or stop medications that are potentially inappropriate). Evidence-based deprescribing guidelines are designed to help clinicians take action on reducing or stopping medications that may be causing more harm than benefit. OBJECTIVES: Determine if implementation of evidence-based guidelines increases self-efficacy for deprescribing proton pump inhibitor (PPI), benzodiazepine receptor agonist (BZRA) and antipsychotic (AP) drug classes...
January 28, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28214145/effect-of-reduction-mammoplasty-on-acute-radiation-side-effects-and-use-of-lumpectomy-cavity-boosts
#17
Jolinta Y Lin, Rachel Bluebond-Langner, Enid Choi, Sally Cheston, Elizabeth M Nichols, Randi J Cohen, Soren M Bentzen, Cynthia Drogula, Susan Kesmodel, Emily Bellavance, Paula Rosenblatt, Katherine Tkaczuk, Sheri Slezak, Steven J Feigenberg
PURPOSE: Reduction mammoplasty (RM) during breast-conserving surgery is popular among women with large-volume breasts because it reduces redundant breast folds and may decrease skin-related morbidity from radiation therapy. However, RM may obscure the lumpectomy cavity (LC) and pose challenges to administering an LC boost, potentially affecting local control. We investigated the impact of RM on acute side effects and use of LC boosts. METHODS AND MATERIALS: The records of 645 consecutive women treated with whole-breast irradiation at an urban university and 2 community practices between January 2012 and December 2014 were reviewed on an institutional review board-approved study...
January 7, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28214140/a-review-of-strategies-for-infarct-size-reduction-during-acute-myocardial-infarction
#18
REVIEW
Yasir Parviz, Sethumadhavan Vijayan, Shahar Lavi
Advances in medical and interventional therapy over the last few decades have revolutionized the treatment of acute myocardial infarction. Despite the ability to restore epicardial coronary artery patency promptly through percutaneous coronary intervention, tissue level damage may continue. The reported 30-day mortality after all acute coronary syndromes is 2 to 3%, and around 5% following myocardial infarction. Post-infarct complications such as heart failure continue to be a major contributor to cardiovascular morbidity and mortality...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28214097/impact-of-an-enhanced-recovery-after-surgery-programme-in-radical-cystectomy-a-cohort-comparative-study
#19
R Casans-Francés, A T Roberto-Alcácer, A C García-Lecina, M L Ferrer-Ferrer, J Subirá-Ríos, J Guillén-Antón
OBJECTIVE: To evaluate the results of the implementation of an enhanced recovery program (ERAS) for open approach radical cystectomy compared to the historical cohort of the same hospital. MATERIAL AND METHODS: A retrospective analysis of 138 consecutive patients who underwent radical cystectomy with Bricker or Studer ileal derivation (97 historical vs. 41 ERAS). Overall complication rate, Clavien-Dindo stage>2 complications, mortality, hospital and critical care length of stay and readmission rates, as well as need for reoperation, nasogastric intubation, transfusion or parenteral nutrition were compared...
February 14, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28214003/lipoma-of-the-mitral-valve
#20
William C Roberts, Paul A Grayburn, Baron L Hamman
Described herein is a 67-year-old morbidly obese man who had a lipoma excised from his posterior mitral leaflet after it was found by echocardiogram. Findings in 6 other previously reported cases are reviewed.
January 6, 2017: American Journal of Cardiology
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