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https://www.readbyqxmd.com/read/28434102/outcomes-following-surgical-management-of-cauda-equina-syndrome-does-race-matter
#1
Amit Jain, Emmanuel Menga, Addisu Mesfin
Cauda equina syndrome (CES) is a surgical emergency requiring urgent spinal decompression. Our objective is to analyze the association between race and in-hospital outcomes (complications, mortality, length of stay, and discharge disposition) in patients with CES. This is a retrospective cohort study of CES patients identified via the Nationwide Inpatient Sample (NIS) from 2000 to 2010 in inpatient hospitalizations in the USA. The patient sample includes 46,017 patients ≥18 undergoing spine surgery for CES...
April 21, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28433757/surgical-volunteerism-or-voluntourism-are-we-doing-more-harm-than-good
#2
EDITORIAL
Faheem Ahmed, Madeline Grade, Carl Malm, Sophia Michelen, Na'eem Ahmed
The significant rise in the number of international health electives undertaken by medical students and doctors in the US, Canada and UK reflects acknowledgement of the inter-connected nature of these challenges to health systems and the drive to help solve them. However, the next generation of international volunteers often operate under a conflicting duality: whilst many of their role models have devoted their lives to global health following a similar volunteering experience, there are pervasive ethical problems associated with short-term global health work that must be identified and addressed to ensure positive outcomes for all parties involved...
April 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28430293/three-cases-of-ectopic-sphenoid-sinus-pituitary-adenoma
#3
Ernest Jan Bobeff, Karol Wiśniewski, Wielisław Papierz, Ludomir Stefańczyk, Dariusz Jan Jaskólski
<i><b>Introduction</b>: Ectopic sphenoid sinus pituitary adenoma is a rare tumour originating from embryologic remnants of Rathke's pouch. Although it is considered a clinically benign neoplasm, necrosis is encountered in 25% of cases and it can invade adjacent bone structures. <b>Aims</b>: To establish clinical, radiological and histopathological features of ectopic sphenoid sinus pituitary adenoma. <b>Material and methods: </b> Analysis of three cases: two females and one man, aged 61-70...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28419032/formal-physical-therapy-after-total-hip-arthroplasty-is-not-required-a-randomized-controlled-trial
#4
Matthew S Austin, Brian T Urbani, Andrew N Fleischman, Navin D Fernando, James J Purtill, William J Hozack, Javad Parvizi, Richard H Rothman
BACKGROUND: The value of formal physical therapy after total hip arthroplasty is unknown. With substantial changes that have occurred in surgical and anesthesia techniques, self-directed therapy may be efficacious in restoring function to patients undergoing total hip arthroplasty. METHODS: We conducted a single-center, randomized trial of 120 patients undergoing primary, unilateral total hip arthroplasty who were eligible for direct home discharge. The experimental group followed a self-directed home exercise program for 10 weeks...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28414660/a-mullerian-cyst-resected-from-the-posterior-mediastinum
#5
Ronald Mowad, Navdeep Singh Samraf, Vyas Rao
Differential diagnoses of mediastinal masses are often based on the anatomic locations. Traditionally the posterior mediastinum has been home to esophageal and neurogenic cysts, but a new entity has been found to be prevalent since its initial report in 2005: the Müllerian cyst. We present a 49-year-old with history of cough who was found to have such a mass. We will discuss the surgical outcome and the details of this interesting entity. The literature pertinent to this type of cyst will be evaluated. In all cases reported, the literature demonstrates that surgical removal results in uneventful follow-up with no evidence of malignancy or cyst recurrence...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413381/delayed-cytoreductive-nephrectomy-following-three-years-of-targeted-therapy-for-metastatic-renal-cell-carcinoma
#6
Ariel Schulman, Mathew Fakhoury, Jean P Wuilleumier, Kevin Becker, Bernadine Donahue, Ruoqing Huang, James Butler, Howard Goodman, Ervin Teper, David Silver
We present a 55-year-old male, with good performance status who was diagnosed with a case of metastatic renal cell carcinoma following a pathologic femur fracture. Despite good performance status, multifocal metastases and poor-prognostic features portended a grim prognosis with predicted overall survival of less than nine months. On initial presentation, he was excluded from cytoreductive nephrectomy based on brain metastasis and interleukin-2 was not pursued as the primary tumor was to be left in situ. The patient was reconsidered for cytoreductive nephrectomy after sustained response to fifth line targeted therapies with shrinkage of tumor burden...
January 2017: Current Urology
https://www.readbyqxmd.com/read/28410562/superior-vena-cava-reconstruction-under-the-left-internal-jugular-vein-to-left-femoral-vein-bypass-support
#7
Jun Ba, Runsheng Peng, Hui Shi, Chunsheng Wang
The complete surgical resection of malignant thymoma is recommended. We present a rare case of tumor resection and superior vena cava (SVC) reconstruction under veno-venous bypass support from the left internal jugular vein to the left femoral vein. The full amount of systemic heparinization (3 mg/kg) was avoided. The surgical pathology revealed thymic squamous cell carcinoma. No complications such as fatal extensive bleeding, coagulopathy, thromboembolism or transfusion reaction were found postoperatively...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28408077/does-timing-of-gastroschisis-repair-matter-a-comparison-using-the-acs-nsqip-pediatric-database
#8
Lori A Gurien, Melvin S Dassinger, Jeffrey M Burford, Marie E Saylors, Samuel D Smith
BACKGROUND: There is no consensus on optimal timing of gastroschisis repair. The 2012-2014 ACS NSQIP Pediatric Participant Use Data File was used to compare outcomes of primary versus staged gastroschisis repair. METHODS: Cases were divided into primary repair (0-1day) and staged repair (4-14days). Baseline characteristics and outcomes were compared for primary versus staged closure using Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables...
February 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28404984/giant-iliopsoas-abscess-caused-by-morganella-morganii
#9
Mikio Nakajima, Masamitsu Shirokawa, Yasuhiko Miyakuni, Tomotsugu Nakano, Hideaki Goto
BACKGROUND While uncommon, iliopsoas abscesses can become the underlying cause of a fever of unknown origin. Even in such cases, it is considered rare for an iliopsoas abscess to extend into the subcutaneous space. CASE REPORT A 74-year-old woman with a history of schizophrenia was referred to our hospital with a high-grade fever. The patient was unaware of her febrile status prior to admission. There was no previous hospital admission. Examination revealed a non-tender mass in the lower right back that the patient had been aware of for approximately 1 month...
April 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28399547/early-ambulation-decreases-length-of-hospital-stay-peri-operative-complications-and-improves-functional-outcomes-in-elderly-patients-undergoing-surgery-for-correction-of-adult-degenerative-scoliosis
#10
Owoicho Adogwa, Aladine A Elsamadicy, Jared Fialkoff, Joseph Cheng, Isaac O Karikari, Carlos Bagley
STUDY DESIGN: Ambispective cohort review. OBJECTIVE: To examine the effects of early mobilization on patient outcomes, complications profile and 30-day readmission rates. SUMMARY OF BACKGROUND DATA: Prolonged immobilization after surgery can result in functional decline and an increased risk of hospital-associated complications. METHODS: We conducted an ambispective study of 125 elderly patients (> 65 years old) undergoing elective spinal surgery for correction of adult degenerative scoliosis...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28398964/postacute-care-and-recovery-after-cancer-surgery-still-a-long-way-to-go
#11
Courtney J Balentine, Peter A Richardson, Meredith C Mason, Aanand D Naik, David H Berger, Daniel A Anaya
OBJECTIVE: To determine whether postacute care (PAC) facilities can compensate for increased mortality stemming from a complicated postoperative recovery (complications or deconditioning). BACKGROUND: An increasing number of patients having cancer surgery rely on PAC facilities including skilled nursing and rehabilitation centers to help them recover from postoperative complications and the physical demands of surgery. It is currently unclear whether PAC can successfully compensate for the adverse consequences of a complicated postoperative recovery...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28396616/experiences-of-reduced-work-hours-for-nurses-and-assistant-nurses-at-a-surgical-department-a-qualitative-study
#12
Kristina Gyllensten, Gunnar Andersson, Helena Muller
BACKGROUND: There is a shortage of registered nurses in the European Union (EU), and job dissatisfaction and perceived high work-family conflict have been identified as causes of nursing staff turnover. Reducing work hours is an organisational intervention that could have a positive effect on nurses' and assistant nurses' job satisfaction, work-life balance, and willingness to stay in the job. An orthopaedic surgery department at a large hospital in Sweden introduced reduced work hours for nurses and assistant nurses in order to improve the working situation...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28387923/the-role-of-postmastectomy-radiotherapy-in-women-with-pathologic-t3n0m0-breast-cancer
#13
Richard J Cassidy, Yuan Liu, Shannon T Kahn, Naresh K Jegadeesh, Xi Liu, Preeti D Subhedar, Cletus A Arciero, Theresa W Gillespie, Mylin A Torres
BACKGROUND: The authors determined the impact of postmastectomy radiotherapy (PMRT) on overall survival (OS) among patients with pT3N0M0 breast cancer in the National Cancer Data Base. METHODS: A total of 3437 patients with pT3N0M0 breast cancer who initially were treated with mastectomy between 2003 and 2011 were identified. Of these women, 1644 (47.8%) received PMRT (67% treated with chest wall RT alone and 33% treated with chest wall and regional lymph node irradiation)...
April 7, 2017: Cancer
https://www.readbyqxmd.com/read/28384539/follow-up-after-early-medical-abortion-comparing-clinical-assessment-with-self-assessment-in-a-rural-hospital-in-northern-norway
#14
Carl-Gustav Mählck, Torbjörn Bäckström
OBJECTIVES: A follow-up study was performed on women who had requested medical abortions in a rural hospital in northern Norway to compare clinical assessment with self-assessment of early medical abortion in terms of safety. STUDY DESIGN: During the three-year study period, 392 women requested termination of pregnancy. After excluding those who changed their mind, those who had a spontaneous miscarriage, those who were referred to a central hospital for a two-stage abortion, and those who had the abortion performed surgically, 242 cases remained, and all the medical files were reviewed...
March 29, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28383537/in-hospital-outcomes-of-premature-infants-with-severe-bronchopulmonary-dysplasia
#15
W Jackson, C P Hornik, J A Messina, K Guglielmo, A Watwe, G Delancy, A Valdez, T MacArthur, S Peter-Wohl, P B Smith, V N Tolia, M M Laughon
OBJECTIVE: To characterize in-hospital outcomes of premature infants diagnosed with severe bronchopulmonary dysplasia (BPD). STUDY DESIGN: Retrospective cohort study including premature infants with severe BPD discharged from 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2015. RESULTS: There were 10 752 infants with severe BPD, and 549/10 752 (5%) died before discharge. Infants who died were more likely to be male, small for gestational age, have received more medical interventions and more frequently diagnosed with surgical necrotizing enterocolitis, culture-proven sepsis and pulmonary hypertension following 36 weeks of postmenstrual age compared with survivors...
April 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28378007/do-shorter-lengths-of-stay-increase-readmissions-after-total-joint-replacements
#16
Udai S Sibia, Kip A Waite, Maura A Callanan, Adrian E Park, Paul J King, James H MacDonald
BACKGROUND: Enhanced recovery after surgery protocols for total joint replacements (TJRs) emphasize early discharge, yet the impact on readmissions is not well documented. We evaluate the impact of a one-day length of stay (LOS) discharge protocol on readmissions. METHODS: We conducted a retrospective review of all primary TJRs (hip and knee) from April 2014 to March 2015. Patients who had adequate support to be discharged home were categorized into 2 groups, 1-day (n = 174) vs 2-day (n = 285) LOS groups...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28376756/kalk-study-ultrasound-guided-needling-and-lavage-barbotage-with-steroid-injection-versus-sham-barbotage-with-and-without-steroid-injection-protocol-for-a-randomized-double-blinded-controlled-multicenter-study
#17
Stefan Moosmayer, Ole Marius Ekeberg, Hanna Bjørnsson Hallgren, Ingar Heier, Synnøve Kvalheim, Jesper Blomquist, Are Hugo Pripp, Nils Gunnar Juel, Stein Harald Kjellevold, Jens Ivar Brox
BACKGROUND: For the treatment of calcific tendinitis of the shoulder a variety of treatment regimes exist. Commonly used treatment measures include medication with oral analgesics, corticosteroid injections, extracorporeal shockwave therapy, ultrasound guided needling and lavage, and surgical treatment. Earlier cohort studies suggest that patients may benefit from these treatments, but there are few randomized studies and conflicting evidence about the effectiveness of the various treatments...
April 4, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28365652/interstage-home-monitoring-after-newborn-first-stage-palliation-for-hypoplastic-left-heart-syndrome-family-education-strategies
#18
Jo Ann Nieves, Karen Uzark, Nancy A Rudd, Jennifer Strawn, Anne Schmelzer, Nancy Dobrolet
Children born with hypoplastic left heart syndrome are at high risk for serious morbidity, growth failure, and mortality during the interstage period, which is the time from discharge home after first-stage hypoplastic left heart syndrome palliation until the second-stage surgical intervention. The single-ventricle circulatory physiology is complex, fragile, and potentially unstable. Multicenter initiatives have been successfully implemented to improve outcomes and optimize growth and survival during the interstage period...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28362659/neuroleptic-malignant-syndrome-secondary-to-metoclopramide-use-in-an-elderly-gastroenterologic-surgery-patient
#19
Richard Breeden, Heath Ford, Carey Chrisman, Charles Mascioli
An 84-year-old African American woman was admitted to the hospital secondary to severe abdominal pain accompanied by septic shock. She underwent exploratory laparotomy, which revealed extensive small bowel necrosis likely due to small bowel torsion. A small bowel resection was performed with primary anastomoses and the patient was subsequently transferred to the intensive care unit (ICU). She recovered from shock but had a persistent gastroparesis interfering with enteral feeding, for which metoclopramide was prescribed...
March 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28358595/treatment-of-enterocutaneous-fistulas-then-and-now
#20
Luis Alfonso Ortiz, Bin Zhang, Maureen Walsh McCarthy, Haytham M A Kaafarani, Peter Fagenholz, David R King, Marc De Moya, George Velmahos, Daniel Dante Yeh
BACKGROUND: An enterocutaneous fistula (ECF) is an aberrant connection between the gastrointestinal tract and the skin or atmosphere (enteroatmospheric fistula [EAF]). Multimodal treatment includes surgical procedures, nutrition support, and wound care. We evaluated our practice and compared our outcomes with previous results published from our institution. MATERIALS AND METHODS: We performed a retrospective analysis of hospitalized ECF/EAF patients admitted between January 2011 and November 2015...
March 1, 2017: Nutrition in Clinical Practice
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