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https://www.readbyqxmd.com/read/29034655/surgery-for-distal-hypospadias-what-about-the-catheter
#1
Maria-Grazia Scarpa, Giordano Perin, Massimo Di Grazia, Daniela Codrich, Federica Pederiva, Edoardo Guida, Maria Antonietta Lembo, Antonio Giannotta, Jürgen Schleef
No agreed recommendations exist for timing of urethral stent removal, after distal hypospadias surgery. We compared our preliminary case series with outcomes from literature: 18/44 patients were treated with catheter and 26/44 without it. The surgical outcome was comparable in the two groups. After hypospadias surgery, the main advantage of the immediate postoperative catheter removal was the shorter hospital stay without negatively affecting the care and home management.
September 28, 2017: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/29033614/fusion-of-lower-limbs-with-severe-urogenital-malformation-in-a-newborn-a-rare-congenital-clinical-syndrome-case-report
#2
Fatemah Al Hadhoud, Abeer H Kamal, Abdulmohsen Al Anjari, Michael Fe Diejomaoh
BACKGROUND: Fused lower limbs combined with severe urogenital malformation, also known as sirenomelia, is a rare congenital clinical syndrome. The etiology is unknown, and the outcome for the affected fetus is rather uncertain. CASE REPORT: Mrs RB, a Kuwaiti woman primigravida, married to a non-consanguineous husband, had uneventful antenatal care in a private health service, until she was admitted to the Maternity Hospital, Kuwait, at 31 weeks of gestation with a 3-hour history of ruptured membranes...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29032007/the-effect-of-sevoflurane-compared-to-propofol-maintenance-on-post-surgical-quality-of-recovery-in-patients-undergoing-an-ambulatory-gynecological-surgery-a-prospective-randomized-double-blinded-controlled-clinical-trial
#3
Gildasio S De Oliveira, Jane Bialek, Meghan E Rodes, Mark C Kendall, Robert J McCarthy
OBJECTIVE: The main objective of the current investigation was to evaluate the effect of propofol used as anesthetic maintenance compared to sevoflurane on global post-surgical quality of recovery in female patients undergoing ambulatory gynecological surgery. DESIGN: The study was a prospective randomized double blinded, controlled, clinical trial. INTERVENTIONS: Healthy female subjects were randomized to receive propofol or sevoflurane as anesthetic maintenance...
October 12, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29031173/an-unusual-case-of-transpelvic-impalement-injury-a-case-report
#4
Mushrek Alani, Saeed Mahmood, Ayman El-Menyar, Sajid Atique, Hassan Al-Thani, Ruben Peralta
INTRODUCTION: Impalement injury is a rare type of mechanical injury following forceful insertion of projecting object into the body. Careful planning for removal of the impaling object is essential to decrease the blood loss and preserve the function of the injured organ. PRESENTATION OF CASE: A 27 year-old male fell from 4m height over a U shaped projecting up metallic bar. The bar penetrated the left side of the pelvis and traversed through the left iliac bone causing a comminuted fracture in the supra-acetabular region extending to the left psoas muscle, injuring the viscera and causing fracture of the right femur...
October 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29029665/mohs-micrographic-surgery-key-pharmacologic-considerations
#5
Diana Fischer, Patricia Orlando, Laura Shane-McWhorter
OBJECTIVE: To describe Mohs micrographic surgery and evaluate whether direct oral anticoagulants should be withheld in patients with atrial fibrillation (Afib) prior to the procedure and to consider what type of antibiotic prophylaxis should be used. SETTING: A community setting in which an elderly patient is living independently at home. PRACTICE DESCRIPTION: Academic-affiliated internal medicine clinic that cares for adult patients of all ages, including elderly patients living independently in their own home...
August 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29028785/a-shot-through-the-heart
#6
Marco Centola, Diego Salerno-Uriarte, Laura Toffetti, Stefano Lucreziotti, Carlo Sponzilli, Andrea Moneta, Francesco Donatelli, Stefano Carugo
: The case presented describes a very rare cause of 'needle-like' chest pain in a 52-year-old Egyptian man. A sharp 38-mm long needle was detected in the lateral wall of the right ventricle by means of cardiac computed tomography scan. After heart team discussion, the patient underwent minimally invasive cardiac surgery intervention. The needle was successfully removed though left minithoracotomy, and the patient was discharged home on the 5th day. The diagnosis of intracardiac foreign bodies may be challenging...
October 11, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29028652/novel-dry-lab-training-method-for-totally-endoscopic-coronary-anastomosis-a-pilot-study
#7
Kosuke Ujihira, Akira Yamada
OBJECTIVE: We describe our original dry-lab training system for nonrobotic and beating heart endoscopic coronary artery anastomosis. METHODS: All the materials used for this training were commercially available. We selected a boxed machine, which can produce pulsatile movements of artificial vessels, and on its roof, we installed a two-dimensional home video camera and a monitor. A multiple-holed plate was placed in front of the machine, and through these holes, a trainee inserted endoscopic surgical instruments and anastomosed the artificial vessels by running fashion while watching the monitor...
October 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29027640/the-utility-of-botulinum-toxin-a-in-the-repair-of-distal-biceps-tendon-ruptures
#8
L S Khalil, R A Keller, N Mehran, N E Marshall, K Okoroha, N B Frisch, S P DeSilva
PURPOSE: The purpose of our study is to report the outcomes and complications in patients who underwent distal biceps tendon repair with the use of Botulinum toxin A (BoNT-A) as an adjunct to surgery. METHODS: A retrospective review of 14 patients who underwent 15 distal biceps tendon repairs was performed. All repaired tendons had their correlating muscle bellies injected intraoperatively with a mixture of 100U of BoNT-A and 10 ml of normal saline. Each patient was evaluated for surgical and post-operative complications and followed with Disabilities of the Arm, Shoulder and Hand (DASH) Disability Scores...
October 13, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/29026365/incidental-finding-of-bronchopulmonary-sequestration-in-a-64-year-old-female
#9
Pichapong Tunsupon, Ayesha Arshad, Sumit Patel, M Jeffery Mador
BACKGROUND: Bronchopulmonary sequestration is a congenital abnormality of the primitive foregut. In adults, the typical age at presentation is 20-25 years. CASE REPORT: A 64-year-old female was referred for evaluation of an 8 × 6-cm right lower lobe cystic lesion. Her medical history was significant for recurrent right lower lobe pneumonia requiring multiple hospitalizations. Her physical examination was significant for crackles at the right lung base. Computed tomography (CT) of the chest with contrast showed cystic changes with thickened septation of the medial segment of the right lower lobe lacking distinct visceral pleura and with arterial supply from the anomalous branch of the thoracic aorta arising near the celiac trunk...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29024382/comparison-of-outcomes-with-surgical-cut-down-versus-percutaneous-transfemoral-transcatheter-aortic-valve-replacement-tavr-transfemoral-access-comparisons-between-surgical-cut-down-and-percutaneous-approach
#10
Brandon C Drafts, Charles H Choi, Kunal Sangal, Michael W Cammarata, Robert J Applegate, Sanjay K Gandhi, Edward H Kincaid, Neal Kon, David X Zhao
OBJECTIVES: The objective is to compare the short-term (30 days) and late (12 months) vascular adverse events in patients undergoing transfemoral (TF)-transcatheter aortic valve replacement (TAVR) by surgical cut-down (SC) vs. percutaneous (PC) approaches. BACKGROUND: Programs continue to utilize both approaches in TF-TAVR. There are limited data comparing outcomes by SC vs. PC approaches and long-term effects of endovascular intervention facilitated hemostasis on late vascular adverse events...
October 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29021673/risk-factors-for-30-day-outcomes-in-elective-anterior-versus-posterior-cervical-fusion-a-matched-cohort-analysis
#11
John K Yue, Pavan S Upadhyayula, Hansen Deng, David C Sing, Joseph D Ciacci
OBJECTIVE: Cervical spine fusion is the preferred treatment modality for a variety of degenerative and/or myelopathic disorders. Surgeons select between two approaches (anterior or posterior cervical fusion [ACF; PCF]) based on pathoanatomical features and spinal levels involved. Complications and outcome profiles between the approaches following elective surgery have not been systematically investigated. METHODS: Adult patients undergoing elective ACF or PCF were extracted from the American College of Surgeons National Surgical Quality Improvement Program years 2011-2014...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29016576/quality-of-clinical-notes-lesson-learned-from-elective-surgery-patients-admitted-at-university-teaching-hospital
#12
Jay N Shah, Shantbir Maharjan, Shailendra Shah
BACKGROUND: Informative relevant documentation regarding course of treatment minimizes errors, provides data for evidence based practice and legality. However, the clinical notes are often inadequate. This study aims to analyse quality of structured clinical notes in surgical patients. METHODS: This cross sectional study from Oct 1, 2015 in department of surgery included 100 clinical notes randomly selected by lottery. The entries in notes were predefined. There were 29 general entries (nine for identification, eleven for admission details, eight for treatment progress, and one for handwriting)...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28994646/envisioning-eye-care-from-a-rural-perspective-a-photovoice-project-from-india
#13
Padmaja Kumari Rani, Rajita Kasoju, Venkatiah Komara, Raju Kothapalli, Devichandar Choudary, Jyothi Korani, Jachin D Williams, Clifton M Schor, Nance Wilson
Background To understand barriers and promoters for accessing eye care by rural communities, we used a modified approach to Photovoice, a community-based participatory action research approach Methods Community members took photographs and wrote or spoke stories based upon a series of questions intended to facilitate deeper thinking. Fifteen rural paramedical team members who were affiliated with the rural network of L V Prasad Eye Institute, and 60 people from four villages reported barriers and promoters for eye care access for 20 villages Results Important barriers for accessing eye care included the following: no caretaker at home for grandchildren except for the grandparent(s), alcoholism, uncontrolled blood pressure, inadequate diabetes management, lack of escort for blind people and elders, affordability, and inadequate clinic staffing during summer season when farming villagers were available...
January 1, 2017: International Quarterly of Community Health Education
https://www.readbyqxmd.com/read/28989010/global-health-education-for-medical-students-when-learning-objectives-include-research
#14
Alison M Bales, Anthony R Oddo, David J Dennis, Robert C Siska, Echo VanderWal, Harry VanderWal, Nompumelelo Dlamini, Ronald J Markert, Mary C McCarthy
BACKGROUND: The Luke Commission, a provider of comprehensive mobile health outreach in rural Swaziland, focuses on human immunodeficiency virus testing and prevention, including the performance of over 100 circumcisions weekly. Educational objectives for medical student global health electives are essential. Learning research methodology while engaging in clinical activities reinforces curriculum goals. Medical care databases can produce clinically significant findings affecting international health policy...
October 5, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28988955/work-related-quality-of-life-of-us-general-surgery-residents-is-it-really-so-bad
#15
Muhammad H Zubair, Lala R Hussain, Kristen N Williams, Kevin J Grannan
PURPOSE: The quality of working life of US surgical residents has not been studied, and given the complexity of interaction between work and personal life there is a need to assess this interaction. We utilized a validated Work Related Quality of Life (WRQoL) questionnaire to evaluate the perceived work-related quality of life of general surgery residents, using a large, nationally representative sample in the United States. METHODS: Between January 2016 and March 2016, all US general surgery residents enrolled in an ACGME general surgery training program were invited to participate...
October 4, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28977304/children-with-multiple-congenital-defects-what-are-the-limits-between-therapeutic-obstinacy-and-the-treatment-of-uncertain-benefit
#16
Patricia Souza Valle Cardoso Pastura, Marcelo Gerardin Poirot Land
OBJECTIVE: Therapeutic approach of children with multiple malformations poses many dilemmas, making it difficult to build a line between the treatment of uncertain benefit and therapeutic obstinacy. The aim of this paper was to highlight possible sources of uncertainty in the decision-making process, for this group of children. CASE DESCRIPTION: An 11-month-old boy, born with multiple birth defects and abandoned by his parents, has never been discharged home. He has complex congenital heart disease, main left bronchus stenosis and imperforate anus...
January 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28971468/post-operative-delirium-in-elderly-people-diagnostic-and-management-issues-of-post-operative-delirium-in-elderly-people
#17
Christina Florou, Dimitrios Theofilopoulos, Styliani Tziaferi, Maria Chania
Hippocrates a Greek physician commonly known as the Father of Medicine was the first to describe delirium, 'phrenitis', differencing it from other disorders such as melancholia and mania. Since then, it still remains a clinical problem which is not yet resolved.Postoperative delirium is a common medical problem that occurs preferentially in surgical patients aged 65 years and older. It is a true medical emergency that requires immediate professional attention and treatment. Faced by health professionals and especially nurses it is often undetected, misdiagnosed, and under-treated as a complication by them during clinical care...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28970260/effectiveness-of-a-financial-incentive-to-physicians-for-timely-follow-up-after-hospital-discharge-a-population-based-time-series-analysis
#18
Lauren Lapointe-Shaw, Muhammad Mamdani, Jin Luo, Peter C Austin, Noah M Ivers, Donald A Redelmeier, Chaim M Bell
BACKGROUND: Timely follow-up after hospital discharge may decrease readmission to hospital. Financial incentives to improve follow-up have been introduced in the United States and Canada, but it is unknown whether they are effective. Our objective was to evaluate the impact of an incentive program on timely physician follow-up after hospital discharge. METHODS: We conducted an interventional time series analysis of all medical and surgical patients who were discharged home from hospital between Apr...
October 2, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28968474/increasing-use-of-reverse-total-shoulder-arthroplasty-for-proximal-humerus-fractures-in-elderly-patients
#19
Sean S Rajaee, Dheeraj Yalamanchili, Naudereh Noori, Eytan Debbi, James Mirocha, Carol A Lin, Charles N Moon
This study described surgical treatment patterns for proximal humerus fractures among elderly patients, focusing on reverse total shoulder arthroplasty (TSA), and evaluated how the type of fixation affects inpatient factors (cost, length of stay), transfusion rates, and patient disposition (home vs skilled nursing facility). With Nationwide Inpatient Sample data from 2011 to 2013, the authors identified patients 65 years and older who had proximal humerus fractures and divided them into 3 groups: (1) open reduction and internal fixation (ORIF); (2) hemiarthroplasty; and (3) reverse TSA...
October 2, 2017: Orthopedics
https://www.readbyqxmd.com/read/28967315/the-transcondylar-approach-to-craniocervical-meningiomas
#20
Marcio S Rassi, Jean G de Oliveira, Luis A B Borba
Surgical removal of foramen magnum meningiomas poses great challenges due their deep location within the central skull base and their proximity to vital neurovascular structures. This video depicts the operative nuances of surgical management for a 59-year-old female who presented with a right-sided spinocranial meningioma. Simpson Grade I resection was achieved through a right transcondylar approach. The patient's postoperative period was unremarkable, and she was discharged home on postoperative Day 5 for periodic follow-up...
October 2017: Neurosurgical Focus
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