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Surgical and home

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https://www.readbyqxmd.com/read/29243974/pediatric-cerebral-venous-sinus-thrombosis-or-compression-in-the-setting-of-skull-fractures-from-blunt-head-trauma
#1
David S Hersh, Nir Shimony, Mari L Groves, Gerald F Tuite, George I Jallo, Ann Liu, Tomas Garzon-Muvdi, Thierry A G M Huisman, Ryan J Felling, Joseph A Kufera, Edward S Ahn
OBJECTIVE Pediatric cerebral venous sinus thrombosis has been previously described in the setting of blunt head trauma; however, the population demographics, risk factors for thrombosis, and the risks and benefits of detection and treatment in this patient population are poorly defined. Furthermore, few reports differentiate between different forms of sinus pathology. A series of pediatric patients with skull fractures who underwent venous imaging and were diagnosed with intrinsic cerebral venous sinus thrombosis or extrinsic sinus compression is presented...
December 15, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29242790/surgical-retrieval-of-an-impaled-tapestry-needle-from-the-true-pelvic-cavity-of-a-child-an-unusual-case-report
#2
Nirmal Raj Gopinathan, Rakesh John, Himanshu Kanwat, Pebam Sudesh
Introduction: Impalement injuries of pelvis have been reported in children but are uncommon. Impalement could be associated with injuries to deep organs, wound contamination, crush injuries, and in certain instances, can even be fatal. Case Report: We present a bizarre case of a 2-year-old female child who presented to us with a tapestry needle embedded in the true pelvic cavity after a history of fall on the buttock while playing at home. The impaled needle was eventually successfully extracted surgically using the modified Stoppa's approach and the post-operative period was uneventful...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29238810/correlation-between-24-hour-predischarge-opioid-use-and-amount-of-opioids-prescribed-at-hospital-discharge
#3
Eric Y Chen, Andrew Marcantonio, Paul Tornetta
Importance: The United States is experiencing an opioid abuse epidemic. Opioid overprescription by physicians may contribute to this epidemic. Objectives: To determine if there was a correlation between a postoperative patient's 24-hour predischarge opioid use and the amount of opioids prescribed at hospital discharge and to determine the number of patients who used no opioids prior to discharge but were still prescribed opioids after hospital discharge. Design, Setting, and Participants: This cross-sectional study performed a retrospective record review of 18 343 postoperative patients at Boston Medical Center and Lahey Hospital and Medical Center-Burlington Campus who were discharged home after a postoperative inpatient admission of at least 24 hours...
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29238807/bringing-surgical-care-to-the-home-through-video-visits
#4
Chad Ellimoottil, Richard J Boxer
No abstract text is available yet for this article.
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29237654/investigating-the-effect-of-sociodemographic-factors-on-30-day-hospital-readmission-among-medical-patients-in-toronto-canada-a-prospective-cohort-study
#5
Robert W Smith, Kerry Kuluski, Andrew P Costa, Samir K Sinha, Richard H Glazier, Alan Forster, Lianne Jeffs
OBJECTIVE: To examine the influence of patient-level sociodemographic factors on the incidence of hospital readmission within 30 days among medical patients in a large Canadian metropolitan city. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: Patients admitted to the General Internal Medicine service of an urban teaching hospital in Toronto, Canada participated in a survey of sociodemographic information. Patients were not surveyed if deemed medically unstable, receiving care in medical/surgical step-down beds or were isolated for infection control...
December 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29232299/the-axillary-intra-aortic-balloon-pump-as-a-bridge-to-recovery-allows-early-ambulation-in-long-term-use-case-series-and-literature-review
#6
Nnamdi Nwaejike, Andre Y Son, Chetan B Patel, Jacob N Schroder, Carmelo A Milano, Mani A Daneshmand
We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta...
December 7, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29227322/no-clear-benefit-of-chlorhexidine-use-at-home-before-surgical-preparation
#7
Melvin Chugh Makhni, Kolawole Jegede, Joseph Lombardi, Susan Whittier, Prakash Gorroochurn, Ronald A Lehman, K Daniel Riew
INTRODUCTION: Several studies have evaluated the efficacy of home use of chlorhexidine before surgery to reduce bacterial colonization. However, these studies have provided conflicting evidence about the potential efficacy of this strategy in decreasing bacterial loads and infection rates across surgical populations, and no prior study has analyzed the benefit of this intervention before spine surgery. We prospectively analyzed the effectiveness of chlorhexidine gluconate wipes for decreasing bacterial counts on the posterior neck...
December 11, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29225959/effect-of-removing-the-barrier-of-transportation-costs-on-surgical-utilisation-in-guinea-madagascar-and-the-republic-of-congo
#8
Mark G Shrime, Mirjam Hamer, Swagoto Mukhopadhyay, Lauren M Kunz, Nathan H Claus, Kirsten Randall, Joannita H Jean-Baptiste, Pierre H Maevatombo, Melissa P S Toh, Jasmin R Biddell, Ria Bos, Michelle White
Background: 81 million people face impoverishment from surgical costs every year. The majority of this impoverishment is attributable to the non-medical costs of care-for transportation, for food and for lodging. Of these, transportation is the largest, but because it is not viewed as an actual medical cost, it is frequently unaddressed. This paper examines the effect on surgical utilisation of paying for transportation. Methods: A hierarchical logistic regression was performed on 2692 patients presenting for surgical care to a non-governmental organisation operating in the Republic of the Congo, Guinea and Madagascar...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29224237/major-haemorrhage-fatalities-in-the-australian-national-coronial-database
#9
Jacob S Gipson, Erica M Wood, Merrole F Cole-Sinclair, Zoe McQuilten, Neil Waters, Noel W Woodford
OBJECTIVE: The aim of the study is to describe the epidemiology of major bleeding fatalities. METHODS: A case series analysis of Australia's National Coronial Information System was conducted. Keywords were used to search for closed cases of major haemorrhage in the state of Victoria for the period 1 January 2009 to 31 December 2011. Coroners' findings, autopsy reports and police reports of cases were reviewed. Demographic data were extracted, and cases were assigned to a clinical bleeding context...
December 10, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29221471/in-home-versus-hospital-preoperative-balance-and-proprioceptive-training-in-patients-undergoing-tkr-rationale-design-and-method-of-a-randomized-controlled-trial
#10
José-María Blasco, Celedonia Igual-Camacho, Sergio Roig-Casasús
BACKGROUND: Severe knee osteoarthritis, as well as the surgical procedure of total knee replacement that aims to reduce its symptoms, cause great deterioration on the proprioceptive system. Taking this fact into account, and considering that balance abilities positively influence the capacity to perform basic functional tasks, this trial aims to find the short and mid-term effects of a preoperative balance and proprioceptive training when conducted by patients undergoing total knee replacement...
December 8, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29221336/hemangiopericytoma-11-years-later-delayed-recurrence-of-a-rare-soft-tissue-sarcoma
#11
Keng Peng Cheng, Wei-Jin Wong, Shahrul Hashim, Kein Seong Mun
Hemangiopericytomas (HPCs) are uncommon tumours. We present the case of a 41-year-old female with multiple resections at different sites over the course of 11 years. The approach considerations, as well as treatment options and prognosis are discussed. A 41-year-old female with two previous resections for intracranial meningeal HPC in 2004 and 2008, as well as adjuvant radiotherapy, presented in 2015 with left intrathoracic and left hip recurrence confirmed by positron emission tomography/computed tomography (PET/CT)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29221314/thoracoscopic-left-s4a-subsegmentectomy
#12
Akira Hamada, Hiroyuki Oizumi, Hirohisa Kato, Jun Suzuki, Hikaru Watarai, Katsuyuki Suzuki, Takanori Sasage, Mitsuaki Sadahiro
A 63-year-old woman who underwent a left hepatic lobectomy for hilar cholangiocarcinoma was referred to our department for further management. Chest computed tomography showed a lung nodule that was increased in size to 8 mm in the S4a. The differential diagnosis was metastasis versus primary lung cancer. Thoracoscopic left S4a subsegmentectomy was performed. The operative time was 158 min. The blood loss was minimal. Air leakage was not observed, and a chest tube was removed on POD 1. The patient was discharged home on POD 3...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29217504/challenges-during-implementation-of-a-patient-facing-mobile-app-for-surgical-rehabilitation-feasibility-study
#13
Annie Ys Lau, Kalman Piper, Desmond Bokor, Paige Martin, Victor Sl Lau, Enrico Coiera
BACKGROUND: Translating research into practice, especially the implementation of digital health technologies in routine care, is increasingly important. Yet, there are few studies examining the challenges of implementing patient-facing digital technologies in health care settings. OBJECTIVE: The aim of this study was to report challenges experienced when implementing mobile apps for patients to support their postsurgical rehabilitation in an orthopedic setting. METHODS: A mobile app was tailored to the needs of patients undergoing rotator cuff repair...
December 7, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/29209875/non-routine-discharge-disposition-is-associated-with-post-discharge-complications-and-30-day-readmissions-following-craniotomy-for-brain-tumor-resection
#14
Nikita Lakomkin, Constantinos G Hadjipanayis
Several studies have reported an association between high-volume brain tumor centers and greater rates of routine discharge disposition in the context of better outcomes. However, the relationship between in-hospital complications, discharge destination, and postoperative adverse events (AEs) remains unexplored. The purpose of this study was thus to use a large, prospectively collected database to examine the association between discharge destination, post-discharge complications, readmissions, and reoperations among patients undergoing craniotomy for brain tumor...
December 5, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29208330/what-is-the-impact-of-advancing-age-on-the-outcomes-of-total-hip-arthroplasty
#15
Benjamin P d'S Murphy, Michelle M Dowsey, Tim Spelman, Peter F M Choong
BACKGROUND: The global demand for total hip arthroplasty (THA) is increasing, underscoring its moniker as the "operation of the century." However, debate still exists as to whether the elderly who undergo the operation achieve the same outcomes as those younger. In this study, we sought to investigate the association between older age and the risks and benefits of THA. METHODS: In this study, we aimed to compare the risks and benefits of THA of those aged ≥80 years vs those <80 years...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29206799/simulation-based-educational-module-improves-intern-and-medical-student-performance-of-closed-reduction-and-percutaneous-pinning-of-pediatric-supracondylar-humeral-fractures
#16
Bennet A Butler, Cort D Lawton, Jamie Burgess, Earvin S Balderama, Katherine A Barsness, John F Sarwark
BACKGROUND: Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. METHODS: Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29206730/understanding-the-impact-of-fluid-restriction-on-growth-outcomes-in-infants-following-cardiac-surgery
#17
Melissa Li, Adriana Campa, Fatma G Huffman, Anthony F Rossi
OBJECTIVE: Fluid restriction is reported to be a barrier in providing adequate nutrition following cardiac surgery. The specific aim of this study was to evaluate the adequacy of nutritional intake during the postoperative period using anthropometrics by comparing preoperative weight status, as measured by weight-for-age z scores, to weight status at discharge home. DESIGN: Prospective cohort study. SETTING: Cardiac ICU at Miami Children's Hospital...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29206327/pharyngeal-perforation-after-anterior-cervical-spine-surgery-treated-by-transoral-endoscopic-surgery
#18
Julio Rama-López, Meritxell Tomás-Fernandez, César García-Garza, Milton Martínez-Madrigal
BACKGROUND: Anterior cervical fixation has been used since 1967 for multiple pathologies like traumatism, compressive myelopathy, or spinal infections. METHODS: We report the case of a patient who had undergone cervical spine surgery 10 years previously and presented to our clinic with a pharyngeal fistula due to surgical screw displacement that was treated by transoral endoscopic surgery. RESULTS: The immediate postoperative period occurred without incidence and complete odynophagia resolution...
December 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#19
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29201473/recurrent-huge-left-bartholin-s-gland-abscess-for-one-year-in-a-teenager
#20
Athanase Lilungulu, Bonaventura C T Mpondo, Abdallah Mlwati, Dismas Matovelo, Albert Kihunrwa, Balthazar Gumodoka
Bartholin's gland abscess is the commonest worldwide reported abscess in gynaecological outpatient clinics; it has also been reported that Bartholin's gland abscess is three times more common in occurrences compared to Bartholin's gland cyst. It is more common in women who are at risk of acquiring sexually transmitted infections; however, other causes of infection should be investigated to exclude other causes of disease. We present the case of an 18-year-old female patient, a teenager of the reproductive age group, with the recurrent development of huge Bartholin's gland abscess in a period of one year...
2017: Case Reports in Infectious Diseases
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